Background: An estimated 110 million workers are exposed to welding fumes worldwide. Welding fumes are classified by the International Agency for Research on Cancer ascarcinogenic to humans(group 1), based onsufficient evidenceof lung cancer from epidemiological studies.Objective: To conduct a meta-analysis of case-control and cohort studies on welding or exposure to welding fumes and risk of lung cancer, accounting for confounding by exposure to asbestos and tobacco smoking.Methods: The literature was searched comprehensively in PubMed, reference lists of relevant publications and additional databases. Overlapping populations were removed. Meta-relative risks (mRRs) were calculated using random effects models. Publication bias was assessed using funnel plot, Eggers’s test and Begg’s test.Results: Forty-five studies met the inclusion criteria (20 case-control, 25 cohort/nested case-control), which reduced to 37 when overlapping study populations were removed. For ‘ever’ compared with ‘never’ being a welder or exposed to welding fumes, mRRs and 95% CIs were 1.29 (1.20 to 1.39; I²=26.4%; 22 studies) for cohort studies, 1.87 (1.53 to 2.29; I²=44.1%; 15 studies) for case-control studies and 1.17 (1.04 to 1.38; I²=41.2%) for 8 case-control studies that adjusted for smoking and asbestos exposure. The mRRs were 1.32 (95% CI 1.20 to 1.45; I²=6.3%; 15 studies) among ‘shipyard welders’, 1.44 (95% CI 1.07 to 1.95; I²=35.8%; 3 studies) for ‘mild steel welders’ and 1.38 (95% CI 0.89 to 2.13; I²=68.1%; 5 studies) among ‘stainless steel welders’. Increased risks persisted regardless of time period, geographic location, study design, occupational setting, exposure assessment method and histological subtype.Conclusions: These results support the conclusion that exposure to welding fumes increases the risk of lung cancer, regardless of the type of steel welded, the welding method (arc vs gas welding) and independent of exposure to asbestos or tobacco smoking.

Background: Radiotherapy (RT) for breast cancer (BC) can induce coronary artery disease many years after RT. At an earlier stage, during the first two years after RT, we aimed to evaluate the occurrence of increased coronary artery calcium (CAC) and its association with cardiac exposure. Methods: This prospective study included 101 BC patients treated with RT without chemotherapy. Based on CAC CT scans performed before and two years after RT, the event ‘CAC progression’ was defined by an increase in overall CAC score (CAC RT+ two years—CAC before RT > 0). Dosimetry was evaluated for whole heart, left ventricle (LV), and coronary arteries. Multivariable logistic regression models were used to assess association with doses. Results: Two years after RT, 28 patients presented the event ‘CAC progression’, explained in 93% of cases by a higher CAC score in the left anterior descending coronary (LAD). A dose–response relationship was observed with LV exposure (for Dmean LV: OR = 1.15, p = 0.04). LAD exposure marginally explained increased CAC in the LAD (for D2 LV: OR =1.03, p = 0.07). Conclusion: The risk of early CAC progression may be associated with LV exposure. This progression might primarily be a consequence of CAC increase in the LAD and its exposure.

Background—Radiotherapy (RT) for breast cancer (BC) can lead to an increased risk of coronary artery disease several years after RT. The aim of this study was to evaluate the development of overall, non-calcified and calcified atherosclerotic plaques over 2 years after BC for RT and associations with cardiac exposure. Methods—The study included 101 left- or right-sided BC patients treated with RT without chemotherapy. A coronary CT angiography was performed before and 2 years after RT. Plaque development thorough the entire coronary network was defined as an increased number of plaques. Cardiac exposure was quantified with mean doses to the heart, left ventricle, and coronary arteries. Logistic regression models were used to assess association with doses. Results—At inclusion, 37% of patients had plaques, increasing to 42% two years after RT. Overall plaque development was observed in seven patients: five with calcified plaque development and four with non-calcified plaque development. The risk of overall plaque development was significantly associated with doses to the Left Main and Circumflex coronary arteries (OR at 1 Gy = 2.32, p = 0.03 and OR at 1 Gy = 2.27, p = 0.03, respectively). Specific analyses for calcified and non-calcified plaque development showed similar results. Conclusion—Our study suggests an association between coronary arteries exposure and the risk of developing both calcified and non-calcified atherosclerotic plaques over 2 years after BC RT. Trial registration number: NCT02605512.

While earlier studies on men having sex with men (MSM) tended to examine infection-related cancers, an increasing number of studies have been focusing on effects of sexual orientation on other cancers and social and cultural causes for cancer disparities. As a type of tertiary research, this umbrella review (UR) aims to synthesize findings from existing review studies on the effects of sexual orientation on cancer. Relevant peer-reviewed systematic reviews (SRs) will be identified without date or language restrictions using MEDLINE, Cochrane Database of Systematic Reviews, and the International Prospective Register for Systematic Reviews, among others. The research team members will prepare the data extraction forms. Two reviewers will independently assess extracted SRs using the Assessment of Methodological Quality of Systematic Reviews. A third reviewer will weigh in to resolve discrepancies. The reviewers will be blinded to publisher, journal, and authors, making their judgements on the title, year, and The Preferred Reporting Items for Systematic Reviews and Meta-analysis checklist will guide data synthesis. By collating evidence from multiple reviews into one accessible and usable document, our first UR on global epidemiology of malignancies among MSM would serve as an evidence-based decision-making tool for the public health community.

Evaluation de la cardiotoxicité à moyen terme des radiothérapies pour le cancer du sein: La radiothérapie (RT) constitue un traitement majeur du cancer du sein (CS) ; toutefois, elle peut être associée à un risque accru de complications cardiaques à long terme, notamment de dysfonction cardiaques asympatomatique et d’atteintes coronaires. Avant l’apparition d’événements cliniques, les données concernant les formes précoces et infracliniques sont rares. Dans ce contexte, l’objectif de ce travail était d’étudier l’association entre la RT pour CS et le risque de développer une athérosclérose et une dysfonction myocardique dans les deux années suivant la RT. Cette thèse s’est appuyée sur les données de la cohorte prospective BACCARAT, constituée d’une centaine de patientes traitées par RT du sein, sans chimiothérapie et suivies jusqu’à 24 mois post-RT, Sur le volet coronaire, cette étude a mis en évidence un lien entre le niveau d’irradiation cardiaque, en particulier le ventricule gauche et l’artère coronaire interventriculaire, et le risque de score calcique (CAC) augmenté 2 ans post-RT (OR dose VG=1,15, p=0,04). De plus, l’augmentation du nombre de plaques d’athéromes (plaques calcifiées ou non calcifiées) était lié à la dose coronaire un niveau du tronc commun et de l’artère circonflexe (OR dose Cx= 2,27, p=0,03). Sur le volet fonctionnel myocardique, une dysfonction cardiaque liée au traitement du cancer (CTRCD) tel que définie par l’ESC Cardio-Oncology 2022 a été observé chez 44% des patientes, dont 28% avec une forme légère et 7% avec une forme sévère. Cette étude a montré que les patientes atteintes de CS Les relations dose-réponse étaient significatives pour la dose moyenne à la circonflexe (OR = 2,48,, p = 0,02) et limite significatives pour le V2 du VG (OR = 1,03, p = 0,05). Les seuils optimaux prédictifs ont été déterminés à V2 du VG ≥ 36 % et dose moyenne à la Cx ≥ 1,40 Gy. Ce travail de thèse a ainsi mis en évidence un lien entre l’exposition cardiaque et le risque de développement d’athérosclérose et de dysfonction myocardique dans les 2 ans suivant la RT et ouvre des pistes de recherche intéressantes pour développer des stratégies de prévention.