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An 85-year-old man, formerly heavy smoker, was referred after a 6-month history of weight loss and increasing weakness. The patient reported an occupational exposure to asbestos due to working over 30 years in a shipyard. The chest radiograph showed bilateral pleural calcifications distributed unevenly from the lung base to the apex (Fig. 1). Chest computed tomography demonstrated a left lower lobe mass suspicious for lung cancer (Fig. 2). After detailed discussion of possible therapeutic options, the patient refused further diagnostic work-up and treatment.
However, recent evidence obtained from a study on more than 5400 male individuals enrolled in an asbestos-related disease screening program confirmed that, after adjustment for smoking, lung cancer mortality was associated with the detection of pleural plaques (hazard ratio = 2.41; 95% confidence interval = 1.21–4.85).