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Silicosis and risk of lung Cancer Among Silica Exposed Workers: An evidence based case report = Silikosis dan Risiko Kanker Paru pada Pekerja Terpajan Silika: Laporan Kasus Berbasis Bukti.

Background Silicosis is a pneumoconiosis caused by the inhalation of crystalline silica. The higher relative risks among those with silicosis stimulated continued debate.The purpose of this evidence based case report was to know probability silicosis as risk of lung cancer. Method The literature search was performed to answer clinical question via electronic databases: PubMed and Scopus. The inclusion criteria of this searching strategy were systematic reviews, and cohort study, adult with silicosis, risk of lung cancer. The exclusion criteria of this article were not relevance, inaccessible articles, cohort or case control that have been used in recent systematic review. Article was critically appraised using criteria Oxford Center for Evidence-based Medicine. Result As a result, we chose 29 study. 2 meta analysis articles was critically appraised after exclusion criteria. Critical appraisal of meta analysis that 2 articles was valid. Meta-analysis by Kurihara N, et al (2004) states the relative risks of lung cancer were 2.37 (95% CI, 1.98–2.84) for those with silicosis and 0.96 (95% CI, 0.81 – 1.15) for non-silicosis. Cigarette smoking strongly increased the lung cancer risk in silicosis patients (relative risk, 4.47; 95% CI, 3.17 – 6.30). The other article is a meta-analysis by Erren T.C, et al (2011) which included 38 studies. It stated that silicosis lung cancer risks were found to be doubled RR=2.1 (95% CI, 2.0 - 2.3), and in non silicosis were found RR=1 (95% CI, 0,8-1,3). Conclusion and recommendation Silicosis is a risk factor of lung cancer. Smoking strongly increased the lung cancer risk in patients with silicosis. Silicotic patients who have a risk of lung cancer should be continuously followed-up. Future study should investigate silicosis and silica exposure being as a risk of lung cancer among patients in Indonesia.
Key words: silicosis, silica expose workers, risk of lung cancer


Latar Belakang Silikosis adalah pneumokoniosis yang disebabkan inhalasi silika kristal. Risiko relatif pada silikosis masih menjadi perdebatan.Tujuan dari laporan kasus berbasis bukti ini untuk mengetahui risiko kanker pada silikosis. Metode Pencarian literature menggunakan data base PubMed dan Scopus. Kriteria inklusi penelitian ini adalah meta-analisis, and studi kohort, kasus kontrol, dewasa dengan silikosis, risiko kanker paru. Kriteria eksklusi adalah artikel yang tidak relevan, tidak dapat diakses, studi kohort dan kasus kontrol yang termasuk dalam meta-analisis. Artikel telah dilakukan penilaian kritis menggunakan kriteria Oxford Center for Evidence-Based Medicine. Hasil Sebagai hasil, kami memilih 29 studi. 2 artikel meta analisis dilakukan penilaian kritis setelah melalui kriteria eksklusi. Berdasarkan penilaian kritis 2 artikel meta analisis tersebut valid. Meta-analisis oleh Kurihara N, dkk (2004 ) menjelaskan risiko relative kanker paru adalah 2.37 (95% CI, 1.98 – 2.84) pada silikosis dan 0.96 (95% CI, 0.81 – 1.15 ) untuk non-silikosis. Pada pasien silicosis dan merokok (RR, 4.47; 95% CI, 3.17 – 6.30). Artikel yang lain adalah meta-analisis oleh Erren T.C, dkk (2011)yang memasukkan 38 studi. Artikel ini menjelaskan risiko kanker paru pada silikosis adalah RR=2.1 (95% CI, 2.0 - 2.3), dan pada non silikosis adalah RR=1 (95% CI, 0,8 - 1,3). Kesimpulan dan Rekomendasi Silikosis merupakan faktor risiko kanker paru. Merokok sangat meningkatkan risiko kanker paru pada silikosis. Pasien silikosis harus dilakukan pemantauan secara berkala. Pada studi mendatang agar melakukan investigasi silicosis dan pajanan silika sebagai risiko kanker paru di Indonesia.
Kata Kunci : silikosis, pekerja terpajan silika, risiko kanker paru