Carcinoids of the lung caused by exogenous noxious agents: a scoping review.
8 affiliations
- 1Federal Institute for Occupational Safety and Health, BAuA, Berlin, Germany [email protected].
- 2Federal Institute for Occupational Safety and Health, BAuA, Berlin, Germany.
- 3Institute and Clinic for Occupational, Social and Environmental Medicine, University Hospital, LMU Munich, Munich, Germany.
- 4Comprehensive Pneumology Center Munich (CPC-M), member of the German Center for Lung Research (DZL), Munich, Germany.
- 5Medical Faculty, University of Duisburg-Essen, University Hospital Essen, Essen, Germany.
- 6Institute of Pathology, University Hospital RWTH Aachen, Aachen, Germany.
- 7German Center for Lung Research (DZL), BREATH Hanover, Hannover, Germany.
- 8Center for Integrated Oncology, Aachen Bonn Cologne Düsseldorf (CIO-ABCD), Aachen, Germany.
Abstract
Background
Approximately 2% of lung tumours are pulmonary carcinoids (PCs), divided into typical (90%) and atypical (AC) (10%). The link with external exposure to carcinogens remains controversial.Objective
To investigate the association between occupational exposure to carcinogens and PC tumours.Methods
A PRISMA-ScR-guided scoping review was performed. A systematic search was conducted in PubMed and Embase (January 2025). Studies were reviewed, data extracted, analysed and summarised narratively.Results
1302 studies were reviewed. 27 original studies and seven conference papers on topics including exposure to cigarette smoke (n=23) and asbestos (n=6), or mechanistic information, were included. Following the collapse of the World Trade Center in 2001, carcinoids accounted for 6% of lung cancer cases in people exposed to the resulting dust (9% in women, 3% in men). The proportion of ACs among carcinoids rose from 9.3% (controls) to 16.3% (smokers) and from ∼25% to 45% (probable versus definite asbestos exposure). Basic research has identified biological pathways linking harmful exposures (such as asbestos and cigarette smoke) to neuroendocrine cell proliferation and the potential progression of PCs to higher-grade lung tumours.Discussion
The significance these of findings is limited due to 1) the limited number of studies, 2) the small number of tumours within those studies and 3) the lack of rigid diagnostic (morphological and molecular) criteria for PCs in most studies. Nevertheless, a consistent finding is a higher proportion of AC among carcinoids, particularly following asbestos exposure.Conclusions
Based on these findings, a link between carcinogenic substances (especially asbestos and cigarette smoke) and carcinoids seems plausible. More stringent analyses in epidemiological surveys are needed to further clarify the pathogenesis of PCs.
Related
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- Clinical management of typical and atypical carcinoids/neuroendocrine tumors in ENETS centres of excellence (CoE): Survey from the ENETS lung NET task force.
- Pulmonary Carcinoid Tumors (Lung Carcinoids): Current Concepts in Diagnosis and Management
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- Identification of Defined Molecular Subgroups on the Basis of Immunohistochemical Analyses and Potential Therapeutic Vulnerabilities of Pulmonary Carcinoids
BibTeX
@article{kilo2026carcinoids,
title = {{Carcinoids of the lung caused by exogenous noxious agents: a scoping review.}},
author = {Sonja Kilo and Christin Schröder and Ludwig Frei-Stuber and Karl-Heinz Jöckel and Danny Jonigk and Florian Länger and Dennis Nowak},
journal = {European respiratory review : an official journal of the European Respiratory Society},
year = {2026},
month = oct,
doi = {10.1183/16000617.0145-2026},
url = {https://europepmc.org/article/MED/42906939},
note = {CC BY-NC},
}
RIS
TY - JOUR
TI - Carcinoids of the lung caused by exogenous noxious agents: a scoping review.
AU - Sonja Kilo
AU - Christin Schröder
AU - Ludwig Frei-Stuber
AU - Karl-Heinz Jöckel
AU - Danny Jonigk
AU - Florian Länger
AU - Dennis Nowak
PY - 2026
DA - 2026/10/21
JO - European respiratory review : an official journal of the European Respiratory Society
DO - 10.1183/16000617.0145-2026
UR - https://europepmc.org/article/MED/42906939
AB - Background Approximately 2% of lung tumours are pulmonary carcinoids (PCs), divided into typical (90%) and atypical (AC) (10%). The link with external exposure to carcinogens remains controversial.Objective To investigate the association between occupational exposure to carcinogens and PC tumours.Methods A PRISMA-ScR-guided scoping review was performed. A systematic search was conducted in PubMed and Embase (January 2025). Studies were reviewed, data extracted, analysed and summarised narratively.Results 1302 studies were reviewed. 27 original studies and seven conference papers on topics including exposure to cigarette smoke (n=23) and asbestos (n=6), or mechanistic information, were included. Following the collapse of the World Trade Center in 2001, carcinoids accounted for 6% of lung cancer cases in people exposed to the resulting dust (9% in women, 3% in men). The proportion of ACs among carcinoids rose from 9.3% (controls) to 16.3% (smokers) and from ∼25% to 45% (probable versus definite asbestos exposure). Basic research has identified biological pathways linking harmful exposures (such as asbestos and cigarette smoke) to neuroendocrine cell proliferation and the potential progression of PCs to higher-grade lung tumours.Discussion The significance these of findings is limited due to 1) the limited number of studies, 2) the small number of tumours within those studies and 3) the lack of rigid diagnostic (morphological and molecular) criteria for PCs in most studies. Nevertheless, a consistent finding is a higher proportion of AC among carcinoids, particularly following asbestos exposure.Conclusions Based on these findings, a link between carcinogenic substances (especially asbestos and cigarette smoke) and carcinoids seems plausible. More stringent analyses in epidemiological surveys are needed to further clarify the pathogenesis of PCs.
SN - 0905-9180
SN - 1600-0617
ER -