Occupational exposure to asbestos is strongly associated with pleural and pulmonary fibrosis, lung cancer, and malignant mesothelioma. Although many countries, including Brazil, have recently banned the extraction and usage of asbestos, cases of pulmonary fibrosis and asbestos-related malignancy are still expected to increase, due to the long latency period of disease development. A proper response to this scenario primarily requires awareness and structured surveillance, but also access to screening and diagnostic methods in healthcare, restrict and unequally available in Brazil. Recent evidence suggests that Low Dose Computed Tomography (LDCT) may be an effective tool to screen malignancy in asbestos-exposed workers. Here we describe an initiative to improve screening with a mobile LDCT unit in an underserved population of workers of a former asbestos manufacture factory at Pedro Leopoldo, city, Minas Gerais state, Brazil. In partnership with ABREA (Associação Brasileira dos Expostos ao Amianto) workers with a history of direct or indirect asbestos exposure were included in September 2019, regardless of the exposure duration or respiratory symptoms, to whom an LDCT examination was offered. Thoracic radiologists searched for pleural plaques or nodules, pleural effusion, fibrosis-related findings, and lung nodules, and a structured report was filled in. Pulmonary nodules were managed according to Lung-Rads-1.1. Necessary supplementary investigations were referred to a tertiary oncological center, in which the malignancies were also to be treated. Two hundred and three men and twenty women underwent LDCT screening, the median age of 57 years, 89% directly engaged in asbestos manufacturing. Pleural plaques or nodules were identified in 19% of individuals, with a median exposure time of 13,5 years. Five individuals had moderate or marked signs of pulmonary fibrosis, and one was diagnosed with low-stage pulmonary adenocarcinoma, none of which were suspected under usual care. Although political interference had precluded full attendance of participants, proper treatment was guaranteed with the aid of the Labor Prosecutor Office. The mobile LDCT unit was successful in enhancing screening and awareness of this exposed and underserved population.
Citation Format: Rodrigo Sampaio, Leonardo Almeida, Larissa Ferreira, Maraisa Costa, Ana Oliveira, Bruna Carvalho, Mauro Cardoso, Fabiana Vazquez, Henrique Silveira, Laércio Castilho-Neto, Fernanda Giannasi Fernanda Giannasi, Rui Reis. Screening of Brazilian underserved workers exposed to asbestos in loco with a mobile low dose computed tomography [abstract]. In: Proceedings of the AACR Virtual Conference: 14th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2021 Oct 6-8. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2022;31(1 Suppl):Abstract nr PO-260.