Asbestos exposure: a potential driver of rising lung cancer incidence in China

Abstract Despite sustained reductions in smoking prevalence and improvements in ambient air quality, lung cancer incidence in China continues to rise, suggesting that important risk factors remain insufficiently recognised. Asbestos is a well-established carcinogen, yet its contribution to China’s lung cancer burden has received limited attention, particularly given the continued use of chrysotile and widespread legacy asbestos-containing materials. This review highlights how non-specific clinical presentation, incomplete exposure documentation, and limitations in surveillance systems contribute to systematic underestimation of asbestos-related lung cancer. Diverse exposure scenarios, including occupational, para-occupational, and environmental pathways, further complicate etiologic attribution beyond traditionally defined asbestos workers. A comprehensive asbestos ban represents an important long-term strategy to reduce the future burden of asbestos-related disease in China.