Situation
A patient with carcinoma of the lung and previous asbestos exposure presents to you. Do you think the asbestos caused the carcinoma ?
Is the patient a smoker either current or past, and what is their pack year total ?
If the patient never smoked, has progressive massive fibrosis with a high asbestos count then asbestos may well be the cause.
If the patient smokes heavily for 50 years has no progressive massive fibrosis with a low asbestos count then smoking may well be the cause.
Pleural plaques indicate asbestos exposure but are not thought to be closely associated enough with even mesothelioma for asbestos to be blamed.
In asbestos exposure the ratio of upper to lower lobe carcinomas is about equal, however in smokers upper lobe carcinomas are more common.
So in the majority of cases an impossible question to answer.