Mezotelioma
Epidemiologia

Mezotelioma to rzadki, wysoce śmiertelny nowotwór wywodzący się z komórek mezotelium, silnie związany z ekspozycją na azbest. Rocznie diagnozuje się około 2800-3300 przypadków w USA oraz około 2700 w Wielkiej Brytanii, z globalną zapadalnością około 16 przypadków na milion osób i 15 000-30 000 zgonów rocznie. Choroba charakteryzuje się długim okresem latencji, średnio około 40 lat, co powoduje, że efekty ograniczeń stosowania azbestu wprowadzonych w latach 80. i 90. XX wieku zaczynają być widoczne dopiero obecnie. Zapadalność wykazuje zróżnicowanie geograficzne, odzwierciedlające historyczne wzorce ekspozycji, z najwyższymi wskaźnikami (do 30/milion) w krajach uprzemysłowionych, takich jak Australia, Belgia i Wielka Brytania. Mężczyźni stanowią 70-85% przypadków mezoteliomy opłucnej, jednak obserwuje się wzrost zachorowań u kobiet, które częściej doświadczają ekspozycji parazawodowej lub środowiskowej. Średni wiek diagnozy to około 72 lata, a mediana przeżycia wynosi 8-18 miesięcy.

  1. Epidemiologia mezoteliomy
    1. Częstotliwość występowania mezoteliomy na świecie
    2. Trendy w zapadalności na mezotelomę
    3. Różnice płciowe w epidemiologii mezoteliomy
    4. Rozkład wiekowy mezoteliomy
  2. Systemy nadzoru epidemiologicznego nad mezoteliomą
    1. Krajowe systemy nadzoru nad mezoteliomą
    2. Znaczenie systemów nadzoru epidemiologicznego
    3. Wyzwania w nadzorze epidemiologicznym nad mezoteliomą
  3. Czynniki ryzyka i wzorce ekspozycji na azbest
    1. Rodzaje ekspozycji na azbest
    2. Grupy wysokiego ryzyka
    3. Okresy latencji
    4. Zależność dawka-odpowiedź
  4. Zróżnicowanie geograficzne zachorowań na mezotelomę
    1. Różnice międzynarodowe
    2. Różnice regionalne wewnątrz krajów
    3. Związek z historycznym użyciem azbestu w przemyśle
  5. Badania przesiewowe i wczesne wykrywanie mezoteliomy
    1. Metody badań przesiewowych w kierunku mezoteliomy
    2. Biomarkery w wykrywaniu mezoteliomy
    3. Grupy ryzyka wymagające badań przesiewowych
  6. Znaczenie nadzoru epidemiologicznego dla zdrowia publicznego
    1. Identyfikacja źródeł ekspozycji na azbest
    2. Ocena skuteczności polityk ograniczania ekspozycji na azbest
    3. Ustalanie priorytetów w remediacji środowiskowej
    4. Wpływ na polityki zdrowotne i przepisy prawne
  7. Wnioski i przyszłe kierunki badań
    1. Badania nad ekspozycją środowiskową
    2. Badania nad czynnikami genetycznymi i indywidualną podatnością
    3. Doskonalenie systemów nadzoru
    4. Działania w kierunku globalnego zakazu azbestu
    5. Kolejne rozdziały

Epidemiologia mezoteliomy

Mezotelioma to rzadki, lecz wysoce śmiertelny nowotwór wywodzący się z komórek mezotelium, które wyściełają opłucną, otrzewną, osierdzie lub osłonkę jądra. Jest on silnie związany z ekspozycją na azbest, przy czym związek przyczynowy został dobrze udokumentowany w badaniach naukowych. Chociaż w wielu krajach rozwiniętych wprowadzono ograniczenia lub zakazy dotyczące stosowania azbestu, występowanie mezoteliomy nadal stanowi istotny problem zdrowia publicznego ze względu na długi okres latencji choroby.12

Częstotliwość występowania mezoteliomy na świecie

Mezotelioma jest stosunkowo rzadkim nowotworem. W Stanach Zjednoczonych rocznie diagnozuje się około 2800-3300 nowych przypadków, co stanowi mniej niż 0,2% wszystkich rozpoznań nowotworowych.123 W Wielkiej Brytanii odnotowuje się około 2700 nowych przypadków rocznie, a w innych krajach z wysoką częstością występowania, jak Australia i Belgia, wskaźniki zachorowalności mogą osiągać nawet 30 przypadków na milion mieszkańców rocznie.12

Częstość występowania mezoteliomy różni się znacznie między krajami i regionami, odzwierciedlając historyczne wzorce ekspozycji na azbest. Najniższe wskaźniki, poniżej 1 przypadku na milion, obserwuje się w krajach takich jak Tunezja i Maroko, podczas gdy najwyższe wartości notowane są w krajach uprzemysłowionych z historią intensywnego wykorzystania azbestu.1 Szacuje się, że światowa częstość występowania mezoteliomy wynosi około 16 przypadków na milion osób rocznie, a globalna liczba zgonów spowodowanych mezoteliomą to około 15 000-30 000 rocznie.12

Trendy w zapadalności na mezotelomę

Zapadalność na mezotelomę w krajach rozwiniętych wykazywała tendencję wzrostową od lat 70. XX wieku do wczesnych lat 2000. W Stanach Zjednoczonych częstość występowania osiągnęła szczyt około roku 2000 i obecnie wykazuje tendencję spadkową w wyniku kontroli ekspozycji na azbest.12 Natomiast w Europie wskaźniki zachorowalności zaczęły stabilizować się dopiero w ostatnich latach, co wynika z różnic w czasie wprowadzenia przepisów ograniczających stosowanie azbestu.1

W krajach, gdzie wcześniej wprowadzono ograniczenia dotyczące stosowania azbestu, obserwuje się umiarkowany spadek częstości występowania mezoteliomy. Jednak w wielu regionach świata, szczególnie w krajach rozwijających się, gdzie azbest jest nadal wykorzystywany, zapadalność na mezotelomę wciąż rośnie.12

Biorąc pod uwagę długi okres latencji mezoteliomy, wynoszący średnio około 40 lat, dopiero teraz zaczynamy obserwować efekty zakazów stosowania azbestu wprowadzonych w wielu krajach w latach 80. i 90. XX wieku.12 Przewiduje się, że w krajach, które wprowadziły zakazy azbestu, zapadalność na mezotelomę osiągnie szczyt około 2020-2025 roku, a następnie zacznie spadać.1 Na przykład w Wielkiej Brytanii prognozuje się, że do lat 2038-2040 częstość występowania mezoteliomy spadnie o 27% w porównaniu z latami 2023-2025.1

Różnice płciowe w epidemiologii mezoteliomy

Mezotelioma tradycyjnie była postrzegana jako choroba dotykająca przede wszystkim mężczyzn, co wynikało z historycznie większej ekspozycji na azbest w miejscu pracy w takich sektorach jak budownictwo, przemysł stoczniowy czy wydobywczy. Jednak wzorzec zachorowań na mezotelomę stopniowo się zmienia, a choroba coraz częściej dotyka również kobiet.12

Statystycznie około 70-85% przypadków mezoteliomy opłucnej występuje u mężczyzn.12 Współczynnik zachorowalności mężczyzn do kobiet wynosi około 3:1 dla wszystkich typów mezoteliomy, choć w przypadku mezoteliomy otrzewnej proporcje są bardziej wyrównane – kobiety stanowią od jednej trzeciej do połowy wszystkich przypadków.1

W ostatnich dziesięcioleciach obserwuje się jednak wzrost liczby przypadków mezoteliomy u kobiet. W Wielkiej Brytanii standaryzowane według wieku wskaźniki zapadalności na mezotelomę u kobiet wzrosły o 88% między latami 1993-1995 a 2017-2019, podczas gdy u mężczyzn wzrost wyniósł 43%.1 Roczna liczba zgonów z powodu złośliwej mezoteliomy wśród kobiet w Stanach Zjednoczonych wzrosła o 25%, z 489 w 1999 r. do 614 w 2020 r.1

Ekspozycja kobiet na azbest często różni się od ekspozycji mężczyzn i częściej ma charakter środowiskowy lub parazawodowy, taki jak ekspozycja domowa poprzez kontakt z ubraniami roboczymi członków rodziny pracujących z azbestem. Kobiety mogą również być narażone na azbest w wyniku ekspozycji zawodowej, szczególnie w sektorach takich jak produkcja tekstyliów czy wykorzystujących produkty zawierające azbest.12

Interesującym zjawiskiem jest fakt, że kobiety z mezoteliomą mają zazwyczaj lepsze wskaźniki przeżycia niż mężczyźni, zarówno w przypadku mezoteliomy opłucnej, jak i otrzewnowej. Może to wynikać z różnic w rodzaju i intensywności ekspozycji, różnic genetycznych lub innych czynników biologicznych.1

Rozkład wiekowy mezoteliomy

Mezotelioma najczęściej diagnozowana jest u osób starszych, co jest bezpośrednio związane z długim okresem latencji od momentu ekspozycji na azbest do rozwoju choroby. W Wielkiej Brytanii prawie 60% nowych przypadków mezoteliomy diagnozowanych jest u osób w wieku 75 lat i starszych.1

Wskaźniki zachorowalności specyficzne dla wieku rosną gwałtownie u mężczyzn i stopniowo u kobiet od około 55-59 roku życia, osiągając szczyt w grupie wiekowej 80-84 lat u kobiet i 85-89 lat u mężczyzn.1 Średni wiek w momencie diagnozy mezoteliomy opłucnej wynosi około 72 lata.1

Warto zauważyć, że w ostatnich dekadach nastąpiły zmiany w rozkładzie wiekowym przypadków mezoteliomy. Wskaźniki zachorowalności u osób w wieku 25-59 lat znacząco spadły, podczas gdy u osób starszych (70 lat i więcej) znacznie wzrosły. W Wielkiej Brytanii od początku lat 90. wskaźniki zachorowalności w grupie wiekowej 70-79 lat wzrosły o 148%, a w grupie 80+ lat o 361% u kobiet. Podobne trendy obserwuje się u mężczyzn.1

Systemy nadzoru epidemiologicznego nad mezoteliomą

Systemy nadzoru epidemiologicznego nad chorobami związanymi z azbestem, w tym mezoteliomą, są ważnymi narzędziami zdrowia publicznego przyjętymi na arenie międzynarodowej. Rejestracja przypadków mezoteliomy jest uznawana za podstawowy środek zrozumienia szkód zdrowotnych spowodowanych ekspozycją na azbest i stanowi istotne wsparcie dla działań badawczych.1

Krajowe systemy nadzoru nad mezoteliomą

W wielu krajach utworzono specjalne rejestry mezoteliomy w celu monitorowania zapadalności, identyfikacji źródeł ekspozycji na azbest i wspierania badań nad tą chorobą:

  • Włoski Krajowy Rejestr Mezoteliomy obejmuje całe terytorium kraju poprzez regionalne centra operacyjne, których podstawowymi zadaniami jest aktywne poszukiwanie przypadków zachorowań oraz określanie charakteru ekspozycji na azbest.12
  • Francuski Krajowy Program Nadzoru nad Mezoteliomą (NMSP) został utworzony w 1998 roku i rejestruje przypadki nowotworów opłucnej w 21 francuskich okręgach, obejmujących około jednej czwartej populacji Francji.12
  • W Stanach Zjednoczonych dane dotyczące mezoteliomy są zbierane przez program nadzoru epidemiologicznego Surveillance, Epidemiology, and End Results (SEER) Narodowego Instytutu Raka (NCI).1

Te systemy nadzoru zapewniają standardową procedurę potwierdzania rozpoznań patologicznych i klinicznych, a także gromadzą dane dotyczące ekspozycji zawodowej, czynników ryzyka i wyników leczenia.12

Znaczenie systemów nadzoru epidemiologicznego

Systemy nadzoru nad mezoteliomą pełnią kilka kluczowych funkcji:

  • Monitorowanie trendów w zapadalności na mezotelomę i identyfikacja grup wysokiego ryzyka.1
  • Ocena skuteczności polityk ograniczania ekspozycji na azbest.1
  • Identyfikacja nieznanych lub niedocenianych źródeł ekspozycji na azbest.1
  • Wspieranie badań nad mezoteliomą i poprawy technik diagnostycznych.1
  • Ocena poziomu kompensacji mezoteliomy jako choroby zawodowej.1

Badania pokazują, że ulepszenie sieci nadzoru może zwiększyć czułość wykrywania przypadków mezoteliomy. Na przykład we włoskim badaniu wykazano, że czułość wzrosła z 79,4% w latach 1996-2001 do 91,4% w latach 2008-2013, co przyczyniło się do krótszego czasu raportowania i dokładniejszego określenia ekspozycji.1

Wyzwania w nadzorze epidemiologicznym nad mezoteliomą

Pomimo postępów w nadzorze epidemiologicznym nad mezoteliomą, nadal istnieją znaczące wyzwania:

  • Brak wiarygodnych danych dotyczących mezoteliomy w wielu krajach rozwijających się, co utrudnia globalną ocenę obciążenia tą chorobą.12
  • Niedostateczna świadomość związku między ekspozycją na azbest a mezoteliomą w krajach o niskim i średnim dochodzie, co może opóźniać wprowadzenie zakazów stosowania azbestu.1
  • Trudności w ocenie ekspozycji środowiskowej na azbest i jej wpływu na populację ogólną.1
  • Zróżnicowanie metod diagnostycznych i kryteriów raportowania między różnymi systemami nadzoru.1

Istnieje potrzeba doskonalenia globalnego nadzoru epidemiologicznego nad chorobami związanymi z azbestem, szczególnie śmiertelnością z powodu mezoteliomy. Wiarygodna ocena umieralności z powodu mezoteliomy jest fundamentalnym krokiem w kierunku zwiększenia świadomości związanych z nią zagrożeń i potrzeby międzynarodowego zakazu stosowania azbestu.12

Czynniki ryzyka i wzorce ekspozycji na azbest

Ekspozycja na azbest jest głównym czynnikiem ryzyka rozwoju mezoteliomy. Szacuje się, że ponad 80% przypadków mezoteliomy jest związanych z ekspozycją na azbest.12 Badania wykazały, że długotrwała ekspozycja zawodowa na azbest wiąże się z 8-13% ryzykiem rozwoju mezoteliomy.1

Rodzaje ekspozycji na azbest

Ekspozycja na azbest może mieć różny charakter i jest często klasyfikowana w następujący sposób:

  • Ekspozycja zawodowa – bezpośredni kontakt z azbestem w miejscu pracy, najczęściej w branżach takich jak budownictwo, przemysł stoczniowy, górnictwo, produkcja materiałów zawierających azbest. Jest to najczęstsza forma ekspozycji, odpowiadająca za około 68% przypadków mezoteliomy o znanej ekspozycji.1
  • Ekspozycja parazawodowa (domowa) – dotyczy członków rodzin osób pracujących z azbestem, którzy mogą być narażeni poprzez kontakt z zanieczyszczonymi ubraniami roboczymi.12
  • Ekspozycja środowiskowa – obejmuje obszary z naturalnie występującym azbestem oraz ekspozycję w wyniku zamieszkiwania w pobliżu źródeł przemysłowych/górniczych azbestu.12

Warto zauważyć, że ekspozycja parazawodowa i środowiskowa są częstszymi czynnikami ryzyka u kobiet niż u mężczyzn.1

Grupy wysokiego ryzyka

Pewne grupy zawodowe są szczególnie narażone na zwiększone ryzyko rozwoju mezoteliomy ze względu na historyczną ekspozycję na azbest:

  • Pracownicy stoczni1
  • Pracownicy budowlani, w tym blacharze, hydraulicy, elektrycy i murarze1
  • Górnicy1
  • Pracownicy przemysłu wytwarzającego materiały zawierające azbest1
  • Weterani wojskowi, szczególnie marynarze1

Regiony z silną historią pracy przemysłowej i produkcyjnej mają wyższe wskaźniki chorób związanych z azbestem. Również stany z naturalnie występującymi złożami azbestu, jak Kalifornia i Montana w USA, mają wysokie wskaźniki zachorowalności na mezotelomę.1

Okresy latencji

Mezotelioma charakteryzuje się długim okresem latencji między ekspozycją na azbest a rozwojem choroby. Średni okres latencji wynosi około 40 lat, choć może wahać się od 15 do 60 lat.12

Niektóre badania sugerują, że okres latencji może być krótszy w przypadku intensywnej ekspozycji na azbest oraz że może różnić się w zależności od typu mezoteliomy. Na przykład, okres latencji jest zazwyczaj krótszy dla mezoteliomy otrzewnej niż dla mezoteliomy opłucnej.1

Kobiety mają tendencję do dłuższych okresów latencji niż mężczyźni, co może wynikać z tego, że są one często narażone na niższe poziomy azbestu poprzez ekspozycję wtórną w dłuższym okresie.1 Brytyjskie badanie wykazało, że okres latencji był około 29% dłuższy u kobiet w porównaniu z mężczyznami.1

Zależność dawka-odpowiedź

Analiza danych z badań epidemiologicznych wykazała, że ryzyko mezoteliomy wzrasta wraz ze wzrostem ekspozycji na włókna azbestu, co wskazuje na proporcjonalną zależność między dawką skumulowaną a częstością występowania mezoteliomy.1

Badania pokazują, że nawet niskie poziomy ekspozycji na azbest mogą zwiększać ryzyko mezoteliomy. W badaniu kliniczno-kontrolnym przeprowadzonym w Montrealu wykazano, że iloraz szans (OR) dla mezoteliomy związanej z nieistotną ekspozycją na azbest wynosił 3,1 (95% CI = 0,8-12,3), a dla ekspozycji na istotnym poziomie 15,0 (95% CI = 2,9-78,6).1

W środowisku naukowym panuje konsensus, że nie istnieje znany próg ekspozycji, poniżej którego mezotelioma nie wystąpi, oraz że ekspozycja na azbest w dowolnym, nawet niewielkim stopniu, może zwiększać ryzyko rozwoju tego nowotworu.1

Zróżnicowanie geograficzne zachorowań na mezotelomę

Częstość występowania mezoteliomy wykazuje znaczne zróżnicowanie geograficzne, zarówno między krajami, jak i w obrębie poszczególnych państw. To zróżnicowanie odzwierciedla historyczne wzorce ekspozycji na azbest w różnych regionach.1

Różnice międzynarodowe

Najwyższe roczne surowe wskaźniki zachorowalności na mezotelomę (około 30 przypadków na milion) obserwuje się w Australii, Belgii i Wielkiej Brytanii.1 Są to kraje z silną historią intensywnego wykorzystania azbestu w przemyśle.

Natomiast w wielu krajach o niskim i średnim dochodzie dane dotyczące mezoteliomy są często niedostępne lub niewiarygodne. Szacuje się, że tylko 14% krajów o średnim i niskim dochodzie zgłasza dane dotyczące umieralności z powodu mezoteliomy do WHO, w porównaniu z 68% krajów o wysokim dochodzie.1

Park i współpracownicy, wykorzystując związek między skumulowanym użyciem azbestu a częstością występowania choroby w krajach, gdzie obie te zmienne są publikowane, oszacowali liczbę niezgłoszonych przypadków w krajach, gdzie znane jest tylko zużycie azbestu. Opisali oni ukryte obciążenie chorobą wynoszące około 39 000 przypadków w 15-letnim okresie do 2008 roku, głównie w Rosji, Kazachstanie, Chinach, Indiach i Tajlandii.1

Różnice regionalne wewnątrz krajów

Nawet w obrębie pojedynczych krajów występują znaczące różnice w częstości występowania mezoteliomy między regionami, związane z lokalnymi źródłami ekspozycji na azbest.

W badaniu przeprowadzonym w krajach nordyckich (Dania, Finlandia, Norwegia i Szwecja) wykazano do 3-krotne różnice w częstości występowania mezoteliomy między regionami. Najwyższe wskaźniki odnotowano w regionach związanych z przemysłem stoczniowym, produkcją cementu zawierającego azbest oraz żeglugą.1

Podobnie, w studium geograficznego rozkładu umieralności z powodu mezoteliomy opłucnej we Włoszech zidentyfikowano kilka obszarów o wysokim obciążeniu chorobą, takich jak Casale Monferrato, Broni, Carrara, Bari i Biancavilla, gdzie znajdowały się ośrodki przemysłu wykorzystującego azbest.1

Region Główne źródła ekspozycji na azbest Wskaźnik zachorowalności
Północna Jutlandia (Dania) Produkcja cementu (90% krajowego zużycia azbestu), przemysł stoczniowy 3,2/100 000
Helsinki i Turku (Finlandia) Przemysł stoczniowy Podwyższony
Casale Monferrato (Włochy) Zakłady produkcji materiałów azbestowo-cementowych Znacznie podwyższony
Belfast (Irlandia Północna) Historyczny przemysł stoczniowy Podwyższony
Biancavilla (Włochy) Kopalnia zanieczyszczona fluoro-edenitem Znacznie podwyższony u kobiet

W Stanach Zjednoczonych geograficzny rozkład najwyższych wskaźników umieralności z powodu mezoteliomy wśród kobiet w stanach z przemysłem stoczniowym sugeruje, że ekspozycja na azbest przyniesiony do domu może wpływać na rozwój choroby.1

Związek z historycznym użyciem azbestu w przemyśle

Obszary o wysokim ryzyku mezoteliomy często pokrywają się z lokalizacjami, gdzie historycznie intensywnie wykorzystywano azbest:

  • Tereny, gdzie znajdowały się zakłady produkujące wyroby azbestowo-cementowe1
  • Kopalnie azbestu (chryzotylu w Balangero we Włoszech)1
  • Stocznie12
  • Zakłady petrochemiczne i chemiczne oraz rafinerie1
  • Zakłady włókiennicze1

Ponadto, zaobserwowano podwyższone wskaźniki zachorowalności w regionach z naturalnie występującymi włóknami azbestu lub podobnymi do azbestu, jak w przypadku Biancavilla we Włoszech, gdzie zlokalizowana jest kopalnia zanieczyszczona fluoro-edenitem.1

Badania przesiewowe i wczesne wykrywanie mezoteliomy

Mezotelioma jest chorobą o złym rokowaniu, z medianą przeżycia wynoszącą około 8-18 miesięcy, w zależności od stadium i histologii.12 Wczesne wykrycie może znacząco poprawić wyniki leczenia i przeżywalność.1

Metody badań przesiewowych w kierunku mezoteliomy

Badania przesiewowe w kierunku mezoteliomy obejmują testy mające na celu wykrycie choroby przed pojawieniem się objawów. Główne metody obejmują:

Obecnie nie ma definitywnych zaleceń dotyczących badań przesiewowych w kierunku mezoteliomy w celu wykrycia wczesnego stadium choroby w populacjach narażonych na azbest.1 Jednak badania przesiewowe są zalecane dla osób z ekspozycją na azbest lub innymi czynnikami ryzyka.1

Biomarkery w wykrywaniu mezoteliomy

W ostatnich latach prowadzone są intensywne badania nad biomarkerami, które mogłyby służyć do wczesnego wykrywania mezoteliomy. Jednym z obiecujących podejść jest zastosowanie analizy proteomicznej.

Badacze z wykorzystaniem testu proteomicznego SOMAscan opracowali i zwalidowali wysoce czuły panel 13 biomarkerów do wykrywania mezoteliomy w populacji narażonej na azbest, z dokładnością 92% i wykrywalnością 88% choroby w stadium I i II.1

Takie podejście mogłoby znacząco poprawić nadzór nad mezoteliomą i wczesne wykrywanie, prowadząc do bardziej skutecznego leczenia i potencjalnie dłuższego przeżycia.1

Grupy ryzyka wymagające badań przesiewowych

Badania przesiewowe w kierunku mezoteliomy są szczególnie istotne dla następujących grup:

  • Osoby z historią zawodowej ekspozycji na azbest, zwłaszcza w branżach wysokiego ryzyka1
  • Osoby z historią ekspozycji środowiskowej na azbest1
  • Osoby z historią ekspozycji pośredniej, np. członkowie rodzin pracowników narażonych na azbest1

Regularne badania przesiewowe dla osób z ekspozycją na azbest mogą pomóc we wczesnym wykryciu choroby, co jest kluczowe dla lepszych wyników.1 W przypadku podejrzenia mezoteliomy u siebie lub przez lekarza, szybka diagnoza i leczenie są niezbędne.1

Znaczenie nadzoru epidemiologicznego dla zdrowia publicznego

Nadzór epidemiologiczny nad mezoteliomą ma kluczowe znaczenie dla zdrowia publicznego, dostarczając ważnych informacji na temat trendów zachorowalności, źródeł ekspozycji na azbest oraz skuteczności interwencji profilaktycznych.1

Identyfikacja źródeł ekspozycji na azbest

Systemy nadzoru epidemiologicznego nad mezoteliomą odgrywają kluczową rolę w identyfikacji znanych i nieznanych źródeł ekspozycji na azbest:1

  • Określanie zawodów i sektorów gospodarki związanych z podwyższonym ryzykiem mezoteliomy1
  • Identyfikacja obszarów geograficznych, gdzie azbest występuje naturalnie w środowisku12
  • Wykrywanie nowych lub niedocenianych źródeł zanieczyszczenia azbestem1
  • Dokumentacja wszystkich rodzajów ekspozycji na azbest, które często nie są oczekiwane ze względu na powszechne stosowanie azbestu1

Na przykład, kanadyjskie badanie wykorzystujące nadzór nad mezoteliomą zidentyfikowało kilka zawodów o podwyższonym ryzyku, które nie były wcześniej uznawane za znacząco związane z ekspozycją na azbest, w tym górnicy niewydobywający azbestu (OR = 9,6, 95% CI: 1,8-53), murarze (OR = 5,4, 95% CI: 1,0-28) i robotnicy budowlani (OR = 2,8, 95% CI: 0,7-10,6).1

Ocena skuteczności polityk ograniczania ekspozycji na azbest

Dane z rejestrów nowotworów potwierdzają, że legislacja dotycząca stosowania i produkcji azbestu jest skutecznym sposobem zmniejszenia zawodowej ekspozycji na azbest, a tym samym wskaźników zachorowalności na mezotelomę w populacji ogólnej, szczególnie u mężczyzn.1

W krajach, które wcześnie wprowadziły ograniczenia dotyczące azbestu, obserwuje się spadek zachorowalności na mezotelomę. Na przykład w Stanach Zjednoczonych wskaźniki zachorowalności na mezotelomę osiągnęły szczyt w latach 90. i od tego czasu nieznacznie spadają.1 Podobnie w krajach nordyckich męskie trendy zachorowalności na mezotelomę osiągnęły szczyt i zaczęły spadać, co wskazuje na korzystny wpływ zapobiegania ekspozycji.1

Dane te podkreślają znaczenie całkowitego zakazu stosowania azbestu jako środka zapobiegającego przyszłym przypadkom mezoteliomy.1

Ustalanie priorytetów w remediacji środowiskowej

Wyniki badań epidemiologicznych mogą pomóc w ustaleniu priorytetów interwencji i ocenie skuteczności remediacji środowiskowej:1

  • Identyfikacja obszarów o wysokim obciążeniu mezoteliomą, które wymagają pilnej remediacji środowiskowej1
  • Określenie miejsc o znaczeniu krajowym dla remediacji środowiskowej ze względu na obecność azbestu1
  • Monitoring skuteczności programów rekultywacji i oczyszczania1

Włoskie badanie geograficznego rozkładu mezoteliomy opłucnej zidentyfikowało kilka klastrów (Casale Monferrato, Broni, Carrara, Bari, Biancavilla, Augusta i Siracusa) jako miejsca o znaczeniu krajowym dla remediacji środowiskowej ze względu na obecność azbestu.1

Wpływ na polityki zdrowotne i przepisy prawne

Dane z nadzoru epidemiologicznego nad mezoteliomą mają istotny wpływ na kształtowanie polityk zdrowotnych i przepisów prawnych:

  • Włoski Krajowy Plan Prewencji sformułował zalecenia dotyczące eliminacji ekspozycji na azbest oraz wdrożenia nadzoru zdrowotnego i opieki zdrowotnej dla osób narażonych na azbest.1
  • W marcu 2024 roku administracja Biden-Harris sfinalizowała zakaz stosowania azbestu chryzotylowego w Stanach Zjednoczonych.1
  • Związki zawodowe w Wielkiej Brytanii wzywają do wprowadzenia nowego prawnego obowiązku bezpiecznej eliminacji azbestu ze środowiska zabudowanego, z obowiązkowym 40-letnim harmonogramem jego usunięcia ze wszystkich budynków publicznych.1

Ciągłe ryzyko potencjalnej ekspozycji na włókna azbestu podkreśla potrzebę bieżącego nadzoru w celu monitorowania czasowych trendów w umieralności z powodu złośliwej mezoteliomy.1

Wnioski i przyszłe kierunki badań

Mezotelioma pozostaje istotnym problemem zdrowia publicznego, pomimo postępów w zrozumieniu jej epidemiologii i wprowadzenia ograniczeń w stosowaniu azbestu w wielu krajach. Przyszłe badania powinny koncentrować się na kilku kluczowych obszarach.12

Badania nad ekspozycją środowiskową

Istnieje potrzeba dalszych badań nad bieżącymi źródłami ekspozycji środowiskowej na azbest i związanymi z nią skutkami zdrowotnymi w populacji ogólnej. Obejmuje to identyfikację obszarów geograficznych, gdzie azbest jest naturalnie obecny w środowisku.12

Obecne przepisy są niewystarczające, aby przeciwdziałać ekspozycji na azbest w sąsiedztwie przemysłowych/górniczych źródeł azbestu oraz ekspozycji domowej członków rodzin osób zawodowo narażonych na azbest, a także innym źródłom ekspozycji środowiskowej.1

Badania nad czynnikami genetycznymi i indywidualną podatnością

Potrzebne są badania nad nieznanymi źródłami ekspozycji na azbest, innymi źródłami naturalnej ekspozycji na azbest i włókna podobne do azbestu, a także nad indywidualną genetyczną podatnością na włókna azbestu.12

Możliwe czynniki współdziałające w patogenezie mezoteliomy związanej z azbestem obejmują predyspozycje genetyczne, diety ubogie w owoce i warzywa, wirusy, upośledzenie odporności oraz nawracające zapalenie błon surowiczych.1

Doskonalenie systemów nadzoru

Istnieje ciągła potrzeba monitorowania trendów zachorowalności na mezotelomę, aby lepiej zrozumieć zmiany związane z okresem latencji, poziomami ekspozycji oraz źródłami ekspozycji zawodowej i środowiskowej.12

Rejestr mezoteliomy z lepszymi informacjami na temat historii ekspozycji zawodowej i środowiskowej, charakterystyki pacjentów i nowotworów oraz leczenia znacznie zwiększyłby możliwości badania mezoteliomy.1

Działania w kierunku globalnego zakazu azbestu

Obserwacje z badań epidemiologicznych wskazują, że ekspozycja na azbest nadal stanowi obciążenie na całym świecie, a działania legislacyjne są potrzebne do uzyskania całkowitego zakazu.12

Pomimo ograniczonej ekspozycji w krajach medycznie czujnych, stosowanie azbestu jest kontynuowane w dużych ilościach w wielu częściach świata, co determinuje mezotelomę jako globalny problem zdrowotny na nadchodzące dziesięciolecia.1

Wiarygodna ocena umieralności z powodu mezoteliomy jest fundamentalnym krokiem w kierunku zwiększenia świadomości związanych z nią zagrożeń i potrzeby międzynarodowego zakazu azbestu.1

Podsumowując, pomimo postępów w badaniach nad mezoteliomą i wprowadzenia ograniczeń w stosowaniu azbestu w wielu krajach, choroba ta pozostaje istotnym wyzwaniem dla zdrowia publicznego. Dalsze badania nad epidemiologią mezoteliomy, doskonalenie systemów nadzoru i działania w kierunku globalnego zakazu azbestu są niezbędne, aby zmniejszyć przyszłe obciążenie tą chorobą.12

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  1. 18.04.2026
  2. www.leksykon.com.pl

Materiały źródłowe

  • #1 Epidemiology of mesothelioma in the 21st century in Europe and the United States, 40 years after restricted/banned asbestos use
    https://pmc.ncbi.nlm.nih.gov/articles/PMC7082259/
    Research has established a strong association between asbestos exposure and malignant mesothelioma, a deadly form of cancer. […] However, some countries continue to use asbestos, and worldwide rates of mesothelioma are still increasing. […] In some countries with earlier asbestos restrictions, mesothelioma incidence has been in a modest decline over time. […] The pattern of mesothelioma is shifting from a mostly male disease to a disease that affects females as well in substantial numbers. […] Studies on unknown sources of asbestos exposure, of other sources of natural exposure to asbestos and asbestos-like fibers, as well as of individual genetic susceptibility to asbestos fibers are needed. […] There is a well-established causal relationship between asbestos exposure and malignant mesothelioma, although the latency period can be long.
  • #1 Incidence of Malignant Mesothelioma | U.S. Cancer Statistics | CDC
    https://www.cdc.gov/united-states-cancer-statistics/publications/mesothelioma.html
    Mesothelioma is a rare cancer; 2,803 cases were reported in the United States in 2021. […] The decline in asbestos exposure is reflected by declines in mesothelioma incidence rates. […] Data in this brief come from U.S. Cancer Statistics, the official federal cancer statistics. U.S. Cancer Statistics incidence data are from population-based registries that participate in CDC’s National Program of Cancer Registries (NPCR) and/or the National Cancer Institute’s Surveillance, Epidemiology, and End Results (SEER) Program and met high-quality data criteria during 1999-2021 for the 2023 data submission period, covering 97% of the U.S. population (excluding data from Indiana, Mississippi, and South Dakota).
  • #1 Malignant pleural mesothelioma: an epidemiological perspective – Robinson- Annals of Cardiothoracic Surgery
    https://www.annalscts.com/article/view/1053/1582
    Malignant mesothelioma is a tumour arising from the mesothelial lining of the pleura, peritoneum, pericardium and tunica vaginalis. Pleural mesothelioma is the most common of these, accounting for approximately 90% of disease. Disease incidence varies markedly within and between countries. The highest annual rates of disease, approximately 30 case per million, are reported in Australia and Great Britain. With the exception of the United States, incidence continues to increase. In developed countries peak incidence is expected to occur before 2030. […] Worldwide malignant mesothelioma incidence has been rising since the mid 20th century. Analysis of mesothelioma mortality recorded in the WHO mortality database between 1994 and 2008 yielded an age-adjusted mortality rate of 4.9 per million, a mean age at death of 70 years and male to female ratio of 3.6:1. There is marked heterogeneity in malignant mesothelioma incidence within and between countries. Some of the most robust data comes from national registries in Australia and the United Kingdom, where age standardised incidence for 2009 was 29 per million of population in both countries. Incidence has been increasing each year since 16 cases were reported in 1980.
  • #1 Mesothelioma – Wikipedia
    https://en.wikipedia.org/wiki/Mesothelioma
    Epidemiology of mesothelioma indicates that although reported incidence rates have increased in the past 20 years, mesothelioma is still a relatively rare cancer. The incidence rate varies from one country to another, from a low rate of less than 1 per 1,000,000 in Tunisia and Morocco, to the highest rate in Britain, Australia, and Belgium: 30 per 1,000,000 per year. […] Incidence of malignant mesothelioma currently ranges from about 7 to 40 per 1,000,000 in industrialized Western nations, depending on the amount of asbestos exposure of the populations during the past several decades. Worldwide incidence is estimated at 16 per 1,000,000. […] Incidence of mesothelioma lags behind that of asbestosis due to the longer time it takes to develop; due to the cessation of asbestos use in developed countries, mesothelioma incidence is expected to decrease.
  • #1 Mesothelioma Statistics | Learn More About Facts & Incidences
    https://www.mesothelioma.com/mesothelioma/statistics/
    The life expectancy for pleural mesothelioma is 18 months. For peritoneal mesothelioma it is 31 months. […] The 3-year survival rate with treatment for pleural mesothelioma is 23% and the same rate for peritoneal mesothelioma is 74%. […] Mesothelioma death rate refers to the rate of deaths caused by mesothelioma in a given time period. […] 54,905 people died in the United States from mesothelioma from 1999 to 2020. […] Approximately 3,000 new cases of mesothelioma are diagnosed each year in the United States. Additionally, about 2,500 mesothelioma-related deaths occur in the United States each year. […] 66,951 Americans were diagnosed with mesothelioma between 1999 and 2019. […] 54,905 Americans died from mesothelioma between 1999 and 2020. […] Mesothelioma mortality rates remain steady. Since 1999, the rate of deaths per one million people has remained between 6 and 9. […] Researchers estimate more than 20 million people in the United States are at risk of developing mesothelioma at some point in their lives. […] A recent study found an estimated 30,000 deaths occur globally from mesothelioma each year.
  • #1 Epidemiology of malignant pleural mesothelioma – UpToDate
    https://www.uptodate.com/contents/epidemiology-of-malignant-pleural-mesothelioma
    Epidemiology of malignant pleural mesothelioma […] Mesothelioma is an insidious neoplasm arising from the mesothelial surfaces of the pleural and peritoneal cavities, the tunica vaginalis, or the pericardium. Eighty percent of cases are pleural in origin. The predominant cause of malignant mesothelioma is inhalational exposure to asbestos, with approximately 70 percent of cases of pleural mesothelioma being associated with documented asbestos exposure. […] This topic will discuss the epidemiology and risk factors of pleural mesothelioma. […] The annual incidence of mesothelioma in the United States is estimated to be approximately 3300 cases per year. The incidence of mesothelioma in the United States peaked around the year 2000 and is now declining, secondary to control of exposure to asbestos.
  • #1 Epidemiology of mesothelioma in the 21st century in Europe and the United States, 40 years after restricted/banned asbestos use
    https://pmc.ncbi.nlm.nih.gov/articles/PMC7082259/
    Given the long latency period of mesothelioma (approximately 40 years, on average), we may now just be beginning to see the effects of asbestos bans. […] In Europe, rates of mesothelioma were rising sharply in the early 2000s, and may just now be beginning to level off. […] The difference in the timeframe for asbestos ban legislation in the US and Europe, combined with a latency period of decades between exposure and mesothelioma partly explains why a slight decrease in mesothelioma standardized IR is seen in the US, consistent with previous research, while the incidence has just started to level off in Europe. […] However, observational data from cancer registries prove that legislation on asbestos use and production is an effective way to decrease occupational exposure to asbestos, and therefore, mesothelioma rates in the general population, especially in males.
  • #1 Epidemiology of Mesothelioma
    https://www.mdpi.com/2076-3298/6/7/76
    The incidence is increasing worldwide, and it is expected to reach its peak in the coming years, especially in developing countries where asbestos is still used and often without adequate control measures. […] The most recent incidence data available for the USA, reported by the surveillance program Epidemiology (Surveillance, Epidemiology, and End Results (SEER)) of the National Cancer Institute (NCI), are published in the SEER Cancer Statistics Review (CSR), 1975/2016. […] The incidence has steadily increased in the last twenty years in Europe in the industrialized countries and is expected to peak around 2020–2025. […] The world epidemic is at its beginning where consumption has grown, as in developing countries. […] The true dimensions of mesothelioma epidemics worldwide are still unknown, mainly due to the lack of data from industrializing countries.
  • #1 Mesothelioma incidence statistics | Cancer Research UK
    https://www.cancerresearchuk.org/health-professional/cancer-statistics/statistics-by-cancer-type/mesothelioma/incidence
    Mesothelioma incidence rates have varied between age groups in males in the UK since the early 1990s. Rates in 0-24s have remained stable, in 25-49s have decreased by 79%, in 50-59s have decreased by 79%, in 60-69s have decreased by 28%, in 70-79s have increased by 89% and in 80+s have increased by 248%. […] The number of new mesothelioma cases on average each year in the UK is projected to fall from around 2,600 cases in 2023-2025 to around 2,400 cases in 2038-2040. […] Mesothelioma incidence rates are projected to fall by 27% in the UK between 2023-2025 and 2038-2040, to 3 cases per 100,000 people on average each year by 2038-2040. […] For females, mesothelioma European age standardised (AS) incidence rates in the UK are projected to fall by 24% between 2023-2025 and 2038-2040, to 1 case per 100,000 per year by 2038-2040. For males, AS rates are projected to fall by 29% between 2023-2025 and 2038-2040, to 5 cases per 100,000 per year by 2038-2040.
  • #1 Mesothelioma incidence statistics | Cancer Research UK
    https://www.cancerresearchuk.org/health-professional/cancer-statistics/statistics-by-cancer-type/mesothelioma/incidence
    Mesothelioma is not among the 20 most common cancers in the UK, accounting for less than 1% of all new cancer cases (2017-2019). […] In females in the UK, mesothelioma is not among the 20 most common cancers (less than 1% of all new female cancer cases). In males in the UK, it is the 18th most common cancer (1% of all new male cancer cases). […] 17% of mesothelioma cases in the UK are in females, and 83% are in males. […] Mesothelioma incidence rates (European age-standardised (AS) rate) for persons are significantly lower than the UK average in Scotland and Wales and Northern Ireland. Rates in England are similar to the UK average. […] For mesothelioma, like most cancer types, differences between countries largely reflect risk factor prevalence in years past. […] In the UK in 2017-2019, on average each year almost 6 in 10 new cases (58%) were in people aged 75 and over.
  • #1 Malignant peritoneal mesothelioma: Epidemiology, risk factors, clinical presentation, diagnosis, and staging – UpToDate
    https://www.uptodate.com/contents/malignant-peritoneal-mesothelioma-epidemiology-risk-factors-clinical-presentation-diagnosis-and-staging/print
    In the United States, malignant peritoneal mesothelioma (MPM) accounts for approximately 10 to 15 percent of all cases of mesothelioma, and there are approximately 600 new cases diagnosed annually. Mesothelioma rates are rising worldwide, largely a reflection of occupational asbestos exposure. The incidence is expected to peak between 2015 and 2025. However, pleural mesothelioma accounts for most of the rising number of cases. In the United States and elsewhere, incidence rates of MPM have remained stable over the last 30 years. […] In contrast to pleural mesothelioma, which has a male predominance (male to female ratio of between four and five to one), females comprise approximately one-third to one-half of all cases of MPM.
  • #1 Mesothelioma incidence statistics | Cancer Research UK
    https://www.cancerresearchuk.org/health-professional/cancer-statistics/statistics-by-cancer-type/mesothelioma/incidence
    Age-specific incidence rates rise steeply for males and gradually for females from around age 55-59, then drop in the oldest age groups. The highest rates are in the 80 to 84 age group for females and the 85 to 89 age group for males. […] For mesothelioma, like most cancer types, incidence increases with age. This largely reflects cell DNA damage accumulating over time. Damage can result from biological processes or from exposure to risk factors. A drop or plateau in incidence in the oldest age groups often indicates reduced diagnostic activity perhaps due to general ill health. […] Mesothelioma European age-standardised (AS) incidence rates for females and males combined increased by 53% in the UK between 1993-1995 and 2017-2019. The increase was larger in females than in males. […] For females, mesothelioma AS incidence rates in the UK increased by 88% between 1993-1995 and 2017-2019. For males, mesothelioma AS incidence rates in the UK increased by 43% between 1993-1995 and 2017-2019.
  • #1 Malignant Mesothelioma Mortality in Women — United States, 1999–2020 | MMWR
    https://www.cdc.gov/mmwr/volumes/71/wr/mm7119a1.htm
    Inhalation of asbestos fibers causes malignant mesothelioma. […] The annual number of deaths with mesothelioma among women significantly increased, from 489 (age-adjusted death rate = 4.8 per 1 million women) in 1999 to 614 (4.2) in 2020. […] Efforts to limit exposure to asbestos fibers, including among women, need to be maintained. […] The annual number of mesothelioma deaths among women increased significantly, from 489 in 1999 to 614 in 2020; however, the age-adjusted death rate per 1 million women declined significantly, from 4.83 in 1999 to 4.15 in 2020. […] During 1999-2020, 12,227 (age-adjusted death rate: 4.59 per 1 million women) malignant mesothelioma deaths occurred among women aged 25 years in the United States. […] The annual number of malignant mesothelioma deaths increased 25%, from 489 in 1999 to 614 in 2020 (p<0.001), and the annual age-adjusted death rate declined from 4.83 per 1 million women in 1999 to 4.15 in 2020 (p = 0.038).
  • #1 Mesothelioma in Women | Asbestos Exposure & Survival
    https://www.mesothelioma.com/mesothelioma/women/
    The symptoms of mesothelioma can vary based upon the type, stage and location of tumors. […] Female patients diagnosed with peritoneal mesothelioma have reported the following symptoms: […] Given the vague nature of mesothelioma symptoms, misdiagnosis is possible for any patient. […] Women with known asbestos exposure should report their history to a physician. This can help the doctor narrow down the true cause of the patient’s symptoms and lead to an accurate diagnosis. […] Women may respond differently to some treatments than men. […] Research indicates female mesothelioma patients often experience secondary exposure. However, they can also be exposed to asbestos at work, which is occupational exposure. […] Researchers attribute many mesothelioma cases in women to asbestos exposure outside of their job.
  • #1 Mesothelioma in Women | Asbestos Exposure & Survival
    https://www.mesothelioma.com/mesothelioma/women/
    Female mesothelioma patients have several other distinguishing characteristics. They tend to have better survival in cases of peritoneal and pleural mesothelioma than their male counterparts. […] Survival rates in mesothelioma patients depend on various factors. These include mesothelioma stage, treatment protocol and patient health. Female mesothelioma patients may have better survival rates. Researchers have observed this in both pleural and peritoneal mesothelioma cases. […] Female patients also had a 5-year survival rate of 65%. The same rate for male patients was 46%. So female patients also had better long-term survival than male patients. […] Experts have suggested various explanations for better survival rates in female patients with mesothelioma. […] In one study, female patients accounted for about 28% of total mesothelioma cases and 61% of peritoneal cases.
  • #1 Key Statistics About Mesothelioma | American Cancer Society
    https://www.cancer.org/cancer/types/malignant-mesothelioma/about/key-statistics.html
    Mesothelioma is fairly rare in the United States. About 3,000 new cases are diagnosed each year. […] The rate of mesotheliomas in the United States increased from the 1970s to the early 1990s, but since then it has leveled off and even gone down slightly. These changes have largely been seen in men, and are probably related to changes in workplace exposures to asbestos. The rate of mesothelioma is lower in women and has been fairly steady for some time. In many other countries, the rate of mesothelioma is still increasing. […] Mesothelioma is more common in White, Hispanic, and Latino people than in African Americans or Asian Americans. […] Mesotheliomas are much more common in older people than younger people. The average age of people diagnosed with pleural mesothelioma (mesothelioma in the chest) is 72.
  • #1 Mesothelioma incidence statistics | Cancer Research UK
    https://www.cancerresearchuk.org/health-professional/cancer-statistics/statistics-by-cancer-type/mesothelioma/incidence
    Over the last decade in the UK (between 2007-2009 and 2017-2019), mesothelioma AS incidence rates for females and males combined decreased by 11%. In females AS incidence rates decreased by 11%, and in males rates decreased by 12%. […] For mesothelioma, like most cancer types, incidence trends largely reflect changing prevalence of risk factors and improvements in diagnosis and data recording. Recent incidence trends are influenced by risk factor prevalence in years past, and trends by age group reflect risk factor exposure in birth cohorts. […] Mesothelioma incidence rates have varied between age groups in females in the UK since the early 1990s. Rates in 0-24s have remained stable, in 25-49s have remained stable, in 50-59s have decreased by 56%, in 60-69s have remained stable, in 70-79s have increased by 148% and in 80+s have increased by 361%.
  • #1 Epidemiology of Mesothelioma
    https://www.mdpi.com/2076-3298/6/7/76
    Epidemiological surveillance systems of related asbestos diseases are instruments of public health adopted internationally. […] The experience and the operating methodology of the Italian mesothelioma registry and the data produced from 1996 to 2015 highlight how in countries where the asbestos ban has been active for over 20 years the risk of asbestos remains present, especially in the construction sector as well as for the environmental exposures of the resident population near companies that used asbestos in their production cycle. […] Epidemiological surveillance of incident cases of mesothelioma is recognized, both nationally and internationally, to be of primary importance for the understanding of health damages from exposure to asbestos. […] The registration of mesothelioma cases is an essential tool for the development of epidemiological knowledge and a support to research activities.
  • #1 The French national mesothelioma surveillance program
    https://www.santepubliquefrance.fr/determinants-de-sante/exposition-a-des-agents-physiques/amiante/the-french-national-mesothelioma-surveillance-program
    The French National Mesothelioma Surveillance Program (NMSP) was established in 1998 by the national Institute for health surveillance (InVS). Its objectives are to estimate the trends in mesothelioma incidence and the proportion attributable to occupational asbestos exposure, to help improve its pathology diagnosis, to assess its compensation as an occupational disease and to contribute to research. […] The NMSP records incident pleural tumours in 21 French districts that cover a population of approximately 16 million people (a quarter of the French population). […] The attributable risk fraction for occupational asbestos exposure in men was 83.2% (95% CI: 76.8-89.6). […] The NMSP is a large scale epidemiologic surveillance system with several original aspects, providing important information to improve the knowledge of malignant pleural mesothelioma, such as monitoring the evolution of its incidence, of high risk occupations and economic sectors, and improving pathology techniques.
  • #1 SciELO – Public Health – Mesothelioma mortality surveillance and asbestos exposure tracking in Italy Mesothelioma mortality surveillance and asbestos exposure tracking in Italy
    https://www.scielosp.org/article/aiss/2012.v48n3/300-310/
    The present study refers to the years 2003-2009, which is the most recent period for which mortality data are available (excluding the years 2004 and 2005, for which coded data are not yet available). […] The results may contribute to detect asbestos exposure and to set priorities for environmental remediation. […] The study of the geographic distribution of pleural mesothelioma in Italy, especially the cluster analysis, has led to the detection of several areas of the country where the burden of asbestos-related disease is evident. […] Several among the clusters showed in Figures 2 and 3 (namely, Casale Monferrato, Broni, Carrara, Bari, Biancavilla, Augusta and Siracusa) are included among the sites of national concern for environmental remediation, because of the presence of asbestos. […] As far as the remaining clusters are concerned, and in many individual municipalities characterized by high mesothelioma mortality rates, it is necessary to rank priorities of intervention and to evaluate the effectiveness of environmental remediation.
  • #1 The French National Mesothelioma Surveillance Program | Occupational & Environmental Medicine
    https://oem.bmj.com/content/63/6/390.short
    The French National Mesothelioma Surveillance Program (NMSP) was established in 1998 by the National Institute for Health Surveillance (InVS). Its objectives are to estimate the trends in mesothelioma incidence and the proportion attributable to occupational asbestos exposure, to help improve its pathology diagnosis, to assess its compensation as an occupational disease, and to contribute to research. […] The NMSP records incident pleural tumours in 21 French districts that cover a population of approximately 16 million people (a quarter of the French population). A standardised procedure of pathological and clinical diagnosis ascertainment is used. […] The NMSP is a large scale epidemiological surveillance system with several original aspects, providing important information to improve the knowledge of malignant pleural mesothelioma, such as monitoring the evolution of its incidence, of high risk occupations and economic sectors, and improving pathology techniques.
  • #1 Mesothelioma incidence surveillance systems and claims for workers’ compensation. Epidemiological evidence and prospects for an integrated framework | BMC Public Health | Full Text
    https://bmcpublichealth.biomedcentral.com/articles/10.1186/1471-2458-12-314
    Malignant mesothelioma is an aggressive and lethal tumour strongly associated with exposure to asbestos (mainly occupational). In Italy a large proportion of workers are protected from occupational diseases by public insurance and an epidemiological surveillance system for incident mesothelioma cases. […] A permanent MM epidemiologic surveillance system, based on a national register (ReNaM), has been established in Italy to estimate incidence rates, investigate asbestos exposures, identify any possible underestimated or unknown sources of asbestos contamination, and promote research and reclamation programs. ReNaM has published figures for incidence, survival, latency and asbestos exposure. […] The overall rate of compensation for mesothelioma claims in Italy due to occupational exposure to asbestos is 49.7%, and more than 90% of these are granted by the workers compensation authority. A substantial number of people who deserve compensation for MM do not seek it.
  • #1 The effects of improving the mesothelioma surveillance network on sensitivity, timeliness in reporting and asbestos exposure assessment | La Medicina del Lavoro
    https://www.mattioli1885journals.com/index.php/lamedicinadellavoro/article/view/5929
    In Italy, Mesothelioma Registries (MRs) have been established by law for the epidemiological surveillance of occupational cancers. […] This study evaluated the impact of the extension of the network on MR sensitivity and timeliness. […] Sensitivity increased from 79.4% (1996-2001), to 89.0% (2002-2007) and to 91.4% (2008-2013). […] The extended network improved the MR sensitivity and allowed shorter reporting and interview times and more frequent patient interviews, thus improving accuracy of exposure definition.
  • #1 Malignant pleural mesothelioma: an epidemiological perspective – Robinson- Annals of Cardiothoracic Surgery
    https://www.annalscts.com/article/view/1053/1582
    Global incidence of mesothelioma is likely to be significantly higher than mortality registries suggest due unreported cases occurring in developing counties. Park et al. used the relationship between cumulative asbestos use and disease incidence in countries where both variables are published to estimate unreported cases in countries where only asbestos consumption is known. They describe a hidden burden of disease of approximately 39,000 cases in the 15-year period to 2008, predominantly in Russia, Kazakhstan, China, India and Thailand. […] Given the role of asbestos in the aetiology of malignant mesothelioma, it is unsurprising that the relative risk of various occupational exposures have been extensively addressed in the epidemiological literature. Three waves of disease have been described. The first affected miners and millers of raw asbestos and in the manufacture of asbestos products. A second wave of disease subsequently became evident in workers who used asbestos products in industry. Since the 1990s changing risk groups have been identified, prompting classification of a third wave of disease, in people with often unknown, short term or low level exposure to asbestos.
  • #1 The Epidemiological Surveillance of Mesothelioma Mortality in Italy as a Tool for the Prevention of Asbestos Exposure
    https://www.mdpi.com/1660-4601/20/11/5957
    All types of asbestos are certain carcinogens for humans, causing malignant mesothelioma, including cancers of the lungs, larynx and ovary; a positive association between asbestos and pharynx, stomach and colorectal cancers has also been reported. Asbestos exposure also causes benign diseases: pleural plaques and fibrosis and asbestosis. Asbestos is among the main worldwide occupational carcinogens and exceeding mortality from asbestos-related diseases (ARDs) among non-occupational exposed people has also been reported. […] The implementation of surveillance plans of ARDs, in order to eliminate them by 2023, was recommended by the WHO. Deaths from MM were often used to quantify the global impact of ARDs. The issue concerning the worldwide availability and reliability of MM mortality data was recently raised. Odgerel et al. showed that 78% of WHO-reported MM deaths were from high-income and upper-middle-income countries, while the remaining were from low-income countries. Only 14% of middle- and low-income (MLI) countries reported MM mortality data to the WHO vs. 68% of high-income (HI) countries. This could determine a low public awareness of the health risk of asbestos and delay the ban of its use. HI countries might share technologies and information with MLI countries to detect MM cases and, primarily, to eliminate asbestos.
  • #1 Epidemiology of mesothelioma in the 21st century in Europe and the United States, 40 years after restricted/banned asbestos use
    https://pmc.ncbi.nlm.nih.gov/articles/PMC7082259/
    Increased knowledge and better regulations since the early 1980s, with restrictions or bans on production and use of asbestos in many developed countries has led to abatement of exposure, particularly in the occupational setting. […] However, despite bans, people may still be exposed to asbestos, due to its presence in several structures such as schools or public buildings, and the construction of residential areas in close proximity to former asbestos mines, factories, or soil containing natural asbestos. […] Thus the disease burden associated with environmental asbestos exposure remains difficult to quantify and is understudied. […] The goal of this report is to provide an overview of asbestos use, and mesothelioma incidence and mortality in the US and Europe, within the context of changes in asbestos policies around the world.
  • #1 MALIGNANT PLEURAL MESOTHELIOMA–EPIDEMIOLOGY AND PULMONARY ASBESTOS FIBERS : A NATIONAL CANCER REGISTRY COHORT STUDY
    https://helda.helsinki.fi/items/800b4492-840a-473f-8f43-1d1b6ef97226
    Malignant pleural mesothelioma (MPM) is a rare cancer that is strongly associated with previous occupational asbestos exposure; its prognosis is usually dismal. […] Due to its long period of latency, the annual incidence of MPM in Finland is still around 100 cases despite the effective ban on the use of asbestos that has been in place for decades. […] This study aimed to 1) determine the current epidemiology of MPM in Finland and evaluate the uniformity of existing protocols regionally and between sexes; 2) assess clinical factors associated with prolonged survival in patients with MPM; and 3) evaluate the distribution and concentration of asbestos fibers in pulmonary tissue, and also examine their prognostic role. […] Study I showed regional and gender variation in MPM incidence and occupational practices; also, treatment methods varied across different healthcare districts.
  • #1 Asbestos Consumption and Malignant Mesothelioma Mortality Trends in the Major User Countries | Annals of Global Health
    https://annalsofglobalhealth.org/articles/10.5334/aogh.4012
    According to the Global Burden of Diseases, Injuries, and Risk Factors Study 2017, exposure to asbestos fibres causes more than 250,000 deaths annually. […] The causal association between mesothelioma and asbestos exposure is conclusive, and many studies have proved that the trend in asbestos use is a strong predictor of the pattern in mesothelioma cases with an adequate latency time (generally around 30-40 years or more). […] There is a need to improve the global epidemiological surveillance of asbestos-related diseases, particularly mesothelioma mortality, and the absence of reliable data for some major asbestos-user countries is a real concern. […] A reliable assessment of mesothelioma mortality is a fundamental step towards increasing the awareness of related risks and the need of an international ban on asbestos.
  • #1 Mesothelioma Statistics: Incidence, Key Facts & Trends
    https://www.asbestos.com/mesothelioma/statistics/
    Mesothelioma is a rare cancer that forms in the lining of the lungs, abdomen or heart. In 2021 (most recent data), a total of 2,803 U.S. cases were reported. Most are linked to asbestos exposure and affect older men. Mesothelioma affects 1 in 100,000 people in the U.S. annually. […] Long-term asbestos exposure is the leading cause of mesothelioma. Asbestos workers with years of exposure have an 8% to 13% risk of developing mesothelioma. […] The highest incidence rates occur in regions with histories of industrial and asbestos-heavy industries. Mesothelioma incidence rates describe the risk of developing this cancer. […] Malignant mesothelioma isn’t a common cancer. For every 100,000 people in the United States, less than 1 new mesothelioma case was reported in 2021. In the U.S., doctors reported 2,803 new mesothelioma cases in 2021, the latest year for which data is available from the Centers for Disease Control and Prevention.
  • #1 The Epidemiological Surveillance of Mesothelioma Mortality in Italy as a Tool for the Prevention of Asbestos Exposure
    https://www.mdpi.com/1660-4601/20/11/5957
    Since 2002 a National Registry of MM cases (ReNaM) has been operated in Italy through Regional Operating Centres (COR-ReNaM). The most recent report revealed 31,572 cases of MM diagnosed in the 1993–2018 period: 93% MM of pleura (MPM) and around 6% of peritoneum (MPeM). The average age at diagnosis was 70 years with a male-to-female ratio of 2.6:1. Of those cases with known asbestos exposure, 68% had been exposed to asbestos in the workplace, and 4% reported an environmental exposure. Building, engineering, textile and shipyard work sectors are those most involved. […] The aim of this survey is to present an update of the rates of mortality caused by MM at the municipal level (2010–2019) in Italy, as part of a surveillance plan started in the early 1990s.
  • #1 Epidemiology of mesothelioma in the 21st century in Europe and the United States, 40 years after restricted/banned asbestos use – Alpert – Translational Lung Cancer Research
    https://tlcr.amegroups.org/article/view/33627/24348
    The classification of environmental, non-occupational exposure to asbestos is very heterogeneous in the literature and often includes (I) areas with naturally occurring asbestos, (II) neighborhood exposure based on residence in close proximity to industrial/mining sources of asbestos, and (III) household exposure for family members of occupationally exposed people, of which the latter two are more specific exposure risk factors for females. […] Given the long latency period of mesothelioma (approximately 40 years, on average), we may now just be beginning to see the effects of asbestos bans. […] The difference in the timeframe for asbestos ban legislation in the US and Europe, combined with a latency period of decades between exposure and mesothelioma partly explains why a slight decrease in mesothelioma standardized IR is seen in the US, consistent with previous research, while the incidence has just started to level off in Europe.
  • #1 Mesothelioma surveillance to locate sources of exposure to asbestos | Health & Environmental Research Online (HERO) | US EPA
    https://hero.epa.gov/hero/index.cfm/reference/details/reference_id/3081326
    Mesothelioma surveillance to locate sources of exposure to asbestos […] To determine whether there were previously unrecognized sources of asbestos exposure in British Columbia, incident mesothelioma cases (n = 51) and population-based controls (n = 154) were interviewed about their occupational histories and asbestos exposures. The following occupations were at elevated risk: sheet metal workers (OR = 9.6, 95% CI: 1.5-106), plumbers and pipefitters (OR = 8.3, 95% CI: 1.5-86), shipbuilding workers (OR = 5.0, 95% CI: 1.2-23), painters (OR = 4.5, 95% CI: 1.0-24), welders (OR = 3.9, 95% CI: 0.8-22), gardeners (OR = 3.9, 95% CI: 0.8-22), bricklayers (OR = 3.5, 95% CI: 0.9-14), miners (OR = 3.4, 95% CI: 0.9-13), machinists (OR = 3.2, 95% CI: 1.0-11), construction foremen (OR = 3.1, 95% CI: 0.9-11), and electricians (OR = 3.0, 95% CI: 0.8-12). […] In a reanalysis excluding subjects who worked in occupations or processes considered strongly a priori at risk, three groups remained of interest: non-asbestos miners (OR = 9.6, 95% CI: 1.8-53), bricklayers (OR = 5.4, 95% CI: 1.0-28), and construction labourers (OR = 2.8, 95% CI: 0.7-10.6).
  • #1 Mesothelioma Types, Prognosis, Symptoms & Treatment | Mesothelioma
    https://www.mesotheliomaguide.com/mesothelioma/
    Less than 3,000 cases are diagnosed each year in the U.S. […] Asbestos exposure is the only cause, and it takes decades to develop after exposure. […] The prognosis is typically poor due to challenges in diagnosis and treatment. […] The only risk factor for mesothelioma is exposure to asbestos. […] Due to the widespread use of asbestos throughout the U.S. in the 20th century, many people are at risk of developing mesothelioma. […] Military veterans make up an estimated 33% of mesothelioma cases. […] There are less than 3,000 documented cases of mesothelioma in the U.S. each year. […] Mesothelioma is an aggressive cancer that can spread quickly to vital organs, such as your lungs, diaphragm, heart or intestines. […] The average survival time for mesothelioma is 1-2 years, but medical advancements have improved the prognosis for many patients. […] The main way to stop the spread of mesothelioma is through early diagnosis and early treatment.
  • #1 Mesothelioma Statistics: Incidence, Key Facts & Trends
    https://www.asbestos.com/mesothelioma/statistics/
    Areas with a strong history of industrial work and manufacturing have higher rates of asbestos-related diseases. States with naturally occurring asbestos deposits, like California and Montana, have high mesothelioma rates as well. […] In March 2024, the Biden-Harris administration finalized a ban on chrysotile asbestos in the United States. Regulations have restricted its use since the 1970s. As a result, experts believe incidence will decline in the future. However, mesothelioma’s long latency period means those exposed decades ago will continue to develop this cancer. […] Statistics vary depending on the location where mesothelioma tumors first develop. The incidence rate of pleural mesothelioma is significantly higher than for any other type. About 80% of cases occur in the pleura, the smooth tissue surrounding the lungs.
  • #1 Mesothelioma Statistics: Incidence, Key Facts & Trends
    https://www.asbestos.com/mesothelioma/statistics/
    A key to successful outcomes is beginning treatment as early as possible. Many mesothelioma symptoms are similar to other more common illnesses. They also often don’t appear until people are already in later stages. Regular screenings for those with asbestos exposure can help catch the disease early. […] Government agencies break down and study mesothelioma statistics among different demographics to help understand risk and prognosis. Different age, gender and race or ethnicity have different incident rates. […] The latency period is generally shorter for peritoneal mesothelioma than for pleural mesothelioma. Most people diagnosed with peritoneal and pleural mesothelioma are about 51 and 67 years old, respectively. […] Women tend to have longer latency periods than men. It’s believed this is because they’re often exposed to lower levels of asbestos through secondhand exposure over time. […] The 5-year survival rate also appears to vary between races. The most recent year for compiled data by race is 2015 when the reported 5-year survival rate was about 19% for Black people and 9% for those who were white.
  • #1 The latency period of mesothelioma among a cohort of British asbestos workers (1978–2005) | British Journal of Cancer
    https://www.nature.com/articles/bjc2013514
    The median latency period for mesothelioma among this cohort was 22.8 years, which is shorter than that found in the review by Lanphear and Buncher (1992) (median 32 years). […] Excluding them produced an estimated median latency of 30.2 years (95% CI=28.0-32.2), which is closer to that expected. […] There was evidence that sex, year of first occupational asbestos exposure, age at first exposure, duration of exposure, and presence of asbestosis were associated with mesothelioma latency in the fully adjusted AFT model. […] Mesothelioma latency was around 29% longer for females compared with males (95% CI=1.18-1.342), and 5% shorter for those who died with asbestosis compared with those who did not (95% CI=0.91-0.99). […] There was no evidence of an association between mesothelioma latency and occupation, main smoking status, and mesothelioma type.
  • #1 Epidemiology of Mesothelioma
    https://www.mdpi.com/2076-3298/6/7/76
    The National Mesothelioma Registry covers the entire national territory for the detection of mesothelioma cases by a regional operations center (COR) in each region, whose fundamental activities are the active search for incident cases (through health facilities in the area of their competence, which diagnose and treat cases) and the definition of the modalities of exposure to asbestos. […] The detection of MM cases is carried out at competent health facilities that diagnose and treat cases (occupational health services, anatomy and pathological histology, pneumology departments, thoracic surgery, and oncology). […] The analysis of data provided by epidemiological studies has shown that the risk of MM increases with the increase in exposure to asbestos fibers, so there are no doubts regarding the proportional relationship between cumulative dose and MM frequency.
  • #1
    https://journals.lww.com/epidem/abstract/2003/09001/risk_of_lung_cancer_and_mesothelioma_associated.156.aspx
    The OR for mesothelioma associated with non-substantial exposure to asbestos was 3.1 (95%CI = 0.812.3) and 15.0 (95%CI = 2.978.6) for exposure at the substantial level. […] In conclusion, low levels of occupational exposure to asbestos were not associated with an excess risk of lung cancer while higher levels were. Excess risks of mesothelioma were manifest at low and high levels.
  • #1 Epidemiology: Open Access – Mesothelioma from Asbestos Exposure in Brake Mechanics: Epidemiology in Context
    https://www.omicsonline.org/open-access/mesothelioma-from-asbestos-exposure-in-brake-mechanics-epidemiology-in-context-2161-1165-1000340-101473.html
    It is the consensus of the medical and scientific community that there is no known threshold of exposure below which mesothelioma will not occur. […] Multiple studies have shown that all levels of exposure to asbestos increase the risk of mesothelioma. […] The mainstream scientific community has concluded that there is no safe level of exposure to asbestos of any type and that an occupational history of brief or low-level exposure should be considered sufficient for mesothelioma to be designated occupationally related to asbestos exposure. […] Epidemiology has been flawed and not adequately applied and then often results misinterpreted. […] Despite these shortcomings, the weight of evidence conclusion is that workers performing brake repair and installation with asbestos containing products are at significant risk of developing mesothelioma.
  • #1 Malignant Mesothelioma: Global Incidence and Relationship with Asbestos
    https://www.jstage.jst.go.jp/article/indhealth/45/3/45_3_379/_article
    Mesothelioma incidence varies markedly from one country to another. The highest annual crude incidence rates (about 30 cases per million) are observed in Australia, Belgium, and Great Britain. […] A lot of data indicate a relationship between mesothelioma and asbestos. The hot areas for mesothelioma exactly correspond to the sites of industries with high asbestos use, such as shipbuilding and asbestos-cement industry. […] However, in many countries with high asbestos consumption, mesothelioma incidence is low. The reasons for this fact are not clear. […] The latency periods elapsing between first exposure to asbestos and development of mesothelioma are mostly longer than 40 yr. An inverse relationship exists between intensity of asbestos exposure and length of the latency period. Mesothelioma generally develops after long-time exposures to asbestos. Some recent studies show that the risk increases with the duration of exposure.
  • #1 Incidence, mortality and survival in malignant pleural mesothelioma before and after asbestos in Denmark, Finland, Norway and Sweden | BMC Cancer | Full Text
    https://bmccancer.biomedcentral.com/articles/10.1186/s12885-021-08913-2
    In the Nordic countries, the male incidence trends for MPM climaxed and started to decrease, indicating that the prevention of exposure was beneficial. Survival in MPM has improved for both sexes but long-term survival remains dismal. […] The incidence in MPM was far lower in women than in men probably because exposures in women may be largely environmental rather than occupational. […] The analysis of regional MPM rates showed up to 3-fold intra-country differences, except less in NO. The DK peak in north Jutland at 3.2/100,000 is internationally high. The regional differences were telling about the sources of asbestos. In DK, north Jutland has been the center of cement manufacturing which has consumed 90% of the national asbestos. Additionally the region has had shipbuilding industry. In FI, Helsinki and Turku have been the centers of shipbuilding. NO has traditionally been a seafaring nation and the home of half of all Nordic seafarers and 2/3 of all fishermen.
  • #1 Malignant Mesothelioma Mortality in Women — United States, 1999–2020 | MMWR
    https://www.cdc.gov/mmwr/volumes/71/wr/mm7119a1.htm
    The geographic distribution of the highest mesothelioma death rates among women in states with a shipyard industry suggests that take-home asbestos exposure might affect disease development. […] The continuing risk for potential exposure to asbestos fibers underscores the need for ongoing surveillance to monitor temporal trends in malignant mesothelioma mortality.
  • #1 The Epidemiological Surveillance of Mesothelioma Mortality in Italy as a Tool for the Prevention of Asbestos Exposure
    https://www.mdpi.com/1660-4601/20/11/5957
    The Epidemiological Surveillance of Mesothelioma Mortality in Italy as a Tool for the Prevention of Asbestos Exposure […] As part of a surveillance plan active since the early 1990s, this study evaluates malignant mesothelioma (MM) mortality for the time-window 2010–2019 in Italy, a country that banned asbestos in 1992. National and regional mortality rates for MM, and municipal standardized mortality ratios (all mesotheliomas, pleural (MPM) and peritoneal (MPeM)), by gender and age group were calculated. A municipal clustering analysis was also performed. There were 15,446 deaths from MM (11,161 males, 3.8 × 100,000; 4285 females, 1.1 × 100,000), of which 12,496 were MPM and 661 were MPeM. In the study period, 266 people ≤50 years died from MM. A slightly decreasing rate among males since 2014 was observed. The areas at major risk hosted asbestos-cement plants, asbestos mines (chrysotile in Balangero), shipyards, petrochemical and chemical plants, and refineries. Female mortality excesses particularly were found in municipalities with a fluoro-edenite-contaminated mine (Biancavilla) and textile facilities. Excesses were also found in a region with the presence of natural asbestos fibres and in males living in two small islands. The Italian National Prevention Plan stated recommendations to eliminate asbestos exposures and to implement health surveillance and healthcare for people exposed to asbestos.
  • #1 Mesothelioma epidemiology and prognosis | Partnership for Work, Health and Safety
    https://pwhs.ubc.ca/research/injury-and-disease-surveillance/mesothelioma-epidemiology-and-prognosis/
    Considerable geographic variability in incidence rates was observed, which is typical of occupational or environmental diseases, and is related to historic asbestos use in some industries. […] Median survival has improved little over the past 25 years and in 2012-2016 was 8 months. […] Mesothelioma epidemiology and prognosis.
  • #1 Mesothelioma Screening: Early Detection of Asbestos Cancer
    https://www.asbestos.com/mesothelioma/screening/
    Screening for cancer and other diseases aims to find issues early, before symptoms show up. Catching mesothelioma early allows for quicker treatment. This is crucial for better outcomes, higher survival rates, and a better quality of life. […] Early diagnosis and treatment are key for the best mesothelioma outcome. If you’re at high risk from asbestos exposure, see a specialist soon. Don’t wait. If you or your doctor suspect mesothelioma, get diagnosed and treated quickly.
  • #1 Mesothelioma Screening: Early Detection of Asbestos Cancer
    https://www.asbestos.com/mesothelioma/screening/
    People at high risk of developing mesothelioma from asbestos exposure can be screened for signs of cancer before symptoms appear. Mesothelioma screening is vital because it can find cancer at an early stage, which improves treatment and survival outcomes. […] Mesothelioma screening involves tests, such as X-rays, CT scans and PET scans, to check for cancer before symptoms show. Screening is crucial for people at high risk of getting mesothelioma. Early detection boosts treatment success. […] Mesothelioma screening may detect cancer at an early stage before symptoms appear. […] People at high risk of mesothelioma can benefit from screening. […] Screening is recommended for people with asbestos exposure or other risk factors. […] People exposed to asbestos at work, in the environment, or indirectly have a higher risk of mesothelioma. They should get screened by a doctor before symptoms appear.
  • #1 Early Detection of Malignant Pleural Mesothelioma in Asbestos-Exposed Individuals with a Noninvasive Proteomics-Based Surveillance Tool | PLOS One
    https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0046091
    Malignant pleural mesothelioma (MM) is an aggressive, asbestos-related pulmonary cancer that is increasing in incidence. […] To improve surveillance and detection of MM in the high-risk population, we completed a series of clinical studies to develop a noninvasive test for early detection. […] The SOMAmer biomarker panel discovered and validated in these studies provides a solid foundation for surveillance and diagnosis of MM in those at highest risk for this disease. […] Since MM is a low incidence disease even in the asbestos-exposed population, a need still exists for a highly specific test for risk surveillance and early detection while avoiding false positive results and unnecessary invasive procedures. […] Using the SOMAscan proteomic assay, a highly sensitive candidate 13-biomarker panel was discovered and validated for the detection of MM in the asbestos-exposed population with an accuracy of 92% and detection of 88% of Stage I and II disease. […] Our data suggest that the candidate markers and classifier described in this series of discovery, verification, and validation studies have the potential to improve MM surveillance and early detection, leading to more effective treatment and the potential for prolonged survival.
  • #1 Mesothelioma – Pulmonary Disorders – Merck Manual Professional Edition
    https://www.merckmanuals.com/professional/pulmonary-disorders/environmental-and-occupational-pulmonary-diseases/mesothelioma
    Malignant mesothelioma is a rare, aggressive, and almost always fatal cancer, with a 5-year survival rate of about 10%. […] The great majority of malignant mesotheliomas are related to asbestos exposure, which can be occupational, para-occupational, or from environmental sources. […] There are no definitive screening recommendations for mesothelioma to detect early-stage disease in asbestos-exposed populations. […] Historically, most cases of mesothelioma occurred in males, given work in industrial jobs with heavy asbestos exposure. […] As the incidence of mesothelioma in males has declined over time, the proportionate disease burden of malignant mesothelioma in females has increased. […] Prognosis remains poor despite novel therapeutic approaches such as immunotherapy. Median survival is approximately 6 to 18 months, depending on stage and histology. […] Epithelioid mesothelioma, which is the most common histological subtype, is associated with longer median survival than sarcomatoid mesothelioma.
  • #1 Epidemiology of mesothelioma in the 21st century in Europe and the United States, 40 years after restricted/banned asbestos use
    https://pmc.ncbi.nlm.nih.gov/articles/PMC7082259/
    The identification of current sources of environmental exposure to asbestos and the associated health effects in the general population remains an important area of future research, including the identification of geographic areas where asbestos is naturally present in the environment. […] In conclusion, we report here the status of mesothelioma epidemiology in the recent years, and observe that asbestos exposure is still a burden worldwide, and legislative action is needed to obtain a complete ban.
  • #1 Mesothelioma incidence surveillance systems and claims for workers’ compensation. Epidemiological evidence and prospects for an integrated framework | BMC Public Health | Full Text
    https://bmcpublichealth.biomedcentral.com/articles/10.1186/1471-2458-12-314
    The likelihood of an individual with mesothelioma due to occupation seeking and receiving compensation was gender-specific. […] The probability of seeking compensation for MM cases with occupational asbestos exposure declined steeply in relation to age at diagnosis. […] In the multivariate model, after adjustment for all variables, the region of residence at diagnosis remained a significant source of variation in the probability of not seeking compensation for occupationally exposed patients. […] Our data highlight the importance of the documentation and dissemination of all asbestos exposure modalities since many – considering the large-scale use of asbestos and the absence of a threshold for the dose-response curve – are frequently not expected. Regulatory and public health agencies need effective notification systems to ensure that all individuals newly diagnosed with MM seek compensation benefits.
  • #1 Epidemiology of mesothelioma in the 21st century in Europe and the United States, 40 years after restricted/banned asbestos use – Alpert – Translational Lung Cancer Research
    https://tlcr.amegroups.org/article/view/33627/html
    The identification of current sources of environmental exposure to asbestos and the associated health effects in the general population remains an important area of future research, including the identification of geographic areas where asbestos is naturally present in the environment. […] In conclusion, we report here the status of mesothelioma epidemiology in the recent years, and observe that asbestos exposure is still a burden worldwide, and legislative action is needed to obtain a complete ban.
  • #1 Photographic Essay: International Workers Memorial Day 2025
    https://www.ibasecretariat.org/lka-photographic-essay-international-workers-memorial-day-2025.php
    Italy has the highest number of mesothelioma deaths of all EU member states, accounting for more than 20% of annual EU mesothelioma mortality. […] For each case of mesothelioma, there are between 1-2 cases of asbestos-related lung cancer as well as other cancers and respiratory diseases. […] The TUC is calling for a new legal duty to safely eradicate asbestos from the built environment with a mandatory 40-year timetable for its removal from all public buildings. […] With millions of tonnes of asbestos material still contaminating national infrastructures and over a million tonnes of asbestos fiber being used every year, neither workers nor the public are safe from deadly exposures. It is imperative that campaigners continue to raise awareness of the serious health hazard posed by asbestos whenever possible and it is gratifying to see that this life-saving work continues to be part of IWMD commemorations.
  • #1 Epidemiology of mesothelioma in the 21st century in Europe and the United States, 40 years after restricted/banned asbestos use – Alpert – Translational Lung Cancer Research
    https://tlcr.amegroups.org/article/view/33627/24348
    Current legislation is insufficient to address neighborhood asbestos exposure based on residence in close proximity to industrial/mining sources of asbestos and household asbestos exposure for family members of occupationally exposed people, as well as other sources of environmental exposure. […] The identification of current sources of environmental exposure to asbestos and the associated health effects in the general population remains an important area of future research, including the identification of geographic areas where asbestos is naturally present in the environment. […] In conclusion, we report here the status of mesothelioma epidemiology in the recent years, and observe that asbestos exposure is still a burden worldwide, and legislative action is needed to obtain a complete ban.
  • #1 Malignant Mesothelioma: Global Incidence and Relationship with Asbestos
    https://www.jstage.jst.go.jp/article/indhealth/45/3/45_3_379/_article
    Possible co-factors in the pathogenesis of asbestos-related mesothelioma include genetic predisposition, diets poor in fruit and vegetables, viruses, immune impairment, recurrent serosal inflammation. […] While a levelling-off in mesothelioma incidence has been registered in some countries, a worsening of the epidemic is predictable in large parts of the world.
  • #1 Mesothelioma epidemiology and prognosis | Partnership for Work, Health and Safety
    https://pwhs.ubc.ca/research/injury-and-disease-surveillance/mesothelioma-epidemiology-and-prognosis/
    Mesothelioma is a cancer of the tissue that lines internal organs, such as the lungs, that is caused by exposure to asbestos. […] 5-year survival is extremely poor, treatment options are limited, and the annual number of newly diagnosed cases in Canada has been steadily increasing for many decades. […] There is a continuing need to monitor mesothelioma trends to better understand changes related to latency and levels and sources of exposure. Case numbers are unlikely to decrease soon and may even increase as the population ages and grows. […] The number of cases of mesothelioma in BC has risen annually from ~35 cases diagnosed in 1993 to nearly 100 cases diagnosed in 2017. The majority of cases were male (85%) and over the age of 60 when diagnosed (83%). […] Incidence rates in men are much higher than in women, reflecting their much higher levels of occupational asbestos exposure in the past.
  • #1 Mesothelioma: Epidemiology and Prognosis – Occupational Cancer Research Centre
    https://www.occupationalcancer.ca/project/mesothelioma-epidemiology-prognosis/
    The primary purpose of this project was to update our understanding of mesothelioma incidence in Canada, and to examine the changing patterns and time trends. […] Previous investigations of mesothelioma in Canada found that disease incidence rates are increasing. […] There is a continuing need to monitor mesothelioma trends to better understand changes related to latency, levels of exposure and both occupational and environmental sources of exposure. Although overall rates of mesothelioma may have plateaued in Ontario, case numbers are unlikely to decrease soon and may even increase as the population ages and grows. […] A mesothelioma registry, with better information on occupational and environmental exposure history, patient and tumour characteristics, and treatment would greatly increase our ability to study mesothelioma in Ontario and Canada.
  • #1 Incidence, mortality and survival in malignant pleural mesothelioma before and after asbestos in Denmark, Finland, Norway and Sweden | BMC Cancer | Full Text
    https://bmccancer.biomedcentral.com/articles/10.1186/s12885-021-08913-2
    The incidence data by birth cohort may help to define the period of maximal MPM exposure. Figure 5 shows that in the birth cohort of 1907 the diagnostic age curves crossed suggesting that this birth cohort was exposed to something (asbestos) that pushed the MPM incidence at age 75-79 equally high as the incidence at higher ages. […] In conclusion, MPM is an asbestos-related disease for which the latency from exposure to diagnosis is long and for which cessation of exposure may not reduce risk in exposed individuals. In spite of limited exposures in medically alert countries, the use of asbestos continues in large volumes in many parts of the world, which predestines MPM as a global health problem for decades to come.
  • #2 Epidemiology of malignant pleural mesothelioma – UpToDate
    https://www.uptodate.com/contents/epidemiology-of-malignant-pleural-mesothelioma
    Epidemiology of malignant pleural mesothelioma […] Mesothelioma is an insidious neoplasm arising from the mesothelial surfaces of the pleural and peritoneal cavities, the tunica vaginalis, or the pericardium. Eighty percent of cases are pleural in origin. The predominant cause of malignant mesothelioma is inhalational exposure to asbestos, with approximately 70 percent of cases of pleural mesothelioma being associated with documented asbestos exposure. […] This topic will discuss the epidemiology and risk factors of pleural mesothelioma. […] The annual incidence of mesothelioma in the United States is estimated to be approximately 3300 cases per year. The incidence of mesothelioma in the United States peaked around the year 2000 and is now declining, secondary to control of exposure to asbestos.
  • #2 Mesothelioma Statistics: Incidence, Key Facts & Trends
    https://www.asbestos.com/mesothelioma/statistics/
    Mesothelioma is a rare cancer that forms in the lining of the lungs, abdomen or heart. In 2021 (most recent data), a total of 2,803 U.S. cases were reported. Most are linked to asbestos exposure and affect older men. Mesothelioma affects 1 in 100,000 people in the U.S. annually. […] Long-term asbestos exposure is the leading cause of mesothelioma. Asbestos workers with years of exposure have an 8% to 13% risk of developing mesothelioma. […] The highest incidence rates occur in regions with histories of industrial and asbestos-heavy industries. Mesothelioma incidence rates describe the risk of developing this cancer. […] Malignant mesothelioma isn’t a common cancer. For every 100,000 people in the United States, less than 1 new mesothelioma case was reported in 2021. In the U.S., doctors reported 2,803 new mesothelioma cases in 2021, the latest year for which data is available from the Centers for Disease Control and Prevention.
  • #2 Mesothelioma statistics | Cancer Research UK
    https://www.cancerresearchuk.org/health-professional/cancer-statistics/statistics-by-cancer-type/mesothelioma
    There are around 2,700 new mesothelioma cases in the UK every year, that’s more than 7 every day (2017-2019). […] Mesothelioma is not among the 20 most common cancers in the UK, accounting for less than 1% of all new cancer cases (2017-2019). […] In males in the UK, mesothelioma is the 18th most common cancer, with around 2,200 new cases every year (2017-2019). […] Incidence rates for mesothelioma in the UK are highest in people aged 85 to 89 (2017-2019). […] Each year almost 6 in 10 (58%) of all new mesothelioma cases in the UK are diagnosed in people aged 75 and over (2017-2019). […] Since the early 1990s, mesothelioma incidence rates have increased by more than half (53%) in the UK. Rates in females have increased by almost nine-tenths (88%), and rates in males have increased by more than two-fifths (43%) (2017-2019).
  • #2 Epidemiology and Pathology of Malignant Mesothelioma
    https://www.eurekaselect.com/article/77845
    Current epidemiological estimates suggest that mesothelioma will remain a public health problem for a number of years with epidemiological studies suggesting that the peak incidence of mesothelioma has not been reached. […] In the global context, mesothelioma remains responsible for between 15,000 – 20,000 deaths annually.
  • #2 Epidemiology of mesothelioma in the 21st century in Europe and the United States, 40 years after restricted/banned asbestos use
    https://pmc.ncbi.nlm.nih.gov/articles/PMC7082259/
    Given the long latency period of mesothelioma (approximately 40 years, on average), we may now just be beginning to see the effects of asbestos bans. […] In Europe, rates of mesothelioma were rising sharply in the early 2000s, and may just now be beginning to level off. […] The difference in the timeframe for asbestos ban legislation in the US and Europe, combined with a latency period of decades between exposure and mesothelioma partly explains why a slight decrease in mesothelioma standardized IR is seen in the US, consistent with previous research, while the incidence has just started to level off in Europe. […] However, observational data from cancer registries prove that legislation on asbestos use and production is an effective way to decrease occupational exposure to asbestos, and therefore, mesothelioma rates in the general population, especially in males.
  • #2 Epidemiology of Mesothelioma
    https://www.mdpi.com/2076-3298/6/7/76
    The incidence is increasing worldwide, and it is expected to reach its peak in the coming years, especially in developing countries where asbestos is still used and often without adequate control measures. […] The most recent incidence data available for the USA, reported by the surveillance program Epidemiology (Surveillance, Epidemiology, and End Results (SEER)) of the National Cancer Institute (NCI), are published in the SEER Cancer Statistics Review (CSR), 1975/2016. […] The incidence has steadily increased in the last twenty years in Europe in the industrialized countries and is expected to peak around 2020–2025. […] The world epidemic is at its beginning where consumption has grown, as in developing countries. […] The true dimensions of mesothelioma epidemics worldwide are still unknown, mainly due to the lack of data from industrializing countries.
  • #2 Epidemiology of mesothelioma in the 21st century in Europe and the United States, 40 years after restricted/banned asbestos use – Alpert – Translational Lung Cancer Research
    https://tlcr.amegroups.org/article/view/33627/24348
    The classification of environmental, non-occupational exposure to asbestos is very heterogeneous in the literature and often includes (I) areas with naturally occurring asbestos, (II) neighborhood exposure based on residence in close proximity to industrial/mining sources of asbestos, and (III) household exposure for family members of occupationally exposed people, of which the latter two are more specific exposure risk factors for females. […] Given the long latency period of mesothelioma (approximately 40 years, on average), we may now just be beginning to see the effects of asbestos bans. […] The difference in the timeframe for asbestos ban legislation in the US and Europe, combined with a latency period of decades between exposure and mesothelioma partly explains why a slight decrease in mesothelioma standardized IR is seen in the US, consistent with previous research, while the incidence has just started to level off in Europe.
  • #2 Epidemiology of mesothelioma in the 21st century in Europe and the United States, 40 years after restricted/banned asbestos use – Alpert – Translational Lung Cancer Research
    https://tlcr.amegroups.org/article/view/33627/24348
    Research has established a strong association between asbestos exposure and malignant mesothelioma, a deadly form of cancer. […] However, some countries continue to use asbestos, and worldwide rates of mesothelioma are still increasing. […] In some countries with earlier asbestos restrictions, mesothelioma incidence has been in a modest decline over time. […] The pattern of mesothelioma is shifting from a mostly male disease to a disease that affects females as well in substantial numbers. […] Studies on unknown sources of asbestos exposure, of other sources of natural exposure to asbestos and asbestos-like fibers, as well as of individual genetic susceptibility to asbestos fibers are needed. […] Research has shown that IR of mesothelioma are lower in women than in men, and this difference has been attributed to historical differences in occupational asbestos exposure.
  • #2 Mesothelioma: Practice Essentials, Background, Etiology
    https://emedicine.medscape.com/article/280367-overview
    Approximately 3000 cases of malignant mesothelioma are diagnosed annually. […] The risk of mesothelioma is increased in polluted areas by 2-10 fold compared with nonpolluted areas. Of patients with malignant mesothelioma in the United States, 80% have been exposed to asbestos. […] The annual number of deaths from malignant mesothelioma in the US increased by 4.8% from 1999 to 2015, from 2479 to 2579, according to the Centers for Disease Control and Prevention (CDC). However, over that period the age-adjusted mesothelioma death rate decreased nearly 22%, from roughly 14 to 11 per million population. […] Malignant mesothelioma is more common in men than in women, with a male-to-female ratio of 3:1. […] Malignant mesothelioma has a peak incidence 35-45 years after asbestos exposure. Two thirds of cases of malignant mesothelioma develop in the fifth to seventh decade of life. […] Incidence of malignant mesothelioma is 0.9 case per 100,000 persons annually. Marked variability exists in the incidence of malignant mesothelioma in different countries. In some countries, the incidence is low even though asbestos exposure is high. The reasons for these differences are not known.
  • #2 The epidemiology of malignant mesothelioma in women: gender differences and modalities of asbestos exposure | Occupational & Environmental Medicine
    https://oem.bmj.com/content/75/4/254
    The epidemiology of gender differences for mesothelioma incidence has been rarely discussed in national case lists. In Italy an epidemiological surveillance system (ReNaM) is working by the means of a national register. […] In Italy a permanent MM epidemiological surveillance system is working based on a national MM Register (Registro Nazionale dei Mesoteliomi, ReNaM in Italian). ReNaM is devoted to provide estimates of the incidence of malignant mesothelioma, to define and record asbestos exposures, to assess the impact of the disease at the population level and to identify any possible underestimated or unknown source of asbestos contamination. ReNaM regularly publishes figures for epidemiology and asbestos exposure of mesothelioma ill subjects. […] The consistent proportion of mesothelioma cases in women in Italy is mainly due to the relevant role of non-occupational asbestos exposures and the historical presence of the female workforce in several industrial settings. Enhancing the awareness of mesothelioma aetiology in women could support the effectiveness of welfare system and prevention policies.
  • #2 Epidemiology of Mesothelioma
    https://www.mdpi.com/2076-3298/6/7/76
    The National Mesothelioma Registry covers the entire national territory for the detection of mesothelioma cases by a regional operations center (COR) in each region, whose fundamental activities are the active search for incident cases (through health facilities in the area of their competence, which diagnose and treat cases) and the definition of the modalities of exposure to asbestos. […] The detection of MM cases is carried out at competent health facilities that diagnose and treat cases (occupational health services, anatomy and pathological histology, pneumology departments, thoracic surgery, and oncology). […] The analysis of data provided by epidemiological studies has shown that the risk of MM increases with the increase in exposure to asbestos fibers, so there are no doubts regarding the proportional relationship between cumulative dose and MM frequency.
  • #2 The French National Mesothelioma Surveillance Program | Occupational & Environmental Medicine
    https://oem.bmj.com/content/63/6/390.short
    The French National Mesothelioma Surveillance Program (NMSP) was established in 1998 by the National Institute for Health Surveillance (InVS). Its objectives are to estimate the trends in mesothelioma incidence and the proportion attributable to occupational asbestos exposure, to help improve its pathology diagnosis, to assess its compensation as an occupational disease, and to contribute to research. […] The NMSP records incident pleural tumours in 21 French districts that cover a population of approximately 16 million people (a quarter of the French population). A standardised procedure of pathological and clinical diagnosis ascertainment is used. […] The NMSP is a large scale epidemiological surveillance system with several original aspects, providing important information to improve the knowledge of malignant pleural mesothelioma, such as monitoring the evolution of its incidence, of high risk occupations and economic sectors, and improving pathology techniques.
  • #2 Asbestos Consumption and Malignant Mesothelioma Mortality Trends in the Major User Countries | Annals of Global Health
    https://annalsofglobalhealth.org/articles/10.5334/aogh.4012
    According to the Global Burden of Diseases, Injuries, and Risk Factors Study 2017, exposure to asbestos fibres causes more than 250,000 deaths annually. […] The causal association between mesothelioma and asbestos exposure is conclusive, and many studies have proved that the trend in asbestos use is a strong predictor of the pattern in mesothelioma cases with an adequate latency time (generally around 30-40 years or more). […] There is a need to improve the global epidemiological surveillance of asbestos-related diseases, particularly mesothelioma mortality, and the absence of reliable data for some major asbestos-user countries is a real concern. […] A reliable assessment of mesothelioma mortality is a fundamental step towards increasing the awareness of related risks and the need of an international ban on asbestos.
  • #2 Asbestos Consumption and Malignant Mesothelioma Mortality Trends in the Major User Countries | Annals of Global Health
    https://annalsofglobalhealth.org/articles/10.5334/aogh.4012
    The present study performed a country-specific analysis for modelling exposure-response by non-linear models for the most world asbestos consumers in a comparative context. […] Our results emphasized the inconsistency of mesothelioma mortality data for many great asbestos-user countries not reported in the WHO mortality database, supporting the need to improve the epidemiological surveillance of asbestos-related diseases worldwide.
  • #2 Mesothelioma – Wikipedia
    https://en.wikipedia.org/wiki/Mesothelioma
    Mesothelioma occurs more often in men than in women and risk increases with age, but this disease can appear in either men or women at any age. Approximately one fifth to one third of all mesotheliomas are peritoneal. […] Between 1940 and 1979, approximately 27.5 million people were occupationally exposed to asbestos in the United States. […] More than 80% of mesotheliomas are caused by asbestos exposure. […] The incidence of peritoneal mesothelioma is 0.5-3.0 per million per year in men, and 0.2-2.0 per million per year in women. […] Mesothelioma accounts for less than 1% of all cancers diagnosed in the UK, (around 2,600 people were diagnosed with the disease in 2011), and it is the seventeenth most common cause of cancer death (around 2,400 people died in 2012).
  • #2 Occupational, domestic and environmental mesothelioma risks in the British population: a case–control study | British Journal of Cancer
    https://www.nature.com/articles/6604879
    The only significant non-occupational association was living with a potentially exposed worker before 30 years of age (OR 2.0, 95% CI 1.33.2). […] The cumulative female mesothelioma death-rate by age 70 is now more than three times higher in the UK (0.037%) than in the US (0.012%). […] The future burden of mesothelioma is thus still uncertain. […] The mesothelioma risk caused by amosite (brown asbestos) is two orders of magnitude greater than that by chrysotile (white asbestos) (Hodgson and Darnton, 2000).
  • #2 The Epidemiological Surveillance of Mesothelioma Mortality in Italy as a Tool for the Prevention of Asbestos Exposure
    https://www.mdpi.com/1660-4601/20/11/5957
    Since 2002 a National Registry of MM cases (ReNaM) has been operated in Italy through Regional Operating Centres (COR-ReNaM). The most recent report revealed 31,572 cases of MM diagnosed in the 1993–2018 period: 93% MM of pleura (MPM) and around 6% of peritoneum (MPeM). The average age at diagnosis was 70 years with a male-to-female ratio of 2.6:1. Of those cases with known asbestos exposure, 68% had been exposed to asbestos in the workplace, and 4% reported an environmental exposure. Building, engineering, textile and shipyard work sectors are those most involved. […] The aim of this survey is to present an update of the rates of mortality caused by MM at the municipal level (2010–2019) in Italy, as part of a surveillance plan started in the early 1990s.
  • #2 Digital Commons @ East Tennessee State University
    https://dc.etsu.edu/etsu-works-2/131/
    Malignant pleural mesothelioma constitutes about 80% of all mesotheliomas. The peak incidence of malignant mesothelioma estimated using the cancer registries was in early 1990 to 2000 in the United States. The disease is primarily associated with asbestos exposure. The latency period between asbestos exposure and the development of malignant pleural mesothelioma (MPM) can range anywhere from 15 to 60 years. […] Here in our study, we analyze malignant pleural mesothelioma epidemiology in the United States, emphasizing different histological subtypes. […] Overall epidemiology of MPM and epidemiology of epithelioid, fibrous, and biphasic histological subtypes were analyzed separately. […] The overall incidence of MPM in the United States is declining, while the data showed an increase in the incidence of epithelioid and biphasic histological subtypes.
  • #2 Incidence, mortality and survival in malignant pleural mesothelioma before and after asbestos in Denmark, Finland, Norway and Sweden | BMC Cancer | Full Text
    https://bmccancer.biomedcentral.com/articles/10.1186/s12885-021-08913-2
    In the Nordic countries, the male incidence trends for MPM climaxed and started to decrease, indicating that the prevention of exposure was beneficial. Survival in MPM has improved for both sexes but long-term survival remains dismal. […] The incidence in MPM was far lower in women than in men probably because exposures in women may be largely environmental rather than occupational. […] The analysis of regional MPM rates showed up to 3-fold intra-country differences, except less in NO. The DK peak in north Jutland at 3.2/100,000 is internationally high. The regional differences were telling about the sources of asbestos. In DK, north Jutland has been the center of cement manufacturing which has consumed 90% of the national asbestos. Additionally the region has had shipbuilding industry. In FI, Helsinki and Turku have been the centers of shipbuilding. NO has traditionally been a seafaring nation and the home of half of all Nordic seafarers and 2/3 of all fishermen.
  • #2 Mesothelioma – Pulmonary Disorders – Merck Manual Professional Edition
    https://www.merckmanuals.com/professional/pulmonary-disorders/environmental-and-occupational-pulmonary-diseases/mesothelioma
    Malignant mesothelioma is a rare, aggressive, and almost always fatal cancer, with a 5-year survival rate of about 10%. […] The great majority of malignant mesotheliomas are related to asbestos exposure, which can be occupational, para-occupational, or from environmental sources. […] There are no definitive screening recommendations for mesothelioma to detect early-stage disease in asbestos-exposed populations. […] Historically, most cases of mesothelioma occurred in males, given work in industrial jobs with heavy asbestos exposure. […] As the incidence of mesothelioma in males has declined over time, the proportionate disease burden of malignant mesothelioma in females has increased. […] Prognosis remains poor despite novel therapeutic approaches such as immunotherapy. Median survival is approximately 6 to 18 months, depending on stage and histology. […] Epithelioid mesothelioma, which is the most common histological subtype, is associated with longer median survival than sarcomatoid mesothelioma.
  • #2 Epidemiology of mesothelioma in the 21st century in Europe and the United States, 40 years after restricted/banned asbestos use – Alpert – Translational Lung Cancer Research
    https://tlcr.amegroups.org/article/view/33627/24348
    Current legislation is insufficient to address neighborhood asbestos exposure based on residence in close proximity to industrial/mining sources of asbestos and household asbestos exposure for family members of occupationally exposed people, as well as other sources of environmental exposure. […] The identification of current sources of environmental exposure to asbestos and the associated health effects in the general population remains an important area of future research, including the identification of geographic areas where asbestos is naturally present in the environment. […] In conclusion, we report here the status of mesothelioma epidemiology in the recent years, and observe that asbestos exposure is still a burden worldwide, and legislative action is needed to obtain a complete ban.
  • #2 Mesothelioma: Epidemiology and Prognosis – Occupational Cancer Research Centre
    https://www.occupationalcancer.ca/project/mesothelioma-epidemiology-prognosis/
    The primary purpose of this project was to update our understanding of mesothelioma incidence in Canada, and to examine the changing patterns and time trends. […] Previous investigations of mesothelioma in Canada found that disease incidence rates are increasing. […] There is a continuing need to monitor mesothelioma trends to better understand changes related to latency, levels of exposure and both occupational and environmental sources of exposure. Although overall rates of mesothelioma may have plateaued in Ontario, case numbers are unlikely to decrease soon and may even increase as the population ages and grows. […] A mesothelioma registry, with better information on occupational and environmental exposure history, patient and tumour characteristics, and treatment would greatly increase our ability to study mesothelioma in Ontario and Canada.
  • #2 Epidemiology of mesothelioma in the 21st century in Europe and the United States, 40 years after restricted/banned asbestos use – Alpert – Translational Lung Cancer Research
    https://tlcr.amegroups.org/article/view/33627/html
    The identification of current sources of environmental exposure to asbestos and the associated health effects in the general population remains an important area of future research, including the identification of geographic areas where asbestos is naturally present in the environment. […] In conclusion, we report here the status of mesothelioma epidemiology in the recent years, and observe that asbestos exposure is still a burden worldwide, and legislative action is needed to obtain a complete ban.
  • #2 Malignant pleural mesothelioma: an epidemiological perspective – Robinson- Annals of Cardiothoracic Surgery
    https://www.annalscts.com/article/view/1053/1582
    Despite a clear understanding of malignant mesothelioma aetiology, the worldwide incidence continues to climb. The long latency of this disease and the continued distribution and consumption of asbestos products ensure that the toll of asbestos exposure will continue well into 21st century. The large future caseload underlines the ongoing importance of research directed towards early diagnosis and disease management.
  • #3 Epidemiology of malignant pleural mesothelioma – UpToDate
    https://www.uptodate.com/contents/epidemiology-of-malignant-pleural-mesothelioma
    Epidemiology of malignant pleural mesothelioma […] Mesothelioma is an insidious neoplasm arising from the mesothelial surfaces of the pleural and peritoneal cavities, the tunica vaginalis, or the pericardium. Eighty percent of cases are pleural in origin. The predominant cause of malignant mesothelioma is inhalational exposure to asbestos, with approximately 70 percent of cases of pleural mesothelioma being associated with documented asbestos exposure. […] This topic will discuss the epidemiology and risk factors of pleural mesothelioma. […] The annual incidence of mesothelioma in the United States is estimated to be approximately 3300 cases per year. The incidence of mesothelioma in the United States peaked around the year 2000 and is now declining, secondary to control of exposure to asbestos.

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