Global Burden Assessment of Mesothelioma – Trends, Socioeconomic Influences, and Asbestos Exposure

Academic Background

Mesothelioma is a rare form of cancer that primarily affects the lining of the lungs (pleura) but can also occur in the lining of the abdominal cavity (peritoneum), heart, or testicles. Due to its rarity and long latency period, mesothelioma has received limited attention in cancer research and public health policies. Asbestos is the primary risk factor for mesothelioma. Although the use of asbestos has been widely restricted since the 1980s, its lingering health impacts remain significant. This study aims to assess the global burden of mesothelioma, trends by age, sex, and geographic location, as well as the influence of socioeconomic factors and asbestos exposure on mesothelioma incidence.

Source of the Paper

This paper was co-authored by Ziran Zhao, Jiagen Li, Fengwei Tan, Qi Xue, Shugeng Gao, and Jie He from the Department of Thoracic Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China. The paper was published online on July 2, 2024, in the International Journal of Surgery.

Research Process and Results

Data Sources and Study Design

This study utilized data from the 2022 Global Cancer Observatory (GCO) and the 2019 Global Burden of Disease Study. The GCO provided mesothelioma incidence data from 185 countries, while the Global Burden of Disease Study offered data on premature mortality and disability associated with over 350 diseases. The study employed multivariable linear regression analysis to explore the relationship between mesothelioma incidence and the Human Development Index (HDI), GDP per capita, and occupational asbestos exposure, adjusting for age and sex.

Key Findings

1. Global Mesothelioma Incidence: In 2022, there were 30,870 global cases of mesothelioma, with a higher incidence rate in males (0.25 per 100,000) compared to females (0.39 per 100,000).
2. Geographic Distribution: Europe had the highest mesothelioma incidence, particularly in Northern Europe (3,946 cases). Asia followed, with Eastern Asia reporting the highest number of cases (5,815). Australia and New Zealand also showed high incidence rates, with males at 1.2 per 100,000 and females at 2 per 100,000.
3. Age Distribution: The incidence rate was significantly higher in older populations (50–85 years) compared to younger populations (15–49 years). For example, in Australia and New Zealand, the incidence rate in older populations exceeded 1,130 per 100,000, while in younger populations, it was below 207.8 per 100,000.
4. Socioeconomic Factors: HDI and GDP per capita were positively correlated with mesothelioma incidence. For every 0.1 increase in HDI, mesothelioma incidence increased by 0.133; for every $10,000 increase in GDP per capita, incidence increased by 0.101. This association was particularly pronounced in older populations.
5. Asbestos Exposure: Occupational asbestos exposure was significantly associated with mesothelioma incidence, with an overall β coefficient of 0.122. This association was more evident in older populations (β=0.195) but not significant in younger adults (β=0.025).

Conclusions

The study indicates that mesothelioma incidence is higher in males and developed regions, particularly in Northern Europe. Socioeconomic factors (such as HDI and GDP per capita) and occupational asbestos exposure are significantly associated with mesothelioma incidence, especially in older populations. Although global mesothelioma incidence has declined overall, persistent cases among females highlight the need for continued attention to environmental and occupational exposure risks.

Research Highlights

1. Global Analysis: This study provides a detailed assessment of the global burden of mesothelioma, analyzing trends by age, sex, and geographic location.
2. Socioeconomic Influences: Mesothelioma incidence is significantly associated with HDI and GDP per capita, underscoring the impact of socioeconomic status on disease burden.
3. Asbestos Exposure: Occupational asbestos exposure remains a critical risk factor for mesothelioma, particularly in older populations.
4. Geographic Disparities: Northern Europe has the highest mesothelioma incidence, reflecting the historical industrial use of asbestos in the region.
5. Sex Differences: Mesothelioma incidence is higher in males than females, emphasizing the role of occupational exposure in historically male-dominated industries.
6. Temporal Trends: Overall mesothelioma incidence has declined, particularly in the 15–49 age group, reflecting global asbestos regulations and improved occupational safety standards.

Research Significance

This study provides important insights into the global epidemiology of mesothelioma, highlighting the influence of socioeconomic factors and asbestos exposure on disease burden. The findings have significant implications for shaping public health policies and future research directions, particularly in high-incidence regions and the management of environmental exposure risks.

Additional Valuable Information

The study also notes that, despite restrictions on asbestos use, its environmental residues remain a significant public health concern. Future research should focus on the long-term effects of exposure and how policies and interventions can further reduce mesothelioma incidence.