BTS statement on malignant mesothelioma in the UK, 2007

Our plain-English summary of BTS statement on malignant mesothelioma in the UK, 2007, by British Thoracic Society Standards of Care Committee (Thorax, 2007).

The study

• Author: British Thoracic Society Standards of Care Committee
• Journal: Thorax
• Published: 2007;62 Suppl 2(Suppl 2):ii1-ii19
• Type of article: Consensus statement
• Cited by: 138 articles, as counted by NIH iCite
• Read it: PubMed · Publisher · Free full text

In plain English

This article is not an original study. It is the second British Thoracic Society statement on malignant mesothelioma. A Working Party of clinicians wrote it to help with the management of pleural and peritoneal malignant mesothelioma in the UK. The authors said it was not strictly evidence-based, because they did not attempt a comprehensive literature review, and that most aspects of the subject had no randomised trials. Citing other studies, the statement reported projections that deaths in Britain would peak at between 1950 and 2450 per year sometime between 2011 and 2015. It also cited evidence that about 85% of mesothelioma in men may be directly attributable to occupational asbestos exposure. It said risks from amphibole asbestos appear considerably higher than from chrysotile. Median survival ranged from 8 to 14 months across studies. The statement said annual chest radiographs of previously exposed people cannot be recommended, and that radical surgery should only be considered within randomised trials. In one cited trial, median survival was 12.1 months with pemetrexed plus cisplatin and 9.3 months with cisplatin alone.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: Clinical practice statement (expert consensus document) by a British Thoracic Society Working Party, based on literature searches and reviews by its members; not original research and, by the authors' account, not strictly evidence-based
• Who was studied: Covers patients with pleural and peritoneal malignant mesothelioma in the UK; written primarily for clinicians caring for these patients (2007)
• Exposure: Asbestos, described as the cause of most cases. Chrysotile was the most widely used type in the UK, amosite was also used in substantial quantities and crocidolite to a lesser extent. Para-occupational and non-industrial environmental exposures and the non-asbestos fibre erionite are also discussed.
• Main results:
  • Cited projections: annual mesothelioma deaths in Britain would peak at between 1950 and 2450 deaths per year sometime between 2011 and 2015
  • Cited evidence from two British studies: the proportion of men with mesothelioma directly attributable to occupational asbestos exposure may be about 85%
  • The statement said there is evidence that mesothelioma risks from amphibole asbestos are considerably higher than from chrysotile
  • Median survival varied from 8 to 14 months in different studies
  • The statement said annual chest radiographs of previously asbestos-exposed individuals cannot be recommended
  • The statement said radical surgery should only be considered within a randomised trial, as no randomised trials had established its role
  • In a cited randomised trial, median survival in the whole group was 12.1 months with pemetrexed plus cisplatin and 9.3 months with cisplatin alone (p = 0.02)
  • Palliative radiotherapy provided pain relief in about half of all patients, according to the statement's key points
  • In an asbestos-exposed population, the ratio of pleural to peritoneal disease was described as high, in the order of 12:1
• The authors' conclusion: The authors stated that malignant mesothelioma will increase in incidence over the next 5 to 10 years and is inexorably progressive with very poor survival. They kept the term 'statement' rather than 'guidelines' because management remains subject to debate.
• Limitations the authors state:
  • The authors did not attempt a comprehensive review of all available literature
  • For most aspects of the subject there were still no randomised trials on which to base guidelines
  • The long-range predictions of future deaths were described as highly uncertain

Topics

The National Library of Medicine indexes this study under subjects our site covers: Mesothelioma, Peritoneal mesothelioma.

Medical terms in this study, explained in our Lexicon: Malignant Mesothelioma.

Related studies

• Statement on malignant mesothelioma in the United Kingdom — British Thoracic Society Standards of Care Committee (2001)
• The Delphi and GRADE methodology used in the PSOGI 2018 consensus statement on Pseudomyxoma Peritonei and Peritoneal Mesothelioma — R.J. Lurvink, L. Villeneuve, et al. (2021)
• Clinical problem-solving. Red snapper or crab? — P.B. Cornia, B.A. Lipsky, et al. (2004)
• Guidelines for the cytopathologic diagnosis of epithelioid and mixed-type malignant mesothelioma: Complementary Statement from the International Mesothelioma Interest Group, Also Endorsed by the International Academy of Cytology and the Papanicolaou Society of Cytopathology — A. Hjerpe, V. Ascoli, et al. (2015)
• Peritoneal mesothelioma — W.J. Plaus (1988)
• Radiologic Considerations and Standardization of Malignant Pleural Mesothelioma Imaging Within Clinical Trials: Consensus Statement from the NCI Thoracic Malignancy Steering Committee - International Association for the Study of Lung Cancer - Mesothelioma Applied Research Foundation Clinical Trials Planning Meeting — R.R. Gill, A.S. Tsao, et al. (2019)

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