Differences between peritoneal and pleural mesothelioma in Lombardy, Italy

Our plain-English summary of Differences between peritoneal and pleural mesothelioma in Lombardy, Italy, by C. Mensi, M. Mendola, B. Dallari, et al (Cancer Epidemiology, 2017).

The study

• Authors: C. Mensi, M. Mendola, B. Dallari, M. Sokooti, R. Tabibi, L. Riboldi, D. Consonni
• Journal: Cancer Epidemiology
• Published: 2017;51:68-73
• Cited by: 11 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

Background: We examined characteristics of peritoneal (PEM) and pleural (PLM) mesothelioma in Lombardy, Italy.

Methods: From the Lombardy Mesothelioma Registry we selected PEM (N=300) and PLM (N=5011) cases diagnosed in 2000-2014. We investigated asbestos exposure and presence of asbestosis or pleural plaques.

Results: Incidence rates (per 1,000,000 person-years, world standardized) of PEM were 1.2 (men) and 0.9 (women), compared with 22.6 and 8.4 for PLM. Asbestosis (both genders) and pleural plaques (men) were more frequent among PEM cases. Occupational asbestos exposure was similar in PEM and PLM cases. We found higher proportions of PEMs employed in the asbestos cement production.

Conclusion: The higher frequency of pleural plaques in PEM cases confirm the association between asbestos and peritoneal mesothelioma. The higher proportions of asbestosis and of past employment in the asbestos-cement sector among PEM cases suggest a possible role of high exposures to asbestos in the peritoneal mesothelioma genesis.

Copyright © 2017 Elsevier Ltd. All rights reserved.

In plain English

The authors used the Lombardy Mesothelioma Registry in Italy to compare 300 people with peritoneal mesothelioma and 5,011 with pleural mesothelioma diagnosed from 2000 to 2014. Patients or relatives were interviewed about jobs and other asbestos sources, and chest CT scans were reviewed for asbestosis and pleural plaques. World-standardized incidence of peritoneal mesothelioma was 1.2 per million person-years in men and 0.9 in women, compared with 22.6 and 8.4 for pleural mesothelioma. Past occupational asbestos exposure was similar in both groups: about 70% of men and over one third of women. Pleural plaques were more frequent among men with peritoneal than pleural mesothelioma (22.6% vs 13.8%). Among women the difference was small and not statistically significant (9.1% vs 8.1%). Asbestosis was more frequent among peritoneal cases in both sexes (men 2.8% vs 0.5%; women 2.3% vs 0.1%). Among occupationally exposed people, more peritoneal than pleural cases had worked in asbestos-cement production (men 12.0% vs 2.8%; women 9.6% vs 1.4%). The authors concluded that the findings confirm the association between asbestos and peritoneal mesothelioma and suggest a possible role of high asbestos exposures.

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: Population-based mesothelioma registry study comparing characteristics, incidence and asbestos exposure of peritoneal versus pleural mesothelioma cases
• Who was studied: 300 peritoneal mesothelioma cases (156 men, 144 women) and 5,011 pleural mesothelioma cases (3,279 men, 1,732 women) among residents of Lombardy, Italy, diagnosed 2000 to 2014
• Exposure: Lifetime asbestos exposure assessed by standardized interview of patients or next-of-kin and classified as occupational, para-occupational (through cohabitants), home-related, environmental or unknown; occupational exposure was broken down by industry, including asbestos-cement production. Fiber types were not reported.
• Main results:
  • World-standardized incidence rates per 1,000,000 person-years: peritoneal mesothelioma 1.2 in men and 0.9 in women; pleural mesothelioma 22.6 in men and 8.4 in women.
  • Peritoneal mesothelioma rates fell slightly in men (minus 0.5% per year) and rose slightly in women (plus 1.2% per year). Pleural mesothelioma rates rose in both sexes (plus 1.8% per year in men, plus 1.2% in women).
  • Median age at diagnosis was lower for peritoneal cases: men 66.7 vs 70.5 years; women 67.9 vs 73.6 years.
  • Past occupational asbestos exposure was similar in peritoneal and pleural cases. Men: 108 of 156 (69.2%) vs 2388 of 3279 (72.8%). Women: 52 of 144 (36.1%) vs 644 of 1732 (37.2%).
  • Pleural plaques among men: 33 peritoneal cases (22.6%) vs 445 pleural cases (13.8%), p = 0.003. Among women: 12 (9.1%) vs 138 (8.1%), p = 0.69. Asbestosis among men: 4 (2.8%) vs 16 (0.5%), p = 0.01. Among women: 3 (2.3%) vs 1 (0.1%), p = 0.001. Cases with missing information were excluded.
  • Restricted to definite diagnoses, pleural plaques among men: 27 peritoneal (21.8%) vs 367 pleural cases (13.8%), p = 0.01. Among women: 11 (10.2%) vs 106 (8.2%), p = 0.47.
  • Among occupationally exposed cases, past employment in asbestos-cement production was more frequent in peritoneal than pleural cases. Men: 13 of 108 (12.0%) vs 67 of 2388 (2.8%), p less than 0.001. Women: 5 of 52 (9.6%) vs 9 of 644 (1.4%), p = 0.002. The finding held when restricted to definite diagnoses.
• The authors' conclusion: The authors concluded that the high frequency of occupational exposure and of pleural plaques in peritoneal cases confirms the association between asbestos and peritoneal mesothelioma. They also concluded that the higher proportions of asbestos-cement employment and asbestosis among peritoneal cases suggest a possible role of high asbestos exposures in its development.

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: Pleural Mesothelioma, Mesothelioma, Asbestos Exposure, Pleural Plaques, Incidence, Asbestos-Cement, Peritoneal Mesothelioma.

Related studies

• Peritoneal mesothelioma and asbestos exposure: a population-based case-control study in Lombardy, Italy — D. Consonni, C. Calvi, et al. (2019)
• Gender differences in pleural mesothelioma occurrence in Lombardy and Piedmont, Italy — D. Consonni, E. Migliore, et al. (2019)
• Incidence of mesothelioma in Lombardy, Italy: exposure to asbestos, time patterns and future projections — C. Mensi, S. De Matteis, et al. (2016)
• Estimate of environmental and occupational components in the spatial distribution of malignant mesothelioma incidence in Lombardy (Italy) — D. Catelan, D. Consonni, et al. (2020)
• Mesothelioma in Agriculture in Lombardy, Italy: An Unrecognized Risk — C. Mensi, B. Dallari, et al. (2021)
• Asbestos Exposure in Patients with Malignant Pleural Mesothelioma included in the PRIMATE Study, Lombardy, Italy — A. Spinazzè, D. Consonni, et al. (2022)

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