Epidemiology of peritoneal mesothelioma: a review

Our plain-English summary of Epidemiology of peritoneal mesothelioma: a review, by P. Boffetta (Annals of Oncology, 2007).

The study

• Author: P. Boffetta
• Journal: Annals of Oncology
• Published: 2007;18(6):985-90
• Type of article: Review
• Cited by: 210 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

The epidemiology of peritoneal mesothelioma is complicated by possible geographic and temporal variations in diagnostic practices. The incidence rates in industrialized countries range between 0.5 and three cases per million in men and between 0.2 and two cases per million in women. Exposure to asbestos is the main known cause of peritoneal mesothelioma. Results on peritoneal mesothelioma have been reported for 34 cohorts exposed to asbestos, among which a strong correlation was present between the percentages of deaths from pleural and peritoneal mesothelioma (correlation coefficient 0.8, P < 0.0001). Studies of workers exposed only or predominantly to chrysotile asbestos resulted in a lower proportion of total deaths from peritoneal mesothelioma than studies of workers exposed to amphibole or mixed type of asbestos. Cases of peritoneal mesothelioma have also been reported following exposure to erionite and Thorotrast, providing further evidence of common etiological factors with the pleural form of the disease. The role of other suspected risk factors, such as simian virus 40 infection and genetic predisposition, is unclear at present. Control of asbestos exposure remains the main approach to prevent peritoneal mesothelioma.

In plain English

This article was a review of the epidemiology of peritoneal mesothelioma, written by one author at the International Agency for Research on Cancer. Using European cancer registry data and United States SEER registry data, the author reported incidence rates among men of 0.5 to about three cases per million, and rates of 0.2 to 2 per million among women in most populations. The author compared 34 published cohorts of asbestos-exposed workers and asbestosis patients, measuring peritoneal mesothelioma deaths as a share of all deaths. No peritoneal mesothelioma deaths were reported in 14 of the 34 studies. There was a strong correlation between the percentages of pleural and peritoneal mesothelioma deaths (correlation coefficient 0.80). Cohorts exposed to chrysotile more often had no peritoneal mesothelioma deaths (nine of 15) than cohorts exposed to amphiboles or mixed fibers (four of 17). The share of deaths was higher in amphibole or mixed-fiber cohorts, but that difference was not statistically significant. Patients given Thorotrast for radiological examinations had a cumulative incidence of 0.2% to 0.6%. The author concluded that, although the evidence was not conclusive, the association with asbestos appeared less strong than for pleural mesothelioma.

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: Review of registry incidence data and published studies, including the author's own comparison of 34 asbestos-exposed cohorts
• Who was studied: Population-based cancer registry data from Europe (Eurocim) and the United States (SEER), plus 34 published cohort studies of asbestos-exposed workers and asbestosis patients from several countries
• Exposure: Asbestos, grouped as chrysotile (pure or predominant), amphiboles, or mixed fibers; also erionite, man-made vitreous fibers, Thorotrast and other ionizing radiation, simian virus 40, and genetic factors
• Main results:
  • In the registry data, age-standardized incidence rates among men ranged from 0.5 to about three cases per million population
  • In most populations, rates among women were 0.2 to 2 per million and were lower than among men
  • No peritoneal mesothelioma deaths were reported in 14 of the 34 cohort studies
  • Across the asbestos-exposed cohorts, there was a strong correlation between the percentage of pleural and the percentage of peritoneal mesothelioma deaths (correlation coefficient 0.80, p less than 0.0001)
  • No peritoneal mesothelioma deaths were reported in 9 of 15 chrysotile-exposed cohorts, compared with 4 of 17 cohorts exposed to amphiboles or mixed fibers (chi-square test, P value 0.04)
  • The proportion of mesothelioma deaths over total deaths was higher in cohorts exposed to amphiboles or mixed fibers than in chrysotile-exposed cohorts, but the difference was not statistically significant (P value 0.09 after adjustment for geographic region)
  • Cohorts of workers first employed before 1950 had a lower proportion of peritoneal mesothelioma deaths than cohorts employed later (adjusted P value 0.005); the author suggested this might reflect improved diagnostic accuracy
  • In three cohorts of patients given Thorotrast, the cumulative incidence of peritoneal mesothelioma was between 0.2% and 0.6%, higher than in many of the asbestos-exposed cohorts
• The authors' conclusion: The author concluded that, although the evidence was not conclusive, the association between asbestos exposure and peritoneal mesothelioma appears less strong than for pleural mesothelioma
• Limitations the authors state:
  • Using peritoneal mesothelioma deaths as a share of total deaths ignores differences in the age structure of the cohorts and changes in underlying rates over time
  • The disease is rare and its diagnosis is uncertain, which limits understanding of its epidemiology
  • Incidence and mortality data should be interpreted with caution, because diagnostic criteria vary by place and time and may be influenced by known asbestos exposure
  • Only four of the cohort studies were of women, which prevented detailed analyses
  • The effects of different types of amphibole fibers could not be assessed

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: Epidemiology, Peritoneal Mesothelioma, Incidence, Chrysotile, Amphibole Group, erionite, Asbestos Exposure.

Related studies

• Epidemiology of malignant peritoneal mesothelioma: A population-based study — S.A.S. Salo, I. Ilonen, et al. (2017)
• Incidence and survival trends for malignant pleural and peritoneal mesothelioma, Australia, 1982-2009 — M.J. Soeberg, J. Leigh, et al. (2016)
• Epidemiology and outcome of peritoneal and pleural mesothelioma subtypes in Norway. A 20 year nation-wide study — O.T. Brustugun, Y. Nilssen, et al. (2021)
• Peritoneal Mesothelioma with Residential Asbestos Exposure. Report of a Case with Long Survival (Seventeen Years) Analyzed by Cgh-Array — G. Serio, F. Pezzuto, et al. (2017)
• Peritoneal mesothelioma and asbestos exposure: a population-based case-control study in Lombardy, Italy — D. Consonni, C. Calvi, et al. (2019)
• Ferruginous bodies resolved by synchrotron XRF in a dog with peritoneal malignant mesothelioma — E. Pascotto, A. Gianoncelli, et al. (2018)

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