Estimated future incidence of malignant mesothelioma in South Korea: Projection from 2014 to 2033

Our plain-English summary of Estimated future incidence of malignant mesothelioma in South Korea: Projection from 2014 to 2033, by K.M. Kwak, D. Paek, S.S. Hwang, et al (PloS One, 2017).

The study

• Authors: K.M. Kwak, D. Paek, S.S. Hwang, Y.S. Ju
• Journal: PloS One
• Published: 2017;12(8):e0183404
• Type of article: Historical article
• Cited by: 23 articles, as counted by NIH iCite
• Read it: PubMed · Publisher · Free full text

Abstract

Malignant mesothelioma is a malignant tumor on the pleura or the peritoneum caused mostly by asbestos. Although asbestos is not currently used in South Korea, the incidence of mesothelioma is increasing due to its long latent period. This study predicted the incidence of malignant mesothelioma in South Korea over the next 20 years using an age-period-cohort (APC) model. Data regarding mesothelioma incidence from 1994-2013 were acquired from the Korea Central Cancer Registry (KCCR). Demographic data, including prospective resident data, were acquired from the Korean Statistical Information Service (KOSIS) for 1994-2033. An APC model with Møller's power-link function was utilized to predict the incidence of mesothelioma. It was predicted that 2,380 and 1,199 new cases of mesothelioma in men and women, respectively, would occur over the next 20 years. For both sexes, the mesothelioma incidence rate was predicted to be greater in 2029-2033 compared to that in 2009-2013 (men, 0.282 vs 0.563; women, 0.155 vs 0.217). For men, the age-standardized incidence rate was predicted to be slightly greater in 2029-2033 relative to the rate in 2009-2013 (0.228 vs 0.235), while the age-standardized incidence rate in women decreased within the same timeframe (0.113 vs 0.109). The changes in mesothelioma incidence were mostly caused by changes in the population structure due to aging and not by changes in the mesothelioma risk ratio. The results of this study project a continuous increase in mesothelioma incidence in South Korea over the next 20 years. Although the projected increase in mesothelioma incidence was not related to an increase in the mesothelioma risk ratio, continuous preventive efforts are necessary to reduce the exposure to asbestos and prevent the trend from worsening.

In plain English

This study projected how many people in South Korea would be diagnosed with malignant mesothelioma from 2014 to 2033. The authors used mesothelioma cases recorded by the Korea Central Cancer Registry for 1994–2013 (946 men and 534 women) and official population forecasts. They applied a statistical age-period-cohort model, which assumes that past trends continue. They projected 2,380 new cases in men and 1,199 in women over the 20 years. The crude incidence rate per 100,000 was projected to rise from 0.282 in 2009–2013 to 0.563 in 2029–2033 in men, and from 0.155 to 0.217 in women. In women the crude rate was projected to peak in 2024–2028. Age-standardized rates changed very little (men 0.228 to 0.235; women 0.113 to 0.109). The authors attributed most of the rise in case numbers to population aging rather than to changing risk. Asbestos use was not part of the model, and the registry did not separate pleural from peritoneal mesothelioma. The authors concluded that asbestos exposure should be avoided to prevent the projected trend from worsening.

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: Statistical projection study using national cancer registry and population data, with an age-period-cohort (APC) model (Møller's power-link model, Nordpred software)
• Who was studied: Mesothelioma cases recorded by the Korea Central Cancer Registry in South Korea from 1994 to 2013 (946 men and 534 women), set against an average annual population of 48,460,000. Population forecasts for 2014–2033 came from the Korean Statistical Information Service.
• Exposure: Individual asbestos exposure was not studied, and asbestos use was not included in the projection model. National asbestos imports and production (1975–2008) were only compared visually with mesothelioma rates.
• Main results:
  • Over 2014–2033, 2,380 new mesothelioma cases were projected in men and 1,199 in women.
  • The crude incidence rate (per 100,000) was projected to be higher in 2029–2033 than in 2009–2013: men 0.282 vs 0.563; women 0.155 vs 0.217.
  • In women, the crude incidence rate was projected to increase until 2024–2028 and then decrease.
  • In men, the age-standardized incidence rate was slightly higher in 2029–2033 than in 2009–2013 (0.228 vs 0.235).
  • In women, the age-standardized incidence rate was slightly lower in 2029–2033 than in 2009–2013 (0.113 vs 0.109). The authors described these changes as very small.
  • For both sexes, the age-standardized rate was projected to rise slowly until 2019–2023 and then slowly decrease.
  • Between 2009–2013 and 2029–2033, case numbers were projected to increase by 104.2% in men (357 to 729) and 46.9% in women (194 to 285).
  • The part of the change in case numbers due to changes in mesothelioma risk was small (men 2.7%, women -2.9%).
  • Most of the increase in case numbers was due to changes in the population (men 101.5%, women 49.8%). The authors attributed this mainly to population aging.
  • In the visual comparison, there was a gap of 25–30 years between peak asbestos use (imports peaked in the mid-1990s) and the projected peak in the age-standardized rate.
  • The male-to-female ratio of mesothelioma cases in South Korea was about 1.9 to 1.
• The authors' conclusion: The authors concluded that mesothelioma incidence in South Korea is projected to keep increasing even though asbestos is no longer used, and that asbestos exposure should be avoided to prevent the projected trend from worsening.
• Limitations the authors state:
  • The model assumed that past trends would continue into the future and did not account for unpredictable events, so actual incidence could differ.
  • Only the last 20 years of registry data were used, because early registry data had low reliability.
  • Earlier mesothelioma diagnoses may include misdiagnosed cases, and no validation study of diagnostic reliability exists in South Korea.
  • The amount of asbestos used was not included in the model, so its effect on mesothelioma risk could not be identified.
  • The registry did not separate pleural from peritoneal mesothelioma.

Topics

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

Medical terms in this study, explained in our Lexicon: Mesothelioma, Pleura, Peritoneum, Cancer Registry, Incidence.

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• Incidence of Cancer and Asbestos-Related Diseases among Residents Living near Abandoned Asbestos Mines in South Korea: A Retrospective Cohort Study Using National Health Insurance Database — K. Kwak, K.E. Zoh, et al. (2021)
• Incidence of mesothelioma in Lombardy, Italy: exposure to asbestos, time patterns and future projections — C. Mensi, S. De Matteis, et al. (2016)
• Mesothelioma incidence projections in South East England — S.P. Riaz, V.H. Coupland, et al. (2012)
• Time trend of mesothelioma incidence in the United States and projection of future cases: an update based on SEER data for 1973 through 2005 — B. Price, A. Ware (2009)
• Transfer of occupational health problems from a developed to a developing country: lessons from the Japan-South Korea experience — J. Park, N. Hisanaga, et al. (2009)

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