Facts, rumours and speculations about the mesothelioma epidemic

Our plain-English summary of Facts, rumours and speculations about the mesothelioma epidemic, by J.P. van Meerbeeck, R. Damhuis (Respirology, 2011).

The study

• Authors: J.P. van Meerbeeck, R. Damhuis
• Journal: Respirology
• Published: 2011;16(7):1018-9
• Type of article: Editorial, Comment
• Cited by: 10 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Summary of the article

In this editorial, written in response to a paper by Giang et al. on asbestos use and asbestos-related diseases in Asia, the authors discussed mesothelioma incidence, screening and treatment. They noted that international cancer databases did not list mesothelioma as a separate entity, and that the lack of reliable data came with a tendency to ignore or exaggerate the asbestos problem. Earlier studies had predicted annual peaks of 20 000 cases in Western Europe around 2020 and 700 cases in Australia in 2010. A peak in the Netherlands had been forecast for 2025, later amended to 2017. The authors stated that recent data suggested these predictions were overrated and that the peak had passed: Australia recorded a maximum of 649 cases in 2003 and the Netherlands 501 in 2005. A UK peak of 2200 cases was predicted for 2013. Five prospective CT screening studies of 3915 asbestos-exposed people had found 30 lung cancers (0.7%) and 6 mesotheliomas (0.2%). The authors stated that imaging had not improved early detection and that results for serum mesothelin were disappointing. Randomized trials had shown a median survival benefit of 2 months with antifolate-cisplatin treatment. The authors urged inclusion of patients in independently funded clinical trials. They concluded that regulators should not wait for regional data, that asbestos use should be banned, and that international data should be readily available.

PubMed has no abstract for this study, and the article doesn't print one. We wrote this summary from the full article with the help of AI. It is not the authors' wording.

In plain English

This two-page editorial, not an original study, responded to a paper by Giang et al. on asbestos-related diseases in Asia. The authors noted earlier studies had predicted a mesothelioma epidemic, including an annual peak of 700 cases in Australia for 2010. Registry figures they charted showed Australia's highest yearly number was 649, in 2003, and the Netherlands' 501, in 2005. They suggested that the predictions were overrated and that the peak may already have passed. They tabulated five earlier prospective chest CT screening studies of asbestos-exposed groups. Of 3915 people screened, 30 (0.7%) had lung cancer and 6 (0.2%) mesothelioma. The authors wrote that imaging was generally accepted to have made no impact on early detection of mesothelioma. They called results for the blood marker serum mesothelin disappointing and not in favour of adding it to screening. Because demolition or maintenance workers are still exposed, they argued future patients should be considered for clinical trials. The authors concluded that no further research is needed to conclude asbestos use should be banned, but that international data should be available to influence regulators.

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: Editorial (commentary) responding to another paper; it summarizes registry figures and earlier studies and does not report a new study
• Who was studied: No study population of its own. It discusses yearly mesothelioma case numbers for Australia and the Netherlands from 1990 to about 2008, drawn from the Netherlands Cancer Registry and Safe Work Australia. It also tabulates five earlier CT screening studies of asbestos-exposed cohorts, with 3915 people in total.
• Exposure: Asbestos exposure in general; no fiber types are named. Demolition and maintenance work are mentioned as current sources of exposure.
• Main results:
  • Earlier studies cited by the authors had predicted an annual peak of 700 mesothelioma cases in Australia for 2010.
  • Registry data shown by the authors: the highest yearly number of mesothelioma cases in Australia was 649, in 2003.
  • Registry data shown by the authors: the highest yearly number of mesothelioma cases in the Netherlands was 501, in 2005.
  • Recent data, in the authors' reading, suggest that the earlier predictions were overrated and that the peak has already been crossed.
  • Across five earlier prospective chest CT screening studies of asbestos-exposed cohorts (3915 people in total), 30 lung cancers (0.7%) and 6 mesotheliomas (0.2%) were found. The mesotheliomas included both pleural and peritoneal cases. These figures come from the cited studies, not from new work.
  • The authors wrote that it is now generally accepted that imaging has not made any impact on the early detection of mesothelioma.
  • The authors described results for the blood marker serum mesothelin, from other authors' evaluations, as disappointing and not in favour of incorporating it in screening for mesothelioma.
• The authors' conclusion: The authors concluded that no further research or data is needed to conclude that asbestos use should be banned and that protective measures are needed. They added that international data should be readily available to influence regulatory authorities, and that inclusion of patients in clinical trials should be seriously considered.

Topics

Medical terms in this study, explained in our Lexicon: Mesothelioma, Lung Cancer, Mesothelin, Median Survival, Antifolate, Cisplatin, Clinical Trial.

Related studies

• Asbestos as a hazard to health. Fact and speculation — W.C. Cooper (1967)
• Commentary: environmental disease--a preventable epidemic — P.J. Landrigan (1992)
• Asbestos use and asbestos-related diseases in Asia: past, present and future — G.V. le, K. Takahashi, et al. (2011)
• A worn-out welcome: renewed call for a global ban on asbestos — R.C. Haynes (2010)
• Asbestos: facts and fiction — B.T. Mossman (1994)
• The case for a global ban on asbestos — J. LaDou, B. Castleman, et al. (2010)

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