French mesothelioma register

Our plain-English summary of French mesothelioma register, by J. Bignon, P. Sebastien, L. Di Menza, et al (Annals of the New York Academy of Sciences, 1979).

The study

• Authors: J. Bignon, P. Sebastien, L. Di Menza, H. Payan
• Journal: Annals of the New York Academy of Sciences
• Published: 1979;330:455-66
• Cited by: 15 articles, as counted by NIH iCite
• Read it: PubMed · Publisher
• In J-M's library: Johns-Manville's company medical library held a copy (J-M no. 003981).

Abstract

A total of 197 definite cases of mesothelioma (mainly of the pleura) have been reported by pathologists to the French Mesothelioma Register for the period 1965--78. A moderate linear increase in the annual incidence of mesothelioma cases since 1965 was noted. In men and women over the ages of 47 and 41 years, respectively, the annual death rate was higher in those with mesothelioma than in those of the general population. The proportions of mesothelioma patients who had experienced occupational, para-occupational, and unknown asbestos exposures were 77%, 3%, and 20% respectively. The number of cases reported to the register is obviously an underestimate of the true number of mesothelima cases in France, because such cases are not reported to the register systematically. Mesothelioma registers cannot provide information about dose-response relationships; however, with good management of the register, such relationships could be obtained, since a good assessment of dose can be accomplished by biologic monitoring.

In plain English

This article reported on the French Mesothelioma Register as of June 1978. Suspected cases among deaths after 1965 were reported to the register. A panel of pathologists re-examined tissue slides, and asbestos exposure was assessed by questionnaire. Of 477 reported cases, 197 were confirmed: 186 pleural, two pericardial and nine peritoneal. Women made up 18% of confirmed cases, and age at death ranged from 25 to 80 years. Confirmed cases rose from six in 1965 to 24 in 1977, an increase of 1.5 cases per year. A history of asbestos exposure was established for 157 of the 197. Occupational, para-occupational and unknown exposure were reported as 77%, 3% and 20%. Among cases with a definite asbestos history, half died less than 36 years after exposure began. The authors stressed that cases were not reported systematically, so the register underestimated the true number and could not give incidence rates for France. They concluded that registers cannot show dose-response relationships, but that biologic monitoring of dose could make this possible.

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: Descriptive report of a national mesothelioma register (case series of reported and histologically reviewed cases)
• Who was studied: People in France who died after 1965 of suspected pleural or peritoneal mesothelioma, reported to the register by pathologists, clinicians and others. There were 477 reported cases as of June 1978, of which 197 were confirmed after review by a pathology panel.
• Exposure: Asbestos exposure, assessed retrospectively by a pathologist using a standardized questionnaire. It was classified as occupational, para-occupational or unknown. Fiber types were not reported for the cases.
• Main results:
  • Of the reported cases, a definite histologic diagnosis could be made in 56%. Of these, 43% were confirmed as mesothelioma and 13% were excluded.
  • Of the 197 confirmed mesotheliomas, 186 were pleural (67% of these on the right side), two were pericardial and nine were peritoneal.
  • Women made up 18% of the confirmed mesothelioma cases.
  • Annual death rates were compared with the general population of France (1974 vital statistics). Above age 47 in men and age 41 in women, death rates were higher in the mesothelioma group, and the difference increased with age. Below those ages, they were lower.
  • Registered confirmed cases rose linearly, from six in 1965 to 24 in 1977, an increase of 1.5 cases per year.
  • A history of asbestos exposure was established for 157 of the 197 confirmed cases. The proportions with occupational, para-occupational and unknown exposure were given as 77%, 3% and 20%.
  • Among cases with a definite asbestos history, the number of cases was roughly similar across duration-of-exposure categories, except that it was higher in the less-than-5-years category.
  • Among cases with a definite asbestos history, 50% died less than 36 years after onset of exposure.
  • Three cases had a latent period of less than 20 years, and one of these had a latent period of less than 10 years.
  • Time from onset of exposure to death had two peaks, at 30-35 years and at 45-50 years.
• The authors' conclusion: The authors concluded that the register's count underestimates the true number of mesothelioma cases in France. They also concluded that mesothelioma registers cannot provide dose-response information, but that with good management such relationships could be obtained, because dose can be well assessed by biologic monitoring.
• Limitations the authors state:
  • Cases are not entered into the register systematically. Collection depends on pathologists' awareness and their willingness to take part.
  • Mesothelioma cases are underreported and the true number is unknown, so incidence rates cannot be calculated from the register.
  • The rise in registered cases over time may not reflect the true trend in mesothelioma in France.
  • Reporting to the French register appeared very low compared with registers in other industrialized countries.
  • Questionnaires can only roughly determine dose, from the duration and type of exposure.
  • Measurements of asbestos in tissues (biologic monitoring) were still in progress, and the preliminary results were not reported.

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: Mesothelioma, Pleura, Asbestos Exposure, Dose-response relationship.

Related studies

• Features of asbestos-exposed and unexposed mesothelioma — A. Hirsch, P. Brochard, et al. (1982)
• Analysis of latency time and its determinants in asbestos related malignant mesothelioma cases of the Italian register — A. Marinaccio, A. Binazzi, et al. (2007)
• Future trends in mortality of French men from mesothelioma — A. Banaei, B. Auvert, et al. (2000)
• Cytoreductive surgery and hyperthermic intraperitoneal perfusion with chemotherapy in children with peritoneal tumor spread: A French nationwide study over 14 years — A. Scalabre, P. Philippe-Chomette, et al. (2018)
• Factors influencing long-term survival in mesothelioma patients--results of the German mesothelioma register — V. Neumann, A. Rütten, et al. (2004)
• Analysis of survival of mesothelioma cases in the Italian register (ReNaM) — A. Marinaccio, M. Nesti, et al. (2003)

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