Future Incidence of Malignant Mesothelioma in South Korea: Updated Projection to 2038

Our plain-English summary of Future Incidence of Malignant Mesothelioma in South Korea: Updated Projection to 2038, by K. Kwak, S.I. Cho, D. Paek (International Journal of Environmental Research and Public Health, 2021).

The study

• Authors: K. Kwak, S.I. Cho, D. Paek
• Journal: International Journal of Environmental Research and Public Health
• Published: 2021;18(12)
• Cited by: 8 articles, as counted by NIH iCite
• Read it: PubMed · Publisher · Free full text

Abstract

Malignant mesothelioma (MM) is a cancer that is largely caused by exposure to asbestos. Although asbestos is no longer used in South Korea, the incidence of MM continues to increase due to its long latent period. We aimed to update the previous prediction of MM incidence until 2038. We predicted the incidence of MM over the next 20 years (2019-2038) in South Korea using Møller's age-period-cohort (APC) model and a Poisson regression model based on asbestos consumption. The APC model predicted that the crude incidence rate would increase sharply in men and slowly in women. Despite the sex discrepancy in the rate of increase, the incidence rate for both sexes is expected to continue increasing until 2038. In the Poisson model, the crude incidence rate was predicted to increase continuously until 2038, and far more cases of MM were predicted to occur compared with the results of the APC model. When compared with actual incidence data, the APC model was deemed more suitable than the Poisson model. The APC model predicted a continuous increase over the next 20 years with no peak, suggesting that the incidence of MM will continue to rise far into the future.

In plain English

This forecasting study updated the authors' 2017 projection of malignant mesothelioma in South Korea. Using national cancer registry counts for 1994–2018, the authors built two models. One was an age–period–cohort (APC) model based on past incidence trends. The other was a Poisson regression model based on national asbestos consumption, with an assumed 40-year latent period. They tested both by predicting 2014–2018 from 1994–2013 data. The APC model predicted 461 cases in men and 254 in women, against 501 and 233 actually recorded. The Poisson model predicted 634 and 351, overestimating especially at ages 40–59. The authors chose the APC model. Using 1999–2018 data, it projected 3610 new cases in men and 1445 in women for 2019–2038, with numbers rising in every five-year period through 2034–2038, faster in men than in women. The authors concluded that incidence will keep rising in both sexes over the next 20 years. They noted uncertainty because the model assumes past trends continue and relies on projected population figures.

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: Forecasting (projection) study using national cancer registry data. It compared an age–period–cohort model with a Poisson regression model based on asbestos consumption, and checked both against actual incidence for 2014–2018.
• Who was studied: Malignant mesothelioma cases (code C45) recorded in South Korea by the Korea Central Cancer Registry, 1994–2018, together with national resident and projected population data. Models were checked on 2014–2018. Final projections for 2019–2038 were based on 1999–2018 data.
• Exposure: National asbestos consumption, defined as production plus imports minus exports, taken from customs, mining and US Geological Survey data. It was used per capita, with an assumed 40-year latent period, in the Poisson model only. The APC model did not use asbestos data. No fiber types were analysed.
• Main results:
  • Validation for 2014–2018, using 1994–2013 data. The APC model predicted 461 cases in men and 254 in women. The Poisson model predicted 634 in men and 351 in women. The actual counts were 501 in men and 233 in women.
  • Ratio of expected to observed cases (E/O) for the APC model: men 0.920 (95% CI 0.843–1.004), women 1.090 (95% CI 0.999–1.119). For the Poisson model: men 1.265 (95% CI 1.159–1.381), women 1.506 (95% CI 1.380–1.644). The APC ratios were closer to 1.
  • When predictions were compared by age group, the Poisson model overestimated cases at ages 40–59.
  • The APC model, based on 1999–2018 data, projected 3610 new cases in men and 1445 in women for 2019–2038.
  • Projected cases rose in every five-year period through 2034–2038. For men: 645, 825, 999 and 1141. For women: 291, 348, 389 and 417.
  • The crude incidence rate in men was expected to rise more than twice as fast as in women, whose rate was predicted to rise more slowly.
  • Compared with the 2017 analysis, which projected 2380 cases in men and 1199 in women for 2014–2033, the new projection was 1.5 times higher in men and slightly higher in women.
• The authors' conclusion: The authors concluded that mesothelioma incidence in South Korea will increase continuously in both men and women over the next 20 years. They added that the predictions are uncertain because they rest on several assumptions, and should be updated regularly.
• Limitations the authors state:
  • The APC model assumes past trends continue, so unexpected future events were not considered.
  • The predictions used projected population figures and may be affected by unpredictable demographic changes.
  • Records before 1999 came from hospital-based registries and probably missed cases. These early data were mistakenly included during the validation step.
  • The Poisson model rests on multiple arbitrary assumptions (latent period, exposure potential by age group, no lung clearance) and is not robust.
  • The validation period was short and limited.

Topics

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

Medical terms in this study, explained in our Lexicon: Malignant Mesothelioma, Incidence.

Related studies

• Estimated future incidence of malignant mesothelioma in South Korea: Projection from 2014 to 2033 — K.M. Kwak, D. Paek, et al. (2017)
• 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)
• 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)
• Incidence of mesothelioma in Lombardy, Italy: exposure to asbestos, time patterns and future projections — C. Mensi, S. De Matteis, et al. (2016)
• Standardized Incidence Ratio and Standardized Mortality Ratio of Malignant Mesothelioma in a Worker Cohort Using Employment Insurance Database in Korea — E.A. Kim (2021)

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