Future trends in mortality of French men from mesothelioma

Our plain-English summary of Future trends in mortality of French men from mesothelioma, by A. Banaei, B. Auvert, M. Goldberg, et al (Occupational and Environmental Medicine, 2000).

The study

• Authors: A. Banaei, B. Auvert, M. Goldberg, A. Gueguen, D. Luce, S. Goldberg
• Journal: Occupational and Environmental Medicine
• Published: 2000;57(7):488-94
• Cited by: 62 articles, as counted by NIH iCite
• Read it: PubMed · Publisher · Free full text

Abstract

Objectives: Previous projections of mortality from mesothelioma among French men have used the age-generation method, based on the Poisson regression model. In this study an alternative method to model mortality from mesothelioma was used to predict its future trend: this method was based on the risk function that links this mortality to past exposure to asbestos, combined with population exposure data.

Method: Data on past French asbestos imports were used to model the overall past exposure to asbestos in men and assess two extreme scenarios (optimistic and pessimistic) for its future trends. The number of male deaths occurring between the ages of 50 and 79, from 1997-2050, was then calculated with the risk function for mesothelioma.

Results: The results showed that mortality from mesothelioma among French men aged 50-79 will continue to increase, reaching a peak averaging between 1140 (optimistic scenario) and 1300 deaths (pessimistic scenario) annually around the years 2030 and 2040, respectively. No preventive measures applied now will affect this trend before then. These results are similar to those of two other predictions of mortality from mesothelioma among French men: a peak around 2030 of 800-1600 deaths annually among men aged 25-89 years, and a peak around 2020 of 1550 deaths annually among men aged 40-84.

Conclusions: Our results indicate that between 1997 and 2050, the most optimistic and pessimistic trends of future exposure will lead to the deaths from mesothelioma of between 44 480 and 57 020 men, with a corresponding loss of from 877 200 to 1 171 500 person-years of life.

In plain English

This modelling study projected mesothelioma deaths among French men aged 50 to 79 for 1997 to 2050. Past mesothelioma deaths (1925 to 1996) were estimated as 0.81 times registered pleural cancer deaths. French asbestos import figures served as a rough measure of past exposure, combined with a risk function linking mesothelioma risk to that exposure. They then tested two extreme scenarios for future exposure: in the optimistic one exposure fell sharply, in the pessimistic one it stayed at its maximum. In the optimistic scenario, deaths peaked at a mean of 1140 per year around 2027 (2.5th to 97.5th percentiles: 820 to 1480). In the pessimistic scenario, they peaked at a mean of 1300 per year in about 2040 (percentiles 990 to 1630) and stayed there to 2050. Projected totals for 1997 to 2050 were 44 480 deaths (optimistic) and 57 020 (pessimistic). The authors concluded that reducing exposure now would not change the trend before 2030 but would save about 10 000 lives by 2050. Using a ratio of 100% instead of 0.81 would, they noted, raise all results by 20%.

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: Mathematical modelling and projection study. It combined national mortality data with asbestos import data and a risk function, and tested optimistic and pessimistic scenarios for future exposure.
• Who was studied: French men aged 50 to 79. The model was fitted to observed deaths from 1925 to 1996 and projected to 2050. Mesothelioma deaths were estimated as 0.81 times deaths registered under ICD 163 (pleural cancer).
• Exposure: Overall population exposure to asbestos, estimated from French asbestos import data. Little is known about the fiber types imported, but chrysotile seems to have been the most common.
• Main results:
  • Optimistic scenario: annual deaths among men aged 50 to 79 peaked at a mean of 1140 around 2027. The 2.5th to 97.5th percentiles of the projections were 820 to 1480.
  • Pessimistic scenario: annual deaths peaked at a mean of 1300 in about 2040. The 2.5th to 97.5th percentiles were 990 to 1630; Table 5 gives the peak year as 2043.
  • In the pessimistic scenario, deaths stayed at this maximum level until the end of the study period.
  • Total projected deaths for 1997 to 2050: 44 480 (2.5th to 97.5th percentile 32 860 to 58 910) in the optimistic scenario.
  • Total projected deaths for 1997 to 2050: 57 020 (2.5th to 97.5th percentile 45 430 to 68 730) in the pessimistic scenario.
  • Person-years of life lost for 1997 to 2050: 877 200 (647 300 to 1 163 100) in the optimistic scenario and 1 171 500 (913 800 to 1 419 900) in the pessimistic scenario.
  • According to the model, reducing asbestos exposure now would not affect the mortality trend before 2030, but would save about 10 000 lives and 275 000 person-years of life by 2050.
  • Of 15 138 819 parameter combinations tested, 71 152 gave acceptable fits to the observed data. The authors noted that the ranges reported for the parameters are not confidence intervals.
• The authors' conclusion: The authors concluded that deaths from mesothelioma among French men aged 50 to 79 will continue to increase, and that no preventive measure applied now will affect this trend until around 2030.
• Limitations the authors state:
  • The 0.81 ratio of mesothelioma deaths to pleural cancer deaths came from studies limited in time and place, around 1990. It was assumed to hold for all of France across the whole 72-year period.
  • If other pleural cancers did not increase over the period, the 0.81 ratio would overestimate past mesothelioma deaths. That would lead to underestimated projections.
  • Using a ratio of 100%, which would include possible mesotheliomas, would increase all results by 20%.
  • Past pleural cancer deaths were estimated across several ICD revisions, and coding errors occur. Misclassification in both directions is more likely in the older data.
  • The assumption that all exposed men had the same age at first exposure and the same duration of exposure was hypothetical.
  • Life expectancy was assumed to stay at 1995 levels throughout the next half century.

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.

Related studies

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• Mesothelioma risk and environmental exposure to asbestos: past and future trends in Japan — K. Azuma, I. Uchiyama, et al. (2009)
• Peritoneal mesothelioma in Italy: Trends and geography of mortality and incidence — S. Conti, G. Minelli, et al. (2015)
• Estimation of the past and future burden of mortality from mesothelioma in France — A.G. Ilg, J. Bignon, et al. (1998)
• Future trends of mesothelioma mortality in Japan based on a risk function — T. Myojin, K. Azuma, et al. (2012)
• The next mesothelioma wave: mortality trends and forecast to 2030 in Brazil — E. Algranti, C.A. Saito, et al. (2015)

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