Gender differences in pleural mesothelioma occurrence in Lombardy and Piedmont, Italy

Our plain-English summary of Gender differences in pleural mesothelioma occurrence in Lombardy and Piedmont, Italy, by D. Consonni, E. Migliore, F. Barone-Adesi, et al (Environmental Research, 2019).

The study

• Authors: D. Consonni, E. Migliore, F. Barone-Adesi, B. Dallari, S. De Matteis, E. Oddone, A.C. Pesatori, L. Riboldi, D. Mirabelli, C. Mensi
• Journal: Environmental Research
• Published: 2019;177:108636
• Cited by: 4 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

Background: Higher mesothelioma rates in men (vs women) reflect more frequent and more intense asbestos exposure. We assessed the impact of exposure difference between genders on age-specific rates of pleural mesothelioma (PM) occurrence using data from two Italian regions.

Methods: We used data from the Lombardy and Piedmont mesothelioma registries (period 2000-2016, age 45-74 years) to compare rates of PM in men and women and to estimate the rate advancement period (RAP).

Results: Based on 3384 cases (2405 men, 979 women) in Lombardy and 2042 (1389 men, 653 women) in Piedmont, the rate ratio was 2.81 (90% confidence interval: 2.61-3.03) in Lombardy and 2.39 (2.17-2.62) in Piedmont. In both regions RAP ranged from 7 to 10 years (at age 45 and 63 in men, respectively).

Conclusion: Men showed more than twofold increased PM rates and reached the same incidence as women 7-10 years earlier. RAP can be a useful measure of exposure impact on premature disease occurrence.

Copyright © 2019 Elsevier Inc. All rights reserved.

In plain English

This short communication used the Lombardy and Piedmont (north-western Italy) mesothelioma registries to compare pleural mesothelioma rates in men and women diagnosed in 2000 to 2016. Gender was used as a stand-in for asbestos exposure: occupational exposure was found in more than 70% of male cases and about 35% of female cases. The main analysis was limited to ages 45 to 74 (Lombardy: 2405 men, 979 women; Piedmont: 1389 men, 653 women). Men's rates were 2.81 times women's in Lombardy (90% confidence interval 2.61 to 3.03) and 2.39 times in Piedmont (2.17 to 2.62). The authors also estimated the 'rate advancement period': how many years earlier men reached the same rate as women. In both regions it ranged from about 7 years for men aged 45 to about 10 years for men aged 63. The authors concluded that more frequent and more intense asbestos exposure in men translated into a 7 to 10 year advancement in mesothelioma occurrence. They noted that exposure information was not available for the general population, so rates by actual asbestos exposure could not be calculated.

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: Registry-based comparison of pleural mesothelioma incidence rates in men and women (short communication), using Poisson regression to estimate rate ratios and rate advancement periods
• Who was studied: Pleural mesothelioma cases first diagnosed 2000 to 2016 in the Lombardy registry (5842 cases: 3836 men, 2006 women) and the Piedmont registry (3644 cases: 2370 men, 1274 women). The main analysis covered ages 45 to 74: Lombardy 2405 men and 979 women; Piedmont 1389 men and 653 women.
• Exposure: Gender was used as a surrogate for asbestos exposure. Among cases, occupational asbestos exposure was found in more than 70% of men and about 35% of women. Fiber types were not analysed.
• Main results:
  • Ages 45 to 74, Lombardy: the rate of pleural mesothelioma in men compared with women had a rate ratio of 2.81 (90% CI 2.61 to 3.03).
  • Ages 45 to 74, Piedmont: the rate ratio for men compared with women was 2.39 (90% CI 2.17 to 2.62).
  • Lombardy: the rate advancement period (men vs women) ranged from 7.1 years (90% CI 6.6 to 7.6) for men aged 45 to 9.9 years (90% CI 9.2 to 10.7) for men aged 63.
  • Piedmont: the rate advancement period was 6.9 years (90% CI 6.1 to 7.6) for men aged 45 and 9.6 years (90% CI 8.6 to 10.7) for men aged 63.
  • Among occupationally exposed cases, the construction industry ranked first among men in both regions. Among women, the most represented industry was production of textiles and cloths.
• The authors' conclusion: The authors concluded that, compared with women, more frequent and more intense asbestos exposure in men translated into an advancement of 7 to 10 years in mesothelioma occurrence. They also concluded that measures such as the rate advancement period can describe the population health impact of an exposure.
• Limitations the authors state:
  • Gender was used as a surrogate for occupational asbestos exposure.
  • Asbestos exposure information was not available for the general population, so incidence rates specific to asbestos exposure and age could not be calculated.
  • Rate advancement periods for men older than 63 are based on rates in men that women never reached.

Topics

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

Medical terms in this study, explained in our Lexicon: Pleural Mesothelioma, Mesothelioma, Asbestos Exposure, rate ratio, confidence interval.

Related studies

• Differences between peritoneal and pleural mesothelioma in Lombardy, Italy — C. Mensi, M. Mendola, et al. (2017)
• Incidence of mesothelioma in Lombardy, Italy: exposure to asbestos, time patterns and future projections — C. Mensi, S. De Matteis, et al. (2016)
• Estimate of environmental and occupational components in the spatial distribution of malignant mesothelioma incidence in Lombardy (Italy) — D. Catelan, D. Consonni, et al. (2020)
• Peritoneal mesothelioma and asbestos exposure: a population-based case-control study in Lombardy, Italy — D. Consonni, C. Calvi, et al. (2019)
• Mesothelioma in Agriculture in Lombardy, Italy: An Unrecognized Risk — C. Mensi, B. Dallari, et al. (2021)
• Asbestos Exposure in Patients with Malignant Pleural Mesothelioma included in the PRIMATE Study, Lombardy, Italy — A. Spinazzè, D. Consonni, et al. (2022)

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