Health inequality and the global burden of mesothelioma: insights from the global burden of disease study 2021

Our plain-English summary of Health inequality and the global burden of mesothelioma: insights from the global burden of disease study 2021, by L. Lv, W. Gao, D. Fan, et al (BMC Cancer, 2025).

The study

• Authors: L. Lv, W. Gao, D. Fan, C. Ma, B. Yan, G. Li, Y. Jiang
• Journal: BMC Cancer
• Published: 2025;25(1):1179
• Cited by: 5 articles, as counted by NIH iCite
• Read it: PubMed · Publisher · Free full text

Abstract

BACKGROUND: This study aims to systematically analyze the disease burden and epidemiological trends of mesothelioma at the global, regional, and national levels from 1990 to 2021, based on the Global Burden of Disease (GBD) 2021 database, and to explore its relationship with health inequality. METHOD: DALYs were calculated by integrating Years of Life Lost due to premature mortality (YLL) and Years Lost due to disability (YLD) to comprehensively assess the disease burden. Additionally, the study analyzes cross-country health inequalities using the Slope Index of Inequality (SII) and the Concentration Index (CI). RESULTS: Over the past 32 years, global mesothelioma prevalence, incidence, DALYs, and death cases have increased significantly. In 2021, prevalence and incidence rates were highest in the high SDI regions, while the fastest growth occurred in the middle SDI regions. At the national level, Qatar, Bahrain, and Kuwait experienced the largest increases. The 75–79 age group had the highest prevalence and death cases globally. The analysis of health inequity indicates that countries with higher SDI levels are facing a more severe disease burden. CONCLUSION: From 1990 to 2021, the disease burden of mesothelioma exhibited a sustained upward trend. The widening gap in DALYs rates between countries with the highest and lowest SDI levels highlights the growing health inequality. Therefore, there is an urgent need for effective public health policies aimed at reducing occupational exposure, alleviating disease burden, and narrowing health disparities between countries.

In plain English

This study analysed existing figures from the Global Burden of Disease (GBD) 2021 database, which covers 204 countries and regions from 1990 to 2021. The authors examined mesothelioma prevalence, new cases, deaths and disability-adjusted life years (DALYs, a combined measure of years lost to early death and to illness). They compared countries by their Socio-demographic Index (SDI), a measure of development. Worldwide in 2021 the database gave 29,618.93 mesothelioma deaths, 96% more than in 1990, and a death rate of 0.38 per 100,000 people. Prevalence, new cases and deaths among males were about three times those among females. High SDI regions had the highest rates, and middle SDI regions had the fastest rise in rates. Rates were positively correlated with SDI. The absolute gap between the highest- and lowest-SDI countries (the Slope Index of Inequality) widened, while a relative measure (the Concentration Index) did not change significantly. The authors concluded that health inequality was worsening. The authors noted that the database lacked individual-level information, such as occupational and environmental exposure histories, which limited analysis of individual risk factors.

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: Secondary analysis of Global Burden of Disease (GBD) 2021 database figures, with trend (EAPC) and cross-country inequality analyses (Slope Index of Inequality and Concentration Index)
• Who was studied: Populations of 204 countries and regions in the GBD 2021 database, 1990 to 2021, grouped into 5 SDI levels and 21 GBD regions
• Exposure: The analysis reports no asbestos exposure measures and names no fiber types. Countries were compared by Socio-demographic Index (SDI) level. The authors state that the database lacks individual-level occupational and environmental exposure histories.
• Main results:
  • Global 2021 figures for prevalence, incidence, DALYs and deaths were 51,596.54, 31,907.89, 689,358.83 and 29,618.93, increases of 80%, 93%, 78% and 96% over 1990
  • Global 2021 prevalence, incidence, DALY and death rates were 0.65, 0.40, 8.74 and 0.38 per 100,000 population
  • In 2021, prevalence, incidence and death counts in males were about three times those in females, and DALYs about twice
  • High SDI regions had the highest 2021 rates: prevalence 2.38, incidence 1.46, DALYs 25.24 and deaths 1.33 per 100,000. The fastest rise in rates was in middle SDI regions.
  • The largest percentage increases in case counts since 1990 were in low-middle SDI regions: 196% (prevalence), 202% (incidence), 185% (DALYs) and 200% (deaths)
  • Among countries, Qatar, Bahrain and Kuwait had the largest increases, with prevalence counts up 1240%, 872% and 860% respectively
  • Worldwide, the 75–79 age group had the most prevalent cases (8,623.53) and the most deaths (4,674.05)
  • Prevalence, incidence, DALY and death rates were positively correlated with SDI level from 1990 to 2021
  • By the Slope Index of Inequality, the gaps between highest- and lowest-SDI countries widened from 1990 to 2021: prevalence 0.42 to 0.93, incidence 0.25 to 0.58, DALYs 6.14 to 12.32, deaths 0.23 to 0.53
  • The Concentration Index (a relative measure of inequality) did not change significantly over the period
• The authors' conclusion: The authors concluded that the gap between the highest- and lowest-SDI regions widened from 1990 to 2021, which they took to reflect worsening health inequality
• Limitations the authors state:
  • The study relies on secondary GBD data whose quality depends on the original data collection, quality control and reporting standards, particularly in low- and middle-income countries
  • The database lacks individual-level information such as occupational and environmental exposure histories, which limits in-depth analysis of individual risk factors

Topics

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

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

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