Impact of malignant mesothelioma in Taiwan: a 27-year review of population-based cancer registry data

Our plain-English summary of Impact of malignant mesothelioma in Taiwan: a 27-year review of population-based cancer registry data, by L.J. Lee, Y.Y. Chang, J.D. Wang (Lung Cancer, 2010).

The study

• Authors: L.J. Lee, Y.Y. Chang, J.D. Wang
• Journal: Lung Cancer
• Published: 2010;68(1):16-9
• Cited by: 13 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

Purpose: To describe the epidemiologic characteristics of malignant mesothelioma (MM) in Taiwan; to evaluate the impact of the condition.

Methods: The Taiwan Cancer Registry Database was used to retrieve the cases of MM registered from 1979 to 2005. Only cases of histopathologically verified MM were included. For evaluating the impact of MM, the cancer sites of the pleura and peritoneum (ICD-O codes 163 and 158, respectively) were used for statistical analysis and estimation of the expected years of life lost (EYLL). Their survival was calculated by Kaplan-Meier analysis and extrapolated to obtain the EYLL using the Monte Carlo simulation by borrowing information from gender- and age-matched populations in Taiwan.

Results: A total of 423 cases of MM were included; MM of the pleura and peritoneum accounted for 91% of all cases (387/423). The median survival of pleural and peritoneal MM was 7.6 and 13.5 months for males and females, respectively. The incidence of MM increased during the observation period. A total of 232 males and 155 females diagnosed with MM were used for estimation of EYLL: 14.8 [95% Confidence Interval: 13.1-16.6] life years for males and 13.7 [11.2-16.2] life years for females.

Conclusion: The increasing incidence and significant EYLL for MM were observed for both males and females during 1979-2005 in Taiwan, although under-diagnosis and under-estimation were likely.

Crown Copyright (c) 2009. Published by Elsevier Ireland Ltd. All rights reserved.

In plain English

The authors studied malignant mesothelioma in Taiwan's population-based cancer registry from 1979 to 2005, with vital status followed to the end of 2007. Only tissue-confirmed cases were included: 423, of which 387 (91%) were pleural or peritoneal (232 males, 155 females). Among the 387 pleural or peritoneal cases, mean age at diagnosis was 57.9 years, with about 1.5 males per female. Their median survival was 9 months overall, 7.6 for males and 13.5 for females. Compared with the age- and sex-matched general population, the authors estimated 14.2 expected years of life lost per case (95% confidence interval 12.8 to 15.7): 14.8 (13.1 to 16.6) for males and 13.7 (11.2 to 16.2) for females. Incidence rose over the period, significantly among people aged 35 and over. The registry held no exposure histories. The authors noted an apparent time relationship with asbestos imports, which peaked at 35,000 tons a year in the mid-1980s. They concluded that incidence was rising and life years lost were significant in both sexes, though under-diagnosis and under-estimation were likely. They noted 242 further pleural or peritoneal cancers without tissue confirmation.

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: Population-based cancer registry study: descriptive analysis, Kaplan-Meier survival analysis, and estimation of expected years of life lost compared with an age- and sex-matched reference population
• Who was studied: 423 histopathologically verified malignant mesothelioma cases registered in the Taiwan Cancer Registry, 1979 to 2005. Of these, 387 were pleural or peritoneal (232 males, 155 females) and were used for the main analyses. Vital status was followed to the end of 2007.
• Exposure: Individual asbestos exposure was not recorded in the registry. Incidence trends were compared with national asbestos import and domestic production data from Taiwan's Ministry of Economic Affairs.
• Main results:
  • Among the 387 pleural and peritoneal cases, median survival was 9 months for all cases, 7.6 months for males and 13.5 months for females
  • Average expected years of life lost was 14.2 (95% confidence interval 12.8 to 15.7) for all 387 pleural and peritoneal cases
  • Expected years of life lost was 14.8 (95% confidence interval 13.1 to 16.6) for the 232 males
  • Expected years of life lost was 13.7 (95% confidence interval 11.2 to 16.2) for the 155 females
  • Among the 387 pleural and peritoneal cases, mean age at diagnosis was 57.9 years (standard deviation 15.3)
  • The male-to-female ratio was about 1.5 to 1
  • Mesothelioma incidence increased over the observation period. The increase was significant among people aged 35 and over.
  • Asbestos imports into Taiwan peaked at 35,000 tons per year in the mid-1980s and fell to less than 5000 tons per year by 2001
• The authors' conclusion: The authors concluded that increasing incidence and significant expected years of life lost from malignant mesothelioma were observed in both males and females in Taiwan from 1979 to 2005, although under-diagnosis and under-estimation were likely
• Limitations the authors state:
  • The registry held 242 additional pleural or peritoneal cancers without histopathological proof, so the authors regard their figures as a lower bound of true incidence because of potential under-estimation and possible misdiagnosis
  • No exposure histories were available, so the latency period could not be calculated
  • No quality-of-life data were available, so quality-adjusted life years lost could not be calculated

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, Cancer Registry, Pleura, Peritoneum, Median Overall Survival, confidence interval.

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