Incidence and survival of peritoneal malignant mesothelioma between 1989 and 2015: A population-based study

Our plain-English summary of Incidence and survival of peritoneal malignant mesothelioma between 1989 and 2015: A population-based study, by N. Le Stang, V. Bouvier, O. Glehen, et al (Cancer Epidemiology, 2019).

The study

• Authors: N. Le Stang, V. Bouvier, O. Glehen, L. Villeneuve, FRANCIM network, MESOPATH Referent National Center, F. Galateau-Sallé, B. Clin
• Journal: Cancer Epidemiology
• Published: 2019;60:106-111
• Type of article: Historical article
• Cited by: 23 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

Background: Peritoneal malignant mesothelioma is a rare disease for which few population-based studies are available. The aim of this study was to describe the evolution of the incidence and survival of peritoneal malignant mesothelioma in France between 1989 and 2015, using data derived from the French network of cancer registries.

Methods: Age world-standardized incidence rates and overall survival were calculated using data from 16 French cancer registries. Log-linear Poisson regression analysis was used to estimate the average annual percentage change in incidence rates. Overall survival was performed using age-adjusted Cox proportional hazards model.

Results: In French men, the incidence has increased quietly over the reporting period from 0.07 to 0.10 with a maximum of 0.16 per 100,000 persons-years in 2001-2003. For women, the increase in incidence has been lower than for men over the period 1989-2015, ranging from 0.04 to 0.11. A better prognosis was associated with a diagnosis made after 2000 (HR = 1.76; p = 0.013), the epithelioid histological type (p = 0.003), and the fact of being a woman, which has a 5-year risk of death half that of men (HR = 0.55; p = 0.001), regardless of age, diagnosis period or histology.

Conclusion: Our results are similar to those currently available for other countries. In France, peritoneal mesothelioma remains a rare and fatal cancer with a small increase in the incidence rate since 1989 and a median survival of 1 year; it seemed to develop equally in women and men over this period of time.

Copyright © 2019 Elsevier Ltd. All rights reserved.

In plain English

Using 16 French cancer registries covering 20% of the metropolitan population, this population-based study described incidence of peritoneal malignant mesothelioma from 1989 to 2015 and survival for patients diagnosed 1989–2012. The registries did not collect asbestos exposure. Of 349 cases, 195 were men and 154 women. Incidence rose slightly but not significantly. In men, the age-standardized rate went from 0.07 per 100,000 person-years in 1989–1991 to 0.10 in 2013–2015. For women, the text gives 0.04 (1989) and 0.07 (2015); the table gives 0.09 for 1989–1991. Among 282 patients in the survival analysis, median survival was 11.4 months; 5-year survival was 21% (95% CI 17–26). Five-year survival was 33% (95% CI 25–42) in women, 12% (8–18) in men. In an age-adjusted model including diagnosis period and histology, women had a hazard ratio of 0.55 (95% CI 0.39–0.77) versus men. Diagnosis in 1989–1999 had a hazard ratio of 1.76 (95% CI 1.13–2.74) compared with 2010–2012. Non-epithelioid tumors had worse survival than epithelioid ones. The authors concluded the disease remains a rare fatal cancer in France with a median survival of 1 year.

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 registry study of incidence trends (age-adjusted Poisson regression) and overall survival (Kaplan-Meier and age-adjusted Cox model)
• Who was studied: Peritoneal malignant mesothelioma cases recorded by 16 French cancer registries covering 20% of the French metropolitan population. The incidence analysis used 349 cases diagnosed 1989 to 2015 (195 men, 154 women). The survival analysis used 282 cases diagnosed 1989 to 2012.
• Exposure: Asbestos exposure was not studied. The registries did not collect it, and the MESOPATH database does not report it fully.
• Main results:
  • The male-to-female ratio among the 349 incidence cases was 1.3 (195 men, 154 women).
  • No significant change in incidence was observed between 1989 and 2015.
  • In men, world age-standardized incidence went from 0.07 per 100,000 person-years in 1989–1991 to 0.10 in the last period, with a peak of 0.16 in 2001–2003. Table 3 labels the last period 2013–2015; the discussion calls it 2012–2015. The average annual change was +0.94% (–1.04%; 1.40%).
  • In women, the results text reports incidence of 0.04 in 1989 and 0.07 in 2015, with an increase of +0.74% per year (–1.20%; 1.37%). Table 3 gives 0.09 for women in 1989–1991 and 0.07 in 2013–2015.
  • Among all 282 patients in the survival analysis, median overall survival was 11.4 months and 5-year overall survival was 21% (95% CI 17–26).
  • Five-year overall survival was 33% (95% CI 25–42) in women and 12% (95% CI 8–18) in men. In the age-adjusted Cox model, which also included diagnosis period and histology, women had a hazard ratio of 0.55 (95% CI 0.39–0.77; p = 0.001) compared with men.
  • Five-year survival was 31% for patients diagnosed in 2010–2012, against 18% for those diagnosed in 1989–1999 and in 2000–2009. In the age-adjusted model, diagnosis in 1989–1999 had a hazard ratio of 1.76 (95% CI 1.13–2.74; p = 0.013) compared with 2010–2012.
  • Non-epithelioid histology had a 5-year overall survival of 8%. In the age-adjusted model, it had a hazard ratio of 2.00 (95% CI 1.27–3.15; p = 0.003) compared with epithelioid histology.
• The authors' conclusion: The authors concluded that in France peritoneal mesothelioma remains a rare and fatal cancer, with a small increase in incidence since 1989 and a median survival of 1 year, and that it developed equally in women and men over the period.
• Limitations the authors state:
  • The registries did not collect information on asbestos exposure, and the MESOPATH database does not report it fully.
  • The authors called for larger epidemiological studies to understand the trends in relation to biological, occupational and non-occupational causes.

Topics

The National Library of Medicine indexes this study under subjects our site covers: Lung cancer, Mesothelioma, Peritoneal mesothelioma.

Medical terms in this study, explained in our Lexicon: Malignant Mesothelioma, Incidence, Overall Survival, Prognosis, Epithelioid, Histology, Peritoneal Mesothelioma, Median Survival.

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• Epidemiology of malignant peritoneal mesothelioma: A population-based study — S.A.S. Salo, I. Ilonen, et al. (2017)
• Peritoneal mesothelioma in Italy: Trends and geography of mortality and incidence — S. Conti, G. Minelli, et al. (2015)
• Combined grade and nuclear grade are prognosis predictors of epithelioid malignant peritoneal mesothelioma: a multi-institutional retrospective study — N. Benzerdjeb, P. Dartigues, et al. (2021)

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