International Analysis of Age-Specific Mortality Rates From Mesothelioma on the Basis of the International Classification of Diseases, 10th Revision

Our plain-English summary of International Analysis of Age-Specific Mortality Rates From Mesothelioma on the Basis of the International Classification of Diseases, 10th Revision, by P. Boffetta, M. Malvezzi, E. Pira, et al (Journal of Global Oncology, 2018).

The study

• Authors: P. Boffetta, M. Malvezzi, E. Pira, E. Negri, C. La Vecchia
• Journal: Journal of Global Oncology
• Published: 2018;4:1-15
• Cited by: 11 articles, as counted by NIH iCite
• Read it: PubMed · Publisher · Free full text

Abstract

Past analyses of mortality data from mesothelioma relied on unspecific codes, such as pleural neoplasms. We calculated temporal trends in age-specific mortality rates in Canada, the United States, Japan, France, Germany, Italy, the Netherlands, Poland, the United Kingdom, and Australia on the basis of the 10th version of the International Classification of Diseases, which includes a specific code for mesothelioma. Older age groups showed an increase (in the United States, a weaker decrease) during the study period, whereas in young age groups, there was a decrease (in Poland, a weaker increase, starting, however, from low rates). Results were consistent between men and women and between pleural and peritoneal mesothelioma, although a smaller number of events in women and for peritoneal mesothelioma resulted in less precise results. The results show the heterogeneous effect of the reduction of asbestos exposure on different age groups; decreasing mortality in young people reflects reduced exposure opportunity, and increasing mortality in the elderly shows the long-term effect of early exposures.

In plain English

This study used official WHO death certificate data on mesothelioma in ten high-income countries: Canada, the United States, Japan, France, Germany, Italy, the Netherlands, Poland, the United Kingdom and Australia. It covered only years coded under the 10th revision of the International Classification of Diseases, which has a specific code for mesothelioma. It did not measure anyone's asbestos exposure. In 2000 to 2004, rates in men were above 2 per 100,000 in the Netherlands, the United Kingdom and Australia, and below 0.5 per 100,000 in Japan and Poland. In most countries, rates fell in younger age groups and rose in older ones. The exceptions were the United States, where men had decreases in all age groups, and Poland, which had increases in all age groups in both sexes. Women had lower rates, between 0.1 and 0.5 per 100,000 overall, with a similar age pattern. The authors concluded that falling rates in younger people plausibly reflect reduced asbestos exposure. They cautioned that trends in young age groups rest on small numbers of deaths.

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: Descriptive analysis of national death certification data over time (age-standardized and age-specific mortality rates, with joinpoint regression to find changes in trend)
• Who was studied: Deaths certified as mesothelioma (ICD10 code C45, with pleural C45.0 and peritoneal C45.1 analysed separately) in men and women in Canada (2000-2011), the United States (1999-2014), Japan (1995-2013), France (2000-2013), Germany (1998-2014), Italy (2003-2012), the Netherlands (1996-2013), Poland (1999-2014), the United Kingdom (2001-2013) and Australia (1998-2014). These were chosen as high-income countries with valid and consistent data and at least 15 million inhabitants.
• Exposure: No asbestos exposure was measured. The study examined trends in mesothelioma deaths by age group, and the authors interpreted the trends in relation to declining asbestos exposure.
• Main results:
  • In 2000 to 2004, overall mesothelioma mortality rates in men were above 2 per 100,000 in the Netherlands, United Kingdom and Australia, and below 0.5 per 100,000 in Japan and Poland.
  • By 2013, overall rates in men tended to decrease in the Netherlands, Australia, the United States and France (slightly in the United Kingdom). They tended to increase in Japan and mostly in Poland, where they reached 0.6 per 100,000.
  • Overall rates in women were lower, between 0.1 and 0.5 per 100,000. There was no appreciable change between 2000 to 2004 and 2013 except in Poland, where women's rates rose from 0.07 to 0.21 per 100,000. Small increases were also apparent in the United Kingdom and Australia.
  • Among men in most countries, older age groups showed an increase in mortality rates over the study period (a weaker decrease in the United States), while young age groups showed a decrease (a weaker increase in Poland).
  • The only countries with a different pattern were the United States, with a decrease in all age groups among men, and Poland, with an increase in all age groups and both sexes.
  • Women showed an age pattern similar to men's, though in some countries (for example Germany) the shift across age groups was not steady.
  • Pleural mesothelioma made up the vast majority of deaths, and its trends paralleled those for all mesothelioma. For peritoneal mesothelioma, trends could not be properly assessed under age 55 because of small numbers of deaths; in older age groups the patterns were similar to those for all forms.
  • In 2013, mortality rates in men aged 35 to 54 were, in most countries, in the range 0.15 to 0.30 per 100,000, well below the rates measured a decade earlier.
• The authors' conclusion: The authors concluded it is plausible that the results reflect reduced asbestos exposure in younger age groups. They interpreted the rising rates in older people as consistent with a predominant role of early asbestos exposure in later mesothelioma risk.
• Limitations the authors state:
  • Trends in the young age groups should be interpreted with caution because of the small number of deaths.
  • Trends for peritoneal mesothelioma under age 55 were hampered by small numbers of deaths.
  • Mortality data rely on medical certification of cause of death, whose diagnostic accuracy the authors describe as suboptimal.

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, Neoplasm, Peritoneal Mesothelioma, Asbestos Exposure.

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