Letter to the Editor: Largely Unchanged Annual Incidence and Overall Survival of Pleural Mesothelioma in the USA

Our plain-English summary of Letter to the Editor: Largely Unchanged Annual Incidence and Overall Survival of Pleural Mesothelioma in the USA, by D.J. Lauer, K.A. Mundt, W.J. Thompson, et al (World Journal of Surgery, 2020).

The study

• Authors: D.J. Lauer, K.A. Mundt, W.J. Thompson, E.A. Best
• Journal: World Journal of Surgery
• Published: 2020;44(12):4279-4280
• Type of article: Letter, Comment
• Cited by: 1 article, as counted by NIH iCite
• Read it: PubMed · Publisher

In plain English

This is a letter to the editor, not a new study. The authors commented on a published analysis by Keshava et al., which used the US National Cancer Database to estimate pleural mesothelioma case counts from 2004 to 2014 (range 1783–2031) and concluded that incidence had not declined. The letter's authors argued that this approach was not well suited to the question. They wrote that a stable cancer rate in a growing population would still produce more cases each year. They added that pleural mesothelioma risk rises sharply with age, and that "baby boomers" were entering older age groups, so case counts could rise even if age-specific rates stayed stable. Citing other published sources, they noted that rates decreased among men and were stable among women in 2003 to 2008. They also noted that SEER data show a peak rate among men of 2.48 per 100,000 in 1992, followed by a consistent decline, which they said likely reflects declining occupational exposure to amphibole asbestos. The authors concluded that these points strengthen the hypothesis of a peak and later decline in incidence among men. They also concluded that the stable, much lower rates among women primarily reflect cases unrelated to asbestos.

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: Letter to the editor commenting on a previously published study; it presents no new data of its own
• Who was studied: No population was studied by the letter's authors. The letter discusses Keshava et al.'s National Cancer Database estimates of US pleural mesothelioma case counts for 2004 to 2014, which led those investigators to conclude incidence had not declined
• Exposure: Asbestos exposure in general. The letter refers to declining occupational exposure to amphibole asbestos from the 1970s
• Main results:
  • The authors argued that the approach and methods of Keshava et al. were not well suited to answering the research question
  • The authors argued that in a growing population, a stable cancer rate would still produce more cases each year
  • The authors argued that because pleural mesothelioma risk rises sharply with age, and "baby boomers" were entering the ages of highest risk, case counts could rise even if age-specific rates stayed stable
  • Citing Henley et al. (another study), the authors noted that for 2003 to 2008 the number of cases stayed level, while rates decreased among men and were stable among women
  • Citing SEER data (another source), the authors noted a peak incidence rate among men of 2.48 per 100,000 in 1992, followed by a consistent decline. They said this likely reflects declining occupational exposure to amphibole asbestos
  • The authors stated that age-adjusted rates among women have remained stable and much lower than among men, and that these rates primarily reflect cases unrelated to asbestos
• The authors' conclusion: The authors concluded that, taken together, population changes and exposure patterns strengthen the hypothesis that, among men, reduced asbestos exposure after the 1970s would lead to a peak in mesothelioma incidence followed by a decline

Topics

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

Medical terms in this study, explained in our Lexicon: Overall Survival, Pleural Mesothelioma.

Related studies

• Largely Unchanged Annual Incidence and Overall Survival of Pleural Mesothelioma in the USA — H.B. Keshava, A. Tang, et al. (2019)
• Response to Letter to the Editor Regarding "Ambient Asbestos Fiber Concentrations and Long-Term Trends in Pleural Mesothelioma Incidence Between Urban and Rural Areas in the United States (1973-2012)" by Finkelstein — K.A. Keeton, M.E. Glynn, et al. (2018)
• Letter to the editor on commentary: malignant mesothelioma incidence among talc miners and millers in New York state by M M Finkelstein — R.P. Nolan, J.F. Gamble, et al. (2013)
• Letter to the Editor regarding Bullock 2020 — D. Egilman, B. Castleman, et al. (2020)
• Response to Letter to the Editor from Egilman, Castleman and Bird (2020) concerning Bullock (2020), Perspectives on the knowledge of asbestos disease in the United States - what was known, by whom and when — W.H. Bullock (2020)
• Author's response to: "Letter to the Editor" regarding content of "Mesothelioma from asbestos exposures: Epidemiologic patterns and impact in the United States" by R. A. Lemen, Journal of Toxicology and Environmental Health, Part B 2016; 19: 250-265 — (2017)

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