Malignant mesothelioma

Our plain-English summary of Malignant mesothelioma, by R. Rudd (Journal of the Royal Society of Medicine, 1989).

The study

• Author: R. Rudd
• Journal: Journal of the Royal Society of Medicine
• Published: 1989;82(3):126-9
• Type of article: Review
• Cited by: 3 articles, as counted by NIH iCite
• Read it: PubMed · Publisher · Free full text
• In J-M's library: Johns-Manville's company medical library held a copy (J-M no. 000150).

In plain English

This 1989 article was an editorial-style review of published research on malignant mesothelioma. It reported no new study of its own. Citing earlier work, the author wrote that occupational asbestos exposure is responsible for most cases. UK deaths, then more than 600 a year, were still rising, and among people without exposure the yearly rate is probably around 1 to 2 per million. The author described evidence that amphiboles are more potent than chrysotile, while noting animal experiments showing that chrysotile alone can cause mesothelioma. The author also mentioned naturally occurring erionite in Turkey and tremolite in Cyprus and Greece. According to the review, several studies showed that risk rises with cumulative exposure, the risk from low-level or brief exposure is very small, and smoking does not affect risk. One cited UK series found a mean of 38 years (range 3.5 to 53) from first exposure to death. The author concluded that treatment remained unsatisfactory. There was no convincing evidence that treatment improved average survival of about 18 months from diagnosis, although the author wrote that symptomatic treatment was worthwhile.

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: Narrative review / editorial summarising published literature on malignant mesothelioma (causes, fibre types, latency, pathogenesis, pathology, diagnosis, treatment); no original data
• Who was studied: No study population of its own; the article discussed previously published studies of mesothelioma cases and asbestos-exposed groups
• Exposure: Asbestos in general and by fibre type (crocidolite, amosite, chrysotile, tremolite); naturally occurring fibres (erionite in Karain, Turkey; tremolite, and perhaps chrysotile, in Cyprus and Greece); man-made mineral fibres
• Main results:
  • The author stated that occupational asbestos exposure is responsible for most mesothelioma cases
  • UK mesothelioma deaths were reported as more than 600 per year and still rising
  • Among people without asbestos exposure, the annual incidence was given as probably around 1 to 2 per million (from a cited source)
  • In heavily exposed populations, more than 10% of people may die of mesothelioma (from a cited source)
  • The author wrote that the weight of the evidence suggests amphiboles are more potent than chrysotile in causing mesothelioma
  • Animal experiments were cited as confirming that chrysotile alone can cause mesothelioma
  • Endemic pleural mesothelioma in Karain, Turkey, was attributed to a fibrous zeolite, erionite, and possibly other environmental asbestos minerals
  • Several cited studies showed that mesothelioma risk increases with cumulative exposure
  • The author wrote that the risk associated with low-level or brief exposure is very small
  • The author stated that the risk of mesothelioma is not affected by smoking
  • In a cited UK study of cases, the mean interval from onset of exposure to death was 38 years, with a range of 3.5 to 53 years
  • Among 25 000 workers making man-made mineral fibres (a cited study), only one of 1505 deaths was due to mesothelioma
  • Average survival from diagnosis was about 18 months, with no convincing evidence that treatment improves on it
  • The author considered symptomatic treatment worthwhile
• The authors' conclusion: The author concluded that treatment of malignant mesothelioma remained unsatisfactory, with no convincing evidence that it improved average survival, while symptomatic treatment was worthwhile
• Limitations the authors state:
  • The author noted that no ideal studies report dose-specific mesothelioma risk based on individual exposure estimates
  • The author noted that assessing fibre-type effects was difficult because most workers were exposed to a mixture of commercial types
  • The author noted that few treatment studies included a control group

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.

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