Mesothelioma incidence in 50 states and the District of Columbia, United States, 2003-2008

Our plain-English summary of Mesothelioma incidence in 50 states and the District of Columbia, United States, 2003-2008, by S.J. Henley, T.C. Larson, M. Wu, et al (International Journal of Occupational and Environmental Health, 2013).

The study

• Authors: S.J. Henley, T.C. Larson, M. Wu, V.C. Antao, M. Lewis, G.A. Pinheiro, C. Eheman
• Journal: International Journal of Occupational and Environmental Health
• Published: 2013;19(1):1-10
• Cited by: 118 articles, as counted by NIH iCite
• Read it: PubMed · Publisher · Free full text

Abstract

Background: The decline in asbestos use in the United States may impact mesothelioma incidence.

Objective: This report provides national and state-specific estimates of mesothelioma incidence in the United States using cancer surveillance data for the entire US population.

Methods: Data from the National Program for Cancer Registries and the Surveillance, Epidemiology, and End Results program were used to calculate incidence rates and annual percent change.

Results: During 2003-2008, an average of 1.05 mesothelioma cases per 100 000 persons were diagnosed annually in the United States; the number of cases diagnosed each year remained level, whereas rates decreased among men and were stable among women.

Conclusion: US population-based cancer registry data can be used to determine the burden of mesothelioma and track its decline. Even 30 years after peak asbestos use in the United States, 3200 mesothelioma cases are diagnosed annually, showing that the US population is still at risk.

In plain English

The authors used national cancer registry data covering 100% of the US population to describe malignant mesothelioma diagnosed in all 50 states and the District of Columbia from 2003 to 2008. Individual asbestos exposure was not studied. In that period 19 011 cases were diagnosed, about 3200 per year, an average age-adjusted rate of 1.05 cases per 100 000 people per year (95% CI 1.03 to 1.06). The rate was 1.93 among men and 0.41 among women. It was highest among white men (2.06) and among men aged 75 or older. Among men, 85% of cases were pleural and 7% peritoneal; among women, 73% and 18%. State rates ranged from 0.58 to 1.65 per 100 000. Rates fell 2.6% per year among men and were stable among women. Yearly case numbers stayed level at about 2500 men and 700 women. The authors noted that a falling rate does not necessarily mean fewer cases. They concluded that the US population is still at risk. They cautioned that reporting delays, misdiagnosis and migration could affect the figures.

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 population-based study of cancer registry data (incidence rates and trends)
• Who was studied: All cases of malignant mesothelioma diagnosed during 2003–2008 and reported to US cancer registries (NPCR or SEER), covering 100% of the US population in all 50 states and the District of Columbia
• Exposure: Not measured. The study counted diagnosed mesothelioma cases by sex, age, race/ethnicity, anatomic site and state; it did not collect information on individual asbestos exposure.
• Main results:
  • 19 011 mesothelioma cases were diagnosed in the United States during 2003–2008, approximately 3200 per year
  • Average annual age-adjusted incidence rate for the whole population: 1.05 (95% CI 1.03–1.06) cases per 100 000
  • Rate among men 1.93 and among women 0.41 per 100 000. Highest among white men (2.06). The text prints the equals sign as a '5' (for example 'rate51.93'), and Table 1 confirms the values.
  • Rates were highest among men aged 75 years or older (Table 1: 17.07 per 100 000 at ages 75–84 and 17.62 at 85 and older)
  • Anatomic site by sex: among men, 85% pleural and 7% peritoneal; among women, 73% pleural and 18% peritoneal (differences significant, p less than 0.05)
  • Pleural share by age: 44% of cases in people younger than 45 were pleural, compared with 77% at ages 45–64 and 85% at 65 or older
  • About 1% of cases were diagnosed in people younger than 35 years, and 3% in people younger than 45
  • State incidence rates ranged from 0.58 to 1.65 per 100 000. The five states in the top tenth percentile (Alaska, Maine, New Jersey, West Virginia, Washington) averaged 1.51.
  • Within states, pleural and peritoneal mesothelioma rates were correlated (Pearson correlation 0.70, p less than 0.0001, in 28 states). Female rates were higher where male rates were high (correlation 0.78, p less than 0.0001, in 42 states).
  • From 2003 to 2008, incidence rates fell 2.6% per year among men and were stable among women
  • The yearly number of cases stayed the same over 2003–2008: about 2500 among men and 700 among women each year
• The authors' conclusion: The authors concluded that US population-based cancer registry data can be used to determine the burden of mesothelioma and track its decline. They wrote that, with about 3200 cases a year (some in young people born after asbestos use peaked), the US population is still at risk of exposure to asbestos, and possibly erionite, and of developing mesothelioma. They also noted that a falling rate does not necessarily mean fewer cases or fewer people exposed.
• Limitations the authors state:
  • Because people move, state rates may not reflect past asbestos exposure in that state, given the long latency
  • Delays in case reporting may cause underestimates for the most recent years
  • Some tumors, mainly carcinomas, may be misdiagnosed as mesothelioma, causing overestimates
  • Some mesotheliomas, especially peritoneal ones, may have been diagnosed as other cancers (serous papillary carcinomas of the peritoneum or ovary), causing underestimates

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, Epidemiology, Incidence, Cancer Registry.

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