Mesothelioma of the peritoneum during 1967-82 in England and Wales

Our plain-English summary of Mesothelioma of the peritoneum during 1967-82 in England and Wales, by M.J. Gardner, R.D. Jones, E.C. Pippard, et al (British Journal of Cancer, 1985).

The study

• Authors: M.J. Gardner, R.D. Jones, E.C. Pippard, N. Saitoh
• Journal: British Journal of Cancer
• Published: 1985;51(1):121-6
• Cited by: 13 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. 001224).

Abstract

The time-trend and geographical distribution of mesothelioma of the peritoneum during the years 1967-82 in England and Wales have been studied from the Mesothelioma Register held by the Medical Division of the Health and Safety Executive. Over the 16-year period the annual number of cases registered rose from about 15-20 to about 30-50. Although the number occurring in men was double that in women, the trend was similar for both sexes. There is likely to be some further increase before any improvement due to the recent diminished usage of asbestos is seen. Local Authority areas with raised rates have been identified, and the geographical pattern is similar to that of the distribution of the asbestos-using industry in the past. In both sexes there are high registration rates on the east side of London but, in contrast to mesothelioma of the pleura, a concentration of cases among men in the major ports where shipbuilding and ship repairing were carried out is not so apparent.

In plain English

This study used the Health and Safety Executive's Mesothelioma Register to look at how often peritoneal mesothelioma (mesothelioma of the abdominal lining) was registered in England and Wales from 1967 to 1982, and where patients lived. In total 457 cases were registered: 305 (67%) in men and 152 (33%) in women. Across all ages, the average yearly rate was 0.8 per million in men and 0.4 per million in women. Yearly registrations stayed at around 15 to 20 until 1973, then rose to 35 to 50 in later years. For men, the largest excesses over expected numbers were in the east London boroughs of Newham, Barking and Havering. For women, they were in Barking and Newham. The highest relative excess for both sexes was in Washington. Most local areas had no cases. The authors reported that the map resembled the past distribution of the asbestos-using industry. They noted that the tumour tends to be underdiagnosed and that part of the rise may reflect changes in diagnostic practice. They concluded that the geographical concentration still points to nearly all cases being occupational.

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 study of time trend and geographical distribution, based on a national case register (Standardised Registration Ratios by local area)
• Who was studied: All 457 cases of peritoneal mesothelioma entered on the Health and Safety Executive Mesothelioma Register for England and Wales, 1967 to 1982 (305 men, 152 women), allocated to 1366 pre-1974 Local Authority areas
• Exposure: Individual asbestos exposure was not the basis of the analysis. Area registration rates were compared with the past distribution of the asbestos-using industry. Where the Register held exposure information, many east London cases and the cases in Washington, Kingston upon Hull, Cardiff and Swansea seemed associated with insulation and lagging.
• Main results:
  • Of the 457 cases, 305 (67%) were men and 152 (33%) were women
  • Average annual registration rate, all ages: 0.8 per million in men and 0.4 per million in women
  • Annual registrations were steady at about 15 to 20 until 1973, then rose to 35 to 50 cases in later years
  • In both sexes, rates rose with age up to 75, then fell
  • Men: the largest numbers of excess cases were in the London Boroughs of Newham (19 observed against 1.5 expected), Barking and Havering
  • Women: the largest numbers and excesses were in Barking (19 observed against 0.5 expected) and Newham
  • For both sexes, the highest relative excess was in Washington Urban District (men: 5 observed against 0.1 expected; women: 4 observed against 0.1 expected)
  • There were no male cases in 1210 (89%) of the 1366 areas and no female cases in 1272 (93%)
  • For men, raised-rate areas included east London boroughs and ports and dockyard areas such as Portsmouth, Plymouth, Merseyside and Tyneside. For women, Portsmouth was the only port area.
• The authors' conclusion: The authors concluded that the geographical concentration of cases in areas of past asbestos usage still points to nearly all cases being occupational, not the result of contamination of the general environment
• Limitations the authors state:
  • The Register depends on diagnosis, and the tumour tends to be underdiagnosed, possibly more for peritoneal than pleural mesothelioma
  • Histological confirmation was not available for all cases
  • In some years about a quarter of cases had no site (pleura or peritoneum) specified
  • The rise over time may partly reflect changes in diagnostic practice
  • A 1981 industrial dispute may have affected the number of deaths recorded that year

Topics

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

Medical terms in this study, explained in our Lexicon: Mesothelioma, Peritoneum, Pleura.

Related studies

• Mortality from mesothelioma of the pleura during 1968-78 in England and Wales — M.J. Gardner, E.D. Acheson, et al. (1982)
• Mortality of asbestos workers in England and Wales 1971-81 — J.T. Hodgson, R.D. Jones (1986)
• Women's occupation and cancer: preliminary analysis of cancer registrations in England and Wales, 1971-1990 — J. Simpson, E. Roman, et al. (1999)
• Work-related mortality in England and Wales, 1979-2000 — D. Coggon, E.C. Harris, et al. (2010)
• Trends in mortality from occupational hazards among men in England and Wales during 1979-2010 — E.C. Harris, K.T. Palmer, et al. (2016)
• Mesothelioma of pleura and peritoneum following exposure to asbestos in the London area — M.L. Newhouse, H. Thompson (1965)

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