Mesothelioma trends in the United States: an update based on Surveillance, Epidemiology, and End Results Program data for 1973 through 2003

Our plain-English summary of Mesothelioma trends in the United States: an update based on Surveillance, Epidemiology, and End Results Program data for 1973 through 2003, by B. Price, A. Ware (American Journal of Epidemiology, 2004).

The study

• Authors: B. Price, A. Ware
• Journal: American Journal of Epidemiology
• Published: 2004;159(2):107-12
• Cited by: 213 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

Using 1973-2000 mesothelioma incidence data released by the Surveillance, Epidemiology, and End Results Program in April 2003, the authors estimated the parameters of a birth-cohort and age model to determine whether previously reported patterns of mesothelioma in the United States have changed. Compared with analyses based on data through 1992, a slower decline was found in male cases immediately after a peak in 2000-2004, but no other notable changes in the time pattern were detected. Analysis confirmed that the annual number of male mesothelioma cases, which increased steeply from the 1970s through the mid-1990s, has leveled off in terms of both the age-adjusted rate and the absolute numbers of cases. After a peak of approximately 2,000 cases, a return to background levels is expected by 2055. The total projected number of male mesothelioma cases in 2003-2054 is approximately 71,000. The maximum lifetime risk for males, which occurs for the 1925-1929 birth cohort, is 1.8 x 10(-3). The age-adjusted rate for females is constant, as are the female lifetime mesothelioma risk across birth cohorts (3.6 x 10(-4)) and the annual risk (3.9 x 10(-6)). The time pattern of cases for females supports the existence of a threshold exposure for mesothelioma and a quantifiable background rate.

In plain English

This modeling study used U.S. cancer registry data from the Surveillance, Epidemiology, and End Results (SEER) Program on mesothelioma cases diagnosed from 1973 through 2000. The authors fitted a statistical model based on birth cohort and age, separately for males and females, and compared it with the same model fitted to the data through 1992. Pleural and peritoneal mesothelioma were counted together. The age-adjusted rate for males was flat from 1990 through 2000, and the rate for females was virtually constant. Male cases were projected to peak in 2000 to 2004 at slightly more than 2,000 a year, with 70,990 male cases projected for 2003 through 2054. The highest male lifetime risk, 1.8 × 10^-3, was for men born in 1925 to 1929. The female lifetime risk was 3.6 × 10^-4 across birth cohorts. The authors concluded that the pattern had not changed substantively since 1992. They argued that the constant female rate supports an asbestos exposure threshold, meaning a level with negligible added risk. They also argued that it points to a background rate of mesothelioma not linked 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: Statistical modeling of cancer registry incidence data (birth-cohort and age model) with projections of future cases and lifetime risk
• Who was studied: Male and female mesothelioma cases recorded in U.S. SEER cancer registries: nine registries for 1973 through 1991 and 11 registries for 1992 through 2000. The registries represent 14 percent of the U.S. population.
• Exposure: No individual exposure data and no fiber types named. The authors related trends to U.S. asbestos use. In their interpretation, males had high occupational exposure and female exposures were primarily environmental.
• Main results:
  • The age-adjusted mesothelioma rate for males was flat from 1990 through 2000.
  • Males: maximum lifetime risk of 1.8 × 10^-3, in the 1925–1929 birth cohort (1973–2000 data). The model using 1973–1992 data gave a maximum of 2.1 × 10^-3.
  • Females: lifetime mesothelioma risk constant across birth cohorts at 3.6 × 10^-4.
  • Males: projected cases peaked in 2000 to 2004 at slightly more than 2,000 cases, in both data sets.
  • Males: total projected cases for 2003 through 2054 were 70,990 using 1973–2000 data and 73,892 using 1973–1992 data.
  • Females: estimated annual cases in 2003 were approximately 560.
  • Females: the age-adjusted rate averaged about 0.30 per 100,000 from 1973 to 1982, then rose once to 0.40 per 100,000 and stayed constant afterward. The authors attributed this more likely to a diagnostic effect.
  • No increased risk was seen in the 1955–1959 or 1960–1964 birth cohorts, those most likely to have received polio vaccine contaminated with simian virus 40.
  • In SEER, peritoneal mesotheliomas were 7 percent of mesotheliomas in males and 17 percent in females.
• The authors' conclusion: The authors concluded that the U.S. mesothelioma incidence pattern had not changed substantively since 1992. They argued that the constant female risk supports a threshold exposure and a background rate. They also stated that low environmental or other low-level asbestos exposure is unlikely to be associated with more than a negligible risk.
• Limitations the authors state:
  • Some data points with large deviances were excluded to obtain acceptable statistical fits.
  • The background risk estimates would be upper bounds if some female cases were due to occupational, domestic or high environmental exposures.
  • The female background rates may not apply directly to males, because the shares of pleural and peritoneal cases differ by sex.

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, Background Rate.

Related studies

• Re: "Mesothelioma trends in the United States: an update based on surveillance, epidemiology, and end results program data for 1973 through 2003" — J.H. Lange (2004)
• Time trend of mesothelioma incidence in the United States and projection of future cases: an update based on SEER data for 1973 through 2005 — B. Price, A. Ware (2009)
• Malignant mesothelioma due to non-occupational asbestos exposure from the Italian national surveillance system (ReNaM): epidemiology and public health issues — A. Marinaccio, A. Binazzi, et al. (2015)
• Frequency of use and predictors of cancer-directed surgery in the management of malignant pleural mesothelioma in a community-based (Surveillance, Epidemiology, and End Results [SEER]) population — R.M. Flores, E. Riedel, et al. (2010)
• Changes in B-readings over time in the United States Navy Asbestos Medical Surveillance Program — J.G. Muller, W.G. Rudolph, et al. (2007)
• Small area estimation of incidence of cancer around a known source of exposure with fine resolution data — E. Kokki, J. Ranta, et al. (2001)

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