Pleural mesotheliomas are underreported as occupational cancer in Sweden

Our plain-English summary of Pleural mesotheliomas are underreported as occupational cancer in Sweden, by E. Andersson, K. Torén (American Journal of Industrial Medicine, 1995).

The study

• Authors: E. Andersson, K. Torén
• Journal: American Journal of Industrial Medicine
• Published: 1995;27(4):577-80
• Cited by: 11 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

The aim of this study was to estimate to what degree malignant pleural mesotheliomas were reported as occupational cancers. The study included all malignant pleural mesotheliomas (n = 210) found in the Cancer Registry 1980-1989 from four Swedish counties. Whether or not a case was reported as occupational cancer was found in the Swedish Register of Reported Occupational Diseases. To evaluate the presence of exposure histories, the chest department files for 58 mesotheliomas from one county were reviewed. The reporting was low, with only 75 mesotheliomas (36%) reported. All the cases were men, and for the men, the reporting frequency was 42%. The reporting was significantly lower for the last part of the decade than for the first part. The reporting frequency decreased with age. In the review of the chest department files, an exposure history was found in 93% of the reported cases and in 47% of the unreported cases. It is concluded that physicians must give more priority to exposure histories in patients with pleural mesotheliomas.

In plain English

This Swedish study looked at how often cases of malignant pleural mesothelioma were reported as occupational cancers. The authors linked the Swedish Cancer Registry with the Swedish Register of Reported Occupational Diseases for all pleural mesotheliomas diagnosed in 1980-1989 in four industrialized counties in western Sweden. Of 214 cases found, four were excluded as probably benign, leaving 210 (177 men, 33 women). Only 75 (36%) had been reported. All of these were men, so 42% of the men's cases were reported and none of the women's. Reporting fell from 42% in 1980-1984 to 29% in 1985-1989, a statistically significant difference, though the authors said they could not tell whether this was a real decrease or chance. Reporting dropped with age, from 64% in those younger than 50 to 15% in those older than 75. In chest department files for 58 patients from one county, asbestos exposure had been asked about in 14 of 15 reported cases (93%) and 20 of 43 unreported cases (47%). The authors concluded that physicians must give more priority to exposure histories.

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: Registry linkage study (Swedish Cancer Registry linked to the Swedish Register of Reported Occupational Diseases), with a review of hospital chest department files for one county
• Who was studied: All pleural mesotheliomas diagnosed 1980-1989 in four counties in western Sweden (population about 1.4 million) found in the Swedish Cancer Registry: 214 found, 4 excluded as probably benign, leaving 210 (177 men, 33 women according to Table I). Chest department files were reviewed for 58 of the 65 cases from one county.
• Exposure: Asbestos exposure, in terms of whether it was recorded in hospital files. No fiber types, products or jobs are specified. The main outcome was whether a case was reported as an occupational cancer.
• Main results:
  • Of the 210 pleural mesothelioma cases, 75 (36%) were reported to the Swedish Register of Reported Occupational Diseases
  • All reported cases were men, so 42% of the male mesotheliomas were reported. For women the reporting frequency was zero.
  • Reported cases were significantly younger (mean age 62 years, range 31-85) than unreported cases (mean age 70 years, range 37-93)
  • Reporting frequency decreased with age, from 64% among those younger than 50 years to 15% among those older than 75 years
  • Reporting was significantly lower in 1985-1989 (29%) than in 1980-1984 (42%)
  • In the 58 chest department files, asbestos exposure was asked about in 34 patients (59%), and 25 of them were judged to have been exposed
  • Asbestos exposure was asked about in 14 (93%) of the 15 reported cases, compared with 20 (47%) of the 43 unreported cases
  • 20% of the mesotheliomas were diagnosed after death, and 17% of these were reported as occupational cancers
• The authors' conclusion: The authors concluded that, to increase reporting of occupational cancers, physicians must be informed and taught to give more priority to exposure histories in all patients
• Limitations the authors state:
  • The authors stated it was impossible to say whether the decrease in reporting during the 1980s reflected a real decrease or was due to chance
  • Four long-surviving subjects were excluded because they probably had benign mesotheliomas

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: Pleural Mesothelioma, Cancer Registry, Occupational Disease, Mesothelioma, Exposure History.

Related studies

• Pleural mesothelioma in Sweden: an analysis of the incidence according to the use of asbestos — B. Järvholm, A. Englund, et al. (1999)
• Mesothelioma incidence seems to have leveled off in Sweden — K. Hemminki, X. Li (2003)
• Incidence, mortality and survival in malignant pleural mesothelioma before and after asbestos in Denmark, Finland, Norway and Sweden — K. Hemminki, A. Försti, et al. (2021)
• Explaining differences in incidence rates of pleural mesothelioma between Sweden and the Netherlands — A. Burdorf, B. Järvholm, et al. (2005)
• Incidence and familial risk of pleural mesothelioma in Sweden: a national cohort study — J. Ji, J. Sundquist, et al. (2016)
• Occupational exposures and squamous cell carcinoma of the oral cavity, pharynx, larynx, and oesophagus: a case-control study in Sweden — P. Gustavsson, R. Jakobsson, et al. (1998)

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