The Epidemiologic Characteristics of Malignant Mesothelioma Cases in Korea: Findings of the Asbestos Injury Relief System from 2011-2015

Our plain-English summary of The Epidemiologic Characteristics of Malignant Mesothelioma Cases in Korea: Findings of the Asbestos Injury Relief System from 2011-2015, by S.C. Kwon, S.S. Lee, M.S. Kang, et al (International Journal of Environmental Research and Public Health, 2021).

The study

• Authors: S.C. Kwon, S.S. Lee, M.S. Kang, D.A. Huh, Y.J. Lee
• Journal: International Journal of Environmental Research and Public Health
• Published: 2021;18(19)
• Cited by: 4 articles, as counted by NIH iCite
• Read it: PubMed · Publisher · Free full text

Abstract

(1) Background: The purpose of this study was to investigate the epidemiological characteristics of malignant mesothelioma in Korea by investigating cases compensated under the asbestos injury relief system. (2) Methods: A total of 407 compensated cases between 2011 and 2015 were reviewed using medical records and resident registrations in order to investigate the dates of diagnosis and death. Asbestos exposure and patients' general characteristics were investigated through face-to-face interviews. The standardized incidence ratio was calculated as the number of observations from 2005 to 2014 per exposure region in Korea, using the mid-annual population of each region in 2009 as the standard population. (3) Results: Among the 407 cases, 65.1% were male. The pleura and peritoneum were affected in 76.9% and 23.1% of cases, respectively. For peritoneal mesothelioma, the median survival duration was longer (p = 0.005), and the proportion of affected women was higher than that in pleural mesothelioma. The standardized incidence ratio (95% CI) by province of primary exposure was Chungnam 3.33 (2.51-4.35), Ulsan 1.85 (0.97-3.21), and Seoul 1.32 (1.06-1.63). (4) Conclusions: Although the representativeness of the data is limited, it is sufficient to assume the epidemiologic characteristics of malignant mesothelioma, help improve the compensation system, and contribute to future policies.

In plain English

This Korean study described 407 malignant mesothelioma cases from the asbestos injury relief system, 2011 to 2015, using interviews and records. They came from 728 patients or bereaved families compensated or given special bereaved recognition; the rest were unreachable or declined. Of these, 265 (65.1%) were men; 313 (76.9%) had pleural and 94 (23.1%) peritoneal mesothelioma. Men made up 69.0% of pleural and 52.1% of peritoneal cases. Median survival was 8.0 months (95% CI 6.2 to 9.8) for pleural and 10.0 months (3.7 to 16.3) for peritoneal cases, a statistically significant difference. Average latency was 33.3 years (397 cases). Average age at diagnosis rose from 55.0 years (1996 to 2000) to 65.6 years (2011 to 2015). For 310 cases diagnosed in 2005 to 2014, standardized incidence ratios by province of main exposure were 3.33 (95% CI 2.51 to 4.35) for Chungnam, 1.85 (0.97 to 3.21, an interval including one, the no-difference value) for Ulsan and 1.32 (1.06 to 1.63) for Seoul. The authors concluded women and peritoneal cases were more common than in earlier reports. They noted the data do not represent all Korean cases and may carry recall bias.

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 epidemiological study of compensated malignant mesothelioma cases, using structured interviews and review of medical and resident registration records
• Who was studied: 407 malignant mesothelioma cases (patients or their bereaved families) in Korea, out of 728 compensated or given special bereaved recognition under the Asbestos Injury Relief Act between 2011 and 2015. The other 321 were not surveyed: 180 because contact details had changed and 141 because they refused. Interviews took place in 2015 and 2016, and survival was followed to March 2019.
• Exposure: Asbestos exposure (occupational, environmental or domestic) assessed by interview. Fiber types were not specified. 220 of 407 (54.1%) had occupational exposure. A 'primary exposure' province was assigned for exposure at least 15 years before diagnosis.
• Main results:
  • Of all 407 cases, 265 (65.1%) were men.
  • Site of the disease among the 407 cases: pleura in 313 (76.9%), peritoneum in 94 (23.1%).
  • Men made up 69.0% of pleural mesothelioma cases and 52.1% of peritoneal mesothelioma cases (p = 0.003).
  • Median survival from diagnosis was 8.0 months (95% CI 6.2 to 9.8) for pleural mesothelioma and 10.0 months (95% CI 3.7 to 16.3) for peritoneal mesothelioma (log-rank test; p given as 0.005 in the table and less than 0.005 in the text).
  • Long survival (60 months or more in the text; more than 60 months in the table) occurred in 11.5% of pleural cases and 25.5% of peritoneal cases.
  • Occupational exposure was reported in 57.5% of pleural cases and 42.6% of peritoneal cases (p = 0.013 in Table 2).
  • The latency period, measured in 397 cases, averaged 33.3 years (SD 13.4). The authors reported no difference between pleural cases (33.2 years) and peritoneal cases (33.5 years).
  • Mean age at diagnosis rose over time: 55.0 years in 1996 to 2000, 58.8 in 2001 to 2005, 62.1 in 2006 to 2010, and 65.6 in 2011 to 2015 (p less than 0.001).
  • Standardized incidence ratios by province of primary exposure were based on 310 cases diagnosed in 2005 to 2014, with the 2009 regional population as the standard. Results: Chungnam 3.33 (95% CI 2.51 to 4.35), Ulsan 1.85 (0.97 to 3.21, an interval that includes one), Seoul 1.32 (1.06 to 1.63).
• The authors' conclusion: The authors concluded that, in the relief-system data, the share of women and of peritoneal mesothelioma was higher than in previous studies. They found that age at diagnosis rose over time and that survival was longer for peritoneal than pleural mesothelioma. They wrote that regional differences seemed related to asbestos exposure sources such as mines, factories, chemical complexes and redevelopment areas. Although the data's representativeness is limited, they judged them useful for improving the compensation system and future policy.
• Limitations the authors state:
  • The data came from the first five years of the Act and included diagnoses made before the Act took effect.
  • Bereaved family members could answer the interview, so recall bias may have affected exposure histories.
  • Representativeness may be reduced because some cases were lost to contact through death or other reasons.
  • The data do not represent incidence in the whole Korean population. They covered only 32.0% (178 of 556) of cancer-registry cases from 2009 to 2013.

Topics

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

Medical terms in this study, explained in our Lexicon: Malignant Mesothelioma, Asbestos Exposure, Standardized Incidence Ratio (SIR), Pleura, Peritoneum, Peritoneal Mesothelioma, Median Survival, Pleural Mesothelioma.

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• Epidemiologic characteristics of compensated occupational lung cancers among Korean workers — Y.S. Ahn, K.S. Jeong (2014)
• Characteristics of asbestos fibers in lung tissue from occupational and environmental asbestos exposure of lung cancer patients in Busan, Korea — H.S. Jung, E.K. Park, et al. (2020)
• Multidetector CT Findings and Differential Diagnoses of Malignant Pleural Mesothelioma and Metastatic Pleural Diseases in Korea — Y.K. Kim, J.S. Kim, et al. (2016)
• CT Findings in People Who Were Environmentally Exposed to Asbestos in Korea — E.K. Lee, J.S. Kim, et al. (2015)
• Air pollution and survival in patients with malignant mesothelioma and asbestos-related lung cancer: a follow-up study of 1591 patients in South Korea — D.A. Huh, Y.H. Choi, et al. (2024)

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