The expected burden of mesothelioma mortality in Great Britain from 2002 to 2050

Our plain-English summary of The expected burden of mesothelioma mortality in Great Britain from 2002 to 2050, by J.T. Hodgson, D.M. McElvenny, A.J. Darnton, et al (British Journal of Cancer, 2005).

The study

• Authors: J.T. Hodgson, D.M. McElvenny, A.J. Darnton, M.J. Price, J. Peto
• Journal: British Journal of Cancer
• Published: 2005;92(3):587-93
• Cited by: 274 articles, as counted by NIH iCite
• Read it: PubMed · Publisher · Free full text

Abstract

The British mesothelioma register contains all deaths from 1968 to 2001 where mesothelioma was mentioned on the death certificate. These data were used to predict the future burden of mesothelioma mortality in Great Britain. Poisson regression analysis was used to model male mesothelioma deaths from 1968 to 2001 as a function of the rise and fall of asbestos exposure during the 20th century, and hence to predict numbers of male deaths in the years 2002-2050. The annual number of mesothelioma deaths in Great Britain has risen increasingly rapidly from 153 deaths in 1968 to 1848 in 2001 and, using our preferred model, is predicted to peak at around 1950 to 2450 deaths per year between 2011 and 2015. Following this peak, the number of deaths is expected to decline rapidly. The eventual death rate will depend on the background level and any residual asbestos exposure. Between 1968 and 2050, there will have been approximately 90,000 deaths from mesothelioma in Great Britain, 65,000 of which will occur after 2001.

In plain English

This study used the British mesothelioma register, which records all deaths in England, Scotland and Wales from 1968 to 2001 where mesothelioma was mentioned on the death certificate, to predict future mesothelioma deaths in Great Britain. The authors fitted a statistical model (Poisson regression) to deaths in men aged 20 to 89. The model linked deaths to the estimated rise and fall of asbestos exposure during the 20th century. They assumed exposure in 2000 was 4% of its peak, falling to 0.75% by 2050. Annual deaths rose from 153 in 1968 to 1848 in 2001. Two versions of the model fitted past data equally well but predicted different futures. The authors had a modest preference for the version without clearance of fibres from the lung. Including women and men aged 90 or over, they predicted a peak of 2133 deaths a year (95% CI 1950 to 2450). The authors concluded that deaths would peak at around 1950 to 2450 a year between 2011 and 2015. They predicted about 90 000 deaths by 2050, 65 000 of them from 2002 onwards. They said the total to 2050 remained very uncertain.

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 modelling and prediction study using national death register data (Poisson regression model relating past asbestos exposure to mesothelioma deaths)
• Who was studied: All deaths in Great Britain (England, Scotland and Wales) from 1968 to 2001 where mesothelioma was mentioned on the death certificate. The model was based on deaths in men aged 20 to 89 years, and its predicted peak was scaled up to include men aged 90 or older and women.
• Exposure: Average asbestos exposure of the British male population by year and age, estimated within the model rather than measured. The model assumed that exposure in 2000 was 4% of its 1960s peak, falling to 2% by 2010 and 0.75% by 2050. When the authors compared the model's exposure patterns with asbestos import figures, the best match used amosite and crocidolite imports; chrysotile had zero weight.
• Main results:
  • Annual mesothelioma deaths in Great Britain (men and women) rose from 153 in 1968 to 1848 in 2001.
  • In 2001 there were 1579 male mesothelioma deaths, 85% of the total.
  • Under the no-clearance model (the authors' preferred model), annual deaths in men aged below 90 were predicted to peak at 1846 (95% CI 1650 to 2100) in 2013 (95% CI 2011 to 2015).
  • Under the clearance model, annual deaths in men aged below 90 were predicted to peak at 1983 (95% CI 1835 to 2233) in 2011 (95% CI 2009 to 2013).
  • Allowing for men aged 90 or over (estimated male peak 1857) and women (estimated maximum 276 female deaths), the predicted total at the peak was 2133 deaths a year (95% CI 1950 to 2450).
  • The total number of mesothelioma deaths up to 2050 was predicted to be around 90 000, with 65 000 of these occurring from 2002 onwards.
• The authors' conclusion: The authors concluded that mesothelioma deaths in Great Britain were predicted to peak at around 1950 to 2450 a year some time between 2011 and 2015, with around 90 000 deaths by 2050, 65 000 of them from 2002 onwards.
• Limitations the authors state:
  • The assumed level of exposure in 2000 hardly affected the predicted peak but did affect predicted deaths after the peak, so the total burden to 2050 remained very uncertain.
  • Because of the long latency of mesothelioma, exposures after 1980 could not be estimated from the data and had to be assumed.
  • Two model parameters (the increase in risk with time since exposure and the half-life for clearance of asbestos from the lung) could not be estimated independently. Two versions of the model fitted equally well but gave different predictions, and the argument for preferring the no-clearance version was not definitive.
  • The fitted model did not include an allowance for a background rate of mesothelioma not caused by asbestos.
  • The reported ranges are only roughly equivalent to 95% confidence intervals. They are slightly narrower because they cannot account for uncertainty in the mathematical form of the model.

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, Death Certificate, Asbestos Exposure.

Related studies

• Mesothelioma mortality in Great Britain from 1968 to 2001 — D.M. McElvenny, A.J. Darnton, et al. (2005)
• The effect of smoking on the risk of lung cancer mortality for asbestos workers in Great Britain (1971-2005) — G. Frost, A. Darnton, et al. (2011)
• Occupational cancer burden in Great Britain — L. Rushton, S.J. Hutchings, et al. (2012)
• Estimating the number of asbestos-related lung cancer deaths in Great Britain from 1980 to 2000 — A.J. Darnton, D.M. McElvenny, et al. (2006)
• Simple benchmark for mesothelioma projection for Great Britain — M.D. Martínez-Miranda, B. Nielsen, et al. (2016)
• Projection of mesothelioma mortality in Britain using Bayesian methods — E. Tan, N. Warren, et al. (2010)

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