The impact of COVID-19 on new mesothelioma diagnoses in Italy

Our plain-English summary of The impact of COVID-19 on new mesothelioma diagnoses in Italy, by L. Mangone, P. Mancuso, I. Bisceglia, et al (Thoracic Cancer, 2022).

The study

• Authors: L. Mangone, P. Mancuso, I. Bisceglia, P. Giorgi Rossi, E. Chellini, C. Negro, L. Benfatto, E. Migliore, V. Casotto, C. Mensi, A. Romanelli, R. Tumino, I. Grappasonni, D. Cavone, G. Mazzoleni, F. Tallarigo, A. Marinaccio, ReNaM Working Group
• Journal: Thoracic Cancer
• Published: 2022;13(5):702-707
• Cited by: 8 articles, as counted by NIH iCite
• Read it: PubMed · Publisher · Free full text

Abstract

Background: The aim of this work was to evaluate the impact of the restrictions put in place to control the COVID-19 pandemic on new diagnoses of malignant mesothelioma (MM) in Italy.

Methods: Twelve of the 21 Italian malignant mesothelioma CORs (regional operating centres) participated. The study included all cases of MM with microscopic confirmation; cases without microscopic confirmation and death certificate only (DCO) were excluded. For each case, information on sex, date of birth, tumor site, morphology, and date of diagnosis was retrieved. We compared the number of incident cases in 2020 with 2019, looking at the overall picture and for four periods: pre-pandemic (January-February), first wave (March-May), low incidence (June-September), and second wave (October-December).

Results: A total of 604 cases were registered: 307 in 2019 and 297 in 2020. In the 2020 pre-pandemic period, the incidence was higher than in the same months in 2019 (+45%); there was no significant change during the first wave (+1%) or in the low-incidence period (-3%), while a decrease was observed during the second wave (-32%). However, the data were not homogeneous across the country: the increase in the pre-pandemic period concerned mostly the regions of northern (+61.5%) and central Italy (+43.5%); during the first wave, MM diagnoses increased in the northern (+38.5%) and central (+11.4%) regions but decreased in the southern regions (-52.9%). All these differences are compatible with random fluctuations.

Conclusion: The COVID-19 pandemic had little or no impact on new MM diagnoses, and variations were not homogeneous throughout the country.

© 2021 The Authors. Thoracic Cancer published by China Lung Oncology Group and John Wiley & Sons Australia, Ltd.

In plain English

This study asked whether the COVID-19 pandemic changed the number of new malignant mesothelioma diagnoses in Italy. Twelve of Italy's 21 regional mesothelioma centres supplied cases. The authors compared microscopically confirmed cases diagnosed in 2020 with 2019, overall and in four pandemic phases. There were 604 cases: 307 in 2019 and 297 in 2020, a 3.3% decrease (95% confidence interval minus 18% to plus 14%). In January to February 2020, before the pandemic, cases were 45% higher than in the same months of 2019 (confidence interval minus 4% to plus 121%). They changed little in the first wave (plus 1%, interval minus 27% to plus 42%) and the low-incidence period (minus 3%, minus 27% to plus 29%). Cases fell 32% in the second wave, October to December (minus 52% to minus 4%), the only change the authors considered consistent with a pandemic effect. Regional patterns differed; the authors stated these differences were compatible with random fluctuations. They concluded the pandemic had little or no impact on new diagnoses, noting their sample was not necessarily representative of all Italian cases.

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-based comparison of the number of new (incident) mesothelioma cases diagnosed in 2020 versus 2019, overall and by four pandemic periods
• Who was studied: 604 microscopically confirmed (certain or probable) malignant mesothelioma cases diagnosed in 2019 (307) and 2020 (297), reported by 12 of Italy's 21 regional operating centres (7 of 9 in the north, 2 of 4 in the centre, 3 of 8 in the south). The cases were 473 men and 131 women. 567 were pleural and 37 peritoneal.
• Exposure: The COVID-19 pandemic and its restrictions in Italy, divided into pre-pandemic (January to February), first wave (March to May), low incidence (June to September) and second wave (October to December). Asbestos exposure was not analysed.
• Main results:
  • All participating centres: 297 cases in 2020, 10 fewer than the 307 in 2019, a 3.3% decrease (95% CI minus 18% to plus 14%)
  • Pre-pandemic period (January to February): 61 cases in 2020 versus 42 in 2019, plus 45% (95% CI minus 4% to plus 121%)
  • First wave (March to May): 75 versus 74 cases, plus 1% (95% CI minus 27% to plus 42%). Low-incidence period (June to September): 104 versus 107, minus 3% (95% CI minus 27% to plus 29%). The authors described neither change as significant.
  • Second wave (October to December): 57 cases in 2020 versus 84 in 2019, minus 32% (95% CI minus 52% to minus 4%). The authors called this the only change consistent with an effect of the pandemic. It involved all regions.
  • Regional differences as reported in the text: the January to February increase mainly concerned northern (plus 61.5%) and central Italy (plus 43.5%). During the first wave, diagnoses increased in the north (plus 38.5%), were described as stable in the centre (plus 11.4%), and dropped in the south (minus 52.9%).
  • Directly after describing the regional patterns, the authors stated that these differences were compatible with random fluctuations
  • The overall decrease mainly concerned the 55 to 64 and 85-and-over age groups, and the peritoneum (20 to 17 cases) more than the pleura (287 to 280 cases)
• The authors' conclusion: The authors concluded that the COVID-19 pandemic had little or no impact on new malignant mesothelioma diagnoses. They found that variations were not uniform across the country and showed no association with the spread of infection or with control measures.
• Limitations the authors state:
  • Only 12 of the 21 regional centres took part, and each contributed only part of its cases
  • One pathology laboratory was assumed to stand in for an entire region
  • No cases were taken from other sources such as hospital discharge records or death certificates, so the sample is not necessarily representative of all Italian mesothelioma cases
  • Some cases diagnosed in late December 2020 may not yet have been confirmed when data were collected, which could partly explain the drop at the end of the year
  • The study could not tell whether changes were due to early or delayed diagnosis, or to changes in diagnostic procedures that made cases undetectable by its methods

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.

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