The Pleural Mesothelioma Cases and Mortality in Portugal in 2014-2020: A Descriptive Study

Our plain-English summary of The Pleural Mesothelioma Cases and Mortality in Portugal in 2014-2020: A Descriptive Study, by C. Santos, E. Sacadura-Leite, J. Ferreira, et al (Healthcare, 2024).

The study

• Authors: C. Santos, E. Sacadura-Leite, J. Ferreira, M.D.A. Dixe, P. Astoul, A. Sousa-Uva
• Journal: Healthcare
• Published: 2024;12(11)
• Cited by: 1 article, as counted by NIH iCite
• Read it: PubMed · Publisher · Free full text

Abstract

Background: The incidence and mortality of pleural mesothelioma (PM) reflect the production and consumption of asbestos over time. However, despite the current global concern, these data remain to be known.

Objective: Our aim was to carry out a descriptive analysis of PM cases and mortality from some Portuguese databases between 2014 and 2020.

Methods: A retrospective observational study was carried out between 2014 and 2020. Data on the number of PM cases were provided by the Portuguese Cancer Registry, and data on mortality were from the Portuguese Death Certificate Information System.

Results: Between 2014 and 2020, 315 cases of PM were reported, with 222 (70.5%) men. The average age of patients was 72.1, with the highest number of cases in patients aged >70 years (n = 198; 62.9%). The highest number of cases was reported in 2018 (n = 62; 19.7%). Regarding mortality, 169 deaths were reported, with 126 (74.6%) men and mostly in individuals aged >70 years (n = 109; 64.5%). It is estimated that around 520 years of potential life were lost. The highest number of deaths occurred in 2015 (n = 33; 19.5%).

Conclusion: It is mandatory to reinforce the need for surveillance programs that allow us to gather real and reliable data and eliminate asbestos-related diseases.

In plain English

This descriptive study counted pleural mesothelioma among people living in Portugal from 2014 to 2020. It used two national databases: the Portuguese Oncological Registry (RON) for new cases and the Death Certificate Information System (SICO) for deaths. It did not collect information on individual asbestos exposure. The registry recorded 315 cases, 222 (70.5%) in men and 93 (29.5%) in women. The average age at diagnosis was 72.1 years, and 198 cases (62.9%) were in people over 70. Lisbon and Tagus Valley had the most cases (148; 47%). The year with the most cases was 2018 (62). The death database recorded 169 deaths, 126 (74.6%) of them men. Of these deaths, 109 (64.5%) were in people over 70, and the year with the most deaths was 2015 (33). The average crude death rate was 0.2 per 100,000 inhabitants (0.4 for men, 0.1 for women), and an estimated 520 potential years of life were lost. The authors concluded that surveillance programs are needed to gather real and reliable data. They noted that Portugal has no mesothelioma or asbestos exposure surveillance program, so data are scarce and scattered across databases.

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: Retrospective observational descriptive study of national database records (only descriptive statistics)
• Who was studied: Residents of Portugal with pleural mesothelioma (ICD-10 code C45.0), 2014–2020: 315 cases recorded in the Portuguese Oncological Registry (RON) and 169 deaths recorded in the Death Certificate Information System (SICO)
• Exposure: Individual asbestos exposure was not measured. The study counted pleural mesothelioma cases and deaths only. The authors list the scarcity of information on asbestos exposure history as a limitation.
• Main results:
  • 315 pleural mesothelioma cases were recorded in the RON: 222 (70.5%) men and 93 (29.5%) women
  • Average age at diagnosis was 72.1 years (standard deviation 11.3, range 33 to 96). 198 cases (62.9%) were over age 70.
  • Lisbon and Tagus Valley plus the North had 234 cases (74.3%). Lisbon and Tagus Valley alone had 148 (47%).
  • By morphology, 203 cases (64.4%) were coded as malignant mesothelioma (not further specified) and 99 (31.4%) as malignant epithelioid mesothelioma
  • The years with the most cases were 2018 (62 cases; 19.7%) and 2014 (54 cases; 17.1%)
  • SICO recorded 169 pleural mesothelioma deaths: 126 (74.6%) men and 43 (25.4%) women
  • Of the 169 deaths, 109 (64.5%) were in people over 70, and 143 (84.6%) occurred in a health unit
  • The years with the most deaths were 2015 (33 deaths; 19.5%) and 2016 (28 deaths; 16.6%)
  • The average crude mortality rate was 0.2 per 100,000 inhabitants: 0.4 for men and 0.1 for women
  • An estimated 520 potential years of life were lost: 294 for men and 226 for women
  • Of the 315 registry cases, 201 (63.8%) were known to have died: 125 from pleural mesothelioma and 76 from other causes. Whether the other 114 were alive could not be confirmed.
• The authors' conclusion: The authors concluded that it is mandatory to invest in surveillance programs that gather real and reliable data in order to eliminate asbestos-related diseases. They also concluded that pleural mesothelioma will remain a serious global public health problem for years to come.
• Limitations the authors state:
  • There is little information on the occurrence and mortality of pleural mesothelioma, or on the history of asbestos exposure, consumption and production, in Portugal and worldwide
  • Portugal has no mesothelioma or asbestos exposure surveillance program, so the data are scarce, scattered across several databases, and not uniform
  • Mortality data were inconsistent between the databases, so cases were taken only from the RON and deaths only from SICO
  • Because of the nature of the data, only a descriptive analysis was possible

Topics

Medical terms in this study, explained in our Lexicon: Pleural Mesothelioma, Cancer Registry, Death Certificate.

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