Trends in mortality of diffuse malignant mesothelioma of pleura

Our plain-English summary of Trends in mortality of diffuse malignant mesothelioma of pleura, by V.E. Archer, W.N. Rom (Lancet, 1983).

The study

• Authors: V.E. Archer, W.N. Rom
• Journal: Lancet
• Published: 1983;2(8341):112-3
• Type of article: Letter
• Cited by: 17 articles, as counted by NIH iCite
• Read it: PubMed · Publisher
• In J-M's library: Johns-Manville's company medical library held a copy (J-M no. 001733).

Summary of the article

In this letter the authors asked whether the rise in world asbestos use, from about 1 million to 5 million tons between 1950 and 1975, had been followed by an increase in diffuse malignant mesothelioma of the pleura (DMMP). They used a National Cancer Institute compilation of United States cancer deaths to construct age- and sex-specific mortality curves for malignant neoplasms of the pleura. They omitted 1950-57, when DMMP was not separated from other lung and chest neoplasms. They analysed 1958-67 (code 162.2) and 1968-77 (code 163.0) separately because the coding was not comparable, and they gave 90% confidence limits for selected points. No significant secular trends were found. For 1958-67 there was no indication of a change in any age group. For 1968-77 there was a non-significant suggestion that, in both sexes, rates fell among people under 60 and rose among those aged 60-74. Below age 45, rates were comparable between the sexes. Above age 45, rates for males were about twice those for females, which the authors attributed to occupational differences such as insulating and plumbing work. They concluded that by 1978 the increased use of asbestos had produced at most a small increase in DMMP, apparently limited to people exposed occupationally. They also concluded that the lack of any increase among people under 45 suggested consumer asbestos products had been largely innocuous. They called for further study of trends in the 1980s to allow for the 20-40 year latent period.

PubMed has no abstract for this study, and the article doesn't print one. We wrote this summary from the full article with the help of AI. It is not the authors' wording.

In plain English

In this letter, the authors used a National Cancer Institute compilation of United States cancer deaths to chart age- and sex-specific death rates from pleural cancers, mainly diffuse malignant mesothelioma of the pleura (DMMP), for 1958-67 and 1968-77. Cause-of-death coding differed between the two periods, so they could not be directly compared. The authors found no significant trends over time. In 1968-77 there was a suggestion that rates fell among people under 60 and rose among those aged 60-74, but neither trend was statistically significant. Below age 45, rates for men and women were comparable. Above 45, men's rates were about twice women's, which the authors said probably reflected an occupational difference. Rates had not increased among people under 45. The authors concluded that by 1978 rising asbestos use had produced at most a small increase in DMMP, apparently limited to people exposed at work. They suggested that consumer asbestos products had been largely innocuous. They noted that not enough time had passed to judge fully, and they called for study of 1980s trends.

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: Letter to the editor presenting a descriptive analysis of national death-rate trends (age- and sex-specific mortality curves from published cancer mortality data)
• Who was studied: Deaths from malignant neoplasms of the pleura (mainly DMMP) in the United States, drawn from a National Cancer Institute compilation covering 1950-1978. The 1950-57 data were omitted, and the periods 1958-67 and 1968-77 were analysed.
• Exposure: Asbestos in general; no fiber types were named. The authors contrasted occupational exposure (for example in insulating and plumbing) with consumer asbestos products. No individual exposures were measured.
• Main results:
  • No significant trends over time were found in pleural cancer death rates.
  • For 1958-67, there was no indication of a change in DMMP rate for any age group.
  • For 1968-77, among both sexes, there was a suggestion that DMMP fell among people under 60 and rose among those aged 60-74. Neither trend was statistically significant.
  • Under age 45, DMMP rates were comparable between the sexes. Above age 45, rates for males were about twice those for females.
  • The authors said the divergence between the sexes after age 45 probably reflected an occupational difference.
  • There was no increase in DMMP among people under 45, the people who might have been exposed to consumer asbestos products as children.
  • Authors' interpretation: the lack of increase among younger groups suggests consumer asbestos products have been largely innocuous.
• The authors' conclusion: The authors concluded that, by 1978, the recent increase in asbestos use had resulted in at most a small increase in DMMP, and that its influence appeared limited to people exposed occupationally.
• Limitations the authors state:
  • Cause-of-death coding was not comparable between 1958-67 and 1968-77.
  • In 1958-67, many DMMP deaths were probably coded under a general lung-and-pleura category rather than the specific pleural code.
  • Data for 1950-57 did not separate DMMP from other lung and chest cancers and were omitted.
  • Not enough time had elapsed to fully assess the effect of changing asbestos use. Study of 1980s trends is needed to allow for the 20-40 year latent period.

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, Pleura, Neoplasm.

Related studies

• Trends in mortality from malignant mesothelioma of the pleura, and production and use of asbestos in Australia — Z. Xu, B.K. Armstrong, et al. (1985)
• Future trends in mortality of French men from mesothelioma — A. Banaei, B. Auvert, et al. (2000)
• The next mesothelioma wave: mortality trends and forecast to 2030 in Brazil — E. Algranti, C.A. Saito, et al. (2015)
• Diffuse malignant mesothelioma of the pleura: a review of 37 cases — H.C. Oels, E.G. Harrison, et al. (1971)
• An evaluation of trends for mesothelioma mortality in American women: Addressing the content of a recent Morbidity and Mortality Weekly Report (MMWR) — M.E. Stevens, B.P. Tuttle, et al. (2025)
• Time trend of mesothelioma incidence in the United States and projection of future cases: an update based on SEER data for 1973 through 2005 — B. Price, A. Ware (2009)

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