Assessment of Global Trends in the Diagnosis of Mesothelioma From 1990 to 2017

• Published in: JAMA network open 2021-08, Vol.4 (8), p.e2120360-e2120360
• Main Authors: Zhai, Zhen, Ruan, Jian, Zheng, Yi, Xiang, Dong, Li, Na, Hu, Jingjing, Shen, Jianfei, Deng, Yujiao, Yao, Jia, Zhao, Peng, Wang, Shuqian, Yang, Si, Zhou, Linghui, Wu, Ying, Xu, Peng, Lyu, Lijuan, Lyu, Jun, Bergan, Raymond, Chen, Tianhui, Dai, Zhijun
• Format: Article
• Language: English
• Subjects: Age; Age Factors; Asbestos; Bans; Cross-Sectional Studies; Forecasting; Geography; Global Burden of Disease - history; Global Burden of Disease - trends; Global Health; Global Health - statistics & numerical data; Global Health - trends; History, 20th Century; History, 21st Century; Humans; Incidence; Mesothelioma; Mesothelioma - diagnosis; Mesothelioma - epidemiology; Mesothelioma - history; Online Only; Original Investigation; Prevalence; Sex Factors; Socioeconomic Factors; Trends
• ISSN: 2574-3805; 2574-3805
• DOI: 10.1001/jamanetworkopen.2021.20360

It is difficult for policy makers and clinicians to formulate targeted management strategies for mesothelioma because data on current epidemiological patterns worldwide are lacking. To evaluate the mesothelioma burden across the world and describe its epidemiological distribution over time and by sociodemographic index (SDI) level, geographic location, sex, and age. Annual case data and age-standardized rates of incidence, death, and disability-adjusted life-years associated with mesothelioma among different age groups were obtained from the Global Burden of Disease 2017 database. The estimated annual percentage changes in age-standardized rates were calculated to evaluate temporal trends in incidence and mortality. The study population comprised individuals from 21 regions in 195 countries and territories who were diagnosed with mesothelioma between 1990 and 2017. Data were collected from May 23, 2019, to January 18, 2020. Primary outcomes were incident cases, deaths, and their age-standardized rates and estimated annual percentage changes. Secondary outcomes were disability-adjusted life-years and relative temporal trends. Overall, 34 615 new cases (95% uncertainty interval [UI], 33 530-35 697 cases) of mesothelioma and 29 909 deaths (95% UI, 29 134-30 613 deaths) associated with mesothelioma were identified in 2017, and more than 70% of these cases and deaths were among male individuals. In 1990, the number of incident cases was 21 224 (95% UI, 17 503-25 450), and the number of deaths associated with mesothelioma was 17 406 (95% UI, 14 495-20 660). These numbers increased worldwide from 1990 to 2017, with more than 50% of cases recorded in regions with high SDI levels, whereas the age-standardized incidence rate (from 0.52 [95% UI, 0.43-0.62] in 1990 to 0.44 [95% UI, 0.42-0.45] in 2017) and the age-standardized death rate (from 0.44 [95% UI, 0.37-0.52] in 1990 to 0.38 [95% UI, 0.37-0.39] in 2017) decreased, with estimated annual percentage changes of -0.61 (95% CI, -0.67 to -0.54) for age-standardized incidence rate and -0.44 (95% CI, -0.52 to -0.37) for age-standardized death rate. The proportion of incident cases among those 70 years or older continued to increase (from 36.49% in 1990 to 44.67% in 2017), but the proportion of patients younger than 50 years decreased (from 16.74% in 1990 to 13.75% in 2017) over time. In addition, mesothelioma incident cases and age-standardized incidence rates began to decrease after 20 years of a complete ban on asbes