Year: 2011
Type: article
Study design: Observational Study
Abstract: The global mesothelioma burden is unclear.Driscoll et al. estimated that as many as 43 000 people worldwide die from the disease each year.5 It has also been estimated that there are around 10 000 mesothelioma cases annually in Australia, Japan, North America and western Europe combined.1 In addition, Park et al. suggested that one mesothelioma case may be overlooked for every four to five recorded.6 Reports of an increase in the incidence of mesothelioma have been published in a wide range of countries.[7][8][9][10][11] However, to date there is no established global baseline that can be used to evaluate trends in disease occurrence.Since 1994, data on mesothelioma deaths have been included in the WHO mortality database, which records deaths in WHO Member States in each calendar year.Data are specified by disease category, gender and 5-year age intervals and are integrated across countries using a common format.12 Data comparability improved with the introduction of the International Classification of Diseases (ICD), 13 though the category "malignant mesothelioma" was included only in 1993 with the 10th revision (ICD-10).14 However, as acknowledged by WHO, accuracy in diagnosing causes of death varies among countries.13 By 30 January 2011, mesothelioma death figures were available for a 15-year period.The aim of this study was to improve the understanding and management of malignant mesothelioma by carrying out a descriptive analysis of global data available on deaths caused by the disease. MethodsWe extracted the numbers of mesothelioma deaths recorded in the WHO mortality database as malignant mesothelioma (i.e.ICD-10 category C45 or any subcategory thereof ) between 1994 and 2008.In addition, we conducted a literature search of PubMed to identify papers published in English that could provide useful information on national mesothelioma data.However, the data identified lacked detailed information on the numbers of deaths (e.g. on year, age group and gender).Consequently, we used only data from the WHO mortality database in the analysis.The number of deaths was summed by calendar year and country and was stratified according to demographic characteristics, including gender and anatomical disease site.To calculate mortality rates, national population data were obtained from the WHO health statistics and health information systems 12 and the United States Census Bureau, 15 with priority being given to WHO data.National counts were further aggregated by region and income level.We merged the smaller regions defined by the United Nations Statistics Division 16 into the five continents: Africa, the Americas, Asia, Europe and Oceania.In addition, we adapted the World Bank categories of national income level 17 to form three categories: low, middle and high income.The World Bank "up-Abstracts in ,عريب 中文, Français, Pусский and Español at the end of each article.Objective To carry out a descriptive analysis of mesothelioma deaths reported worldwide between 1994 and 2008.Methods We extracted data on mesothelioma deaths reported to the World Health Organization mortality database since 1994, when the disease was first recorded.We also sought information from other English-language sources.Crude and age-adjusted mortality rates were calculated and mortality trends were assessed from the annual percentage change in the age-adjusted mortality rate.Findings In total, 92 253 mesothelioma deaths were reported by 83 countries.Crude and age-adjusted mortality rates were 6.2 and 4.9 per million population, respectively.The age-adjusted mortality rate increased by 5.37% per year and consequently more than doubled during the study period.The mean age at death was 70 years and the male-to-female ratio was 3.6:1.The disease distribution by anatomical site was: pleura, 41.3%; peritoneum, 4.5%; pericardium, 0.3%; and unspecified sites, 43.1%.The geographical distribution of deaths was skewed towards high-income countries: the United States of America reported the highest number, while over 50% of all deaths occurred in Europe.In contrast, less than 12% occurred in middle-and low-income countries.The overall trend in the ageadjusted mortality rate was increasing in Europe and Japan but decreasing in the United States.Conclusion The number of mesothelioma deaths reported and the number of countries reporting deaths increased during the study period, probably due to better disease recognition and an increase in incidence.The different time trends observed between countries may be an early indication that the disease burden is slowly shifting towards those that have used asbestos more recently.
Language: English
Subfield: Pulmonary and Respiratory Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W2150001460