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{{Mesothelioma}}
{{Mesothelioma}}
{{CMG}}{{AE}}{{PSD}}, {{SR}}
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==Overview==
==Overview==
Mesothelioma is a rare disease which accounts for 5-28% of all malignancies that involve the pleura. The [[incidence]] of mesothelioma is estimated to be 3,000 cases annually. The [[incidence]] of [[pleural]] mesothelioma is approximately 1 per 100,000 individuals in the United States. Males are more commonly affected with mesothelioma than females. The male to female ratio is approximately 3 to 1. The [[incidence]] of mesothelioma increases with age; the median age at diagnosis for [[pleural]] mesothelioma and [[peritoneal]] mesothelioma are 74 years and 68 years, respectively. There is no racial predilection to mesothelioma.


==Epidemiology and Demographics==
==Epidemiology and Demographics==
===Incidence===
===Prevalence===
*The incidence of mesothelioma is estimated to be 3,000 cases annually.<ref name="A.X.2012">Philip A. Rascoe, Xiaobo X. Cao and W. Roy Smythe (2012). Molecular Pathogenesis of Malignant Pleural Mesothelioma, Mesotheliomas - Synonyms and Definition, Epidemiology, Etiology, Pathogenesis, Cyto-Histopathological Features, Clinic, Diagnosis, Treatment, Prognosis, Dr Alexander Zubritsky (Ed.), ISBN: 978-953-307-845-8, InTech, Available from: http://www.intechopen.com/books/mesotheliomas-synonyms-and-definition-epidemiology-etiology-pathogenesis-cyto-histopathological-features-clinic-diagnosis-treatment-prognosis/molecular-pathogenesis-of-malignant-pleural-mesothelioma</ref>
*Mesothelioma is a rare disease which accounts for 5-28% of all malignancies that involve the pleura.<ref name="epidemiologymesothelioma1">Epidemiology of mesothelioma. Dr Bruno Di Muzio and A.Prof Frank Gaillard et al. Radiopaedia 2016. http://radiopaedia.org/articles/mesothelioma. Accessed on February 8, 2016</ref>
 
 
:*The annual incidence is about 2200 cases/year. 
::*The incidence has risen approximately 50% in the last decade and is expected to increase further in third World countries.
:*Approximately 80% of mesotheliomas are related to asbestos exposure.
::*Relatively short exposure (1-2 years) and remote exposure (20-25 years in the past) has been noted in some patients with mesothelioma. 
::*The peak incidence is 30-35 years after initial exposure. 
:*Smoking is synergistic with asbestos exposure increasing the risk for all lung cancer by about 60 times.


===Incidence===
===Incidence===
Although reported incidence rates have increased in the past 20 years, mesothelioma is still a relatively rare cancer. The incidence is approximately one per 1,000,000. For comparison, populations with high levels of smoking can have a [[Lung cancer#Epidemiology|lung cancer]] incidence of over 1,000 per 1,000,000. Incidence of malignant mesothelioma currently ranges from about 7 to 40 per 1,000,000 in industrialized Western nations, depending on the amount of asbestos exposure of the populations during the past several decades.<ref name="robinson2005">"Advances in Malignant Mesothelioma" by Bruce W. S. Robinson and Richard A. Lake in ''The New England Journal of Medicine'' (2005) volume 353 pages 1591-1603 {{Entrez Pubmed|16221782}}.</ref> It has been estimated that incidence may have peaked at 15 per 1,000,000 in the United States in 2004. Incidence is expected to continue increasing in other parts of the world. Mesothelioma occurs more often in men than in women and risk increases with age, but this disease can appear in either men or women at any age. Approximately one fifth to one third of all mesotheliomas are peritoneal.
*The [[incidence]] of mesothelioma is estimated to be 3,000 cases annually.<ref name="A.X.2012">Philip A. Rascoe, Xiaobo X. Cao and W. Roy Smythe (2012). Molecular Pathogenesis of Malignant Pleural Mesothelioma, Mesotheliomas - Synonyms and Definition, Epidemiology, Etiology, Pathogenesis, Cyto-Histopathological Features, Clinic, Diagnosis, Treatment, Prognosis, Dr Alexander Zubritsky (Ed.), ISBN: 978-953-307-845-8, InTech, Available from: http://www.intechopen.com/books/mesotheliomas-synonyms-and-definition-epidemiology-etiology-pathogenesis-cyto-histopathological-features-clinic-diagnosis-treatment-prognosis/molecular-pathogenesis-of-malignant-pleural-mesothelioma</ref>
 
*The [[incidence]] of pleural mesothelioma is approximately 1 per 100,000 individuals in the United States.<ref name="Saint-PierrePease2015">{{cite journal|last1=Saint-Pierre|first1=Mathieu D.|last2=Pease|first2=Christopher|last3=Mithoowani|first3=Hamid|last4=Zhang|first4=Tinghua|last5=Nicholas|first5=Garth A.|last6=Laurie|first6=Scott A.|last7=Wheatley-Price|first7=Paul|title=Malignant Pleural Mesothelioma Outcomes in the Era of Combined Platinum and Folate Antimetabolite Chemotherapy|journal=Lung Cancer International|volume=2015|year=2015|pages=1–7|issn=2090-3197|doi=10.1155/2015/590148}}</ref>
Between 1940 and 1979, approximately 27.5 million people were occupationally exposed to asbestos in the United States [http://www.rand.org/pubs/documented_briefings/DB397/DB397.pdf]. Between 1973 and 1984, there has been a threefold increase in the diagnosis of pleural mesothelioma in Caucasian males. From 1980 to the late 1990s, the death rate from mesothelioma in the USA increased from 2,000 per year to 3,000, with men four times more likely to acquire it than women. These rates may not be accurate, since it is possible that many cases of mesothelioma are misdiagnosed as adenocarcinoma of the lung, which is difficult to differentiate from mesothelioma.
*The [[incidence]] of pleural mesothelioma is approximately 1.2 per 100,000 individuals in Canada.<ref name="Saint-PierrePease2015">{{cite journal|last1=Saint-Pierre|first1=Mathieu D.|last2=Pease|first2=Christopher|last3=Mithoowani|first3=Hamid|last4=Zhang|first4=Tinghua|last5=Nicholas|first5=Garth A.|last6=Laurie|first6=Scott A.|last7=Wheatley-Price|first7=Paul|title=Malignant Pleural Mesothelioma Outcomes in the Era of Combined Platinum and Folate Antimetabolite Chemotherapy|journal=Lung Cancer International|volume=2015|year=2015|pages=1–7|issn=2090-3197|doi=10.1155/2015/590148}}</ref>
 
*The [[incidence]] of mesothelioma has decreased over several decades in the United States coincident with diminishing occupational [[asbestos]] exposure and has remained stable since 2003.<ref name="ThomasChen2015">{{cite journal|last1=Thomas|first1=Anish|last2=Chen|first2=Yuanbin|last3=Yu|first3=Tinghui|last4=Gill|first4=Ammara|last5=Prasad|first5=Vinay|title=Distinctive clinical characteristics of malignant mesothelioma in young patients|journal=Oncotarget|volume=6|issue=18|year=2015|pages=16766–16773|issn=1949-2553|doi=10.18632/oncotarget.4414}}</ref>
===Exposure===
Asbestos was known in antiquity, but it wasn't mined and widely used commercially until the late 1800s. Its use greatly increased during World War II. Since the early 1940s, millions of American workers have been exposed to asbestos dust. Initially, the risks associated with asbestos exposure were not publicly known. However, an increased risk of developing mesothelioma was later found among shipyard workers, people who work in asbestos mines and mills, producers of asbestos products, workers in the heating and construction industries, and other tradespeople. Today, the U.S. [[Occupational Safety and Health Administration]] (OSHA) sets limits for acceptable levels of asbestos exposure in the workplace, and created guidelines for engineering controls and respirators, protective clothing, exposure monitoring, hygiene facilities and practices, warning signs, labeling, recordkeeping, and medical exams.  By contrast, the British Government's [[Health and Safety Executive]] (HSE) states formally that any threshold for mesothelioma must be at a very low level and it is widely agreed that if any such threshold does exist at all, then it cannot currently be quantified. For practical purposes, therefore, HSE does not assume that any such threshold exists. People who work with asbestos wear personal protective equipment to lower their risk of exposure.
 
====Occupational====
 
Exposure to asbestos fibres has been recognised as an occupational health hazard since the early 1900s. Several epidemiological studies have associated exposure to asbestos with the development of lesions such as asbestos bodies in the sputum, pleural plaques, diffuse pleural thickening, asbestosis, carcinoma of the lung and larynx, gastrointestinal tumours, and diffuse mesothelioma of the pleura and peritoneum.  
 
The documented presence of asbestos fibres in water supplies and food products has fostered concerns about the possible impact of long-term and, as yet, unknown exposure of the general population to these fibres.  Although many authorities consider brief or transient exposure to asbestos fibres as inconsequential and an unlikely risk factor, some epidemiologists claim that there is no risk threshold.  Cases of mesothelioma have been found in people whose only exposure was breathing the air through ventilation systems.  Other cases had very minimal (3 months or less) direct exposure. 
 
Commercial asbestos mining at Wittenoom, Western Australia, occurred between 1945 and 1966. A cohort study of miners employed at the mine reported that while no deaths occurred within the first 10 years after crocidolite exposure, 85 deaths attributable to mesothelioma had occurred by 1985. By 1994, 539 reported deaths due to mesothelioma had been reported in Western Australia.
 
====Paraoccupational Secondary Exposure====


Family members and others living with asbestos workers have an increased risk of developing mesothelioma, and possibly other asbestos related diseases. This risk may be the result of exposure to asbestos dust brought home on the clothing and hair of asbestos workers. To reduce the chance of exposing family members to asbestos fibres, asbestos workers are usually required to shower and change their clothing before leaving the workplace.
===Age===
*Males are more commonly affected with mesothelioma than females. The male to female ratio is approximately 3 to 1.<ref name="epidemiologymesothelioma1">Mesothelioma. CGMH.ORG 2016. https://www1.cgmh.org.tw/intr/intr5/c6700/OBGYN/f/web/Mesothelioma/index.htm. Accessed on February 15, 2016</ref>
*The [[incidence]] of mesothelioma increases with age; the median age at diagnosis for [[pleural]] mesothelioma and peritoneal mesothelioma are 74 years and 68 years, respectively.<ref name="ThomasChen2015">{{cite journal|last1=Thomas|first1=Anish|last2=Chen|first2=Yuanbin|last3=Yu|first3=Tinghui|last4=Gill|first4=Ammara|last5=Prasad|first5=Vinay|title=Distinctive clinical characteristics of malignant mesothelioma in young patients|journal=Oncotarget|volume=6|issue=18|year=2015|pages=16766–16773|issn=1949-2553|doi=10.18632/oncotarget.4414}}</ref>


====Asbestos in buildings====
===Race===
 
*There is no racial predilection to mesothelioma.<ref name="epidemiologymesothelioma1">Mesothelioma. CGMH.ORG 2016. https://www1.cgmh.org.tw/intr/intr5/c6700/OBGYN/f/web/Mesothelioma/index.htm. Accessed on February 15, 2016</ref>
Many building materials used in both public and domestic premises prior to the banning of asbestos may contain asbestos. Those performing renovation works or diy activities may expose themselves to asbestos dust. In the UK use of [[Chrysotile|Chrysotile asbestos]] was banned at the end of 1999. Brown and blue asbestos was banned in the UK around 1985. Buildings built or renovated prior to these dates may contain asbestos materials.
 
====Environmental Exposure====
 
Incidence of mesothelioma had been found to be higher in populations living near Naturally Occurring Asbestos (NOA).


==References==
==References==
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Fatima Shaukat, MD [2]Parminder Dhingra, M.D. [3], Sujit Routray, M.D. [4]

Overview

Mesothelioma is a rare disease which accounts for 5-28% of all malignancies that involve the pleura. The incidence of mesothelioma is estimated to be 3,000 cases annually. The incidence of pleural mesothelioma is approximately 1 per 100,000 individuals in the United States. Males are more commonly affected with mesothelioma than females. The male to female ratio is approximately 3 to 1. The incidence of mesothelioma increases with age; the median age at diagnosis for pleural mesothelioma and peritoneal mesothelioma are 74 years and 68 years, respectively. There is no racial predilection to mesothelioma.

Epidemiology and Demographics

Prevalence

  • Mesothelioma is a rare disease which accounts for 5-28% of all malignancies that involve the pleura.[1]

Incidence

  • The incidence of mesothelioma is estimated to be 3,000 cases annually.[2]
  • The incidence of pleural mesothelioma is approximately 1 per 100,000 individuals in the United States.[3]
  • The incidence of pleural mesothelioma is approximately 1.2 per 100,000 individuals in Canada.[3]
  • The incidence of mesothelioma has decreased over several decades in the United States coincident with diminishing occupational asbestos exposure and has remained stable since 2003.[4]

Age

  • Males are more commonly affected with mesothelioma than females. The male to female ratio is approximately 3 to 1.[1]
  • The incidence of mesothelioma increases with age; the median age at diagnosis for pleural mesothelioma and peritoneal mesothelioma are 74 years and 68 years, respectively.[4]

Race

  • There is no racial predilection to mesothelioma.[1]

References

  1. 1.0 1.1 1.2 Epidemiology of mesothelioma. Dr Bruno Di Muzio and A.Prof Frank Gaillard et al. Radiopaedia 2016. http://radiopaedia.org/articles/mesothelioma. Accessed on February 8, 2016
  2. Philip A. Rascoe, Xiaobo X. Cao and W. Roy Smythe (2012). Molecular Pathogenesis of Malignant Pleural Mesothelioma, Mesotheliomas - Synonyms and Definition, Epidemiology, Etiology, Pathogenesis, Cyto-Histopathological Features, Clinic, Diagnosis, Treatment, Prognosis, Dr Alexander Zubritsky (Ed.), ISBN: 978-953-307-845-8, InTech, Available from: http://www.intechopen.com/books/mesotheliomas-synonyms-and-definition-epidemiology-etiology-pathogenesis-cyto-histopathological-features-clinic-diagnosis-treatment-prognosis/molecular-pathogenesis-of-malignant-pleural-mesothelioma
  3. 3.0 3.1 Saint-Pierre, Mathieu D.; Pease, Christopher; Mithoowani, Hamid; Zhang, Tinghua; Nicholas, Garth A.; Laurie, Scott A.; Wheatley-Price, Paul (2015). "Malignant Pleural Mesothelioma Outcomes in the Era of Combined Platinum and Folate Antimetabolite Chemotherapy". Lung Cancer International. 2015: 1–7. doi:10.1155/2015/590148. ISSN 2090-3197.
  4. 4.0 4.1 Thomas, Anish; Chen, Yuanbin; Yu, Tinghui; Gill, Ammara; Prasad, Vinay (2015). "Distinctive clinical characteristics of malignant mesothelioma in young patients". Oncotarget. 6 (18): 16766–16773. doi:10.18632/oncotarget.4414. ISSN 1949-2553.


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