Global, Regional, and National Burden of Mesothelioma 1990-2019: A Systematic Analysis of the Global Burden of Disease Study 2019.

RATIONALE: Mesothelioma has become a major health burden since the second world war due to the use of asbestos. Although many countries have imposed a ban on asbestos, there remains significant mortality and morbidity from mesothelioma owing to its long latent period and aggressiveness. Also, the use of asbestos is increasing in low-income countries, potentiating risk of mesothelioma in the upcoming decades. Assessment of global burden of mesothelioma is required to take proper measures against the disease.

OBJECTIVES: To assess the burden of mesothelioma from 1990 to 2019 at the global, regional, and national level and investigate patterns according to sex, age, socio-demographic index (SDI) and risk factors Methods: The numbers, rates, and age-standardised rates of incidence, deaths, and disability-adjusted life years (DALYs) of mesothelioma in 204 countries and territories from 1990 to 2019 were estimated using vital registration and cancer registry data. Relationship between SDI and age-standardised DALY rates was determined and DALYs attributable to occupational exposure to asbestos were calculated.

RESULTS: In 2019, there were 34511 (95% UI 31199 to 37771) incident cases of mesothelioma globally, with an age-standardised rate of 0.43 per 100 000 persons (0.38 to 0.47) which decreased between 1990 and 2019 by -12.6% (-21.8 to -2.3). Mesothelioma was responsible for 29251(26668 to 31006) deaths in 2019, with an age-standardised rate of 0.36 deaths per 100 000 persons (0.33 to 0.39), which decreased between 1990 and 2019 by -9.6% (-17.8 to -1.1). The age-standardised incidence rate increased in central Europe between 1990 and 2019 by 46.1% (16.6 to 72.4). Netherlands, Australia, and UK had the highest age-standardised incidence rates. The incidence rates were higher in males than in females from ages 45-49 to 90-94, peaking at ages 85-89. Occupational exposure to asbestos contributed to 91.9% (90.0 to 93.6) of DALYs.

CONCLUSION: Global burden of mesothelioma is decreasing in terms of age-standardised incidence and mortality rates. Mesothelioma remains a substantial public health challenge in many parts of the world.