Estimation of the global burden of mesothelioma deaths from incomplete national mortality data

Abstract

Background: Mesothelioma is increasingly recognised as a global health issue and the assessment of its global burden is warranted.

Objectives: To descriptively analyse national mortality data and to use reported and estimated data to calculate the global burden of mesothelioma deaths.

Methods: For the study period of 1994 to 2014, we grouped 230 countries into 59 countries with quality mesothelioma mortality data suitable to be used for reference rates, 45 countries with poor quality data and 126 countries with no data, based on the availability of data in the WHO Mortality Database. To estimate global deaths, we extrapolated the gender-specific and age-specific mortality rates of the countries with quality data to all other countries.

Results: The global numbers and rates of mesothelioma deaths have increased over time. The 59 countries with quality data recorded 15 011 mesothelioma deaths per year over the 3 most recent years with available data (equivalent to 9.9 deaths per million per year). From these reference data, we extrapolated the global mesothelioma deaths to be 38 400 per year, based on extrapolations for asbestos use.

Conclusions: Although the validity of our extrapolation method depends on the adequate identification of quality mesothelioma data and appropriate adjustment for other variables, our estimates can be updated, refined and verified because they are based on commonly accessible data and are derived using a straightforward algorithm. Our estimates are within the range of previously reported values but higher than the most recently reported values.

Keywords: asbestos; mesothelioma; statistics.

Figure 1

Availabiltiy of mesothelioma mortality data from 104 reporting countries in the WHO mortality database.

Figure 2

Crude mesothelioma mortality rates across 104 reporting countries with regard to data availability for: the number of reporting years (figure 2A), the number of reported deaths (figure 2B): (1) Unit is in deaths per million population per year. (2) Bubbles are drawn in proportion to the size of the population. (3) Blank and shadowed bubbles indicate that the mesothelioma data were suitable (N = 59) or not suitable (N = 45) for extrapolation, respectively. (4) Shadowed bubbles with solid outline indicates ten or fewer reported deaths (figure 2A) and two or fewer reporting years (figure 2B).

Figure 3

Time trend of the age-adjusted mortality rates by the most recent one year (figure 3A), two years (figure 3B) and three years (figure 3C) across 59 countries used to compile reference rates suitable for extrapolation: (1) Unit in deaths per million population per year. (2) Bubble size is proportional to the number of reporting countries. (3) X axis represents the moving average of age adjusted MR against most recent one (R² = 0.8769; P < 0.0001), two (R² = 0.8868; P < 0.0001) and three (R² = 0.8940; P < 0.0001) calendar years (during 1994–2014) with available data in the 59 countries.