Epidemiology of mesothelioma in the 21st century in Europe and the United States, 40 years after restricted/banned asbestos use

Abstract

Research has established a strong association between asbestos exposure and malignant mesothelioma, a deadly form of cancer. Since the early 1980's many countries have restricted or banned the production of asbestos, leading to a decline of occupational asbestos exposure in many industrialized countries. However, some countries continue to use asbestos, and worldwide rates of mesothelioma are still increasing. Because of the long latency between exposure and mesothelioma occurrence and the persistence of environmental exposure, incidence rates (IR) may decrease very slowly for several years ahead. In this review, we examine estimates of asbestos consumption before widespread asbestos regulations and the trends in incidence and mortality rates, as well as changes over time for the United States and Europe. In some countries with earlier asbestos restrictions, mesothelioma incidence has been in a modest decline over time. However, asbestos exposure is still a burden worldwide and legislative action is needed to obtain a full ban. The pattern of mesothelioma is shifting from a mostly male disease to a disease that affects females as well in substantial numbers. Studies on unknown sources of asbestos exposure, of other sources of natural exposure to asbestos and asbestos-like fibers, as well as of individual genetic susceptibility to asbestos fibers are needed.

Keywords: Carcinogen regulation; environmental exposure; incidence trends; mortality.

Figure 1

Apparent consumption (kg/capita) of asbestos in (A) 1980 and (B) 2007 in the United States and Europe.

Figure 2

World standardized incidence rates of mesothelioma in the United States and Europe for (A) men and (B) women, 2008–2012.

Figure 3

Age specific annual incidence rates [2008–2012], for (A) United States and (B) Europe, by gender.

Figure 4

World standardized incidence rates (per 100,000) over time, overall and by gender in the (A) United States, and (B) Europe. (C) Ratio of world standardized incidence rates for females vs. males, over time in the United States and Europe.