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. 2025 May 16;22(5):787.
doi: 10.3390/ijerph22050787.

Epidemiological Trends in Mesothelioma Mortality in Colombia (1997-2022): A Retrospective National Study

Luisa F Moyano-Ariza  1   2 , Guillermo Villamizar  1   3 , Giana Henríquez-Mendoza  4 , Arthur Frank  5 , Gabriel Camero  6
Affiliations

Epidemiological Trends in Mesothelioma Mortality in Colombia (1997-2022): A Retrospective National Study

Luisa F Moyano-Ariza et al. Int J Environ Res Public Health. .

Abstract

Background: Mesothelioma is a rare and aggressive cancer primarily caused by asbestos exposure. In Colombia, asbestos use began in 1942, but mortality surveillance remains limited. Long latency periods and poor documentation hinder public health action.

Materials and methods: A retrospective descriptive study was conducted using mortality data from 1997 to 2022 obtained from the National Administrative Department of Statistics (DANE), including all mesothelioma cases recorded under the five ICD-10 diagnostic categories (C45.0 to C45.9), covering all anatomical sites of first occurrence. Variables analyzed included sex, age, occupation, and place of residence. Mortality rates and trends were estimated using R, Excel, JoinPoint, and Minitab.

Results: A total of 1539 mesothelioma deaths were recorded. Most occurred in men (65.1%) and in individuals over 60 years old (62.6%). Urban areas accounted for 92% of deaths. The most frequent diagnosis was unspecified mesothelioma (61.3%). Cities with the highest adjusted mortality rates per 100,000 inhabitants were Sibaté (38.36), Soacha (8.41), and Bogotá (1.89), aligning with historical exposure zones.

Conclusions: Mesothelioma is still a preventable public health issue in Colombia, with sustained mortality affecting even working-age populations. The high rate of unspecified diagnoses and weak linkage between morbidity and mortality data underscore the need to strengthen diagnostic capacity, improve surveillance, and implement a national asbestos-related disease elimination strategy.

Keywords: Colombia; ICD-10; asbestos exposure; epidemiology; mesothelioma; mortality trends; occupational disease; public health.

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Conflict of interest statement

Guillermo Villamizar reports financial and administrative support from Fundación Colombia Libre de Asbesto, with which he maintains an employment relationship. Gabriel Camero Ramos and Luisa Fernanda Moyano report administrative support provided by the Colombian General System of Royalties (Sistema General de Regalías). Arthur L. Frank, MD, PhD, reports a relationship with Drexel University Dornsife School of Public Health that includes paid expert testimony. Giana Henríquez declares no conflicts of interest. The authors affirm that none of these affiliations influenced the design, execution, or interpretation of the study.

Figures

Figure 1
Figure 1
Percentage of deaths due to mesothelioma, according to sex, Colombia, 1997–2022. Source: DANE—National Administrative Department of Statistics.
Figure 2
Figure 2
Percentage of deaths due to mesothelioma, by age group, Colombia, 1997–2022. Source: DANE—National Administrative Department of Statistics.
Figure 3
Figure 3
Percentage of deaths due to mesothelioma, by diagnosis, Colombia, 1997–2022. Source: DANE—National Administrative Department of Statistics.
Figure 4
Figure 4
Trend analysis of mesothelioma mortality and diagnosis types, Colombia, 1997–2022. Source: Based on data compiled by the authors.
Figure 5
Figure 5
Historical asbestos consumption in Colombia (tonnes), 1960–2017. Source: United States Geological Survey.
Figure 6
Figure 6
Nested dispersion of adjusted mesothelioma mortality rates, Colombia, 1997–2022. Source: Based on data compiled by the authors.
Figure 7
Figure 7
Process control chart of median mesothelioma mortality, Colombia, 1997–2022. Source: Based on data compiled by the authors.
Figure 8
Figure 8
Difference in median mesothelioma mortality rates, 1997–2012 vs. 2013–2022. Source: Based on data compiled by the authors. Blue dots represent annual adjusted mortality rates per 100,000 population. The control limits (LCS and LCI) and the average line (X¯) are shown for reference. Box plots summarize the distribution of mortality rates for the periods 1997–2012 and 2013–2022. Square symbols indicate the median values for each period. The statistically significant difference between the two medians (p < 0.001; 95% CI: 0.13–0.26) was determined using the Mann–Whitney U test. Values marked with “1” correspond to years in which the adjusted mortality rate exceeded the upper control limit predicted by the model.
Figure 9
Figure 9
Annual mesothelioma cases, deaths, and adjusted mortality rate, Colombia, 2009–2022. Source: National Administrative Department of Statistics. Comprehensive Social Protection Information System (SISPRO).
Figure 10
Figure 10
Annual proportion of mesothelioma cases by occupation type, Colombia, 2008–2022. Source: DANE—National Administrative Department of Statistics.
Figure 11
Figure 11
Adjusted mesothelioma mortality in asbestos-exposed cities, Colombia, 1997–2022. Source: Based on data compiled by the authors.
Figure 12
Figure 12
Mortality rate in adults aged 45–59 years, Colombia, 2013–2022. Source: Based on data compiled by the authors.
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