Assessing the global burden of mesothelioma: trends, socioeconomic influences, and asbestos exposure - a retrospective cohort study

评估间皮瘤的全球负担:趋势、社会经济影响和石棉暴露——一项回顾性队列研究

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Abstract

INTRODUCTION: Mesothelioma is an uncommon type of cancer that has received little attention. This study aims to evaluate the global disease burden, trends of mesothelioma by age, sex, and geographic locations, and its risk factors at the population level. METHODS: The Global Cancer Observatory in 2022 and 2019 Global Burden of Disease were accessed for mesothelioma incidence and its risk factors worldwide. Multivariable linear regression analyses were conducted to explore the associations between mesothelioma incidence and key predictors, including Human Development Index (HDI), Gross Domestic Product (GDP) per capita, and occupational asbestos exposure, adjusting for age and sex across global regions. RESULTS: This study identified 30 870 global cases of mesothelioma in 2022, with a higher age-standardized incidence rate in males (0.25 per 100 000) compared to females (0.39 per 100 000). Geographical analysis indicated the highest disease burden in Northern Europe, with particular prevalence in more developed regions. The incidence was also significantly associated with a higher HDI, with a β coefficient of 0.133 overall, and GDP per capita, with a β coefficient of 0.101. These socioeconomic factors exhibited stronger associations in the elderly population, especially with HDI ( β =0.512) and GDP ( β =0.389), than in adults. Additionally, occupational exposure to asbestos remained a significant risk factor across all groups, except for the younger adult population, with an overall β of 0.122 for incidence. The temporal trend analysis revealed a general decrease in mesothelioma incidence, particularly in the 15-49 years age group. CONCLUSIONS: The analysis indicates a higher mesothelioma incidence in males and in developed regions, with marked disparities noted particularly in Northern Europe. Significant correlations with socioeconomic indicators - HDI and GDP - and occupational asbestos exposure were identified, particularly affecting the elderly. Despite a decline in global incidence, especially among younger individuals, persistent cases in females highlight the need for continued public health measures addressing both occupational and environmental exposures.

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