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

Our plain-English summary of Epidemiological Trends in Mesothelioma Mortality in Colombia (1997-2022): A Retrospective National Study, by L.F. Moyano-Ariza, G. Villamizar, G. Henríquez-Mendoza, et al (International Journal of Environmental Research and Public Health, 2025).

The study

• Authors: L.F. Moyano-Ariza, G. Villamizar, G. Henríquez-Mendoza, A. Frank, G. Camero
• Journal: International Journal of Environmental Research and Public Health
• Published: 2025;22(5)
• Cited by: 2 articles, as counted by NIH iCite
• Read it: PubMed · Publisher · Free full text

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.

In plain English

This retrospective descriptive study examined Colombia's national death records from 1997 to 2022, drawn from the national statistics agency (DANE) and covering all mesothelioma diagnostic codes. It counted 1539 mesothelioma deaths: 1002 in men (65.1%) and 537 in women (34.9%). Most deaths (62.6%; n = 963) were in people over 60. The body site was unspecified in 61.3% of deaths (n = 944) and recorded as pleural in 27.6% (n = 424). Age- and sex-adjusted national rates ranged from 0.17 per 100,000 (2003 and 2007) to 0.59 (2017). The median yearly rate rose from 0.296 in 1997–2012 to 0.4785 in 2013–2022, a statistically significant difference. The authors considered a significant decline from 2017 to 2022 likely artefactual, coinciding with COVID-19. Sibaté, where Colombia's first asbestos plant opened in 1942, had adjusted rates of 4.8 to 38.36 per 100,000. Occupation was missing for 39.8% of deaths. The authors concluded that the records show underreporting and diagnostic imprecision. They noted that death and illness records could not be linked.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: Retrospective descriptive analysis of national mortality records (secondary, anonymized data), with trend analysis (JoinPoint) and comparison of two time periods
• Who was studied: All 1539 deaths recorded as mesothelioma (ICD-10 codes C45.0, C45.1, C45.2, C45.7, C45.9) in Colombia's national mortality data (DANE), 1997–2022. Separate morbidity data (SISPRO) covered 2009–2022.
• Exposure: No individual asbestos exposure was measured. Deaths were analyzed by sex, age, occupation as recorded on the death record (available from 2008), and place of residence. They were interpreted against the history of asbestos industry in Colombia, which began in 1942 with the Eternit Colombiana plant in Sibaté.
• Main results:
  • Of the 1539 deaths, 1002 (65.1%) were in men and 537 (34.9%) in women, a male-to-female ratio of about 2:1.
  • 62.6% of deaths (n = 963) were in people over 60. The 45–59 age group accounted for 28.3% (n = 435), the 30–44 group for 8.0% (n = 121), and under-30s for 1.3% (n = 20).
  • Mesothelioma deaths were also recorded among children aged 5–14 in 1997, 2001, 2003, 2012 and 2016.
  • By diagnosis: unspecified site 61.3% (n = 944), pleura 27.6% (n = 424), other specified sites 6.0% (n = 101), peritoneum 4.0% (n = 61), pericardium 0.6% (n = 9).
  • Age- and sex-adjusted national mortality rates were lowest in 2003 and 2007 (0.17 per 100,000) and highest in 2017 (0.59 per 100,000). The rate in 2022 was 0.41 per 100,000.
  • A statistically significant decline was found between 2017 and 2022 (annual percent change of minus 4.53%). The authors attributed this decline as likely artefactual, coinciding with the COVID-19 pandemic.
  • Pleural mesothelioma (C450) showed the steepest rise, with an annual percent change of +8.75% from 1997 to 2017.
  • The median adjusted mortality rate was 0.296 in 1997–2012 and 0.4785 in 2013–2022. The reported difference was 0.20 (95% CI 0.13 to 0.26; p less than 0.001, Mann–Whitney U test).
  • By department of residence, Bogotá accounted for 43% of deaths (n = 666), Cundinamarca for 16% (n = 241) and Antioquia for 8% (n = 116).
  • Sibaté reported mesothelioma deaths in 18 years, with adjusted rates ranging from 4.8 to 38.36 per 100,000. This was the highest sustained rate among cities. Soacha's maximum rate was 8.41 per 100,000.
  • Occupation was missing for 39.8% of deaths. 23.1% (356 of 1539) were recorded as household-related occupations, mainly homemakers. 6.8% were recorded as pensioners.
  • The study found an annual average of about 62 mesothelioma deaths. The Global Burden of Disease study estimated 98 deaths in Colombia for 2021.
• The authors' conclusion: The authors concluded that Colombia has a sustained, geographically widespread mesothelioma mortality burden affecting both men and women. They found a consistent pattern of underreporting and diagnostic imprecision, especially the high share of unspecified-site diagnoses. They called for better diagnosis, coding and surveillance, and a national mesothelioma registry.
• Limitations the authors state:
  • Mortality and morbidity records could not be linked, so it was unknown how many diagnosed cases ended in death.
  • Occupation was recorded only from 2008, and with low completeness.
  • Prior occupational histories of older decedents (many recorded as pensioners or homemakers) could not be reconstructed, so exposure sources could not be determined.
  • The decline after 2017–2018 may be artefactual, due to COVID-19-era disruption of cause-of-death classification.
  • Patients often seek care in major cities, which may affect where cases are recorded geographically.
  • Institutional variables (treating health facilities, insurers and occupational risk administrators) could not be identified.

Topics

The National Library of Medicine indexes this study under subjects our site covers: Mesothelioma.

Medical terms in this study, explained in our Lexicon: Mesothelioma, Asbestos Exposure, Latency.

Related studies

• Epidemiological patterns of asbestos exposure and spatial clusters of incident cases of malignant mesothelioma from the Italian national registry — M. Corfiati, A. Scarselli, et al. (2015)
• Asbestos Exposure in Low-Middle Income Communities of Cartagena, Colombia: A Survey of Knowledge, Practices, and Environmental Contamination — G. Villamizar, A. Frank, et al. (2025)
• Epidemiology of Asbestosis between 2010-2014 and 2015-2019 Periods in Colombia: Descriptive Study — G. Camero, G. Villamizar, et al. (2023)
• Assessing the global burden of mesothelioma: trends, socioeconomic influences, and asbestos exposure - a retrospective cohort study — Z. Zhao, J. Li, et al. (2025)
• Trends in mesothelioma mortality rates in South Africa: 1995-2007 — D. Kielkowski, G. Nelson, et al. (2011)
• Factors affecting the mesothelioma detection rate within national and international epidemiological studies: insights from Scottish linked cancer registry-mortality data — D.R. Camidge, D.L. Stockton, et al. (2006)

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