Epidemiology and trend analysis on malignant mesothelioma in China

Our plain-English summary of Epidemiology and trend analysis on malignant mesothelioma in China, by J. Zhao, T. Zuo, R. Zheng, et al (Chinese Journal of Cancer Research = Chung-kuo Yen Cheng Yen Chiu, 2017).

The study

• Authors: J. Zhao, T. Zuo, R. Zheng, S. Zhang, H. Zeng, C. Xia, Z. Yang, W. Chen
• Journal: Chinese Journal of Cancer Research = Chung-kuo Yen Cheng Yen Chiu
• Published: 2017;29(4):361-368
• Cited by: 35 articles, as counted by NIH iCite
• Read it: PubMed · Publisher · Free full text

Abstract

Objective: Population-based cancer registration data were used to analyze the epidemiology and trend of malignant mesothelioma in China, and the result would provide basic data for its prevention and control.

Methods: Malignant mesothelioma data in 2013 were retrieved from the database of National Cancer Registry. Malignant mesothelioma incidence and mortality were estimated using age-specific rate by urban/rural and gender according to the national population in 2013. Malignant mesothelioma data from 22 cancer registries were used for trend analysis during 2000-2013.

Results: It is estimated that there were 2,041 new malignant mesothelioma cases and 1,659 malignant mesothelioma deaths occurred in 2013. The crude incidence rate in China were 1.50/106 (males 1.67/106, females 1.32/106), age-standardized incidence rates by Chinese standard population (ASIRC) and by world standard population (ASIRW) were 1.03/106 and 1.02/106, respectively. The crude mortality rate in China was 1.22/106 (males 1.67/106, females 1.32/106), age-standardized mortality rates by Chinese standard population (ASMRC) and by world standard population (ASMRW) were 0.83/106 and 0.81/106, respectively. There was an increasing trend of incidence rate for malignant mesothelioma in registration areas of China during 2000-2013 with annual percentage change (APC) of 2.5% [95% confidence interval (95% CI): 0.6%-4.5%]. After age standardization, no significant differences were observed. No matter for crude mortality rates or age-standardized mortality rates, no significant differences were observed during 2000-2013.

Conclusions: Malignant mesothelioma is the major occupational and environmental neoplasm associated with asbestos exposure. The increasing incidence trend suggests that more attention should be paid on this disease.

In plain English

This study used Chinese population-based cancer registry data to estimate how common malignant mesothelioma was in China in 2013 and how rates changed from 2000 to 2013. National figures for 2013 came from 255 registries covering 226,494,490 people, about 16.65% of the population. The trend analysis used data from 22 registries. The study did not report an analysis of individual asbestos exposure. The authors estimated 2,041 new cases and 1,659 deaths in China in 2013. That is a crude incidence of 1.50 per million people and a crude death rate of 1.22 per million. Rates were higher in urban than in rural areas. In the 22 registries, crude incidence rose by an estimated 2.5% a year (95% CI 0.6% to 4.5%). There was a significant rise in males but not in females. After adjusting for age, the change was not statistically significant. Overall death rates showed no significant trend, although some time periods showed increases in males and in females. The authors concluded that incidence was rising while mortality was stable.

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: Descriptive analysis of population-based cancer registry data: national estimates for 2013 plus a trend analysis for 2000 to 2013 using Joinpoint regression
• Who was studied: 255 qualified Chinese cancer registries (88 cities, 167 counties) covering 226,494,490 people, about 16.65% of China's population at the end of 2013, used to estimate national 2013 figures. Data from 22 cancer registries were used for the 2000 to 2013 trend analysis.
• Exposure: The article reports no analysis of individual asbestos exposure. It counted registered invasive malignant mesothelioma cases (ICD-10 code C45) and analysed rates by area, sex and age group. Asbestos is discussed only as background in the introduction and discussion.
• Main results:
  • An estimated 2,041 new malignant mesothelioma cases occurred in China in 2013, 0.06% of all new cancer cases. Crude incidence was 1.50 per million (males 1.67, females 1.32). Age-standardized incidence was 1.03 per million using the Chinese standard population and 1.02 per million using the world standard population.
  • An estimated 1,659 malignant mesothelioma deaths occurred in China in 2013, 0.07% of all cancer deaths. Crude mortality was 1.22 per million (Table 3: males 1.46, females 0.97). Age-standardized mortality was 0.83 per million (Chinese standard population) and 0.81 per million (world standard population).
  • Rates were higher in urban than in rural areas. Crude incidence was 1.89 per million in urban areas versus 1.04 in rural areas. Crude mortality was 1.57 versus 0.81 per million.
  • In the 22 registries from 2000 to 2013, crude incidence for both sexes increased, with an annual percentage change of 2.5% (95% CI 0.6% to 4.5%).
  • Crude incidence in males increased with an annual percentage change of 3.9% (95% CI 1.4% to 6.5%). No significant change was found in females.
  • After age standardization, the incidence trend was not statistically significant in either sex. For both sexes combined, the annual percentage change was -0.7% (95% CI -2.6% to 1.3%; Table 5).
  • Crude mortality trends were not significant for both sexes combined. In males, crude mortality increased from 2003 to 2013 with an annual percentage change of 3.9% (95% CI 1.2% to 6.6%).
  • In females, crude mortality increased from 2000 to 2009 with an annual percentage change of 7.6% (95% CI 3.1% to 12.4%).
  • After age standardization, mortality trends were not significant, except in females from 2000 to 2007, with an annual percentage change of 7.6% (95% CI 0.3% to 15.4%).
• The authors' conclusion: The authors concluded that the incidence trend of malignant mesothelioma in China was increasing while the mortality trend was stable. They also said that, although rates in China were relatively low compared with western countries, the rising incidence deserves more attention.
• Limitations the authors state:
  • The authors suggested that the low rates in Eastern Asia compared with western countries may partly reflect underdiagnosis or underregistration of malignant mesothelioma.
  • The authors raised concern that most Chinese physicians lack experience diagnosing this rare disease.

Topics

Medical terms in this study, explained in our Lexicon: Epidemiology, Mesothelioma, Cancer Registry, Incidence, confidence interval, Neoplasm, Asbestos Exposure.

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