Epidemiology of mesothelioma in Egypt. A ten-year (1998-2007) multicentre study

Our plain-English summary of Epidemiology of mesothelioma in Egypt. A ten-year (1998-2007) multicentre study, by Y. Akl, S. Kaddah, A. Abdelhafeez, et al (Archives of Medical Science, 2010).

The study

• Authors: Y. Akl, S. Kaddah, A. Abdelhafeez, R. Salah, M. Lotayef
• Journal: Archives of Medical Science
• Published: 2010;6(6):926-31
• Cited by: 6 articles, as counted by NIH iCite
• Read it: PubMed · Publisher · Free full text

Abstract

Introduction: Mesothelioma is a cancer strongly linked to exposure to carcinogenic minerals, especially asbestos. The aim of the study was to detect the incidence of malignant pleural mesothelioma (MPM) in Egypt, to clarify the impact of occupational and environmental risk factors, and to characterise its demographic features.

Material And Methods: They were 584 cases diagnosed as MPM detected in Cairo University Hospitals and National Cancer Institute from 1998 to 2007. Unfortunately, full epidemiological data were only available for 165 cases due to absence of a reliable registration system.

Results: A steady increase in the number of cases was detected, from 24 in 1998, peaking at 82 cases in 2005, followed by a gradual decline (though still high) with 68 cases in 2006 and 51 cases in 2007. Male/female ratio was 1.35/1 (p > 0.05). The occupational exposure to asbestos was 13.9%. Residential exposure plays a major role in two regions, Helwan and Shoubra (27.3% and 20.6% respectively), while in Upper and Lower Egypt the level was 12.7% and 17.5% respectively. Kaplan-Meier survival for sex, residence and the pathological types epithelioid, biphasic and sarcomatoid was insignificant. The median survival for different grades and treatment modalities was significant (P < 0.001).

Conclusions: There was a steady increase in the incidence of MPM from 1998 to 2005 followed by a decline during 2006-2007. Mesothelioma in Egypt is mainly concentrated in areas of high environmental pollution. The decline within the last 2 years may be attributed to recent strict industrial preventive measures. However, a better environmental control programme would benefit Egypt.

In plain English

This retrospective study counted all cases of malignant pleural mesothelioma diagnosed from 1998 to 2007 at the chest and nuclear medicine departments of Cairo University Hospitals and at the National Cancer Institute in Egypt. There were 584 cases. Yearly numbers rose from 24 in 1998 to 82 in 2005, then fell to 51 in 2007. Because of poor record-keeping, full data were available for only 165 patients. Of these 165, 23 (13.9%) had worked in asbestos industries. 45 (27.3%) lived in Helwan and 34 (20.6%) in Shobra, where the authors noted Siegwart asbestos factories are located. Median survival was 7.0 months, and all patients died. Survival differed significantly by tumour grade and by treatment, but not by sex or tissue type. The authors concluded that residential location was linked to mesothelioma in areas of heavy pollution and environmental asbestos exposure. They suggested that stricter environmental measures may explain the recent decline, while noting that no data yet support this. They stated that their counts do not represent the true incidence because Egypt lacks a reliable registration system.

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 multicentre hospital case series
• Who was studied: 584 patients diagnosed with malignant pleural mesothelioma, 1998 to 2007: 314 from the National Cancer Institute, 184 from the chest department and 86 from the nuclear medicine department of Cairo University, Egypt. Full data were available for 165 of them (94 males, 71 females; mean age 50.78 years, range 15 to 83).
• Exposure: Occupational asbestos exposure (work in asbestos industries such as cement pipes, roofing, brake linings, and mining) and place of residence, especially Helwan and Shoubra near Siegwart factories. No fiber types are named.
• Main results:
  • Among all 584 cases, yearly case numbers rose from 24 in 1998 to 82 in 2005, then fell to 51 in 2007.
  • Of the 165 patients with full data, 23 (13.9%) worked in asbestos industries; 142 (86.1%) had no exposure at work.
  • Of the 165 patients, 45 (27.3%) lived in Helwan and 34 (20.6%) in Shobra; 21 (12.7%) were from Upper Egypt and 29 (17.5%) from other parts of Egypt.
  • Of the 165 patients, 94 were male and 71 female. The authors reported no major sex difference (ratio given as 1.35 to 1, p greater than 0.05).
  • Tissue types among the 165 patients: epithelioid 114 (69.1%), biphasic 43 (26.1%), sarcomatoid 8 (4.8%).
  • In the 165 patients, overall median survival was 7.0 months (range 1 to 52 months), and all patients died.
  • Median survival did not differ significantly by sex: 8.0 months for females and 6.0 months for males.
  • Median survival did not differ significantly by tissue type: 9.8 months for epithelioid, 7.1 months for biphasic and 6.5 months for sarcomatoid.
  • Median survival differed significantly by grade (p less than 0.001): 6.0 months for grade I, 8.0 months for grade II and 5.0 months for grade III.
  • Median survival differed significantly by treatment (p less than 0.001): 8.0 months with chemotherapy alone, 3.0 months with surgery alone, 11.0 months with chemotherapy plus surgery and 4.0 months with supportive therapy.
• The authors' conclusion: The authors concluded that cases rose from 1998 to 2005 and declined in 2006 to 2007. They found a positive link between residential location and mesothelioma, associated with areas of heavy pollution and environmental asbestos exposure. They suggested that stricter environmental preventive measures may explain the recent decline.
• Limitations the authors state:
  • Full epidemiological data were available for only 165 of the 584 cases because of poor record-keeping.
  • The case counts do not represent the true incidence because Egypt has no reliable registration and case detection system.
  • Difficulties with sampling and diagnosis, together with short survival, may cause further discrepancies.
  • No data yet support the suggested explanation for the decline in cases.

Topics

Medical terms in this study, explained in our Lexicon: Epidemiology, Mesothelioma, Carcinogenic, Pleural Mesothelioma, Occupational Exposure, Epithelioid, Biphasic Mesothelioma, Sarcomatoid.

Related studies

• Epidemiology of mesothelioma in the 21st century in Europe and the United States, 40 years after restricted/banned asbestos use — N. Alpert, M. van Gerwen, et al. (2020)
• Epidemiology and outcome of peritoneal and pleural mesothelioma subtypes in Norway. A 20 year nation-wide study — O.T. Brustugun, Y. Nilssen, et al. (2021)
• Epidemiology of asbestosis in the Netherlands: a 10-year cohort analysis — I. Smesseim, H. Schouwink, et al. (2026)
• Epidemic of mesothelioma in Egypt — R.M. Gaafar, N.H. Eldin (2005)
• Impact of Some Ecological Factors on Fecal Contamination of Drinking Water by Diarrheagenic Antibiotic-Resistant Escherichia coli in Zagazig City, Egypt — A.E. Fakhr, M.K. Gohar, et al. (2016)
• A multi-disciplinary approach for uranium exploration using remote sensing and airborne gamma-ray spectrometry data in the Gebel Duwi area, Central Eastern Desert, Egypt — M.A.E. Hegab (2024)

Browse return to medical research.