Global, regional, and national trends in mesothelioma burden from 1990 to 2019 and the predictions for the next two decades

Our plain-English summary of Global, regional, and national trends in mesothelioma burden from 1990 to 2019 and the predictions for the next two decades, by W. Zhu, J. Liu, Y. Li, et al (SSM - Population Health, 2023).

The study

• Authors: W. Zhu, J. Liu, Y. Li, Z. Shi, S. Wei
• Journal: SSM - Population Health
• Published: 2023;23:101441
• Cited by: 16 articles, as counted by NIH iCite
• Read it: PubMed · Publisher · Free full text

Abstract

Objectives: We aimed to analyze the secular trends in mesothelioma burden, the effect of age, period, and birth cohort, and project the global burden over time.

Material And Methods: Based on the mesothelioma incidence, mortality, and Disability-Adjusted Life Years (DALYs) data from 1990 to 2019 in Global Burden of Diseases (GBD) database, the annual percentage change (APC) and average annual percent change (AAPC), calculated from joinpoint regression model, was used to describe the burden trends. An age-period-cohort model was utilized to disentangle age, period, and birth cohort effects on mesothelioma incidence and mortality trends. The mesothelioma burden was projected by the Bayesian age-period-cohort (BAPC) model.

Results: Globally, there were the significant declines in age-standardized incidence rate (ASIR) (AAPC = -0.4, 95%CI: -0.6,-0.3, P < 0.001), age-standardized mortality rate (ASMR) (AAPC = -0.3, 95%CI: -0.4,-0.2, P < 0.001), and age-standardized DALY rate (ASDR) (AAPC = -0.5, 95%CI: -0.6,-0.4, P < 0.001) of mesothelioma overall 30 years. For regions, Central Europe presented the most distinct increases and the most substantial decrease was observed in Andean Latin America on all ASRs (age-standardized rates) from 1990 to 2019. At national level, the largest annualized growth for full-range trends of incidence, mortality, and DALYs was in Georgia. Conversely, the fastest descent of all ASRs was observed in Peru. The ASIR, ASMR, and ASDR in 2039 predicted 0.33, 0.27, and 6.90 per 100,000, respectively.

Conclusions: The global burden of mesothelioma declined over the past 30 years, with variability across regions and countries/territories, and this trend will continue in the future.

© 2023 The Authors. Published by Elsevier Ltd.

In plain English

The authors analyzed Global Burden of Disease 2019 estimates of mesothelioma incidence, deaths and disability-adjusted life years (DALYs, years of healthy life lost) for 204 countries and territories from 1990 to 2019, and projected the global figures to 2039. The study covered mesothelioma of all body sites and did not measure asbestos exposure. The global age-standardized incidence rate fell from 0.49 to 0.43 cases per 100,000, an average change of minus 0.4% per year (95% confidence interval minus 0.6% to minus 0.3%). Age-standardized death and DALY rates also fell on average. The death rate rose from 2007 to 2011, and DALY rates rose in low-middle socio-demographic index regions. Among regions, Central Europe had the largest increases and Andean Latin America the largest decreases. Among countries, Georgia rose fastest and Peru fell fastest. The model projected global age-standardized rates of 0.33 new cases and 0.27 deaths per 100,000 in 2039. The authors concluded that the global burden declined and will keep declining. They noted that they used summary rather than individual data, and that registry data quality, especially in low-income regions, could bias the estimates.

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: Secondary analysis of Global Burden of Disease 2019 estimates (not individual patient data), using joinpoint regression for trends, an age-period-cohort model, and a Bayesian age-period-cohort model for projections to 2039
• Who was studied: Populations of 204 countries and territories, grouped into 21 GBD regions and five socio-demographic index (SDI) levels, 1990 to 2019. Projections to 2039 were global only.
• Exposure: No exposure was measured. The study covered mesothelioma of all sites as defined by ICD-10 codes C45.0 (pleura), C45.1 (peritoneum), C45.2 (pericardium), C45.7 (other sites) and C45.9 (unspecified). Asbestos is discussed but was not analyzed.
• Main results:
  • The global age-standardized incidence rate was 0.49 cases per 100,000 population in 1990 and 0.43 per 100,000 in 2019.
  • The global age-standardized incidence rate fell on average by 0.4% per year from 1990 to 2019 (AAPC minus 0.4, 95% CI minus 0.6 to minus 0.3, P less than 0.001).
  • The global age-standardized mortality rate fell on average from 1990 to 2019 (AAPC minus 0.3, 95% CI minus 0.4 to minus 0.2, P less than 0.001), but rose significantly from 2007 to 2011 (APC 0.5, 95% CI 0.2 to 0.9).
  • The global age-standardized DALY rate was 9.44 per 100,000 in 1990 and 8.10 in 2019 (AAPC minus 0.5, 95% CI minus 0.6 to minus 0.4, P less than 0.001). The rate was projected at 6.90 per 100,000 in 2039.
  • In low-middle SDI regions, the age-standardized DALY rate rose, against the global trend (AAPC 0.7, 95% CI 0.4 to 1, P less than 0.001, in Table 1).
  • Among 21 regions, Central Europe had the most distinct increases and Andean Latin America the largest decrease in incidence, mortality and DALY rates from 1990 to 2019. Central Europe nonetheless declined significantly from 2015 to 2019 (incidence APC minus 2.3, 95% CI minus 3 to minus 1.6; mortality APC minus 2.4, 95% CI minus 3.1 to minus 1.7).
  • Among countries, Georgia had the largest annualized growth in incidence, mortality and DALY rates, and Peru had the fastest decline.
  • Australasia had the highest age-standardized incidence, mortality and DALY rates in both 1990 and 2019.
  • Although global numbers fell, case, death and DALY numbers increased in some countries in East Africa and South Asia.
  • Incidence rose rapidly between ages 50 and 80 globally and in all SDI regions. For mortality, the global local drift after age 90 was more than 1, which the authors read as an increasing long-term trend in deaths.
  • Global projections for 2039: an age-standardized incidence rate of 0.33 per 100,000 with 36,222 new cases, an age-standardized mortality rate of 0.27 per 100,000 with 30,012 deaths, and 927,772 DALYs.
• The authors' conclusion: The authors concluded that the global burden of mesothelioma declined over the past 30 years, varied across SDI regions, GBD regions and countries/territories, and that this trend will continue.
• Limitations the authors state:
  • The analysis used summarized data rather than individual-level data, so the burden could not be broken down in detail, for example by disease stage.
  • The accuracy of the estimates depends on the quality of the original registry-based data, especially in low-income regions, which could bias the estimates.
  • Projections were not made for separate SDI regions because the relevant data were unavailable.

Topics

Medical terms in this study, explained in our Lexicon: Mesothelioma, Incidence.

Related studies

• Global, regional, and national burden of non-communicable diseases attributable to occupational asbestos exposure 1990-2019 and prediction to 2035: worsening or improving? — X. Miao, T. Yao, et al. (2024)
• Global, regional, and national burden of ovarian cancer among young women during 1990-2019 — Q. Zhuang, G. Gu, et al. (2025)
• Global, regional, and national trends in the incidence of pneumoconiosis among populations aged 20 and above from 1990 to 2021 — Q. Cheng, S. He, et al. (2025)
• Global, regional, and national burden of ovarian cancer, 1990-2021, and projections to 2050: a cross-sectional analysis of the Global Burden of Disease Study 2021 — W. Xie, S. Tang, et al. (2026)
• Global, regional, and national burden of head and neck cancer in males and associated risk factors from 1990 to 2021: a systematic analysis for the Global Burden of Disease Study 2021 — J. Jiang, Z. Xia, et al. (2025)
• Global, regional and national mortality burden of laryngeal cancer attributable to occupational exposure to sulfuric acid and asbestos: 1990-2021 and projections to 2040 — X. Gong, Y. Xu, et al. (2025)

Browse return to medical research.