Mesothelioma Incidence Rates in Australia since 1982: Exploring Age, Period, and Cohort Effects and Future Projections

Our plain-English summary of Mesothelioma Incidence Rates in Australia since 1982: Exploring Age, Period, and Cohort Effects and Future Projections, by K. Walker-Bone, M.A. Goodwin, B. Bufton, et al (Cancer Epidemiology, Biomarkers & Prevention, 2025).

The study

• Authors: K. Walker-Bone, M.A. Goodwin, B. Bufton, B.A. Davis, H. Wong, J. Harvey, S. Barker, E. Chalker, S. Klebe, S. Prabhakaran, F.J.H. Brims, E. MacFarlane, G. Benke, K. Mahoney, T.R. Driscoll
• Journal: Cancer Epidemiology, Biomarkers & Prevention
• Published: 2025;34(7):1149-1155
• Cited by: 8 articles, as counted by NIH iCite
• Read it: PubMed · Publisher · Free full text

Abstract

Background: The use of asbestos-containing products was banned in Australia in 2003. However, the rates of new cases of mesothelioma, which has a very long latent period between exposure and disease, have continued to increase. The aim of this study was to investigate mesothelioma incidence in Australia by year of birth and age-period-cohort analysis and to develop projections of expected mesothelioma cases until 2034.

Methods: Data were derived from the Australian Cancer Database which provides complete national records of mesothelioma cases notified between 1982 and 2020. Incidence rates were age-standardized to the 2001 Australian standard population to enable comparisons of the population across time. Age-period-cohort models were used to examine the temporal trends of incidence rates by age, calendar year, and birth cohort. Projections for incidence rates of mesothelioma for 2020 to 2034 were estimated using Nordpred models.

Results: Graphs of age-standardized incidence rates of mesothelioma suggest a birth cohort effect, and the age-period-cohort model confirmed this. There was a birth cohort effect in all cohorts born before 1960, strongest in cohorts born during 1920 to 1949. Projection modeling to 2034 suggested that the age-standardized rates will continue to decline whereas crude incidence rates of mesothelioma will stabilize and then gradually decline, mostly among people of 60 to 84 years of age.

Conclusions: The findings are consistent with the greatest risk of mesothelioma in Australia occurring in cohorts with the highest levels of historical cumulative occupational exposure, showing the value of a ban on asbestos.

Impact: The number of new cases of mesothelioma per year is not expected to decline until after 2030.

©2025 The Authors; Published by the American Association for Cancer Research.

In plain English

This study used Australia's national cancer database to examine mesothelioma diagnosed from 1982 to 2020 and to project new cases to 2034. There were 20,064 cases: 16,636 (83%) in men and 3,428 (17%) in women. The authors used an age–period–cohort model to test whether people born in particular decades had higher rates. Individual asbestos exposure was not measured. Compared with people born in 1980 or later, every birth group born before 1960 had significantly higher rates. The effect was largest for those born in the 1930s, followed by the 1920s and 1940s. The age-standardized rate was projected to fall from 2.5 per 100,000 people in 2020 to 1.7 in 2034. Over the same years, the yearly number of cases was projected to rise from 804 in 2020 to a peak of 891 in 2031, then reach 878 in 2034. Cases were projected to keep increasing among people 85 and older. The authors concluded that the pattern is consistent with occupational exposure being the main cause in Australia. They noted that mesothelioma is hard to diagnose and that the data were not split into pleural and other sites.

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: Population-based analysis of national cancer registry data using an age–period–cohort model, with projections of future cases made using Nordpred software
• Who was studied: All 20,064 mesothelioma cases recorded in the Australian Cancer Database, diagnosed in Australia from 1982 to 2020: 16,636 (83%) men and 3,428 (17%) women
• Exposure: Asbestos exposure was not measured for individuals. The study compared eight groups defined by decade of birth, from born before 1920 to born 1980 or later. The authors related the pattern to the history of asbestos use in Australia.
• Main results:
  • The model found statistically significant effects for older age, more recent year of diagnosis, and being born before 1960, each compared with the reference group born in 1980 or later. Birth groups from the 1960s and 1970s were not significantly different from that reference group.
  • Among the birth groups born before 1960, regression coefficients were: 1930s, 0.64; 1920s, 0.49; 1940s, 0.41; before 1920, 0.26; 1950s, 0.10
  • The model's R2 and adjusted R2 were both 0.77
  • The age-standardized rate (all Australia) was projected to decline from 2.5 per 100,000 people in 2020 to 1.7 per 100,000 in 2034
  • The crude incidence rate was projected to fall from 3.1 per 100,000 in 2020 to 2.8 per 100,000 in 2034
  • The annual number of cases was projected to rise from 804 in 2020 to a peak of 891 in 2031, then fall to 878 in 2034
  • Cases were already declining in people under 75. In people 85 and older, cases were projected to keep increasing until at least 2034.
  • People 85 or older made up 17% of those diagnosed in 2020; this share was projected to be 32% in 2034
• The authors' conclusion: The authors concluded that they had shown a birth cohort effect, with age-standardized rates peaking at different times. They described this as consistent with occupational exposure being the predominant cause of mesothelioma in Australia. Assuming rates keep declining after the 2003 total ban, they expected the annual number of new cases to decline from 2031 onwards.
• Limitations the authors state:
  • Mesothelioma can be difficult to diagnose conclusively
  • Diagnostic criteria have been reclassified over time
  • The data were not presented by anatomic site or as pleural versus nonpleural disease
  • Many potentially exposed people have not yet reached the oldest ages, where rates are highest
  • The projections assume that past incidence trends will continue and that no new trends will develop
  • The projections cannot properly account for changing exposure risk from asbestos in buildings or from environmental exposure
  • The projections assume relatively stable life expectancy
  • Assigning a median year of birth to each age group introduces some misclassification

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, Incidence, Occupational Exposure.

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