The epidemic of malignant mesothelioma in China: a prediction of incidence during 2016-2030

Our plain-English summary of The epidemic of malignant mesothelioma in China: a prediction of incidence during 2016-2030, by Y. Zhai, Z. Hui, W. Chen, et al (Translational Lung Cancer Research, 2022).

The study

• Authors: Y. Zhai, Z. Hui, W. Chen, J. Ying, J. Li, S. Gao
• Journal: Translational Lung Cancer Research
• Published: 2022;11(12):2403-2411
• Cited by: 12 articles, as counted by NIH iCite
• Read it: PubMed · Publisher · Free full text

Abstract

Background: Malignant mesothelioma is an invasive cancer with a poor prognosis. The crude incidence rate of malignant mesothelioma in China increased throughout 2000 to 2013, which attracted attention. In order to predict the incidence trend of malignant mesothelioma in China, a Bayesian age-period-cohort (APC) prediction model was constructed using publicly available data from the National Cancer Registration Network.

Methods: Based on the annual reports of the national cancer registration from 2005 to 2015, the incidence trend of malignant mesothelioma from 2016 to 2030 in China was forecast using the APC Modeling and Prediction package from the Institute of Biomedical Engineering, London.

Results: The crude incidence rates of malignant mesothelioma decreased from 2.2 per one million person-years in 2005 to 1.6 per one million person-years in 2015. The incidence rates remained stable over the 11-year time period after age standardization. Aging was found to have a dominant effect on the trends. The Bayesian APC model showed that the crude incidence rates would increase from 1.4 per one million person-years in 2016 to 1.9 per one million person-years in 2030, and the estimated number of new incident cases would increase to 2,775 in 2030. The age-standardized incidence rate (ASR) remained steady.

Conclusions: In the future decade, the incidence of malignant mesothelioma may increase, but the ASR will remain stable. Considering its high degree of malignancy, malignant mesothelioma still needs to be taken seriously.

2022 Translational Lung Cancer Research. All rights reserved.

In plain English

This study used China's national cancer registry annual reports for 2005 to 2015 to describe past rates of malignant mesothelioma (ICD-10 C45) and to forecast rates for 2016 to 2030 with a Bayesian age-period-cohort model. By the end of 2015, 368 qualifying registries covered about 300 million people. Asbestos exposure was not part of the model. The crude incidence rate was 2.2 per one million person-years in 2005, 1.9 in 2010 and 1.6 in 2015, while age-standardized rates stayed relatively stable. The model predicted that crude rates would rise from 1.4 per one million person-years in 2016 (95% CI 0.9 to 2.2) to 1.9 in 2030 (95% CI 0.7 to 5.1), with age-standardized rates steady. It predicted 2,775 new cases in 2030 (95% CI 1,031 to 7,496), 1,554 of them in males (95% CI 592 to 4,214). Predicted rates rose with age. The authors concluded that incidence may increase while the age-standardized rate stays stable. They noted that misdiagnosis may be close to 50%, that asbestos exposure data could not be evaluated, and that the method may underestimate cases after 2016.

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: Analysis of published national cancer registry data (2005 to 2015) with a Bayesian age-period-cohort model used to forecast incidence for 2016 to 2030
• Who was studied: Invasive malignant mesothelioma cases (ICD-10 C45) recorded by Chinese cancer registries from 2005 to 2015. By the end of 2015, data from 368 of 501 registries qualified, covering about 300 million people. Future rates were based on China's projected population from World Population Prospects 2019.
• Exposure: No exposure was studied. The authors left asbestos and other mineral fiber data out of the model and forecast only from past incidence trends.
• Main results:
  • Observed crude incidence rate, all registries, both sexes: 2.2, 1.9 and 1.6 per one million person-years in 2005, 2010 and 2015, respectively
  • Observed age-standardized rates (China and World standards) stayed relatively stable from 2005 to 2015
  • Predicted crude incidence rate, both sexes: 1.4 per one million person-years in 2016 (95% CI 0.9 to 2.2), rising to 1.9 in 2030 (95% CI 0.7 to 5.1). Age-standardized rates remained steady.
  • Predicted number of new cases in China in 2030: 2,775 (95% CI 1,031 to 7,496), including 1,554 male patients (95% CI 592 to 4,214)
  • Predicted incidence rates increased with age group, from 0.1 to 7.0 per one million person-years (both sexes)
  • The authors reported that aging had a dominant effect on the trends
• The authors' conclusion: The authors concluded that incidence of malignant mesothelioma in China may increase over the coming decades while the age-standardized rate stays stable, and that the disease still needs to be taken seriously because of its high degree of malignancy
• Limitations the authors state:
  • The authors used data already processed by statistical analysis rather than raw data
  • Full demographic data and exposure to asbestos and other mineral fibers could not be evaluated, which limited the accuracy of the prediction
  • Misdiagnosis may be high (close to 50%) and vary by region and hospital, largely because immunohistochemistry is used only to a limited extent
  • Past rates used registry-covered populations, while projections used an estimate of China's total population, which may lead to underestimating cases after 2016
  • Because mesothelioma is rare, the sample size was not enough to separate the effects of age, period and cohort

Topics

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

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