The Mesothelioma epidemic in Western Europe: an update

Our plain-English summary of The Mesothelioma epidemic in Western Europe: an update, by C. Pelucchi, M. Malvezzi, C. La Vecchia, et al (British Journal of Cancer, 2004).

The study

• Authors: C. Pelucchi, M. Malvezzi, C. La Vecchia, F. Levi, A. Decarli, E. Negri
• Journal: British Journal of Cancer
• Published: 2004;90(5):1022-4
• Cited by: 65 articles, as counted by NIH iCite
• Read it: PubMed · Publisher · Free full text

Abstract

The number of male deaths from pleural cancer in France, Germany and Italy increased from about 8750 in 1990-1994 to 9550 in 1995-1999, suggesting that mesothelioma deaths in males may be levelling off in most of Western Europe.

In plain English

This short communication checked an earlier forecast of mesothelioma deaths in Western European men. The authors took official World Health Organization counts of male deaths from pleural cancer (cancer of the lining of the lung) in France, Germany and Italy for 1990–1999. They compared these counts with the numbers predicted by a model they had published earlier. For 1995–1999, observed deaths were lower than predicted in all three countries: 2.3% lower in Germany, 6.4% in Italy and 11.4% in France. The gap was largest in the youngest age group. The combined total still rose, from about 8750 deaths in 1990–1994 to 9550 in 1995–1999, but deaths at ages 40–54 fell in every country. Age-standardised death rates were stable in Italy, fell in Germany in 1997 and were still rising in France. The authors concluded that their model had overestimated deaths and that mesothelioma deaths in Europe in 1995–2029 were likely to be fewer than the 250 000 previously estimated. German 1995–1999 figures used 1997 only, and British data were excluded.

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: Short communication: analysis of national death statistics, comparing observed male pleural cancer deaths with numbers previously predicted by the authors' age and birth-cohort model
• Who was studied: Official male deaths from pleural cancer in Germany, France and Italy, 1990–1999, taken from the WHO mortality database (updated January 2003). Switzerland, the Netherlands and Britain were excluded because of coding or registration changes.
• Exposure: No individual exposure was measured. The authors treated pleural mesothelioma deaths as reflecting past asbestos exposure in the population. No specific fiber types were studied.
• Main results:
  • For 1995–1999, observed male deaths were lower than predicted in all three countries. In Germany they were 2.3% lower than predicted.
  • For 1995–1999, observed male deaths were 6.4% lower than predicted in Italy and 11.4% lower than predicted in France.
  • In all three countries the gap between observed and predicted deaths was largest in the youngest age group and smallest in the oldest.
  • At ages 40–54, observed deaths were lower in 1995–1999 than in 1990–1994 in all countries. At ages 65–84, they were higher.
  • The combined number of male deaths in France, Germany and Italy rose from approximately 7550 in 1985–1989 to 8750 in 1990–1994 and 9550 in 1995–1999.
  • For 1995–1999, the highest age-standardised mortality rate (per 100 000 men) was in France (1.54), followed by Italy (1.31) and Germany (1.05). The German figure is for 1997 only.
  • In Germany in 1997, the increasing trend in age-standardised male death rates reversed for the first time since 1970–1974.
  • The Italian age-standardised death rate rose from 1.14 in 1985–1989 to 1.30 in 1990–1994 and then remained stable.
  • France's rate was still increasing in 1995–1999: 8% higher than in 1990–1994 and 126% higher than in 1970–1974.
• The authors' conclusion: The authors concluded that their earlier models had overestimated mesothelioma deaths in men. They said the rising trend should level off in the near future in the three countries, and that asbestos-related mesothelioma deaths in Europe during 1995–2029 are likely to be lower than the 250 000 previously estimated.
• Limitations the authors state:
  • The earlier model's estimates for the most recent birth cohorts rested on few observations and few deaths, so random variation was wide.
  • The earlier model assumed that men born in 1950 had the same rates as those born in 1945, and that the 1955 cohort would have 50% lower rates.
  • Germany adopted a new disease coding system (ICD-10) in 1998, so only 1997 was used to represent 1995–1999 for Germany.
  • Switzerland and the Netherlands were excluded because their adoption of ICD-10 made their data not comparable with earlier data.
  • British data were excluded because of changes in death registration and cause coding.
  • Other factors not included in the model may explain the course of the epidemic, such as the type of asbestos used, duration of exposure and years since last exposure.

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.

Related studies

• An update of cancer mortality among chrysotile asbestos miners in Balangero, northern Italy — G. Piolatto, E. Negri, et al. (1990)
• The European mesothelioma epidemic — J. Peto, A. Decarli, et al. (1999)
• An update of a mortality study of talc miners and millers in Italy — M. Coggiola, D. Bosio, et al. (2003)
• The evolution of an epidemic: age-period-cohort modelling of mesothelioma in Casale Monferrato, 1990-2021, with projections to 2042 — M. Giraldo, D. Zugna, et al. (2025)
• Hotspots of malignant pleural mesothelioma in Western Europe — V. Nuyts, T. Nawrot, et al. (2018)
• Cancer incidence among women and girls environmentally and occupationally exposed to blue asbestos at Wittenoom, Western Australia — A. Reid, J. Heyworth, et al. (2008)

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