ENVIRONMENTAL AND OCCUPATIONAL RISK FACTORS AND PREDICTORS OF SURVIVAL AMONG MALIGNANT PLEURAL MESOTHELIOMA PATIENTS

Abstract

AbstractIntroduction: Malignant pleural mesothelioma (MPM) remains a serious health problem due to the poor outcome of different therapies. In Egypt, it is mainly attributed to an environmental origin with a high incidence in women and young adults. Aim of work: To identify risk factors of malignant pleural mesothelioma and to carry out survival analysis for malignant pleural mesothelioma patients attending outpatient clinic of Clinical Oncology department at Ain Shams University hospital. Materials and methods: Ninety cases with pathologically confirmed MPM attending the outpatient clinic of clinical oncology department at Ain Shams University hospital were interviewed. Patients in critical conditions who needed hospitalization or palliative treatment were excluded. Included patients were then followed up for two years starting from the date of diagnosis. Results: Logistic regression analysis revealed that living in industrial areas, household exposure to asbestos and history of smoking were significant risk factors of MPM. The mean survival duration of all cases was 24.49 months. Cox regression analysis revealed that factors predicting survival were age and gender. The difference in survival between patients treated with different treatment modalities was not statistically significant. Conclusion: Environmental and householdexposure to asbestos as well as smoking play an important role in occurrence of MPM. Age and gender were significant predictors of survival of patients. Strict measures to reduce pollution and thus rates of MPM should be adopted in addition to communityawareness of the possible risk factors and preventive measures. Moreover, development of a national record system is required to determine the true size and scope of this environmental problem in Egypt.