Trends in malignant pleural mesothelioma prevalence in the United States from 2000 to 2020.

Abstract

e20094 Background: Malignant pleural mesothelioma (MPM) is a rare cancer that is closely associated with prolonged asbestos exposure. Its incidence has steadily declined over time with decreasing prevalence of asbestos-related lung disease. Our study aims to provide an update on recent MPM trends in the United States from 2000 to 2020. Methods: This is a retrospective cohort study design. The primary endpoints of this study are age-adjusted MPM rates and annual percentage change (APC) in rates from 2000-2020. We queried the Surveillance, Epidemiology, and End Results (SEER) 17 database for information about demographics, cause of death, and survival time for patients diagnosed with MPM from 2000-2020. For rate analysis, we used the SEER 22 database which covers 22 national cancer registries and approximately 41.9% of the US population. Age-adjusted rate analysis was performed using the National Cancer Institute (NCI) joinpoint regression program. Results: We identified 13,018 patients diagnosed with MPM from 2000-2020 who were eligible for analysis in the SEER 17 database. Individuals with MPM were primarily male (78.2%) and belonged to Non-Hispanic White (80.7%) ancestry. The mean age at diagnosis overall was 72.4 (SD +/- 10.6) years. The overall age-adjusted rate of MPM for all groups decreased from 0.97 (cases per 100,000 population) in 2000 to 0.55 in 2020. When stratified by sex, the MPM rate in males decreased from 1.91 to 0.93. The rate decrease in females over the same period was more modest, from 0.33 to 0.27. Overall APC for all groups from 2000-2013 was -1.45 (95% CI -2.01 to -0.40, p<.05), and from 2013-2020 it was -5.22 (95% CI -8.92 to -3.76, p<.05). The APC for males from 2000-2013 was -1.88 (95% CI -2.62 to -0.62, p<.05) and -6.46 (95% CI -10.49 to -4.57, p<.05) from 2013-2020. The rate decrease for females demonstrated a consistent APC of -0.87 (95% CI -1.54 to -0.26, p<.05) from 2000-2020. Conclusions: MPM is a disease that is best managed at large academic cancer centers due to its rarity. Our study demonstrates an accelerated decline in overall MPM rates since 2013, mainly driven by a similar fall in rates in males over the same period. MPM rates are lower in females and continue to decline, albeit slowly. The continued and reassuring decrease in rates of MPM likely reflects the effectiveness of regulations targeting widespread industrial and residential asbestos use that have been in place since the 1990s. [Table: see text]