Mesothelioma Incidence and Trends

How Common Is Mesothelioma?

There were 48,073 cases of mesothelioma diagnosed from 1999 to 2018 in the United States, according to the Centers for Disease Control and Prevention. That is about 2,400 cases of mesothelioma a year, meaning the disease is not common compared to other cancers.

That statistic matches the National Cancer Institute’s Surveillance, Epidemiology and End Results (SEER) database, which shows the annual incidence rate for mesothelioma is slightly fewer than one new case per 100,000 people.

Mesothelioma Epidemiology

The annual incidence of mesothelioma in the United States is nearly 3,000 cases. In 2018, there were 2,875 mesothelioma cases reported at an incidence rate of 0.7 per 100,000.

Mesothelioma epidemiology tracks the incidence and distribution of mesothelioma cases among specific groups of people. While disease prevalence only measures the total number of cases observed at any given time, incidence research reveals the risk for specific groups, including high-risk occupations.

Because exposure to asbestos causes an overwhelming number of mesothelioma cases, U.S. and global disease trends are closely related to trends in asbestos exposure.

Mesothelioma Incidence by Gender

Historically, mesothelioma has been diagnosed mostly in men. And although men still represent the majority of new cases, women now account for nearly one-fourth of all cases.

According to mesothelioma statistics gathered from 1975 to 2019, incidence among men peaked in 1992, hitting 2.49 per 100,000. In comparison, the peak rate for women occurred in 1983 at 0.49 per 100,000. The incidence ratio between men and women has been closer in the last 10 years than it has since SEER began tracking the data in 1975.

A 2021 research study found that among those older than 44 years, the incidence and death rates were higher among male individuals compared with female individuals. However, among those younger than 45 years, female individuals had higher incidence and death rates than male individuals

Overall, mesothelioma incidence in the U.S. has fluctuated minimally in the past few decades. The highest rates occurred from 1989 to 2002, with a rate of more than one case per 100,000 people each year in that span. In the last 10 years of data tracked by SEER, there has only been one year (2005) with an incidence above one.

Multiple research studies have stated that the incidence of asbestos-related cancers in industrialized nations has not yet peaked but predict the number of cases will max out during the 2020s and 2030s. In the U.S., however, it is likely that the peak in mesothelioma incidence has already occurred.

Mesothelioma Incidence By Age and Race

Mesothelioma carries an unusually long latency period of 20 to 60 years — the main reason most patients are diagnosed at age 65 or older. According to the latest SEER report, people aged 80-84 have the highest mesothelioma incidence, with 8.9 new cases per 100,000. Ages 85 and older are close behind with 8.5 new cases.

Men are nearly twice as likely to be diagnosed before age 65 compared to women. Since 2003, more men between the ages of 35-39 were diagnosed with mesothelioma than women in that age range.

After 65 years old, the gap in incidence between males and females continues to grow. The incidence for females is highest between ages 80 and 84, but males in that category represent 14.9 cases per 100,000.

The largest differential between genders for age-specific incidence was in ages 85+, with men representing 16.3 cases per 100,000 and women representing 2.6 cases per 100,000.

Mesothelioma incidence is also influenced by race. At 0.4 new cases per 100,000, the rate for Black Americans in 2019 was half the rate of 0.8 cases per 100,000 for whites. However, Blacks have the same incidence rate before age 65 as whites.

Although black men have a higher incidence than black women, the difference is significantly closer than that between white men and women.

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Incidence by Mesothelioma Type

Pleural mesothelioma — the most common of the four types — had an incidence rate of 3.05 cases per 100,000 people, according to a 2013 study by the Centers for Disease Control and Prevention.

The second-most-common type, peritoneal mesothelioma, had an age-adjusted incidence of only 0.21 cases. However, those under 45 years of age were just as likely to develop peritoneal mesothelioma as they were pleural.

The largest difference in incidence between types, 6.11 for pleural and 0.25 for peritoneal, occurred in patients 75 and older.

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States with the Highest Mesothelioma Incidence

Malignant mesothelioma is primarily attributed to asbestos exposure, and most patients were first exposed to the toxic mineral while on the job.

Researchers have observed high rates of mesothelioma in regions and communities that relied heavily on asbestos, including places with a history of shipbuilding and industry.

According to data from the CDC, mesothelioma incidence among the 50 U.S. states ranged from 0.58 to 1.65 per 100,000 people.

The average incidence rate among those states was 1.51.

Rates Higher Near Asbestos Factory in New Jersey

From 1912 to 1980, Johns Manville Corporation operated a large asbestos manufacturing plant in Manville, New Jersey. Epidemiologists studied the impact of asbestos production on the borough’s residents because many of them worked at the plant, where they were exposed to airborne fibers.

Mesothelioma rates in the Manville plant were roughly 25 times higher than the average statewide rates.

Hot Spots for Mesothelioma Incidence

Geographical areas with naturally occurring asbestos deposits, such as Montana and California, have exhibited historically high rates of mesothelioma. Areas containing former asbestos mines are considered major mesothelioma hot spots.

Because the average life expectancy for mesothelioma patients is about a year, the disease’s mortality and incidence are typically very close.

California Contains Several Large Asbestos Deposits

California is home to some of the world’s largest deposits of naturally occurring asbestos. The state leads the nation in mesothelioma deaths. In 2015 alone, California had 247 mesothelioma-related deaths, according to the CDC. In comparison, Florida, which is second to California, had 143 deaths.

The SEER age-adjusted incidence rate for California from 2010 to 2014 was 0.89 new cases per 100,000.

New York at Risk of Becoming a Hot Spot

Researchers predict that New York City will also become a hot spot. Because of the large clouds of asbestos dust released by the collapse of the Twin Towers at the World Trade Center, it is believed that mesothelioma could become a huge concern for New York City paramedics, police, and firefighters or anyone else who lived in lower Manhattan immediately after the tragedy.

Mesothelioma Trends in the United States

Although asbestos use is not officially banned in the U.S., government regulations severely restricted the toxic mineral’s use since the 1970s. As a result, researchers believe the incidence of mesothelioma may have already peaked in the U.S.

Although mesothelioma cases in the U.S. appear to be on the decline, people exposed to asbestos decades ago will continue to develop this cancer in the coming years because of its lengthy latency period.

One study projected approximately 85,000 cases from 2008 to 2054.

Today, most U.S. workers are exposed to asbestos through the demolition, renovation and maintenance of homes and buildings built before the 1980s. That’s why raising awareness of the disease will help prevent future cases.

Worldwide Mesothelioma Trends

Occupational asbestos exposure accounts for most of the world’s exposure to asbestos.

In many of the world’s industrialized countries, workplace exposure to asbestos reached its peak and is receding. This is because the mining, consumption and manufacturing of asbestos were banned outright, limited by law and regulation, or declined because of an increased understanding of asbestos-related health risks.

Europe

The importation, production and use of asbestos and asbestos-containing products are banned in all 28 countries of the European Union.

United Kingdom

The UK banned blue and brown asbestos in 1985 and white asbestos in 1999. According to recent reports, rates of mesothelioma in the UK have reached a crisis level.

The heavy use of brown asbestos is part of the reason why the UK and Australia have the highest mesothelioma rates in the world.

In 2017, the Health and Safety Executive reported 2,523 deaths from mesothelioma in the UK. Rates of mesothelioma nearly doubled between 1995 and 2017.

Australia

Australia banned asbestos in 2004, but the effects of prior exposure continue to affect incidence rates in the country.

According to the Australian Institute of Health and Welfare, more than 700 Australians were diagnosed with mesothelioma in 2017. That averages to two cases diagnosed per day.

The highest incidence rates were in Western Australia, with 4.9 cases diagnosed for every 100,000 people.

Canada

Canada banned the toxic mineral in 2018, leaving the U.S. the only major industrialized nation without a complete asbestos ban.

From 1983 to 2003, the annual incidence rate rose from 1.4 to 2.1 per 100,000 people.

Other Countries

Developing countries, including such as China, Kazakhstan, Russia, India, Pakistan, Mexico, Indonesia and Thailand, continue to use, produce and export asbestos. In these countries, asbestos exposure is still on the rise.

Researchers predict that ongoing asbestos consumption in developing nations will contribute to additional diseases in the future but exactly how much is hard to quantify.

Precise analyses are difficult because data models differ from country to country. This is because of historic differences in asbestos exposure and consumption. Accurate data on asbestos use and disease are not available in some countries.

In addition, mesothelioma cancer’s long latency period makes it difficult to predict mortality curves with speculative data.

Still, most researchers estimate that it will take at least another 50 years before mesothelioma and other asbestos-related cancer incidence rates decrease.