What Is Mesothelioma Screening?

Mesothelioma screening is medical testing for signs of possible mesothelioma before any symptoms develop. Cancer screening is important for people at high risk for specific cancers. Catching cancer at an early stage can improve the odds of successful treatment.

Asbestos exposure is the main risk factor for mesothelioma. People with known asbestos exposure or other risk factors may benefit from screening. Because it has a long latency of 20 to 60 years, it can take decades for mesothelioma to develop and begin causing symptoms. Symptoms usually do not appear until mesothelioma has reached an advanced stage, which makes it more difficult to treat.

Key facts about mesothelioma screening:
  • Mesothelioma screening may detect cancer at an early stage before symptoms appear.
  • People at high risk of mesothelioma can benefit from screening.
  • A positive screening test requires additional testing to diagnose mesothelioma.

Primary care doctors typically order screening tests. If a screening test comes back positive, the doctor will refer you to a specialist. If you have a positive screening test, that doesn’t necessarily mean you have mesothelioma cancer. Additional tests, imaging and a biopsy are necessary to correctly diagnose mesothelioma.

How Can You Screen for Mesothelioma?

No single test can screen for mesothelioma, so a combination of different types of medical tests is necessary to find evidence of the disease. Detecting mesothelioma is difficult even in people who are experiencing symptoms. Doctors must look at all the available data to make a judgment about whether mesothelioma is likely present.

By using a variety of imaging tests and blood tests together, doctors can find early signs of mesothelioma. Imaging scans look for changes in the lungs and abdomen that can indicate the early stages of mesothelioma, while blood tests look for specific proteins and genetic markers associated with mesothelioma or increased risk of mesothelioma. Pulmonary function tests also detect signs of lung damage. Doctors can track changes in these tests over time to help detect mesothelioma in its early stages.

Imaging Tests

There are many imaging tests used to detect mesothelioma, but mesothelioma screening guidelines typically call for chest X-rays, CT scans and PET scans. Each of these technologies can provide different information about potential tumors in the body.

  • Chest X-rays can show abnormalities in the lungs and pleura that are potential signs of mesothelioma.
  • CT scans provide detailed cross-section images of the chest and abdomen that can help doctors see small abnormalities associated with mesothelioma.
  • PET scans can identify areas of increased metabolic activity in the body that can indicate cancer and also help determine the cancer stage.

X-rays are good for identifying diseases in the lungs, but they aren’t as useful for finding peritoneal mesothelioma. CT scans provide more detail than X-rays, making them useful for finding small, early tumors throughout the body. PET scans are excellent for detecting cancer cells throughout the body, but they aren’t as good for detecting very small tumors. Periodic imaging helps doctors look for small changes over time that may be signs of mesothelioma.

Biomarker Tests 

Biomarkers are proteins or other substances that can act as indicators of disease. There are no biomarkers that can definitively detect mesothelioma. However, the levels of several proteins are commonly elevated when mesothelioma occurs. Testing for these proteins may help doctors find mesothelioma in its early stages. 

Several blood tests and biomarkers can help diagnose mesothelioma. Both routine blood tests and mesothelioma-related blood tests can offer clues about whether mesothelioma is present in the body. Soluble mesothelin-related peptide (SMRP), osteopontin and BRCA-associated protein-1 (BAP1) are useful for both screening and diagnosis. Additional tests for other markers are under development.

In addition to blood, specialists can also test pleural fluid — such as from a pleural effusion —  for biomarkers. A malignant effusion caused by pleural mesothelioma can have elevated levels of SMRP and other markers. A pleural effusion can be the first sign of mesothelioma. Testing this fluid may help detect mesothelioma early.

Testing SMRP Levels

Mesothelioma can increase blood levels of SMRP. MESOMARK and similar tests detect SMRP in the blood. If SMRP levels are high, this may indicate the presence of mesothelioma. High SMRP levels can also occur in fluid from pleural effusions caused by mesothelioma.

However, blood levels of SMRP alone are not always reliable indicators of mesothelioma. Other asbestos-related conditions — mainly asbestosis — can also increase SMRP levels. Following SMRP levels over time can help doctors identify mesothelioma as it develops.

BAP1 Gene Testing

BAP1 is a tumor suppressor gene that helps prevent cancer and other tumors. People with an abnormal BAP1 gene are at higher risk of mesothelioma. According to research, tests for BAP1 are more useful when combined with tests for other genes, such as MTAP, Merlin and p53.

Tumor predisposition syndrome — a condition that causes various types of tumors — is related to BAP1. Research shows that people who lack a functioning BAP1 gene may be at a much greater risk of mesothelioma, even without asbestos exposure. BAP1 gene and mesothelioma genetic testing may be able to help identify people at very high risk of mesothelioma.

Who Should Get Screened for Mesothelioma?

Anyone exposed to asbestos at any time should get screening for mesothelioma and other asbestos-related diseases they may eventually develop. Occupational asbestos exposure is a risk factor for mesothelioma. Repeated exposure to high levels of asbestos significantly increases the odds of developing mesothelioma. Due to its long latency period, mesothelioma risk also increases with age.

Asbestos exposures have decreased since the 1970s, when laws started limiting asbestos use. People with potential asbestos exposure during the 1970s and earlier may be at higher risk. Family members of people exposed to asbestos are also at risk for secondary exposure from contaminated clothing or other items.

People who are at risk for mesothelioma:
  • Anyone with a history of asbestos exposure who develops symptoms of mesothelioma: persistent cough, shortness of breath, chest pain or unexplained weight loss
  • Family members with secondary asbestos exposure
  • People living near asbestos mines or natural deposits
  • People who have worked in asbestos mining or processing
  • People who have used asbestos-containing products, including talcum powder
  • Military veterans and family members
  • Workers in construction, shipbuilding and similar industries

People with occupational, environmental or secondary asbestos exposure have an increased risk of developing mesothelioma. These people should be screened before symptoms arise. People experiencing symptoms of mesothelioma should undergo screening and examination by a doctor to find signs of disease.

Benefits of Early Mesothelioma Detection

The purpose of screening for cancer or other diseases is to detect signs of disease before symptoms start. By detecting potential mesothelioma early, doctors can diagnose and treat it sooner. Early treatment is important to improve mesothelioma outcomes, including treatment outcomes, survival rates and quality of life.

Early detection of mesothelioma can lead to:
  • Improved Treatment Outcomes: Early detection allows for more treatment options and improved outcomes.
  • Increased Survival Rates: Timely diagnosis enhances the chances of successful treatment and improved long-term survival.
  • Enhanced Quality of Life: Early intervention can alleviate symptoms, manage complications and improve overall well-being.

While early detection of mesothelioma does not guarantee a better outcome, it can greatly improve your odds of finding successful treatment. Screening for mesothelioma is important for providing the best care as soon as possible.

Why Is Early Detection of Mesothelioma Difficult?

Mesothelioma is difficult to detect at early stages because there is no single screening test for it, and it does not have any unique symptoms. It is a rare disease that most physicians have no experience with and can easily confuse with other conditions, including other types of cancer. Mesothelioma also has a long latency period after asbestos exposure, often between 20 and 60 years.

All of these factors make it easy for doctors to miss potential signs of disease and misdiagnose mesothelioma. While mesothelioma screening allows for early detection and treatment, the difficulty of getting a correct diagnosis limits its effectiveness.

Dr. Jacques Fontaine and Dr. Virginia Wolf
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When Should You See a Mesothelioma Doctor?

People with a history of asbestos exposure should consult with a mesothelioma specialist who has experience diagnosing and treating it. Additionally, if you or your doctor suspect possible mesothelioma based on symptoms, mesothelioma screening tests or other tests, you should see a specialist.

Early diagnosis and treatment are essential to ensure the best possible outcome with mesothelioma. If you know you are at high risk of developing mesothelioma due to asbestos exposure, you should seek help from a mesothelioma specialist sooner rather than later. Don’t hesitate if you or your doctor suspect mesothelioma. Seek a mesothelioma diagnosis and treatment as soon as possible.