Written by Dr. Kristopher Bunting | Edited By Walter Pacheco | Last Update: July 8, 2024

What Is Mesothelioma Screening?

Mesothelioma screening is medical testing for signs of possible mesothelioma before any symptoms develop. Cancer screening is essential 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 leading 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 challenging 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. The doctor will refer you to a specialist if a screening test returns positive. A positive screening test does not necessarily mean you have mesothelioma cancer. Additional tests, imaging and a biopsy are necessary to diagnose mesothelioma correctly.

How Can You Screen for Mesothelioma?

No single test can screen for mesothelioma, so combining different 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 judge whether mesothelioma is likely present.

Doctors can find early signs of mesothelioma by using a variety of imaging tests and blood tests together. Imaging scans look for changes in the lungs and abdomen that can indicate the early stages of mesothelioma. In contrast, 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 to help detect mesothelioma in its early stages.

Imaging Tests

Many imaging tests can detect mesothelioma and 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 suitable for identifying lung diseases but not as helpful in finding peritoneal mesothelioma. CT scans provide more detail than X-rays, making them useful in finding small, early tumors throughout the body. PET scans are excellent for detecting cancer cells throughout the body but not as good for detecting tiny tumors. Periodic imaging helps doctors look for minor changes that may be signs of mesothelioma.

Biomarker Tests 

Biomarkers are proteins or other substances that can act as indicators of disease. No biomarkers can definitively detect mesothelioma. However, the levels of several proteins increase 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 helpful for screening and diagnosis. Additional tests for other markers are under development.

Specialists can also test pleural fluid, such as that 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 help identify people at high risk of mesothelioma.

Who Should Get Screened for Mesothelioma?

Anyone exposed to asbestos at any time should get screened 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 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 exposed to occupational, environmental or secondary asbestos have an increased risk of developing mesothelioma. These people should see a doctor for screening before symptoms arise, and those experiencing symptoms should undergo a doctor’s screening and examination to find signs of the disease.

Benefits of Early Mesothelioma Detection

Screening for cancer or other diseases aims to detect signs of disease before symptoms start. By detecting potential mesothelioma early, doctors can diagnose and treat it sooner. Early treatment is essential in improving mesothelioma outcomes, including treatment outcomes, survival rates and quality of life.

Benefits of Early Detection
  • 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 significantly improve your odds of finding successful treatment. Screening for mesothelioma is essential for providing the best care as soon as possible.

Headshot of Jacques Fontaine

It’s so important to be able to catch or detect the cancer early on before the patient has any symptoms. When we catch the cancer early, we offer them the best chances.

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 no unique symptoms. It is a rare disease that most physicians have no experience with and can easily be confused with other conditions, including different 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, getting a correct diagnosis limits its effectiveness.

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, you should see a specialist if you or your doctor suspect possible mesothelioma based on symptoms, mesothelioma screening tests or other tests.

The day I decided I wasn’t going to sit back was at the last appointment I had with my first oncologist. It was scary walking into the unknown, but I knew there was more to my life than this devastating diagnosis.

Early diagnosis and treatment are essential to ensure the best possible outcome with mesothelioma. Suppose you know you are at high risk of developing mesothelioma due to asbestos exposure. In that case, 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 quickly as possible.

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