Research & Clinical Trials

Duke Completes Largest Study of Mesothelioma in Women

Written By:
Feb. 05, 2020
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Written By: Tim Povtak,
February 5, 2020

Women diagnosed with peritoneal mesothelioma were 10 years younger on average than those with pleural mesothelioma in a recent case study at the Duke University Medical Center.

It was the largest study of women with mesothelioma at a single institution that included histopathology, survival, exposure, demographics and objective markers (asbestosis, fiber analysis and parietal pleural plaques).

The American Journal of Surgical Pathology published the report in December 2019. The study included 354 cases of malignant mesothelioma and was a continuation of an ongoing study of women with this rare and aggressive cancer.

“We did not expect that much of an age difference between those with pleural and those with peritoneal mesothelioma,” Dr. Elizabeth Pavlisko, lead author and assistant professor of pathology at Duke University Medical Center, told The Mesothelioma Center at “Household contact also stood out in the study.”

More than half of the cases were exposed to asbestos — the primary cause of mesothelioma — by household contact, typically from a family member with industrial or occupational exposure.

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Women with Pleural Mesothelioma Have Markers

The majority of the women in the study with the “objective markers” had pleural mesothelioma.

The pleural version is the most common type of mesothelioma. It starts in the protective lining around the lungs.

Peritoneal mesothelioma forms in the lining around the abdomen and is the second most common type.

This study of women included 275 cases of pleural mesothelioma and 79 cases of peritoneal. Papillary mesothelioma and localized mesothelioma cases were excluded.

Previous reports have shown that 22% to 29% of mesothelioma cases involve women, but only 12% in this particular study.

Other Notable Takeaways

  • The majority of those studied were exposed to asbestos through household contact.
  • Women who worked in occupations and industries associated with higher asbestos exposure had objective markers of exposure similar to men.
  • Survival was longer for the epithelial subtype of mesothelioma and magnified with the peritoneal location.
  • Women with peritoneal mesothelioma had an average age of 52.8 years, compared to those with pleural mesothelioma at an average of 62.1 years.

Household Contact Is Dominant

Information regarding asbestos exposure was listed in 92% of the 354 cases. It included 200 cases where household exposure — typically from a husband, father or son — was listed as the only known exposure.

“Household contact can be a real significant source of exposure, depending upon the industry that contact worked with,” Pavlisko said.

Among the jobs most exposed to asbestos are those in shipyards, power plants and construction, along with firefighters and industrial workers.

There were 40 cases that included direct industrial and occupational exposure to asbestos for women.

“With those industries that are associated with higher levels of asbestos, what you see in men, you also see in women,” Pavlisko said.

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