Documents Delgermaa, Vanya 2 results

"BACKGROUND: Little is known about the global magnitude of mesothelioma. In particular, many developing countries, including some with extensive historical use of asbestos, do not report mesothelioma.
OBJECTIVES: To estimate the global magnitude of mesothelioma accounting for reported and unreported cases.
METHODS: For all countries with available data on mesothelioma frequency and asbestos use (n = 56), we calculated the 15-year cumulative number of mesotheliomas during 1994-2008 from data available for fewer years, and assessed its relationship with levels of cumulative asbestos use during 1920-1970. We used this relationship to predict the number of unreported mesotheliomas in countries for which no information on mesothelioma is available but which have recorded asbestos use (n = 33).
RESULTS: Within the group of 56 countries with data on mesothelioma occurrence and asbestos use, the 15-year cumulative number of mesothelioma was approximately 174,300. There was a statistically significant positive linear relation between the log-transformed national cumulative mesothelioma numbers and the log-transformed cumulative asbestos use (adjusted R2 = 0.83, p < 0.0001). Extrapolated to the group of 33 countries without reported mesothelioma, a total of approximately 38,900 (95% CI, 36,700-41,100) mesothelioma cases were estimated to have occurred in the fifteen year period 1994-2008.
CONCLUSIONS: We estimate conservatively that, globally, one mesothelioma case has been overlooked for every four to five reported cases. As our estimation is based on asbestos use until 1970, the many countries which increased asbestos use since then should anticipate a higher disease burden in the immediate decades ahead."

"To carry out a descriptive analysis of mesothelioma deaths reported worldwide between 1994 and 2008.
Methods
We extracted data on mesothelioma deaths reported to the World Health Organization mortality database since 1994, when the disease was first recorded. We also sought information from other English-language sources. Crude and age-adjusted mortality rates were calculated and mortality trends were assessed from the annual percentage change in the age-adjusted mortality rate.
Findings
In total, 92 253 mesothelioma deaths were reported by 83 countries. Crude and age-adjusted mortality rates were 6.2 and 4.9 per million population, respectively. The age-adjusted mortality rate increased by 5.37% per year and consequently more than doubled during the study period. The mean age at death was 70 years and the male-to-female ratio was 3.6:1. The disease distribution by anatomical site was: pleura, 41.3%; peritoneum, 4.5%; pericardium, 0.3%; and unspecified sites, 43.1%. The geographical distribution of deaths was skewed towards high-income countries: the United States of America reported the highest number, while over 50% of all deaths occurred in Europe. In contrast, less than 12% occurred in middle- and low-income countries. The overall trend in the age-adjusted mortality rate was increasing in Europe and Japan but decreasing in the United States.
Conclusion
The number of mesothelioma deaths reported and the number of countries reporting deaths increased during the study period, probably due to better disease recognition and an increase in incidence. The different time trends observed between countries may be an early indication that the disease burden is slowly shifting towards those that have used asbestos more recently."