Evolution of pleural cancers and malignant pleural mesothelioma incidence in France between 1980 and 2005

Abstract

The evolution of pleural cancers and malignant pleural mesothelioma incidence in France between 1980 and 2005 was analysed using data derived from the French network of cancer registries (FRANCIM) and the French National Mesothelioma Surveillance Program (PNSM). Mesothelioma proportions in pleural cancers were calculated by diagnosis year in the 1980-2000 period. Our results suggest that the incidences of pleural cancer and mesothelioma levelled off in French men since 2000 and continued to increase in French women. A decrease of the annual pleural cancer incidence average in men was noticed (23.4% of annual rate of change) between 2000 and 2005. The proportion of pleural cancers that were mesothelioma was unchanged between 1980 and 2003 with an average of 86%. The age standardised incidence rate of pleural mesothelioma remained relatively stable between 1998 and 2005 with a slight falling trend. For women, the age standardised incidence rate of pleural cancers and mesothelioma increased during the period 1998-2005. Additionally, the proportion of pleural cancers that were mesothelioma increased during the same period of time. Finally, the increased trend observed in the incidence of pleural mesothelioma and cancers in women is credibly due to their under diagnosis in the 1980-1997 period. The comparison between the French incidence and the American and British ones shows that the decreasing trend in incidence of mesothelioma and pleural cancers in French men since 2000 is potentially associated with a lower amphibole consumption and by the implementation of safety regulations at work from 1977.The incidence of pleural cancers, specifically malignant pleural mesothelioma in men, has shown a consistent increase in many industrialised countries for several decades. Despite marked variations from one country to another, a rise of mesothelioma incidence and mortality has been observed in European countries, including Great Britain, Denmark, Norway, Italy, and in Canada and Japan. [1][2][3][4][5][6][7] Incidence calculated projections suggest a peak in men around

Temporal patterns of occupational asbestos exposure and risk of pleural mesothelioma

“…This finding is in contradiction with previous projections for France, which predicted a peak of PM around 2020-2025 [27]. One possible explanation for the decrease in the incidence of PM was linked to the facts that chrysotile asbestos consumption in France peaked in the 1970s and that the first regulations regarding asbestos exposure at work were implemented in 1977 [26]. Another complementary explanation could be the ignorance of the decrease of the risk of PM with time since last exposure in statistical models used to predict future incidence trend of PM.…”

“…Reduced rates of pleural cancer many years after exposure have also been reported in other cohort studies [22][23][24][25]. In France, we observed a decline of the pleural cancer incidence between 2000 and 2005 [26]. This finding is in contradiction with previous projections for France, which predicted a peak of PM around 2020-2025 [27].…”

Global mesothelioma deaths reported to the World Health Organization between 1994 and 2008

“…2,26,32,33 However, the ratio was very high in the United Kingdom, at 5.7:1, and Australia, at 5.4:1, but very low in middle-income countries, at 1.9:1, and in Italy, at 2.4:1. These differences warrant further investigation.…”

Characterization of a French series of female cases of mesothelioma

“…In the absence of asbestos exposure, its background incidence is estimated at around 1-2 per million per year in both sexes according to backward extrapolation of mortality trends from epidemiological studies from various countries [McDonald and McDonald, 1996;Hillerdal, 1999]. In France, the incidence rate is 10-fold higher than background, with sex differences, men being more frequently exposed to asbestos than women [Le Stang et al, 2010]. The National Mesothelioma Surveillance Program (PNSM) was established in 1998 to set up epidemiological surveillance of the effects of asbestos exposure on the French population health based on continuing follow-up of malignant pleural mesothelioma [Goldberg et al, 2006].…”