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  Medical Deaths: World Wide Mesothelioma Trends

 

   Malignant pleural mesothelioma in Australia


  

Overview

Australia has the world’s highest per capita rate of mesothelioma affliction with the worst yet to come. The type of mesothelioma most common in Australia is malignant pleural mesothelioma (MPM), which affects the pleura (protective lining over the lungs).  

Most cases diagnosed are clearly attributable to past exposure to asbestos, though almost a third of the cases have no such history. Survival time between diagnosis and death is usually less than a year because of the disease’s long latency period, hence late detection. However, Australia is also one of the world’s most active countries in mesothelioma research and recent medical breakthroughs promise to reduce the mortality rate.

Incidence and epidemiology

Australia has as many as 16 cases per million population aged 20 years and above affected with mesothelioma. This makes it the world’s most severely mesothelioma-affected country. The rate is hugely higher in men (28.3) than women (3.3).

In absolute terms, over 600 mesothelioma cases are diagnosed in Australia every year. Given the long latency period of the disease, the diagnosis rate will certainly increase in the foreseeable future, projected to peak at 13,000 cases circa 2020. While asbestos is the number one cause of MPM, Australia has also seen 28% of cases in people with no history of asbestos exposure.

Significantly, in asbestos-related mesothelioma, it has been established that even a brief exposure causes the same intensity of the disease as long exposures. Regions that have thus far seen the highest incidence of MPM are (in the given order):

  1. New South Wales
  2. Victoria
  3. Queensland
  4. Western Australia

The occupations (present or past) that account for the highest incidence of MPM in Australia are (in the given order):

  1. Carpenters / joiners
  2. Wittenoom workers and town residents,
  3. Builders / laborers
  4. Members of the Navy or Merchant Navy
  5. Shipbuilding / dockyard workers
  6. Railway workers
  7. Asbestos factory workers
  8. Power station workers

New treatment

Conventional cancer treatments, i.e. surgery, radiology, and chemotherapy are clearly not yielding desired results in the treatment of mesothelioma. This is more so because the cancer usually has deteriorated to a non-curable stage by the time it is detected.

The first solution therefore lies in early detection. Australian researchers get the credit for inventing a new screening procedure involving determination of SMR (soluble mesothelin-related) proteins in serum. This helps screen asbestos-exposed individuals for early evidence of MPM. Australian researchers are also working on tumor immunology and clinical immunology for better management of MPM.


Future outlook

The outlook for Australia therefore is that while the number of diagnosed MPM cases will continue to rise through to 2020, the lifespan from diagnosis to death will be considerably higher than the present average of less than a year.

Summary

Australia has the highest per capita rate of MPM affliction. The number of diagnosed cases will peak by 2020. However, Australia is one of the most active countries in mesothelioma research. A breakthrough has already been made in early diagnosis through SMR protein detection in serum. So, while the numbers of cases cannot be reduced due to a historic causative factor, more effective treatment and longer post-diagnosis lifespans can certainly be expected.