Overview
MESOTHELIOMA, the dreaded cancer usually caused by past exposure to asbestos dust, is the single-biggest occupational health disaster in modern times. Devouring over 200,000 lives annually worldwide, mesothelioma has all the makings of an epidemic that will peak circa 2020 in the developed countries and later, with even more deaths, in the developing countries.
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Great hopes are being invested in national and cross-country clinical trials of new treatments for this disease, which is still treated usually with conventional cancer therapies that have proved inadequate. If a clear-cut medical breakthrough fails to materialize, the world will witness a staggering mesothelioma death toll of over a million in the developed countries alone in the next 15 years or so. And a few more millions in the poorer countries thereafter. The tragedy of it all is that this horrific specter of death would have been vanquished by now if only governments were to ban asbestos in the 1960s itself, when the carcinogenic properties of this material started being reported.
Globally consistent epidemiology
Barring statistical variations between countries, there is a great degree of consistency in the epidemiological findings related to mesothelioma worldwide. The main findings are as follows:
- Most mesothelioma patients have had prior occupational exposure to asbestos dust.
- In many cases, families of asbestos workers have also contracted the disease since asbestos dust can be carried on clothing.
- In about 10%-15% of cases, mesothelioma has been linked to environmental exposure outside of the workplace, e.g. in areas like Wittenoom in Australia where asbestos mining was once the economic mainstay.
- Mesothelioma is four times more prevalent among men than women.
Mesothelioma in selected countries / regions
As mentioned above, epidemiological studies of mesothelioma in different countries have yielded similar results. Following is a brief look at salient aspects of the epidemic in selected countries/regions:
- United States:
- About 2,500 deaths annually.
- Death toll expected to peak in 2015.
- At least 200,000 deaths in the next 10 years.
- Canada:
- Continues to mine asbestos for export.
- 340 deaths annually from mesothelioma or lung cancer traceable to asbestos-exposed patients.
- Death toll to mount as mesothelioma from asbestos exposures in 1970s and 1980s start being detected.
- Europe (approximate statistics):
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- 75 cases per year
- 18 cases per million population per year
- 870 cases per year
- 18 cases per million population per year
- 1,094 cases per year
- 16 cases per million population per year
- 1,050 cases per year
- 21 cases per million population per year
- 389 cases per year
- 30 cases per million population per year
- 57 cases per year
- 16 cases per million population per year
- 149 cases per year
- 20 cases per million population per year
- World’s first country to show declining incidence due to early asbestos ban
- 1,862 cases per year
- 39 cases per million population per year
- Australia:
- 600 cases per year
- 16 cases per million population aged 20 years or above. This makes Australia the world’s most threatened by mesothelioma.
- Deaths expected to peak to 13,000 circa 2020.
- 900 cases per year
- Five-to-six cases per million population
- Smoking widely prevalent among men. Synergistic effect between tobacco smoke and past asbestos exposure.
- 100,000 deaths expected by 2040
Reporting of mesothelioma cases in the following countries/regions is lower than the actual numbers. So, extrapolated figures are being given below:
- India: 10,000 cases per year
- China: 12,000 cases per year
- Pakistan: 1,500 cases per year
- South Korea: 452 cases per year
- Africa:
- Egypt: 714 cases per year
- Sudan: 367 cases per year
- Ethiopia: 670 cases per year
- South Africa: 420 cases per year
- Commonwealth of Independent States (CIS):
- Russia: 1,350 cases per year
- Ukraine: 447 cases per year
- Uzbekistan: 250 cases per year
Future outlook
Most asbestos exposure in the developed countries stopped by the late 1990s or early 21st century. Given a 15-40 year latency period, a majority of mesothelioma cases can be expected to peak between 2020 and 2040. On the other hand, the situation in the developing countries is even more alarming. In most countries in this bracket, asbestos continues to be used with little or no protection. Thus, mesothelioma breeding grounds are still existent.
Applying the same latency period as for developed countries, mesothelioma seems likely to scourge the poorer countries for long after the epidemic subsides in the richer ones. A breakthrough in medical research alone provides a ray of hope for future mesothelioma patients. Immunotherapy looks a promising area. |
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Summary
More than a million people are headed for death by mesothelioma in approximately the next 15 years in the developed countries alone. The world’s poorer countries continue to use asbestos almost as freely as the United States did in the 1970s. Therefore, mesothelioma deaths in the poorer countries will exceed by far figures for the richer countries and mortalities will continue well after the epidemic peaks in the ‘first world’. Statistics given in this report bring into sharp focus the case for shutting down all asbestos mines.
Canada would also do well for itself and others if it stops campaigning against asbestos ban in countries that have not yet banned the killer substance. While mesothelioma cases cannot be reduced because its causative factor lies in the past, hopes for better treatment, possibly cure, comes from new therapies and procedures currently in third-phase clinical trials across countries. |
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