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Largely Unchanged Annual Incidence and Overall Survival of Pleural Mesothelioma in the USA

  • Hari B. Keshava
  • Andrew Tang
  • Hafiz Umair Siddiqui
  • Siva Raja
  • Daniel P. Raymond
  • Alejandro Bribriesco
  • James Stevenson
  • Sudish C. Murthy
  • Usman AhmadEmail author
Original Scientific Report

Abstract

Background

Projections based on regulations curtailing asbestos use in the USA suggest that peak incidence of pleural mesothelioma would occur between 2000 and 2005 and then decline. We analyzed the National Cancer Database (NCDB) to assess current trends in disease incidence, patient demographics, cancer treatment, and survival.

Methods

The NCDB was queried to identify patients diagnosed with pleural mesothelioma from 2004 through 2014. Clinical and pathologic characteristics, treatments, and survival were analyzed. Risk factors for death were identified by multivariable Cox regression.

Results

A total of 20,988 patients with pleural mesothelioma were reported to the NCDB. The number of cases per year increased from 1783 to 1961, accounting for roughly 0.3% of all reported cancers each year. The proportion of elderly patients increased from 75 to 80%, but distribution by sex remained constant (20% female). The proportion of patients undergoing treatment increased from 34 to 54%. One-year survival increased from 37 to 47% and 3-year survival from 9 to 15% (p < 0.001). Factors associated with improved survival included younger age, female sex, epithelioid histology, treatment in an academic center, health insurance, higher income, and multimodality therapy.

Conclusions

The annual incidence of mesothelioma has not declined this century and remains stable. Reporting of histologic and clinical staging has improved. National trends suggest that survival is slowly increasing despite an aging cohort. Multimodal therapy and treatment at academic centers are modifiable risk factors associated with improved survival.

Abbreviations

CD

Charlson–Deyo

NCDB

National Cancer Database

NOS

Not otherwise specified

Notes

Funding

The Mary Elizabeth Holdsworth Fund and Cleveland Clinic Heart and Vascular Institute. Andrew Tang is a National Heart, Lung, and Blood Institute Clinical Research Scholar of the Cardiothoracic Surgical Trials Network (National Institutes of Health Grant U01 HL088955).

Supplementary material

268_2019_5132_MOESM1_ESM.docx (22 kb)
Supplementary file1 (DOCX 22 kb)

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Copyright information

© Société Internationale de Chirurgie 2019

Authors and Affiliations

  • Hari B. Keshava
    • 1
  • Andrew Tang
    • 1
  • Hafiz Umair Siddiqui
    • 1
  • Siva Raja
    • 1
  • Daniel P. Raymond
    • 1
  • Alejandro Bribriesco
    • 1
  • James Stevenson
    • 1
  • Sudish C. Murthy
    • 1
  • Usman Ahmad
    • 1
    Email author
  1. 1.Department of Thoracic and Cardiovascular Surgery, Taussig Cancer Center, Heart and Vascular InstituteCleveland ClinicClevelandUSA

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