Mesothelioma European age-standardised (AS) mortality rates for males and females combined increased by 858% in Great Britain between 1971-1973 and 2014-2016. The increase was larger in males than in females.
For males, mesothelioma AS mortality rates in Great Britain increased by 872% between 1971-1973 and 2014-2016. For females, mesothelioma AS mortality rates in Great Britain increased by 657% between 1971-1973 and 2014-2016.
Over the last decade in Great Britain (between 2004-2006 and 2014-2016), mesothelioma AS mortality rates for males and females combined increased by 8%.[1-2] In males AS mortality rates remained stable, and in females rates increased by 20%.
Mesothelioma (C45), European Age-Standardised Mortality Rates per 100,000 Population, Great Britain, 1971-2016
Trends in mesothelioma mortality correlate with the rise and fall of asbestos exposure in the UK in the 20th century
Mesothelioma mortality rates have increased overall in some broad adult age groups in males in Great Britain since the early 1970s, but have decreased or remained stable in others.[1-2] Rates in 25-49s have decreased by 68%, in 50-59s have remained stable, in 60-69s have increased by 482%, in 70-79s have increased by 1474%, and in 80+s have increased by 2724%.
Mesothelioma (C45), European Age-Standardised Mortality Rates per 100,000 Population, By Age, Males, Great Britain, 1971-2016
Mesothelioma mortality rates have increased overall in most broad adult age groups in females in Great Britain since the early 1970s, but have remained stable in some.[1-2] Rates in 25-49s have remained stable, in 50-59s have increased by 103%, in 60-69s have increased by 422%, in 70-79s have increased by 1530%, and in 80+s have increased by 1298%.
Mesothelioma (C45), European Age-Standardised Mortality Rates per 100,000 Population, By Age, Females, Great Britain, 1971-2016About this data
Data is for Great Britain, 1971-2016, C45.
Mortality trends over time data are taken from the Health and Safety Executives record of death certificates mentioning mesothelioma [1-2], as it is the most reliable source of information on mesothelioma mortality in past decades.
A better understanding of survival rates for lung transplant recipients
For John Iguidbashian and Alejandro Suarez-Pierre, general surgery residents in the Department of Surgery at the University of Colorado School of Medicine, the research started as a way to give patients who were eligible for lung transplants more accurate information about their life expectancy after the surgery.
“We were constantly counseling patients who needed lung transplants, and it was pretty obvious that the main thing they wanted to know is what their life would look like after the transplant and how long they would live,” Iguidbashian says. “All the papers that had already been written were giving 10-year survival rates, but nobody really studied how that compared to a general population that hadn’t received lung transplants.” Looking at multiple factors
To help answer this question, the two started their own research study, looking at survival rates for lung transplant patients versus adults who didn’t receive a lung transplant, further classifying the results by factors including age, gender, race, and socioeconomic status.
Iguidbashian and Suarez-Pierre used data from the U.S. Census Bureau’s National Longitudinal Mortality Study to get information on death rates of nonhospitalized adults, and they obtained numbers from the Organ Procurement and Transplantation Network to calculate mortality rates for patients who underwent lung transplantation. To ensure a robust control group that accounted for all variables, they gathered data on five nonhospitalized adults for every one lung transplant recipient.
“The ultimate result of this study was that the standardized mortality rate is approximately five times higher for transplant recipients, which is a lot,” Suarez-Pierre says.
One reason for the discrepancy is that lung transplant recipients take immunosuppressive medications so their immune systems will not reject the new organ, leaving them more susceptible to infections.
“There are viruses and bacteria that are usually not a problem for healthy people that can be a very severe problem for transplant recipients,” Suarez-Pierre says.
The body’s rejection of the new lung is another common cause of death, as is pneumonia. TUncovering health disparities
A concerning finding from the study was that Hispanic lung transplant recipients have a tenfold increase in mortality compared to Hispanic healthy individuals in the U.S. — double the number in other ethnic groups.
The researchers theorize that may have a lot to do with social determinants of health, and they have another study underway to dig more deeply into the numbers.
“For example, if you’re a lung transplant recipient but you don’t have a private vehicle to go to your doctor’s appointments, you may miss your doctor’s appointments or not be able to pick up your medications,” Suarez-Pierre says. We want to understand what the barriers are, and also which barriers are low-hanging fruit so we can start to tackle this problem.” Improvements in technique and selection
Another significant finding from the study is that mortality rates for lung transplant recipients improved over time in the period the researchers looked at, which was 1990 to 2007.
“That seems to mean that we’re getting better at transplant in a lot of ways,” Iguidbashian says. “Not only organ selection, but also the surgical technique. In the first five years of the study, lung transplant recipients were almost six times more likely to die within 10 years, and toward the end of that spectrum, by 2006 or 2007, that ratio was well under five times more likely.”
Now that the data is published, Iguidbashian and Suarez-Pierre hope to use it not only to talk to patients more generally about survival and mortality rates, but to use data on a patient’s age, gender, race, and more to give them more personalized and accurate information.
“The next step is when we see patients in clinic or in the hospital, we can plug in their characteristics with age, gender, ethnicity, and what type of transplant, and we can get that ratio compared to the general population,” Iguidbashian says. “That’s a much more accurate 10-year survival rate than just that standard 10-year rate with no characteristic stratification.”Journal
Journal of Cardiac Surgery
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The Experience of Long-term Survival in People Affected by Pleural Mesothelioma and Their Carers
This study aimed to gain an understanding of the experience of living as a long-term survivor (three or more years) of pleural mesothelioma from the perspective of the people diagnosed with the condition and their main carer.
Plural mesothelioma has a poor outcome, and it has no known curative treatment. However, a significant minority of people diagnosed with the condition can go on to live with it for several years, some surviving more than eight or even twelve years. New treatments available are likely to increase the numbers of those surviving beyond current expectation. There is limited research literature exploring what it is like for patients to be diagnosed with malignant pleural mesothelioma (MPM), including the emotional impact and symptom burden. Much of this research, however, focuses on the initial period around the time of the diagnosis and little is known about the experience of living with the condition long-term.
This study aimed to gain an in-depth understanding of the experience of living as a long-term survivor with pleural mesothelioma from the perspective of both the people diagnosed with the condition and their primary carers. Ultimately we aimed to make recommendations on the support needs of long-term survivors and their carers living with pleural mesothelioma.
Three themes were developed. Participants ‘Living beyond expectations’ remained acutely aware that MPM was incurable, but developed a range of coping strategies. Periods of disease stability were punctuated with crises of progression or treatment ending, straining coping. ‘Accessing treatment’ was important for patients and carers, despite the associated challenges. They were aware options were limited, and actively sought new treatments and clinical trials. ‘Support needs’ were met by healthcare professionals, voluntary groups and social media networks. Managing patients via regional MPM multidisciplinary teams, facilitating equal access to treatment and trials, could reduce patient and carer burden. Greater awareness and support around crisis points for this group could improve care.