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Study Shows Asbestos Bans are Slow to Reduce Malignant Mesothelioma Rates

It has been more than 32 years since Denmark began in 1972 a ban on the use of asbestos insulation. In the late 1980s, Denmark also extended its ban to include other products containing asbestos.  And now, Denmark is one of 55 countries who have completely banned asbestos  products.  

But according to the new study of mesothelioma in Denmark, a steady rise in cases of this asbestos-linked cancer that began in the 1950s is still going on.

Mesothelioma and Asbestos

Mesothelioma is an aggressive cancer of the membranes around internal organs, most often the lungs or abdomen of the patient. It is a deadly disease that comes from exposure to the mineral asbestos.

Asbestos was made into a popular insulator and component in building materials worldwide back in the 1930s because it was readily available, cost little, and its very resistant to fire and corrosion.  The use of Asbestos in the building materials has put hundreds of thousands of workers at risk for mesothelioma.

Many countries, including Denmark, began in the 1950s and 60s to reduce their use of Asbestos products after it was linked to mesothelioma cancer as well as other unhealthy conditions.Pleural Mesothelioma Asbestos Lung Cancer

In a Danish study, the research team used data from the years 1943 through 2009 about mesothelioma stored at the Danish Cancer Registry. The researchers discovered the total incidence of mesothelioma continued to rise throughout the study period showing a peak of 1.76 cases per 100,000 people during the years 2008-2009.

The study also identified more cases in the Region of Northern Jutland in comparison to Southern Denmark.  While mesothelioma survival rate has improved slightly, the researchers noted that the  prognosis for getting mesothelioma continues to remain poor based on a median rate of 12.5 months survival for men and 13.3 months survival for women in the years 2008 through 2009.

In the Danish Medical Journal, the authors conclude:

“The national malignant mesothelioma incidence for men continues to increase, perhaps showing a slight tendency towards deceleration in the most recent decade,”

But they go on to say that:

“A clear long-term effect of the Danish asbestos ban has not yet occurred.”

Lag Time between Asbestos Exposure and Mesothelioma Diagnosis

With mesothelioma, the lag time  (latency period) between exposure to asbestos  and the development of the disease can be many decades.   It is during the latency period that the disease is very difficult to detect and diagnose, much less tracing its source.  Frequently mesothelioma cancer is diagnosed late in its development, and it tends to progress quickly.  Estimates from the World Health Organization show that since 1994, more than 92,000 people have died from mesothelioma cancer.

RESULTS:

In Denmark, the national incidence of malignant mesothelioma cancer for men has been rising during the study period, reaching its total maximum of 1.76 in 2008-2009.  The incidence rate has remained relatively steady for women with a maximum of 0.5 in 1973 through 1977.

Northern Jutland and the surrounding region records the highest male incidence rate of mesothelioma since the late 1980s. The difference in relative risk for men in the Region of Southern Denmark and the Region of Northern Jutland was 1.53 during the period of 2008-2009.  The relative risk of developing mesothelioma cancer in the Region of Northern Jutland for the entire study period when collectively compared to the whole of Denmark was 1.38.  The study showed there are no notable regional differences for women at risk of developing mesothelioma.  Therefore, survival has slightly improved for both genders, but still remains poor with a median survival of 12.5 months for men and 13.3 months for women in the period of 2008 through 2009.

CONCLUSION:

Within Denmark the national malignant mesothelioma incidence for men continues to increase, perhaps showing a slight tendency towards deceleration in the most recent decade. A measurable long-term mitigating effect of the Danish ban on asbestos products  has not yet occurred.

The original Danish study appeared in the Danish Medical Journal. (Skammeritz, E, et al, “Regional difference in incidence of malignant mesothelioma in Denmark“, March 2013, Danish Medical Journal.

http://www.ncbi.nlm.nih.gov/pubmed/23484611

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Related Mesothelioma Cancer Press Releases

Second Round of Chemotherapy May Not Help

According to a study by Turkish researchers, a second round of chemotherapy may not do much good for mesothelioma patients whose cancer returns after first-line treatment.

Chemotherapy CRS-207 mesothelioma vaccinationTheir findings are based on an analysis of 51 pleural mesothelioma patients from a Turkish hospital. All patients in the study were initially treated with chemotherapy, the standard first-line treatment for mesothelioma. But, when their mesothelioma tumors began to grow again several months later, some patients were treated with second-line chemotherapy (SLCT) while others had best supportive care (BSC), which includes symptom management only.

Chemotherapy Standard Is Tough

While chemotherapy is a standard first-line treatment for mesothelioma, an aggressive cancer of the mesothelial membranes, there is disagreement within the medical community as to whether or not second-line chemotherapy is effective. While it can sometimes slow the progression of mesothelioma, chemotherapy is also hard on the body and causes a range of dangerous side effects. For this reason, only the healthiest patients are even considered candidates for second-line chemotherapy.

Chemotherapy Survival Rates

In the Turkish study, patients who had chemotherapy as both a first- and second-line treatment had a median overall survival of 20.3 months. These patients had a median survival of 5.9 months after the end of their first-line chemotherapy. Patients who had only BSC when their mesothelioma began to grow again had a median overall survival of 14.7 months. The median overall survival for these patients from the end of their first-line chemotherapy treatment was 4.7 months.

While the figures seem to show that the second-line chemotherapy patients had better outcomes than those receiving BSC, the authors of the study say the differences between the two are not statistically significant. In addition, the fact that second-line chemotherapy is usually reserved for select patients may also contribute to the apparent skew of the results. They conclude, Our results do not support the proposal that second-line chemotherapy could be effective in patients with malignant pleural mesothelioma.”

While such studies can help guide mesothelioma treatment planning, treatment decisions are made on a case-by-case basis, based on a range of criteria. The original study appears in the Asian Pacific Journal for Cancer Prevention. (Mutlu, H, et al,
Secondline chemotherapy versus best supportive care in patients with malignant pleural mesothelioma: a retrospective study
2013
Asian Pacific Journal of Cancer Prevention
pp. 3887-3889
http://www.apocpcontrol.org/page/apjcp_issues_view.php?no=4654&gubun=p&s_search=mesothelioma&s_paper_vol=14&s_number33=6