The History of Mesothelioma

The North American Experience with Malignant Mesothelioma

Incidence
In the United States

In 1890 Biggs’ reported a case of ‘endothelioma’ of the pleura. This report may have been the first recognized case of malignant mesothelioma in North America. Since then the incidence of mesothelioma in North America and the world has steadily climbed.

Studies of the incidence of mesothelioma in North America have been hampered by a paucity of data. Before 1988, the United States did not even have a specific code for mesothelioma, so many cases were misclassified on death certificates as lung cancers or abdominal cancers. In the United States, the best estimates of mesothelioma incidence are derived from the Surveillance, Epidemiology, and End Results (SEER) Program of the National Cancer Institute. The SEER database includes about 9.5 per cent of the United States population. It covers 10 regional areas, in five states (Connecticut, Iowa, New Mexico, Utah and Hawaii), and five major urban areas – San Francisco-Oakland, New Orleans, Seattle, Atlanta and Detroit. Although the SEER regions are reasonably representative of the United States population in terms of demographic and epidemiological factors, the program may not accurately reflect the country as a whole. It includes some shipbuilding areas, but large urban areas where asbestos was used in manufacturing and construction are underrepresented. The database is organized by case; each case is identified by age, sex, race, date of diagnosis and cancer type. The data for mesothelioma are published only intermittently. However, this database provides the most comprehensive national incidence data available for this disease.

In 1997 Price’ analyzed the SEER data for mesothelioma. He divided the data into five-year age groups in each diagnosis year. He found the consistently higher rate for mesothelioma in men than the women. The rate for women remained relatively constant over the years. On the other hand, the rate for men increased until 1992, when it peaked at 1.9 per 100 000 people.