05 - Epidemiology of malignant mesothelioma 1-> 5...

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Official reprint from UpToDate ® www.uptodate.com ©2010 UpToDate ® Authors Daniel H Sterman, MD Leslie A Litzky, MD Larry R Kaiser, MD Steven M Albelda, MD Section Editors Arthur T Skarin, MD Andrew Nicholson, MD Deputy Editor Michael E Ross, MD Epidemiology of malignant mesothelioma Last literature review version 18.1: Ocak 2010 | This topic last updated: Şubat 9, 2009 INTRODUCTION — Mesothelioma is an insidious neoplasm arising from the mesothelial surfaces of the pleural and peritoneal cavities, the tunica vaginalis, or the pericardium. Eighty percent of all cases are pleural in origin. The predominant cause of malignant mesothelioma is inhalational exposure to asbestos, with approximately 70 percent of cases of pleural mesothelioma being associated with documented asbestos exposure. This topic will discuss the epidemiology and pathology of mesothelioma. Treatment as well as the clinical presentation, evaluation, and staging of malignant mesothelioma will be discussed separately. (See "Clinical presentation, diagnosis, and staging of malignant pleural mesothelioma" and "Treatment approaches for localized malignant pleural mesothelioma and solitary fibrous tumor of the pleura" .) EPIDEMIOLOGY — The annual incidence of mesothelioma in the United States is estimated to be approximately 3300 cases per year [ 1 ]. The incidence of mesothelioma in the United States appears to have peaked around the year 2000 and is now declining, secondary to control of exposure to asbestos [ 2 ]. The incidence is increasing in many other places in the world, particularly in Great Britain, where a peak of up to 2450 deaths per year expected around the year 2015 [ 3 ]. After that time, mesothelioma rates are expected to drop in England and other developed countries because of recent legislation aimed at reducing asbestos exposure in the workplace and the general environment. In contrast, mesothelioma incidence rates are predicted to increase dramatically in the Third World secondary to the poor regulation of asbestos mining and the proliferation of industrial and household utilization of asbestos [ 3-5 ]. Asbestos exposure — Asbestos is the commercial name for a group of hydrated magnesium silicate fibrous minerals. There are two major types: serpentine and amphibole. Ninety percent of the asbestos currently used in the United States is Canadian chrysotile, a serpentine fiber that is reportedly less carcinogenic [ 3,4 ]. Asbestos is valued in industry for its resistance to heat and combustion. It is still used in cement, ceiling and pool tiles, automobile brake linings, and in shipbuilding. As many as eight million living persons in the United States have been occupationally exposed to asbestos over the past 50 years. With the acknowledgment that asbestos exposure may endanger the health of American workers, the Occupational Safety and Health Administration established 5 fibers per cubic milliliter of air as the standard acceptable exposure in 1970. This level has since
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05 - Epidemiology of malignant mesothelioma 1-> 5...

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