ResearchGlobal mesothelioma mortality Vanya Delgermaa et al.

BackgroundLittle is known about the global magnitude of mesothelioma. In particular, many developing countries, including some with extensive historical use of asbestos, do not report mesothelioma.ObjectivesWe estimated the global magnitude of mesothelioma accounting for reported and unreported cases.MethodsFor all countries with available data on mesothelioma frequency and asbestos use (n = 56), we calculated the 15-year cumulative number of mesotheliomas during 1994–2008 from data available for fewer years and assessed its relationship with levels of cumulative asbestos use during 1920–1970. We used this relationship to predict the number of unreported mesotheliomas in countries for which no information on mesothelioma is available but which have recorded asbestos use (n = 33).ResultsWithin the group of 56 countries with data on mesothelioma occurrence and asbestos use, the 15-year cumulative number of mesothelioma was approximately 174,300. There was a statistically significant positive linear relation between the log-transformed national cumulative mesothelioma numbers and the log-transformed cumulative asbestos use (adjusted R2 = 0.83, p < 0.0001). Extrapolated to the group of 33 countries without reported mesothelioma, a total of approximately 38,900 (95% confidence interval, 36,700–41,100) mesothelioma cases were estimated to have occurred in the 15-year period (1994–2008).ConclusionsWe estimate conservatively that, globally, one mesothelioma case has been overlooked for every four to five reported cases. Because our estimation is based on asbestos use until 1970, the many countries that increased asbestos use since then should anticipate a higher disease burden in the immediate decades ahead.

BackgroundMesothelioma is increasingly recognised as a global health issue and the assessment of its global burden is warranted.ObjectivesTo descriptively analyse national mortality data and to use reported and estimated data to calculate the global burden of mesothelioma deaths.MethodsFor the study period of 1994 to 2014, we grouped 230 countries into 59 countries with quality mesothelioma mortality data suitable to be used for reference rates, 45 countries with poor quality data and 126 countries with no data, based on the availability of data in the WHO Mortality Database. To estimate global deaths, we extrapolated the gender-specific and age-specific mortality rates of the countries with quality data to all other countries.ResultsThe global numbers and rates of mesothelioma deaths have increased over time. The 59 countries with quality data recorded 15 011 mesothelioma deaths per year over the 3 most recent years with available data (equivalent to 9.9 deaths per million per year). From these reference data, we extrapolated the global mesothelioma deaths to be 38 400 per year, based on extrapolations for asbestos use.ConclusionsAlthough the validity of our extrapolation method depends on the adequate identification of quality mesothelioma data and appropriate adjustment for other variables, our estimates can be updated, refined and verified because they are based on commonly accessible data and are derived using a straightforward algorithm. Our estimates are within the range of previously reported values but higher than the most recently reported values.

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Summary Parental smoking data have been abstracted from the interview records of the case-control study that first indicated that pregnancy radiographs are a cause of childhood cancer (Oxford Survey of Childhood Cancers, deaths from 1953 to 1955). Reported smoking habits for the parents of 1549 children who died from cancer were compared with similar information for the parents of 1549 healthy controls (matched pairs analysis). There was a statistically significant positive trend between paternal daily consumption of tobacco and the risk of childhood cancer (P < 0.001). This association could not be explained by maternal smoking, social class, paternal or maternal age at the birth of the survey child, sibship position or obstetric radiography. About 15% of all childhood cancers in this series could be attributable to paternal smoking.Keywords: childhood cancer; smoking; case-control study A recent review of the published literature on childhood cancer risks and parental use of tobacco concluded that 'the associations between maternal smoking during pregnancy and childhood cancer have been studied intensively, but there is no clear association overall, or for specific sites' (Tredaniel et al, 1994). The review also summarized information on paternal smoking from 13 case-control studies. Many of these studies were small in size and a total of only 1953 childhood cancers (varying diagnostic groups) formed the combined case series. The review concluded that no clear associations have been identified'.A further four case-control study reports (additional combined series of 2772 cases) are now available, which include information on paternal smoking and childhood cancer risks (Severson et al, 1993;Shu et al, 1994Shu et al, , 1996Sorahan et al, 1995). No association was found with maternal smoking in any of these reports but, in three of them, positive associations were found for paternal smoking (Shu et al, 1994Sorahan et al, 1995). In the largest of these studies, reported consumptions of alcohol and tobacco for the parents of 1641 children who died from cancer in England and Wales during the period 1977-81 were compared with similar information for the parents of 1641 healthy control children (Sorahan et al, 1995). These data were obtained from the interview records of the Oxford Survey of Childhood Cancers (OSCC) and relations between maternal consumption of cigarettes and birth weights indicated that the (maternal) smoking data were equally reliable for case and control parents. For mothers, consumption of cigarettes was not shown to be associated with an increased risk of childhood cancer, whereas there was a statistically significant positive trend (P < 0.001) between daily consumption of cigarettes by fathers and childhood cancer risks. Earlier OSCC data have, therefore, been revisited to seek further information on this topic.

Objectives: To test the "Gardner hypothesis" that childhood leukaemia and non-Hodgkin lymphoma can be caused by fathers' exposure to ionising radiation before the conception of the child, and, more generally, to investigate whether such radiation exposure of either parent is a cause of childhood cancer. Design: Case-control study. Setting: Great Britain.

Summary Parental smoking data have been reabstracted from the interview records of the Oxford Survey of Childhood Cancers (deaths from 1971 to 1976). Reported smoking habits for the parents of 2587 children who died with cancer were compared with similar information for the parents of 2587 healthy controls (matched pairs analysis). Matemal daily consumption of cigarettes and paternal use of pipes or cigars were unimportant, but there was a statistically significant positive trend between paternal daily consumption of cigarettes and the risk of childhood cancer (P < 0.001). This association could not be explained by maternal smoking, social class, parental ages at the birth of the survey child, sibship position or obstetric radiography. Relations between maternal consumption of cigarettes and birth weights suggested that (maternal) smoking data were equally reliable for case and control subjects. About 14% of all childhood cancers in this series could be attributable to paternal smoking. These data were combined with smoking data from two previously published reports from the Oxford Survey (deaths from 1953 to 1955, deaths from 1977 to 1981) to obtain further information on risks for different types of cancer and different ages at onset of disease. Paternal cigarette smoking emerged as a potential risk factor both for the generality of childhood cancer and for all ages at onset.