Mesothelioma: Scientific clues for prevention, diagnosis, and therapy

A marked increase in the age-standardized mesothelioma incidence and mortality rates began in the 1960s after the massive use of asbestos during World War II and thereafter

Michele Carbone

2019

Scholarcy highlights

  • A marked increase in the age-standardized mesothelioma incidence and mortality rates began in the 1960s after the massive use of asbestos during World War II and thereafter
  • As the cohorts of asbestos workers vanish because of old age, increasing percentages of mesotheliomas, especially peritoneal mesotheliomas, occur in individuals who are not occupationally exposed to asbestos
  • These mesotheliomas may be caused by environmental exposure, genetic predisposition, or GxE interaction
  • Pathogenic germline mutations of BRCA1-asssociated protein 1 and, less frequently, of other tumor suppressor genes have been detected in approximately 12% of patients
  • This subgroup of genetically linked mesotheliomas occurs in younger individuals who rarely report asbestos exposure, with a M:F ratio of 1:1 and survival from 5 to 10 or more years
  • Eighteen studies in 12 countries comprising 665 cases were included; a significantly increased risk of pleural mesothelioma was reported for both household exposure and neighborhood exposure
  • Genetic testing of relatives helps detect those who inherited the mutations and who will benefit from early detection screening, which can be life-saving
  • As we wait for the outcome of the ongoing clinical trials that, we hope, will improve therapeutic options, there are things that can be done to help patients: 1) reduce the percentage of misdiagnosis, estimated at 14%

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