Projecting future mortality risk of pleural mesothelioma in Italy (2020-2034): Bayesian age-period-cohort analysis over 40 years of death registration.

INTRODUCTION

Italy, a major former producer, banned asbestos in 1992. A high incidence of mesothelioma, one of the asbestos legacies, is still observed due to the long latency and exposure from residual asbestos-containing materials. Future mortality forecasts at both national and subnational levels are still lacking. This work aims to project future age-stratified mortality rates (2020-2034) for pleural mesothelioma (PM) in Italy, both nationally and for each administrative region.

METHODS

Data on pleural cancers and PM in Italy between 1980 and 2019 were extracted from death registries, adjusted for PM misclassification in ICD-9, and aggregated in eight periods, eighteen age classes, and fifteen birth cohorts. Bayesian age-period-cohort models were implemented to generate age-specific mortality projections, stratified by sex assigned at birth.

RESULTS

Between 1980 and 2019, 33,889 people died from PM in Italy, and 19,092 more deaths are expected between 2020 and 2034. The national peak is predicted for 2020-2024, with 6,740 deaths. Age groups under 75 years have already reached the peak of mortality rates. Region-specific trends by sex and time reflect the country's industrialization history.

DISCUSSION: These results align with the literature in predicting the timing of the mesothelioma peak and offer new insights into age-specific trends, the rate of decline, and geographical patterns. They provide valuable evidence on the heterogeneous asbestos legacy across regions, supporting targeted public health actions and health planning.