Global trends, future projections, and epidemiological associations of Mesothelioma: A comprehensive analysis from 1980 to 2050.

BACKGROUND

Malignant mesothelioma is a rare but aggressive cancer primarily caused by occupational asbestos exposure. This study aims to comprehensively assess global mesothelioma incidence and mortality trends, examine their associations with the Human Development Index (HDI), project future burden through 2050, and investigate epidemiological correlations with other malignancies.

METHODS

We extracted mesothelioma incidence and mortality data from GBD 2021 and GLOBOCAN 2022, covering 204 and 185 countries from 1980 to 2022, respectively. Temporal trends were analyzed using estimated annual percentage change (EAPC), while age-period-cohort (APC) modeling was applied in six high-HDI countries to assess generational burden shifts. Future projections were generated using age-stratified machine-learning models trained on historical data and validated against multiple forecasting methods. Additionally, mesothelioma's epidemiological associations with 27 other cancers were analyzed using linear and logistic regression.

RESULTS

Between 1990 and 2021, global mesothelioma incidence and mortality showed a modest decline (ASIR EAPC: -0.2 [95 % UI: -0.32 to -0.08]; ASDR EAPC: -0.23 [95 % UI: -0.3 to -0.16]). Males exhibited a significantly higher burden than females, with the UK and Australia reporting the highest incidence and mortality rates. A clear threshold effect of HDI was observed, with mesothelioma rates remaining stable below HDI 0.8 but rising sharply beyond this level. Additionally, mesothelioma demonstrated strong positive correlations with tracheobronchial lung cancer, ovarian cancer, and Hodgkin lymphoma, suggesting potential shared environmental and occupational risk factors.

CONCLUSIONS

Our findings provide the most up-to-date epidemiological insights into mesothelioma, highlighting its stable long-term burden, gender disparities, and socioeconomic influences.