Cancer epidemiology · 2026
Beyond the pleura: National trends in mesothelioma mortality by anatomical site in Spain, 1999-2024.
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Cayuela Lucía, Gaeta Anna Michela, Ortega-Calvo Manuel, Machancoses Francisco H, Cayuela Aurelio
Аннотация
OBJECTIVES: Mesothelioma mortality continues to reflect asbestos exposure because of its long latency. While previous Spanish studies focused primarily on pleural disease, this study assessed mesothelioma mortality across the ICD-10 C45 category in Spain from 1999 to 2024.
MATERIALS AND METHODS: A population-based time-trend study was conducted using mortality data (ICD-10 C45) from the Spanish National Statistics Institute. Age-standardised mortality rates (ASMRs) were calculated using the 2013 European Standard Population. Temporal trends and sex-specific parallelism were evaluated using Joinpoint regression.
RESULTS: Among 9733 recorded mesothelioma deaths (7311 men, 2422 women), ASMRs were consistently higher in men, although temporal trends were parallel by sex. Overall mortality increased until 2016 (annual percentage change [APC] 2.3%, 95% CI 1.5-3.0) and subsequently declined non-significantly, yielding an average annual percentage change (AAPC) of 1.0% (95% CI 0.2-1.7) for 1999-2024. Pleural mortality increased until 2011 before declining non-significantly, whereas recorded peritoneal mortality increased throughout the study period (AAPC 2.0%, 95% CI 0.7-3.2). Deaths coded as unspecified site (C45.9) showed the largest increase in ASMR (AAPC 2.1%, 95% CI 1.1-3.1) and accounted for 43.5% of male and 31.8% of female mesothelioma deaths in 2024.
CONCLUSIONS: Absolute mesothelioma deaths increased in Spain while age-standardised rates attenuated after 2016. The continued increase in recorded peritoneal mortality and the substantial contribution of unspecified-site deaths indicate that surveillance should not rely solely on pleural mesothelioma, highlighting the need for comprehensive monitoring of the complete ICD-10 C45 category and improved anatomical classification.
MATERIALS AND METHODS: A population-based time-trend study was conducted using mortality data (ICD-10 C45) from the Spanish National Statistics Institute. Age-standardised mortality rates (ASMRs) were calculated using the 2013 European Standard Population. Temporal trends and sex-specific parallelism were evaluated using Joinpoint regression.
RESULTS: Among 9733 recorded mesothelioma deaths (7311 men, 2422 women), ASMRs were consistently higher in men, although temporal trends were parallel by sex. Overall mortality increased until 2016 (annual percentage change [APC] 2.3%, 95% CI 1.5-3.0) and subsequently declined non-significantly, yielding an average annual percentage change (AAPC) of 1.0% (95% CI 0.2-1.7) for 1999-2024. Pleural mortality increased until 2011 before declining non-significantly, whereas recorded peritoneal mortality increased throughout the study period (AAPC 2.0%, 95% CI 0.7-3.2). Deaths coded as unspecified site (C45.9) showed the largest increase in ASMR (AAPC 2.1%, 95% CI 1.1-3.1) and accounted for 43.5% of male and 31.8% of female mesothelioma deaths in 2024.
CONCLUSIONS: Absolute mesothelioma deaths increased in Spain while age-standardised rates attenuated after 2016. The continued increase in recorded peritoneal mortality and the substantial contribution of unspecified-site deaths indicate that surveillance should not rely solely on pleural mesothelioma, highlighting the need for comprehensive monitoring of the complete ICD-10 C45 category and improved anatomical classification.