title: Patterns in the incidence, mortality and survival of malignant pleural and peritoneal mesothelioma, New South Wales, 1972-2009.
abstract: BACKGROUND
  Malignant pleural mesothelioma (MPM) and malignant peritoneal mesothelioma (MPeM) are often grouped together in descriptive epidemiological analyses, resulting in limited understanding of epidemiological patterns for these tumour types.
  
  
  METHODS
  We studied patterns in the incidence, mortality and survival of people diagnosed with MPM (n=4,076) and MPeM (n=293) in New South Wales (NSW), Australia, 1972-2009. We also calculated 5-year relative survival for people diagnosed 1972-2006 followed up to 2007. We assessed patterns for each tumour type and histological subtype and, where possible, by combination of these categories.
  
  
  RESULTS
  Annual MPM cases steadily increased over time (n=208 in 2009). There was an increasing trend in the MPM age-standardised incidence rate from 1972 up to 1994. This rate increase has levelled off in the past 10 years. Since 1999, 11 cases of MPeM were diagnosed each year, on average. Five-year relative survival remained stable for MPM and MPeM. However, 5-year relative survival in 2002-2006 was substantially higher for people with MPM epithelioid histological subtype (11.7% [95%CI 6.8-18.2%]) compared to all other non-epithelioid histological subtypes (6.9% [95%CI 5.0-9.1%]), a 70% difference. Survival was also greater for women with MPM (13.4% [95%CI 8.5-19.4%]) compared to men (7.0% [95%CI 5.1-9.2%]).
  
  
  CONCLUSIONS
  MPM incidence rates have stabilised since the mid-1990s, suggesting that maximum incidence levels have been reached. When more up-to-date data are available, survival estimates should be reanalysed to include people likely to benefit from the wide introduction of combination chemotherapy in 2007, including pemetrexed.
authors.affiliation: Cancer Epidemiology and Services Research (CESR), Sydney School of Public Health, Sydney Medical School, University of Sydney, New South Wales.|Asbestos Diseases Research Institute, University of Sydney, New South Wales.
authors.forename: Matthew J
authors.initials: MJ
authors.lastname: Soeberg
authors.affiliation: Cancer Institute NSW, New South Wales.
authors.forename: Nicola
authors.initials: N
authors.lastname: Creighton
authors.affiliation: Cancer Institute NSW, New South Wales.
authors.forename: David C
authors.initials: DC
authors.lastname: Currow
authors.affiliation: Cancer Epidemiology and Services Research (CESR), Sydney School of Public Health, Sydney Medical School, University of Sydney, New South Wales.
authors.forename: Jane M
authors.initials: JM
authors.lastname: Young
authors.affiliation: Asbestos Diseases Research Institute, University of Sydney, New South Wales.
authors.forename: Nico
authors.initials: N
authors.lastname: van Zandwijk
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D018572:Disease-Free Survival; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008654:Mesothelioma / Q000188:drug therapy / Q000453:epidemiology* / Q000401:mortality / Q000473:pathology; D008875:Middle Aged; D009517:New South Wales / Q000453:epidemiology; D010534:Peritoneal Neoplasms / Q000188:drug therapy / Q000453:epidemiology*; D010997:Pleural Neoplasms / Q000188:drug therapy / Q000453:epidemiology*; D012042:Registries; D017678:Sex Distribution; D016019:Survival Analysis; D055815:Young Adult
keywords: Australia; incidence; malignant mesothelioma; mortality; peritoneal; pleural; relative survival