title: Incidence and survival trends for malignant pleural and peritoneal mesothelioma, Australia, 1982-2009.
abstract: BACKGROUND
  Australia is known to have had one of the highest per-capita asbestos consumption rates, yet there are few contemporary reports on malignant mesothelioma trends.
  
  
  METHODS
  Data on 10 930 people with malignant pleural mesothelioma (MPM) and 640 people with malignant peritoneal mesothelioma diagnosed in Australia during 1982-2009 were analysed. Observed incidence rate trends were quantified. Incidence rates were projected up to 2030 using observed incident cases during 1982-2012. The relative per-decade change in excess mortality during 1999-2009 was estimated.
  
  
  RESULTS
  During 1982-2009, acceleration in MPM age-standardised incidence rates were highest for women and those aged 75 years and above, with average annual percentage changes of +4.9 (95% CI 3.6 to 6.2) and +7.2 (95% CI 5.4 to 9.0), respectively. Age-standardised incidence rates for men with MPM aged 0-64 years decelerated rapidly during 2003-2009, an average annual percentage change of -5.1% (95% CI -7.6% to -2.5%). Overall, male age-specific MPM incidence rates in the age group of 65-74 year during 2010-2030 are projected to decline with rates projected to increase for older men and women with MPM. There was a statistically significant 16% relative reduction in the excess mortality rate (EMR) up to 5 years postdiagnosis for people diagnosed with malignant pleural and peritoneal mesothelioma combined in 2009 compared with those diagnosed in 1999, an EMR ratio of 0.84 (95% CI 0.77 to 0.92).
  
  
  CONCLUSIONS
  Australia's malignant mesothelioma incidence rates appear to have reached maximum levels but with differences over time by age, gender and tumour location. Improvements over time in survival provide a glimpse of hope for this almost invariably fatal disease.
authors.affiliation: Sydney School of Public Health, Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia Asbestos Diseases Research Institute, University of Sydney, Sydney, New South Wales, Australia.
authors.forename: Matthew J
authors.initials: MJ
authors.lastname: Soeberg
authors.affiliation: Asbestos Diseases Research Institute, University of Sydney, Sydney, New South Wales, Australia.
authors.forename: James
authors.initials: J
authors.lastname: Leigh
authors.affiliation: Sydney School of Public Health, Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia.
authors.forename: Tim
authors.initials: T
authors.lastname: Driscoll
authors.affiliation: Sydney School of Public Health, Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia.
authors.forename: Bruce
authors.initials: B
authors.lastname: Armstrong
authors.affiliation: Sydney School of Public Health, Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia.
authors.forename: Jane M
authors.initials: JM
authors.lastname: Young
authors.affiliation: Asbestos Diseases Research Institute, University of Sydney, Sydney, New South Wales, Australia.
authors.forename: Nico
authors.initials: N
authors.lastname: van Zandwijk
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001194:Asbestos / Q000009:adverse effects*; D001315:Australia / Q000453:epidemiology; D002273:Carcinogens; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D004781:Environmental Exposure; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D008168:Lung / Q000473:pathology; D008175:Lung Neoplasms / Q000453:epidemiology* / Q000401:mortality; D008297:Male; D008654:Mesothelioma / Q000453:epidemiology* / Q000401:mortality; D000086002:Mesothelioma, Malignant; D008875:Middle Aged; D010534:Peritoneal Neoplasms / Q000453:epidemiology* / Q000401:mortality; D010537:Peritoneum / Q000473:pathology; D010997:Pleural Neoplasms / Q000453:epidemiology* / Q000401:mortality; D055815:Young Adult
chemical_list: D002273:Carcinogens; D001194:Asbestos