US Mesothelioma Trends: Absolute Cases and Deaths on the Rise
Mesothelioma cases and deaths in the U.S. rose between 1990 and 2023 despite decades of asbestos regulation, according to a study analyzing national and state-level trends. While age-standardized incidence and mortality rates declined, absolute numbers increased, with women and specific regions showing sharper rises. The research highlights persistent asbestos exposure risks and limited treatment progress for the aggressive cancer.
The study, led by Chinmay Jani, MD, and colleagues, used the Global Burden of Disease database to track mesothelioma trends. Age-standardized incidence fell 33% nationally from 1990 to 2023, but absolute cases rose 27.7%, from 2,094 to 2,675 annually. Mortality increased 30.7%, from 1,981 to 2,591 deaths per year, with women experiencing steeper relative increases than men.
Why are women and certain states seeing higher rates?
Women accounted for a smaller share of cases but saw a 64% relative increase in incidence compared to 18% for men. Researchers attribute this to non-occupational exposures, such as environmental contact with legacy asbestos in older buildings or secondary exposure through family members. States with heavy historical asbestos use—like Minnesota, Maine, and Alaska—showed the highest burdens, linked to mining, shipbuilding, and military infrastructure.
What does this mean for treatment and survival?
Mesothelioma survival rates have not improved significantly since 1990, with median survival for pleural cases remaining 9–12 months. The mortality-to-incidence ratio, a proxy for survival, plateaued at 0.95 overall, indicating nearly all diagnosed patients die from the disease. Researchers noted limited data on molecular factors driving outcomes, calling for more studies on early detection and personalized therapies.
What challenges remain in asbestos regulation?
Occupational exposure still accounts for 95.7% of mesothelioma deaths in 2023, though its role has shifted toward secondary exposures during construction, demolition, or maintenance of older structures. Despite bans, asbestos persists in 18% of U.S. buildings, according to federal estimates, creating ongoing risks for workers and communities.
What may happen next?
Future research could explore non-occupational exposure pathways and regional disparities. Policymakers may prioritize stricter regulations on asbestos-containing materials in aging infrastructure or expand screening programs for high-risk populations. However, without new data, projections remain speculative.
Frequently Asked Questions
What is mesothelioma? A rare, aggressive cancer linked to asbestos exposure, typically affecting the lining of the lungs, chest, or abdomen.
How has asbestos use changed over time? The U.S. banned most asbestos use by the 1980s, but the material remains in older buildings, ships, and industrial sites, posing ongoing risks.
Why are women affected more now? Historically, women had lower occupational exposure, but environmental or secondary exposures—such as living with asbestos workers—may contribute to rising rates.
What steps could communities with high mesothelioma rates take to mitigate risks?