Letter to the Editor: Largely Unchanged Annual Incidence and Overall Survival of Pleural Mesothelioma in the USA

Excerpt

We read with great interest the analysis of pleural mesothelioma by Keshava et al. [1]. One of the stated objectives of this study was to “evaluate trends in the incidence of malignant pleural mesothelioma… in the modern era” acknowledging the long-standing hypothesis that “a decrease in peak asbestos exposure after the 1970s would translate into a peak incidence of mesothelioma in the early 2000s followed by a subsequent decline” [1]. Using data from the National Cancer Database (NCDB), the investigators estimated the US case counts from 2004 to 2014 (range 1783–2031), concluding that “the annual incidence of mesothelioma has not declined this century and remains stable,” and “there is little to suggest that the decrease in industrial use [of asbestos] over the past several decades has translated into a decreased incidence of pleural mesothelioma” [1]. While this research question is important, the approach and methods employed are not well suited for addressing it. …