Abstract
We analyzed mesothelioma incidence in the Surveillance, Epidemiology, and End Results (SEER) database over the period 1973–2005 using extensions of the age–period–cohort (APC) models. In these analyses, the usual non-specific age effects of the conventional APC models were replaced by hazard functions derived from two multistage models of carcinogenesis, the Armitage–Doll model and the two-stage clonal expansion (TSCE) model. The extended APC models described the incidence data on pleural and peritoneal mesotheliomas well. After adjustment for temporal trends, the data suggest that the age-specific incidence rates of both pleural and peritoneal mesotheliomas are identical in men and women. Driven largely by birth cohort effects, age-adjusted rates of pleural mesothelioma among men rose from about 7.5 per million person-years in 1973 to about 20 per million person-years in the early 1990s and appear to be stable or declining thereafter. Age-adjusted rates of pleural mesothelioma among women have remained more or less constant at about 2.5 per million person-years over the period 1973–2005. Age-adjusted rates for peritoneal mesothelioma in both men (1.2 per million person-years) and women (0.8 per million person-years) exhibit no temporal trends over the period of the study. We estimate that approximately 94,000 cases of pleural and 15,000 cases of peritoneal mesothelioma will occur in the US over the period 2005–2050.
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Notes
Incidence data for the same tumor can be downloaded using different coding schemes from the SEER registry. These distinct methods of downloading the data should yield identical numbers. For example, one can download mesothelioma incidence data using either ICD 10 codes (C45.0 for mesothelioma of the pleura and C45.1 for mesothelioma of the peritoneum, including omentum and mesentery), or using site & morphology = ‘peritoneum, omentum and mesentery’ and histology = 9,050–9,059 (mesothelial neoplasms). For peritoneum, these two codings yield highly discrepant results, with the latter coding yielding approximately four times as many tumors as the former. For pleura, the appropriate equivalents to these two approaches yield identical numbers. In this manuscript, we present the results of analyses of peritoneal mesothelioma incidence based on the second approach for the following reasons. First, this is the older method of coding and, therefore, probably less susceptible to error. Second, it appears to have been the method used in the papers by Teta et al. [9] and Boffetta [31]. We have also performed the analyses using the data obtained using the first method. Our conclusions regarding trends and model fits remain unchanged. However, our estimated rates for peritoneal mesothelioma and projected number of cases are approximately a fourth of those presented here. We would be happy to share these results with any interested reader.
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Moolgavkar, S.H., Meza, R. & Turim, J. Pleural and peritoneal mesotheliomas in SEER: age effects and temporal trends, 1973–2005. Cancer Causes Control 20, 935–944 (2009). https://doi.org/10.1007/s10552-009-9328-9
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DOI: https://doi.org/10.1007/s10552-009-9328-9