Study Highlights Treatment Disparities in Female Mesothelioma Patients

Female mesothelioma patients are less likely to have surgery and other aggressive treatments than male patients are, but they still tend to live longer. That’s according to a nine-year study of nearly 19,000 pleural mesothelioma patients. 

Researchers at the University of Pennsylvania’s Perelman School of Medicine led the study.

The team used the National Cancer Database to identify pleural mesothelioma cases diagnosed between 2004 and 2013. The study included more than four thousand female mesothelioma patients. 

The conclusion is that there are serious disparities in the way doctors treat men and women with malignant mesothelioma.

Gender Differences in Mesothelioma Incidence

Exposure to asbestos is the primary cause of malignant mesothelioma. Although it can affect either gender, most mesothelioma patients are men. Less than a quarter of mesothelioma patients are women. 

Historically, men were more likely to work in jobs that exposed them to asbestos. These include fields like construction, manufacturing, mining, and military service. 

Female mesothelioma patients were more likely to encounter asbestos outside of work. Some lived near an asbestos mine or plant that used asbestos. Others were exposed to a spouse or parent’s contaminated work clothes. A few women trace their only exposure to asbestos-tainted talcum powder.  

Female Mesothelioma Patients Less Likely to Have Surgery or Chemo

Female mesothelioma patients are less common but they are more likely to survive. Around 45 percent of women are still alive a year after a mesothelioma diagnosis. The figure is only 38 percent for men. 

But the new research suggests this has little to do with how they are treated. According to the Penn researchers, “Surgery and chemotherapy are disproportionately underutilized in female patients with malignant pleural mesothelioma.”

For the right patients, mesothelioma surgery offers the best odds for long-term survival. But a patient has to be in good overall health and have few other health problems. 

The researchers found that more female mesothelioma patients meet this criteria than males. Even so, men are more likely than women to have surgery. The same is true for mesothelioma chemotherapy.

Why Women with Mesothelioma Live Longer

If female mesothelioma patients are treated less aggressively, why do they live longer than men?

One reason may be that most women are younger and healthier at diagnosis. While the average age for pleural mesothelioma diagnosis is 72, the average age for women to be diagnosed with any type of mesothelioma is just 60.

Some researchers theorize that the latency period for mesothelioma is shorter for women than it is in men. It may be that women are simply more attuned to mesothelioma symptoms and recognize the disease sooner. 

Female mesothelioma patients are also more likely than men to have the epithelioid form of the disease. Epithelioid mesothelioma tends to be more responsive to treatment than other subtypes. 

“Further research to understand factors that lead to gender disparities in malignant pleural mesothelioma is warranted,” concludes the report. 

Source:

Barsky, AR, et al, “Gender-based Disparities in Receipt of Care and Survival in Malignant Pleural Mesothelioma”, May 2020, Clinical Lung Cancer, Epub ahead of print, https://linkinghub.elsevier.com/retrieve/pii/S1525730420301613

Pavlisko, EN, et al, “Malignant Diffuse Mesothelioma in Women: A Study of 354 Cases”, December 23, 2019, American Journal of Surgical Pathology, Epub ahead of print, https://journals.lww.com/ajsp/Abstract/publishahead/Malignant_Diffuse_Mesothelioma_in_Women__A_Study.97509.aspx