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Pleural Mesothelioma Risk: Genes and Exposure Both Play a Role

When it comes to the development of malignant pleural mesothelioma, your job and your relatives both appear to play critical roles.

A new study in the European Journal of Cancer points to the interplay between environment and genetics in the development of the asbestos cancer.

The study shows, once again, just how destructive asbestos can be to human health.

Analyzing Mesothelioma Incidence Among Swedes

The new research used data from the Swedish Family-Cancer Database, which includes all Swedes born after 1931 and their biological parents – a total of 16.1 million people, including 2.3 million cancer patients.

After analyzing the data on all people with pleural mesothelioma, the researchers determined that those who worked around asbestos were more than three times as likely as other people to contract mesothelioma. But asbestos-exposed people who also had a first-degree relative with pleural mesothelioma had an even greater chance of receiving a mesothelioma diagnosis.

“In those who had a history of mesothelioma in their first-degree relatives and an asbestos-related occupation, risk of mesothelioma dramatically increased compared with individuals without such occupations and family history,” writes researcher Elham Kharazmi of the German Cancer Research Center in Heidelberg.

Asbestos Exposure Counts More than Family History

Although people in asbestos-related occupations faced a higher risk for mesothelioma if a relative had the disease, the reverse was not true.

The Swedes with a parent who had malignant mesothelioma were unlikely to contract the cancer themselves if they weren’t in a high-risk occupation.

In fact, their mesothelioma risk was comparable to those who had no family history of pleural mesothelioma and no on-the-job asbestos exposure, suggesting that asbestos exposure is still  the biggest factor in mesothelioma development.

Familial Risk of Mesothelioma and Other Cancers

Although researchers have not yet identified all of the genes associated with increased mesothelioma risk, certain people are known to be more susceptible.

For instance, people with BAP1 syndrome, a condition characterized by a loss of the BAP1 tumor suppressor gene, have a higher risk not only for mesothelioma but also for certain kinds of skin cancer and a rare eye condition.

Nearly 85 percent of patients with peritoneal mesothelioma and 20 to 30 percent of pleural mesothelioma patients have been found to have alterations of the BAP1 gene.

In 2016, a group of researchers at the Center for Primary Health Care Research in Malmo, Sweden found that having family members with bladder or kidney cancer also appeared to increase the risk for pleural mesothelioma in asbestos-exposed people.

Reducing the Risk for Mesothelioma

Although a person has no control over their genetics, it is possible to reduce the chances of contracting malignant mesothelioma, even if a family member already has it.

The most important preventative is to avoid exposure to asbestos. Even those who don’t work in an asbestos industry can be at risk. In the US, many older homes and public buildings still contain asbestos insulation and other asbestos products. These materials should never be touched and should only be removed by trained abatement professionals.

While repeated exposure to asbestos raises the risk of eventually developing mesothelioma, the EPA has stated that no level of exposure is safe and even a brief exposure could have deadly consequences.


Kharazmi, E, et al, “Familial risk of pleural mesothelioma increased drastically in certain occupations: A nationwide prospective cohort study”, September 6, 2018, European Journal of Cancer, Epub ahead of print

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