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Preventing Malignant Mesothelioma through National Asbestos Regulation

Preventing Malignant Mesothelioma through National Asbestos RegulationAfter almost 30 years, one key to preventing malignant mesothelioma is found.

A national ban on asbestos in the Netherlands has shown positive effects. Results from a new study show the ban cut malignant mesothelioma incidence.

Malignant mesothelioma incidence has peaked about 10 years earlier than predicted. This is after the Dutch national ban on asbestos.

Mesothelioma treatment advances have led to somewhat better survival in the Netherlands. But the prognosis is still dismal.

National Regulation Can Prevent Malignant Mesothelioma

In 1993, a national ban on asbestos went into effect in the Netherlands. This ban was preventing malignant mesothelioma in future generations.

Malignant mesothelioma is an aggressive cancer. It arises from the pleura or peritoneum due to asbestos exposure. A new study reviewed the Dutch population-based incidence, treatment and survival since the national ban on asbestos in 1993.

The review included patients with malignant mesothelioma diagnosed from 1993 to 2018. Surgeons used a Dutch cancer registry to collect the data.

Their findings show that national asbestos laws can lead to a decreased mesothelioma incidence sooner than predicted. This supports the notion that preventing malignant mesothelioma may lie in national regulation.

Yet, treatment patterns and survival outcomes in over 12,000 patients show a need for better mesothelioma therapeutics.

Breaking Down the Results Further

In total, this study reviewed 12,168 patients. The number of malignant mesothelioma cases decreased in the last decade for younger male patients. But the total number of cases among both male and female patients aged over 80 years increased.

Starting in 2003, more patients used systemic chemotherapy. But, over 62% of mesothelioma patients received no antitumor treatment.

Two common reasons for refusing anti-tumor treatments were patient preference and performance status.

The median overall survival improved from 7.3 in 1993to 8.9 in 2003. By 2011, the overall patient survival improved to 8.9. And that number rose yet again to 9.3 months from 2012 to 2018.

The Other Side of the Peak

Experts believe malignant mesothelioma cases reached their peak in the Netherlands around 2010. This is hopeful news for preventing malignant mesothelioma.

Experts also agree that “the incidence is declining in most age groups.” Improved patient survival is likely tied to the common use of systemic chemotherapy from 2003.


van Kooten, J. P., Belderbos, R. A., von der Thüsen, J. H., Aarts, M. J., Verhoef, C., Burgers, J. A., … & Madsen, E. V. (2022). Incidence, treatment and survival of malignant pleural and peritoneal mesothelioma: a population-based study. Thorax. http://dx.doi.org/10.1136/thoraxjnl-2021-217709

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