Newly published research has revealed a troubling paradox in mesothelioma trends across the United States. While age-standardized mesothelioma rates have declined by roughly one-third since 1990, the actual number of people diagnosed with mesothelioma increased by nearly 30%, and annual deaths have continued climbing. This means that the rare, asbestos-related disease is evolving rather than disappearing.
Despite Progress, Mesothelioma Burden Continues to Rise
The mesothelioma study, which was published in JCO Global Oncology, was conducted by researchers at the Sylvester Comprehensive Cancer Center at the University of Miami Miller School of Medicine. In the most comprehensive national and state-level analysis to date, the scientists analyzed the incidence, mortality, and disability burden of the disease across all 50 states from 1990 to 2023. They found that while decades of asbestos regulation and reduced industrial use have led to falling mesothelioma rates, population growth and aging have meant that the disease’s disability burden—measured in disability-adjusted life years—rose 14% since 1990.
“Mesothelioma behaves like a time capsule,” said co-lead author Dr. Chinmay Jani, medical oncologist at Sylvester. “What we’re seeing today reflects exposures that happened 30 or 40 years ago and, in some cases, exposures that are still happening in quieter, less visible ways.” Declining mesothelioma rates don’t necessarily mean fewer lives affected—when examining absolute numbers and disability burden, mesothelioma remains a substantial public health problem claiming thousands of lives annually.
Mesothelioma Rates Falling Among Men but Rising in 20 States Among Women
The study found that the gradual aging out of those historically exposed to asbestos in shipbuilding, construction, and insulation work has led to a shop drop in mesothelioma incidence and mortality rates in men, but that those declines were much more modest in women, with diagnoses in women actually increasing in 20 states and women’s mortality risingse in 18 states, particularly in parts of the Midwest and Appalachia. “For women, mesothelioma often doesn’t come with a neat occupational history,” said Dr. Estelamari Rodriguez, Sylvester’s clinical research lead of the Thoracic Site Disease Group. “Environmental exposure, para-occupational exposure from family members, and legacy asbestos in schools, homes, and public buildings likely play a much larger role.”
Mesothelioma Survival Has Not Meaningfully Improved Despite New Treatments
The study showed a striking impact of geography on mesothelioma diagnoses, with states including Maine, Alaska, Washington, and Minnesota consistently carrying the highest incidence, mortality, and disability burdens in 2023 based on historic occupational exposure. Researchers also found that the mortality-to-incidence ratio has remained high. Despite the approval of new therapies, including immune checkpoint inhibitors, most people diagnosed with mesothelioma still die from it. Dr. Gilberto Lopes, Sylvester’s chief of medical oncology, said. “Despite all our scientific advances, mesothelioma remains one of the most lethal solid tumors,”
The study confirmed that nearly 96% of U.S. mesothelioma deaths in 2023 were attributable to occupational asbestos exposure. This statistic is almost the same as it was in 1990, showing both the impact of asbestos embedded in older buildings and infrastructure and the reality that the United States has never fully banned asbestos use. “Mesothelioma reminds us that prevention and treatment are inseparable,” said Dr. Lopes. “We have to keep people from being exposed in the first place, while also doing better for those who are diagnosed.”
If you or someone you love has been diagnosed with mesothelioma, the Patient Advocates at Mesothelioma.net are here to help. Contact us today at 1-800-692-8608 to learn more.
