Author of

• 10883

  +

  P1.14 - Poster Session 1 - Mesothelioma (ID 194)

  • Event: WCLC 2013
  • Type: Poster Session
  • Track: Mesothelioma
  • Presentations: 1
  • Moderators:
  • Coordinates: 10/28/2013, 09:30 - 16:30, Exhibit Hall, Ground Level

  • 10884

    +

    P1.14-001 - Estimates of expected years of life lost and lifetime direct medical costs for malignant pleural mesothelioma patients: data from Taiwan and New South Wales, Australia (ID 108)

    09:30 - 16:30  |  Author(s): M.J. Soeberg
    • Abstract

    Background
    Quantifying the burden of malignant pleural mesothelioma (MPM) is an important yet challenging task. Little is understood about the societal and economic costs following a diagnosis of MPM. We investigated survival, years of life lost, and direct medical costs associated with MPM using data from Australia and Taiwan.

    Methods
    159 and 136 MPM patients from New South Wales (NSW) Disease Dust Board data and Taiwanese Cancer Registry (TCR) data respectively were included in: (i) survival function analyses and (ii) analyses to estimate the years of life lost associated with a MPM diagnosis. Further, data on 428 patients from the Taiwanese National Health Insurance Research Database, and the NSW data linked to Medicare data, were also used to (iii) estimate lifetime healthcare expenditure following a MPM diagnosis.

    Results
    (i) The mean age at MPM diagnosis in NSW was 71 and 60 in Taiwan. Median survival in months for NSW MPM patients was 11.7 (95% CI 9.3, 13.5) and 6.0 (95% CI 5.1, 7.8) for TCR patients. Four and eight percent of patients in NSW and Taiwan respectively were estimated to survive up to five years following a MPM diagnosis. (ii) The lifetime survival difference between the MPM patient cohort and a comparable population free of the disease was estimated to be 13.6 (95% CI 13.4, 13.8) years in the NSW cohort and 18.8 (95% CI 18.5, 19.1) years in the TCR cohort. (iii) Using national health insurance data in Taiwan, we estimated that the direct heath care costs following a MPM diagnosis to be USD$18,812. In NSW, this cost was estimated to be USD$20,573.

    Conclusion
    We analysed MPM cohort data from Taiwan and Australia to estimate survival and expected life years lost, with possible differences in the age at diagnosis and median survival. We also analysed Taiwan and Australian data to estimate direct medical costs following a MPM diagnosis. The impact of selection bias in this study cannot be ruled out as there is likely under-ascertainment of MPM cases in the Taiwanese Cancer Registry and the NSW data is a subset of all MPM cases diagnosed in NSW. However, these estimates provide useful data to contribute to evidence-based clinical and policy decision-making in the area of MPM prevention and care services.

• 11826

  +

  P2.14 - Poster Session 2 - Mesothelioma (ID 196)

  • Event: WCLC 2013
  • Type: Poster Session
  • Track: Mesothelioma
  • Presentations: 1
  • Moderators:
  • Coordinates: 10/29/2013, 09:30 - 16:30, Exhibit Hall, Ground Level

  • 11833

    +

    P2.14-007 - Global patterns in the incidence of malignant mesothelioma, 1988-2002, using data published by the International Agency for Research on Cancer (IARC) (ID 2019)

    09:30 - 16:30  |  Author(s): M.J. Soeberg
    • Abstract

    Background
    Malignant mesothelioma is a rare but aggressive form of cancer which has a strong causal link to asbestos exposure. While descriptive analyses have been undertaken of global patterns of mesothelioma deaths, the global pattern of malignant mesothelioma incidence is unclear. Since 1988, the International Agency for Research on Cancer (IARC) has been reporting count and incidence data for malignant mesothelioma. The aim of this study was to improve understanding of the global patterns of malignant mesothelioma.

    Methods
    We extracted mesothelioma incidence count data by sex recorded in Volumes VII (1988-1992, 150 registries in 50 countries), Volume VIII (1993-1997, 186 registries in 57 countries) and Volume IX (1998-2002, 225 registries in 60 countries) of the IARC Cancer Incidence in Five Continents reports. We also extracted the related age-standardised incidence rates and their standard errors. The data extraction was done for each reporting cancer registry or country in the six IARC regions (Africa, Asia, Central and South America, Europe, North America, and Oceania). The number of incident cases was summed by region and stratified by calendar period and sex. To provide accurate and conservative estimates, we removed sub-regional data from summary counts where total regional data were provided. The male to female ratio of incident count data was calculated for each combination of sex, region and calendar period. From the standard errors, we calculated lower and upper 95% confidence intervals. Inverse variance weighting was then used to provide a pooled estimate for each IARC region in each combination of calendar period by sex.

    Results
    We identified a total 120,544 cases of mesothelioma reported by IARC in the calendar period 1988-2002. There were 95,466 males and 25,068 females with a male to female ratio of 3.8. Of the total number of cases, 58% of these were from North American region, 33% from European region, 5% from the Oceania region, and 3% from the Asian region. The African and Central and Southern American regions made up less than 1% of cases respectively. The estimated incidence pooled across all IARC regions between 1998 and 2002 is 1.47 per 100,000 for males (95% CI 1.46, 1.48) and 0.31 per 100,000 (95% CI 0.30, 0.32) for females. There was little change in the female incidence rate from the 1988-1992 to 1998-2002 period. However, there was a non-statistically significant difference increase in the male incidence rate over the same periods.

    Conclusion
    We found that males made up 79% of all mesothelioma cases reported between 1988 and 2002. The majority of cases were from the European, North American and Oceania regions but this maybe an artefact of better diagnosis and reporting in those regions. Pooled across countries and calendar periods, we also found that the male incidence rate was almost 5 times higher than the female incidence rate. Continued assessment of patterns in the proportion of cases in each region and time trends in incidence by sex and region will help to evaluate trends in disease occurrence.