CDC: Mesothelioma Deaths Up Among Women

While use of asbestos has gone down in the U.S., deaths from mesothelioma still increased 25% among women over the last two decades, researchers found.

From 1999 to 2020, mesothelioma deaths among women rose significantly from 489 to 614, though the age-adjusted death rate per 1 million women fell from 4.83 to 4.15, reported Jacek Mazurek, MD, of the CDC, and colleagues.

Interestingly, the largest proportion of deaths was linked to homemakers (23%), while healthcare and social assistance had the largest proportion of deaths by industry (16%), the authors wrote in the Morbidity and Mortality Weekly Report.

Cancer of the mesothelium, the layer of tissue surrounding internal organs in the chest and abdomen, has long been associated with men due to occupational exposure to asbestos in construction and manufacturing, Mazurek and colleagues noted. However, “limited data” exist on women.

Mazurek’s group examined death certificate data from 1999 to 2020 where an ICD-10 code for malignant mesothelioma was listed in the CDC WONDER database. Deaths were limited to women ages 25 and up, and annual death rate per million women was age-adjusted to the U.S. population in 2000, the authors said.

Overall, there were 12,227 malignant mesothelioma deaths among women ages 25 and up. Nearly all occurred among women ages 55 and up (91%), among white women (94%), with malignant mesothelioma listed as the underlying cause of death (94%). The majority of deaths were “unspecified location” (72%), followed by mesothelioma of “other sites” (11%) and mesothelioma of the peritoneum (9%).

Deaths varied by state, with seven states reporting an annualized mesothelioma age-adjusted death rate higher than 6.0 per 1 million women: Louisiana, Maine, Minnesota, Montana, Oregon, Washington, and Wisconsin.

Occupational information was available for 567 of 614 mesothelioma deaths in 2020. Jobs with the highest proportion of mesothelioma deaths were homemakers (23%), elementary and middle school teachers (6%), and registered nurses (5%). When examined by industry groups, healthcare and social services sustained the most deaths (16%), followed by education services (11%) and manufacturing (9%).

The authors noted that 85% of mesotheliomas among men are attributed to work-related exposure to asbestos, while “overall attributable risk” among women was 23%. They hypothesized about how women are exposed in other ways, such as “potential environmental exposure to naturally occurring asbestos, indoors when older building materials containing asbestos are present, or from take-home exposures by indirect contact via family members who were exposed to asbestos fibers at workplaces outside of the home,” they wrote.

“Higher mesothelioma death rates in northern states might reflect greater use of asbestos in older building stock in that region,” the authors added.

They urged clinicians to “maintain a high index of suspicion” for diseases caused by asbestos exposure when evaluating family members of exposed workers.