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Mesothelioma Today: Global Trends, Clinical Challenges, and Policy Responses
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Mesothelioma Today: Global Trends, Clinical Challenges, and Policy Responses

A special issue of Cancers (ISSN 2072-6694). This special issue belongs to the section "Cancer Epidemiology and Prevention".

Deadline for manuscript submissions: 30 April 2027 | Viewed by 1017

Editors

Dr. Pierpaolo Ferrante

E-Mail Website
Guest Editor
Occupational Medicine Department (DML), National Workers Compensation Authority (INAIL), Research Area, Via Stefano Gradi 55, 00143 Rome, Italy
Interests: epidemiology; statistical modeling; public health
Special Issues, Collections and Topics in MDPI journals
Dr. Marco Tomasetti

E-Mail Website
Guest Editor
Department of Clinical and Molecular Sciences, Polytechnic University of Marche, Ancona, Italy
Interests: malignant mesothelioma; cancer prevention

Special Issue Information

Dear Colleagues,

Malignant mesothelioma remains a major public health challenge worldwide, reflecting both the legacy of past asbestos use and ongoing exposure in several regions. Despite advances in regulation and awareness, the disease continues to present significant clinical, epidemiological, and policy-related challenges. Today, mesothelioma not only represents a model of environmentally and occupationally driven cancer, but also a critical test case for the effectiveness of prevention strategies, health surveillance systems, and global health policies.

This Special Issue aims to provide a comprehensive and multidisciplinary perspective on the current state of knowledge and practice in this field. We invite contributions addressing the epidemiology of mesothelioma, including incidence and mortality trends, geographic variability, and population-based studies. We also welcome papers exploring clinical manifestations, diagnostic challenges, and patient pathways, as well as analyses of health policies, prevention strategies, and the impact of asbestos regulation at local, national, and international levels.

Submissions may include original research, systematic reviews, and methodological contributions. Both regional experiences and international comparative studies are strongly encouraged, particularly those highlighting differences in exposure patterns, healthcare systems, and policy implementation. By bringing together diverse perspectives, this Special Issue seeks to foster a deeper understanding of mesothelioma in its contemporary context and to support efforts aimed at reducing the burden of this largely preventable disease.

Dr. Pierpaolo Ferrante
Dr. Marco Tomasetti
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as communications are invited. For planned papers, a title and short abstract (about 250 words) can be sent to the Editorial Office for assessment.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-anonymized peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Cancers is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2900 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • malignant mesothelioma
  • asbestos exposure
  • occupational cancer
  • epidemiology
  • public health policy

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Published Papers (2 papers)

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Research

17 pages, 749 KB  
Article
Sex-Specific Patterns of Asbestos Exposure and Prognostic Biomarkers in Surgically Treated Pleural Mesothelioma: A Retrospective Cohort Study
by Nicolas Pinzon, Shubham Gulati, Andrew Del Re, Emanuela Taioli, Raja Flores, Andrea S. Wolf and Stephanie Tuminello
Cancers 2026, 18(16), 2624; https://doi.org/10.3390/cancers18162624 - 14 Aug 2026
Viewed by 301
Abstract
Background/Objectives: Sex-based differences in asbestos exposure and tumor biology in pleural mesothelioma (PM) remain incompletely characterized. As an expert tertiary center, we sought to systematically characterize asbestos exposure by sex and assess biomarker prognostic relevance in surgically treated pleural mesothelioma. Methods: We conducted [...] Read more.
Background/Objectives: Sex-based differences in asbestos exposure and tumor biology in pleural mesothelioma (PM) remain incompletely characterized. As an expert tertiary center, we sought to systematically characterize asbestos exposure by sex and assess biomarker prognostic relevance in surgically treated pleural mesothelioma. Methods: We conducted a retrospective, single-center cohort encompassing all patients who underwent surgical intervention for PM at our institution. Demographic characteristics, asbestos exposure history, tumor biomarker profiles, and survival outcomes were extracted from this database and supplemented by review of the electronic medical record. Sex differences in asbestos exposure and biomarker expression were assessed using Fisher’s exact test on an available-case basis, while logistic regression was used to identify predictors of documented asbestos exposure. Overall survival was estimated using Kaplan–Meier analysis; independent associations between biomarkers and mortality were determined via multivariable Cox proportional hazards models adjusted for age, sex, and histological subtype. Results: Between 2015 and 2024, 106 patients (75% males) underwent surgical intervention for PM, with a median follow-up of 4.4 years. The mean age at surgery was 67.5 years (Standard Deviation [SD], 11). The cohort predominantly consisted of patients with epithelioid histology (n = 86, 81%), followed by biphasic (n = 16, 15%), and sarcomatoid (n = 4, 4%) subtypes. Thirty (28.3%) were alive at last follow-up. Median overall survival was 15.6 months (95% Confidence Interval [CI], 13.8–25.4 months), and 5-year survival was 17.8%. Of 92 patients with available exposure data, 66 (72%) had documented exposure histories. Although most of these exposures were occupational (46, 78%), a striking disparity was observed between occupational exposures in males vs. females (44 [86%] vs. 2 [25%]; n = 8 classifiable females; p < 0.001). Multivariable analysis demonstrated that male sex was associated with increased odds of asbestos exposure (Adjusted Odds Ratio [ORadj], 5.45; 95% Confidence Interval [CI], 1.90–16.35). PD-L1, Ki-67, or BAP1 expression were not associated with sex, age, or asbestos exposure. High Ki-67 (>15%) and PD-L1 (>15%) were associated with a four-fold and three-fold increased risk of mortality (Hazard Ratioadj [HRadj], 4.33 [95% CI, 1.85–10.13] and HRadj, 2.80 [95% CI, 1.39–5.64], respectively), whereas BAP1 loss was not (HRadj, 0.80; 95% CI, 0.45–1.44). Conclusions: Our findings underscore the potential value of sex-sensitive screening protocols that more comprehensively assess non-occupational asbestos exposure pathways and offer additional evidence regarding the prognostic relevance of PD-L1, Ki-67, and BAP1 in surgical patients. Full article
(This article belongs to the Special Issue Mesothelioma Today: Global Trends, Clinical Challenges, and Policy Responses)
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13 pages, 2873 KB  
Article
Burden of Mesothelioma in China, 1990–2023: Trends, Decomposition, and Projections Until 2045
by Kang Hu, Qichen Ye, Rongrong Zhao, Chao Ma, Xiao Zhang, Tianhao Xie, Chenye Shao, Cheng Ding, Jun Zhao and Hao Ding
Cancers 2026, 18(15), 2521; https://doi.org/10.3390/cancers18152521 - 6 Aug 2026
Viewed by 358
Abstract
Background: Mesothelioma is a rare but highly aggressive malignancy strongly associated with asbestos exposure. Owing to its long latency and poor prognosis, its burden requires systematic evaluation. Methods: Data on prevalence, incidence, deaths, disability-adjusted life years (DALYs), and age-standardized rates were [...] Read more.
Background: Mesothelioma is a rare but highly aggressive malignancy strongly associated with asbestos exposure. Owing to its long latency and poor prognosis, its burden requires systematic evaluation. Methods: Data on prevalence, incidence, deaths, disability-adjusted life years (DALYs), and age-standardized rates were extracted from the Global Burden of Disease Study 2023. The estimated annual percentage change, Joinpoint regression, Das Gupta decomposition, and Nordpred forecasting were used to assess temporal trends, identify turning points, quantify demographic and epidemiological contributions, and project future burden through 2045. Results: From 1990 to 2023, the absolute burden of mesothelioma in China increased substantially. Prevalent cases rose by 189%, incident cases by 150%, DALYs by 98%, and deaths by 142%. Males consistently showed a higher burden than females, and the burden was concentrated mainly among middle-aged and older adults. The age-standardized prevalence rate and age-standardized incidence rate increased, whereas the age-standardized DALY rate and age-standardized mortality rate remained stable or declined slightly. Decomposition analysis indicated that population growth and aging were the principal drivers of increased DALYs and deaths, while epidemiological change contributed negatively. Projections suggested that deaths may continue to increase through 2045, despite declining age-standardized fatal burden. Conclusions: This is the first update of the burden of mesothelioma in China over the past thirty-four years. The absolute burden of mesothelioma in China, as estimated by the GBD study, increased markedly, largely driven by demographic changes. Strengthening asbestos exposure surveillance, diagnostic standardization, and cancer registration systems would enable burden estimates to be derived from directly observed and certified data rather than relying primarily on model-based assumptions, while potentially identifying previously unrecognized sources of asbestos exposure. Full article
(This article belongs to the Special Issue Mesothelioma Today: Global Trends, Clinical Challenges, and Policy Responses)
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