Malignant Mesothelioma

Mesothelioma is a rare type of cancer that develops from the lining of organs. Worldwide, mesothelioma ranks 32nd in incidence with 30,870 new cases in 2020 [1]. Every year, around 3000 new cases of mesothelioma are reported in the United States. According to the GLOBOCAN 2020, mesothelioma ranks 26th in mortality with a mortality rate of 0.03% (26,278 deaths in the year 2020). As per SEER statistics, the 5-year survival rate is 20%, 16%, and 8% for localized, regional, and metastatic mesothelioma, respectively. Among all cases of mesothelioma, 70–90% are of pleural mesothelioma and the remaining are of peritoneal mesothelioma whereas pericardial and tunica vaginalis are very rare [2]. Eastern Asia has the highest incidence and mortality rates, followed by the Western Europe. The global incidence and mortality rates are significantly higher in males (21,560 cases, cumulative risk 0.05; 18,681 deaths, cumulative risk 0.04) than in females (9310 cases, cumulative risk 0.02; 7597 deaths, cumulative risk 0.02). Most patients diagnosed with mesothelioma are men of >65 years of age. Incidence of mesothelioma is also affected by race: the rate for black Americans is 0.5 per 100,000, which is half than that of white Americans (1 per 100,000). Majority of the malignant mesothelioma cases are primarily due to asbestos, often occurring 40 years after the exposure [3]. Exposure to asbestos is reported in 70–80% of people diagnosed with mesothelioma. Zeolites such as erionite, a mineral, are also a cause of malignant mesothelioma [4]. Mesothelioma is also caused due to exposure to high doses of radiation to the chest or abdomen as part of the treatment for Hodgkin lymphoma [5]. Infection with simian virus 40 (SV40) can be a risk factor for developing mesothelioma [6]. Mutations in the CDK2N, NF2, and BAP1 also causes mesothelioma and these mutations could be familial [7]. Tobacco smoking by itself does not increase the risk of mesothelioma, but in combination with asbestos can increase the risk of mesothelioma [8].