Trends in Mesothelioma Mortality in the United States Between 1999 and 2020

Introduction: Mesothelioma is a rare but aggressive cancer primarily caused by asbestos exposure. In March 2024, the Environmental Protection Agency banned asbestos in the United States, but its use will take years to phase out. Therefore, asbestos remains a threat, and incidence may remain stable or slowly decrease due to the long latency between exposure and diagnosis. This study investigates mesothelioma mortality trends in the United States from 1999 to 2020, focusing on demographic and geographic variations. Methods: Data on mesothelioma-related deaths from 1999 to 2020 were extracted from the Centers for Disease Control and Prevention database. Variables including race/ ethnicity, sex, geographic density, and mesothelioma subtype were assessed. Age-adjusted mortality rates were calculated per 1 million individuals and standardized to the 2000 United States population. Joinpoint regression identified statistically significant changes in mortality trends over time. Results: From 1999 to 2020, there were 54,905 mesothelioma-related deaths in the United States (age-adjusted mortality rate = 7.5). Pleural mesothelioma accounted for 8.1% of deaths, peritoneal for 4.6%, pericardial for 0.01%, other sites for 10.9%, and unspecified sites for 76.3%. Most deaths (81.3%) occurred in individuals aged over 65 years. Overall mortality decreased from 8.5 in 1999 to 5.7 in 2020 at-1.9% annually. Non-Hispanic Whites had the highest mortality, and male individuals experienced higher mortality than female individuals. Suburban and rural populations had the highest mortality rates. Conclusions: The study highlights significant declines in mesothelioma mortality in the United States from 1999 to 2020, with variations across demographic and geographic groups. Continued monitoring and targeted interventions are necessary to address disparities and further reduce mesothelioma mortality. (c) 2025 The Authors. Published by Elsevier Inc. on behalf of the International Association for the Study of Lung Cancer. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/ 4.0/).