Potential influence of cancer history on mesothelioma incidence: an ecologic analysis in the U.S. population

There is a demand for population level research on the potential genetic-basis of mesothelioma (e.g. BRCA1-associated protein-1 [BAP1]) independent of other risk factors, such as amphibole asbestos exposure. By surrogate, another primary cancer history can be used to explore this issue, including in the USA, where the incidence rates (IRs) in men, but not women, are temporally aligned with historical asbestos consumption.

We computed age-adjusted IRs of mesothelioma in females and males stratified by other primary cancer history using publicly available U.S. cancer data from 1975 to 2021. To facilitate comparison with other cancers associated with BAP1, we calculated age-adjusted IRs for female breast cancer and melanoma.

Similar to breast cancer and melanoma, ~ 25% of females with mesothelioma had a history of at least one other primary cancer. While IRs of mesothelioma in males without a history of other primary cancers were temporally aligned with historical asbestos consumption trends in the USA, IRs of mesothelioma among males with other primary cancer histories showed no relationship with asbestos consumption trends.

Our findings suggest that a genetic predisposition for malignancy contributes to U.S. mesothelioma rates and is a distinct risk factor independent of asbestos exposure.