OBJECTIVE: To provide the most up-to-date data on the burden of malignant mesothelioma (MM) and the projections through 2029 in China. METHODS: Data on patients diagnosed with MM from China during 1990-2019 were obtained from the Global Burden of Disease (GBD) 2019 database, including annual cases and deaths data and age-standardized rates of incidence, mortality, and disability-adjusted life-years (DALYs) associated with MM among different age groups. Temporal trends during 1990-2019 were analyzed by the Joinpoint regression models using 95% confidence interval (CI), while the projections through 2029 were calculated by the Bayesian age-period-cohort model. Data on the production and consumption of asbestos in China were obtained from the United States Geological Survey on Mineral Commodity Summaries during 1996-2023. RESULTS: We observed a significant elevation in incident new cases and deaths over the last 3 decades, increasing from 1193 in 1990 to 2815 in 2019 for incident cases and from 1134 in 1990 to 2773 in 2019 for death cases. We found a roughly 6% increase in the proportion of incident cases for those aged >70 years (30% in 2019 versus 24% in 1990), while for the proportion of deaths similar elevation for those aged >70 years was found. Additionally, men had significantly higher DALYs due to MM across age groups compared with women. Asbestos consumption in China dramatically dropped since 2012 and reached the bottom in 2017 with 230 kilotons. By 2029, the projected age-standardized rate for incidence and mortality is expected to reach 1.2 per million for both. CONCLUSION: We found, for the first time using GBD data on the Chinese population, that the burden of MM has been significantly increasing in China over the last three decades and will continue to increase in the upcoming decade, suggesting an urgent need for a complete ban on chrysotile asbestos in China.

Biomedical Center Faculty of Medicine and Biomedical Center in Pilsen Charles University Prague Pilsen Czech Republic

Center for Primary Health Care Research Lund University Malmö Sweden

Department of Cancer Prevention Zhejiang Cancer Hospital Hangzhou China

Department of Gynecology Oncology Fujian Maternity and Child Health Hospital College of Clinical Medicine for Obstetrics and Gynecology and Pediatrics Fujian Medical University Fujian China

Division of Cancer Epidemiology German Cancer Research Center Heidelberg Germany

Hangzhou Institute of Medicine Chinese Academy of Sciences Hangzhou China

Latner Thoracic Surgery Research Laboratories Division of Thoracic Surgery Toronto General Hospital Princess Margaret Cancer Research Centre University Health Network University of Toronto Toronto Canada

School of Public Health Hangzhou Normal University Hangzhou China

State Key Laboratory for Oncogenes and Related Genes; NHC Key Laboratory of Digestive Diseases Division of Gastroenterology and Hepatology Shanghai Institute of Digestive Disease Renji Hospital School of Medicine Shanghai Jiao Tong University Shanghai China

The 1st Affiliated Hospital of Wenzhou Medical University Wenzhou China

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