Mesothelioma as a real pathologic entity
Klemperer and Rabin used the word ‘mesothelioma’ for the first time in 1931.
In this early period, the biphasic pattern of this tumour, epithelial and mesenchymatous, had
been demonstrated by different pathologists.
Thereafter, we have to wait until the 1950s to find case reports of ‘primary diffuse pleural mesotheliomas’ described by different authors in Europe and in North America.
Finally, in the 1960s, the pioneer work of European and North American pathologists reached a consensus for considering that diffuse malignant mesothelioma, located mainly in the pleura and less frequently in the peritoneum, was a primary neoplasmarising from the pluripotential mesothelial cells. The pathological diagnosis of mesothelioma appeared difficult, so that, in most serious epidemiological studies, the diagnosis was ascertained by a panel of national or supranational expert pathologists.
At present, most European countries have a mesothelioma panel of trained pathologists.
Discovery of the relationship with asbestos exposure
Another major step in the history of mesothelioma was the studies which demonstrated that asbestos exposure was a strong causal factor for the development of this malignant tumour. In fact, it took about 30 years for this to be demonstrated! While a case of mesothelioma associated with asbestos exposure was published in 1943 by Wedler in Germany, this tumour was very rare in Europe and North America, so its relationship with asbestos exposure was not identified.
Incidence of malignant mesothelioma (MM)
As mesothelioma, whatever its two main locations (pleura and peritoneum), represents a severe disease, highly related to asbestos exposure, all industrialised countries are presently concerned with the evaluation of the true incidence of this cancer and its relationships with the different types of asbestos exposure. This section will cover the incidence of mesothelioma in European countries and the role played by accurate registration of cases for assessing this fundamental parameter.
General trend in Europe
In the countries where registration of mesothelioma was accurate, between the 1950s and now, a linear progression of mesothelioma incidence (about 5–10% per year) was observed (apart from Finland). This increase was parallel to the progression of asbestos imports, but with a delay of 30 to 40 years, due to the long latency period of asbestos- related mesothelioma. Elsewhere, the curve of this progression showed different slopes, in relation to the tonnages of crocidolite and amosite imports.
The incidence of mesothelioma in France seems to be lower than that observed in the other European countries. This could be due to a later widespread use of asbestos in France compared to other European countries.
Klemperer and Rabin used the word ‘mesothelioma’ for the first time in 1931.
In this early period, the biphasic pattern of this tumour, epithelial and mesenchymatous, had
been demonstrated by different pathologists.
Thereafter, we have to wait until the 1950s to find case reports of ‘primary diffuse pleural mesotheliomas’ described by different authors in Europe and in North America.
Finally, in the 1960s, the pioneer work of European and North American pathologists reached a consensus for considering that diffuse malignant mesothelioma, located mainly in the pleura and less frequently in the peritoneum, was a primary neoplasmarising from the pluripotential mesothelial cells. The pathological diagnosis of mesothelioma appeared difficult, so that, in most serious epidemiological studies, the diagnosis was ascertained by a panel of national or supranational expert pathologists.
At present, most European countries have a mesothelioma panel of trained pathologists.
Discovery of the relationship with asbestos exposure
Another major step in the history of mesothelioma was the studies which demonstrated that asbestos exposure was a strong causal factor for the development of this malignant tumour. In fact, it took about 30 years for this to be demonstrated! While a case of mesothelioma associated with asbestos exposure was published in 1943 by Wedler in Germany, this tumour was very rare in Europe and North America, so its relationship with asbestos exposure was not identified.
Incidence of malignant mesothelioma (MM)
As mesothelioma, whatever its two main locations (pleura and peritoneum), represents a severe disease, highly related to asbestos exposure, all industrialised countries are presently concerned with the evaluation of the true incidence of this cancer and its relationships with the different types of asbestos exposure. This section will cover the incidence of mesothelioma in European countries and the role played by accurate registration of cases for assessing this fundamental parameter.
General trend in Europe
In the countries where registration of mesothelioma was accurate, between the 1950s and now, a linear progression of mesothelioma incidence (about 5–10% per year) was observed (apart from Finland). This increase was parallel to the progression of asbestos imports, but with a delay of 30 to 40 years, due to the long latency period of asbestos- related mesothelioma. Elsewhere, the curve of this progression showed different slopes, in relation to the tonnages of crocidolite and amosite imports.
The incidence of mesothelioma in France seems to be lower than that observed in the other European countries. This could be due to a later widespread use of asbestos in France compared to other European countries.
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