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Other Possible Causes Of Mesothelioma

Although it is clear that asbestos causes mesothelioma, other factors also play a role. It is not clear why only a relatively small proportion of people exposed to asbestos develop mesothelioma, or why anywhere from 20 to 60 per cent of people with me sothelioma in different studies lack a known history of asbestos exposure.

There may be as-yet unidentified cofactors that act as cocarcinogens with asbestos in the induction of mesothelioma.
Evidence that not all cases of mesothelioma are caused by asbestos is threefold. First, we have evidence that a background rate of mesothelioma does exist.

Historically, primary malignant tumours of the pleura were recognised by pathologists the late nineteenth century, before the industrial use of asbestos could have been responsible, and without any link to occupation. Epidemiological evidence from mortality statistics for mesothelioma over the past 50 years in the United States and Canada also support a background rate of mesothelioma. Many studies have shown that disease incidence has increased much more rapidly in men than in women, reflecting occupational asbestos exposure among the men. The rate among women has remained relatively stable, indicating that it may be the background rate of mesothelioma. Back- ward extrapolation suggests that before the diverging pattern began, mortality was about 1–2 per million population in both sexes. This possibility is supported by data from regions with low mesothelioma mortality where both male and female rates are at about this level, and by data for California,19 after exclusion of related cases.

However, it is also possible that waterborne or airborne fibres originating from naturally occurring asbestos deposits are the cause of this background rate of mesothelioma.
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