Radical surgery for mesotheliomaBMJ 2004; 328 doi: https://doi.org/10.1136/bmj.328.7434.237 (Published 29 January 2004) Cite this as: BMJ 2004;328:237
- Tom Treasure, professor (Tom.Treasure@gstt.sthames.nhs.uk),
- David Waller, consultant thoracic surgeon,
- Simon Swift, research registrar,
- Julian Peto, professor of epidemiology
- Cardiothoracic Unit, Guy's Hospital, London SE1 9RT
- Glenfield Hospital, Leicester LE3 9QP
- Thoracic Surgery, Guy's Hospital, London SE1 9RT
- Section of Epidemiology, Institute of Cancer Research, Sutton, Surrey SM2 5NG
The epidemic is still to peak and we need more research to manage it
One in every hundred men born in the 1940s will die of die of malignant pleural mesothelioma, which is almost exclusively a consequence of exposure to asbestos, with a lag time that is rarely less than 25 years and often more than 50 years from first exposure. Half of all cases are now aged over 70, with 80% in men. For a man first exposed as a teenager, who remained in a high risk occupation, such as insulation, throughout his working life, the lifetime risk of mesothelioma can be as high as one in five.w1 There are now over 1800 deaths per year in Britain (about one in 200 of all deaths in men and one in 1500 in women), and the number is still increasing.1 w2 As exposure in the United Kingdom continued until 1980 the peak of the epidemic is still to come, and we need a strategy to manage these patients.
Asbestos was a valuable and versatile material and imports rose after the second world war when it was widely used as an insulator, in the manufacture of filters, cements, friction products, and as a fire retardant. It found a place in shipbuilding and industry and was used extensively in building in the form of light workable boards.2 It was a convenient partitioning material that …
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