ESTIMATION OF THE PAST AND FUTURE BURDEN OF MORTALITY FROM MESOTHELIOMA IN FRANCE

Objectives-Firstly to evaluate future mortality from mesothelioma in F rance with an age-period-cohort approach and evaluate different hypoth eses on risk of mesothelioma for the most recent birth cohort. Secondl y to compare the results with a British and an American study. Thirdly to study if any trends were detectable on data for women which would be consistent with the consequences of increasing environmental exposu re tee asbestos, Methods-Estimates of mortality from mesothelioma amon g men and women in France from 1950 to 1995 were based on the analysis of the pleural cancer mortality data coded 163 in the ninth revision of the international classification of diseases (ICD-9). Correction fa ctors were used to derive the mortality from mesothelioma from these d ata, based on two regional registries. The analysis of the past mortal ity data has been performed by an age-cohort model (with a maximum lik elihood technique). Predictions of deaths from mesothelioma over the n ext 50 years were based on four different assumptions on the risk of d eath from mesothelioma in future birth cohorts. Results-The predicted lifetime probability of dying from mesothelioma increases until the la st birth cohort 1964-8 among men whereas it decreases strongly from th e 1954-8 birth cohort among women. The projected numbers of deaths fro m mesothelioma in France until 2020 are similar, whichever hypothesis is considered: around 20 000 deaths from mesothelioma might occur amon g men and 2900 among women from 1996 to 2020. Conclusions-French data show an increasing lifetime probability of death from mesothelioma in the more recent male cohorts. Although the mortality burden can be pre dicted untill 2020, and is intermediate between the United Kingdom. an d United States estimates, there is still high uncertainty an the figu res after 2020. No increase is found in women, and this does not suppo rt the hypothesis that current environmental exposure to asbestos coul d be associated with a detectable risk of death. Specific surveillance should be set up to monitor future trends or their absence.