Malignant pleural mesothelioma: A scourge of a disease – An audit of a single South African tertiary center

Abstract

Objectives: The incidence of malignant pleural mesothelioma (MPM) is on the rise worldwide, especially in low- to medium-income countries (LMICs). Diagnosing and treating MPM poses a significant challenge due to its heterogeneity. Exposure to asbestos fibers can be occupational and environmental in LMICs like South Africa (SA). The latter may be compounded by challenges in rehabilitating abandoned mines in SA since the ban on asbestos mining. Environmental exposure enables MPM compensation inequity as it is currently limited to occupational exposure cases, raising moral concerns. The study sought to assess the incidence of MPM at the Dr George Mukhari Academic Hospital thoracic unit. Materials and Methods: A retrospective cross-sectional data analysis involved reviewing data of patients diagnosed with some tumor from all histology specimens collected from pleural biopsies, decortications, pulmonary resections, and lung biopsies from between 2012 and 2021. The data were retrieved from the National Health Laboratory Services database. Results: Of the 91 cases diagnosed with some tumor, 34.07% (n = 31) were diagnosed with adenocarcinoma, which was the highest, followed by 23.08% (n = 21) diagnosed with MPM, of which 76.19% (n = 16) were male. About 52.38% of MPM cases were linked to decortication compared to 47.62% from pleural biopsies. No MPM was diagnosed from lung biopsy or pulmonary resection. Most cases, 61.9%, involved patients above 55 years (n = 13), between 35 and 55 years at 33, 33% (n = 7), and 4.75% (n = 1) for age below 35. Conclusion: MPM is a public health issue affecting more men than women, and it also affects younger people.