Living in a city and having a better socioeconomic status does not necessarily increase the odds of surviving mesothelioma.
That is the message from a 15-year Australian study of more than 300,000 cancer patients.
Some studies suggest cancer survival rates are lower in rural areas. But that does not appear to be the case for mesothelioma in Australia.
Unfortunately, the odds of surviving mesothelioma remain low no matter where a person lives.
Australia used to mine and export more asbestos than any other country. The mineral has been banned there since 2003, but Australian mesothelioma rates are still among the highest in the world.
Asbestos fibers are biopersistent. Once they are embedded in the tissue, they never leave the body. By the time a patient receives a mesothelioma diagnosis, the odds of surviving mesothelioma for more than 18 months are low.
Australias mesothelioma cases came in waves. The first wave included asbestos mine workers, their families, and people who lived near mines. The second wave occurred among construction and demolition workers exposed to asbestos in buildings.
Public health officials say the third wave is happening among homeowners who fail to protect themselves during DIY home improvement projects. Australia has launched media campaigns to educate homeowners. Earlier diagnosis improves the odds of surviving mesothelioma.
Researchers with the Cancer Council of Victoria found 331,302 cases of cancer in the region between 2001 and 2015. Pleural mesothelioma was one of 30 cancers represented.
People living outside the cities had lower survival for 11 kinds of cancer. But the odds of surviving mesothelioma, uterus, or small intestine cancer stayed the same in the country and the city.
People in rural areas tend to be poorer than those in cities. When the researchers adjusted for the differences in socieconomic status, survival rates for many cancers went down.
The observed differences in survival decreased for most cancers and disappeared for colorectal cancer, but they remained largely unchanged for cancers of esophagus, stomach, liver, pancreas, lung, connective/soft tissue, ovary and kidney, the researchers write.
The odds of surviving mesothelioma were unaffected by patients finances.
The finding suggests that asbestos cancer is uniformly deadly. However, some US studies show longer mesothelioma survival among people living near academic cancer centers. This seems to be related to the experience level of doctors in these centers.
Larger cancer centers are also more likely to offer mesothelioma clinical trials, which have been shown to improve the odds of surviving mesothelioma.
Source:
Afshar, N, et al, Differences in cancer survival by remoteness of residence: an analysis of data from a population-based cancer registry, April 30, 2020, Cancer Causes and Control, Epub ahead of print, https://link.springer.com/article/10.1007/s10552-020-01303-2
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