Decades after strict regulations were introduced to limit asbestos exposure, a deadly reminder of its past use continues to haunt public health systems. Mesothelioma, a rare and aggressive cancer linked primarily to asbestos exposure, is still claiming lives, with diagnoses and deaths continuing to pose a major health challenge.

A new study published in JCO Global Oncology has revealed that while the overall rates of mesothelioma have declined in the United States since 1990, the total number of people affected remains significant. Researchers say that the disease continues to create a heavy health burden because of the long-term impact of asbestos exposure, which can take several decades to develop into cancer.

The study, led by Kyle Edwards from the University of Miami Miller School of Medicine, analysed national and state-level data from 1990 to 2023 using information from the Global Burden of Disease database. Researchers found that age-adjusted mesothelioma incidence rates dropped by about 33 per cent, while death rates declined by nearly 31 per cent during the study period.

However, experts caution that falling rates do not necessarily mean the problem has disappeared. The absolute number of people living with the disease and the disability caused by mesothelioma remain substantial.

“Declining rates don't necessarily mean fewer lives affected,” Edwards said, highlighting that the disease continues to impact many individuals and families.

The study found that occupational asbestos exposure remains the dominant cause behind mesothelioma deaths, accounting for nearly 96 per cent of fatalities in 2023. Workers who were exposed to asbestos in industries such as construction, manufacturing, shipbuilding, and mining continue to face health consequences years after exposure.

The burden of the disease has also shown differences between men and women. Researchers observed a much larger decline in mesothelioma rates among men compared with women. While men experienced a 42 per cent reduction in new cases and a 41 per cent reduction in death rates, the decline among women was much smaller, with only a 7 per cent reduction in incidence and an 8 per cent reduction in mortality.

Despite improvements in diagnosis and treatment approaches, the study found no major improvement in population-level survival outcomes. The ratio between deaths and new cases remained almost unchanged, suggesting that mesothelioma continues to have a poor prognosis.

Researchers also noted that while disability-adjusted life-year (DALY) rates declined by about 40 per cent, the total number of DALYs increased by 14 per cent, reflecting the growing impact of the disease on patients’ quality of life.

Certain regions, including Maine, Alaska, Washington state, and Minnesota, recorded some of the highest rates of mesothelioma cases and deaths.

Mesothelioma remains a stark example of how environmental and workplace exposures can affect generations. Although asbestos use has been restricted in many countries, its health effects continue to emerge because the disease often develops 20 to 50 years after exposure.

The findings underline the need for continued workplace safety measures, early diagnosis, better treatment options, and long-term monitoring of populations exposed to asbestos. Researchers emphasise that reducing current risks is essential, but addressing the legacy of past exposure remains a major public health challenge.