Pathophysiology: Mesothelioma is a cancer which affects the membrane lining of the lungs and abdomen. It is most commonly caused by exposure to asbestos. The most common anatomical site for mesothelioma is the pleura (the outer lining of the lungs and internal chest wall), but it can also arise in the peritoneum (the lining of the abdominal cavity), the pericardium (the sac that surrounds the heart), or the tunica vaginalis (a sac that surrounds the testis). Once fibers cause biological damage, the stage is set for the decades-long latency period for the development of malignant mesothelioma.
Signs & Symptoms: Mesothelioma signs may not appear until 20 to 50 years (or more) after exposure to asbestos. The most common symptoms of peritoneal mesothelioma are abdominal swelling and pain due to ascites (a buildup of fluid in the abdominal cavity). Other features may include weight loss, fever, night sweats, poor appetite, vomiting, constipation, and umbilical hernia. If the cancer has spread beyond the mesothelium to other parts of the body, symptoms may include pain, trouble swallowing, or swelling of the neck or face.
Statistics: The annual incidence of pleural mesothelioma has increased considerably between the 1960s and 1980s, especially among men. In 1995 there were 92 cases of pleural mesothe-lioma in men and 15 cases in women. There is an increasing incidence in recent birth cohorts in men, but no such tendency is found in women. Of special interest are the youngest birth cohorts (table). Below the age of 35 the incidence is very low and not suitable for trend analysis.