Published in Ca: A Cancer Journal for Clinicians, online version on July 9, 2019
Mesothelioma affects mostly older individuals who have been occupationally exposed to asbestos. The global incidence and mortality rates are unknown, because data are not available from developing countries that continue to use large amounts of asbestos. The rate of mesothelioma has decreased in Australia, the United States, and Western Europe, where the use of asbestos was banned or strictly regulated in the 1970s and 1980s, demonstrating the value of these preventive measures. However, in these same countries, the overall number of deaths from mesothelioma has not decreased as the size of the population and the percentage of old people have increased. Moreover, hotspots of mesothelioma may occur when carcinogenic fibers that are present in the environment are disturbed as rural areas are being developed. Novel immunohistochemical and molecular markers have improved the accuracy of diagnosis; however, about 14% (high-resource countries) to 50% (developing countries) of mesothelioma diagnoses are incorrect, resulting in inadequate treatment and complicating epidemiological studies. The discovery that germline BRCA1-associated protein 1 (BAP1) mutations cause mesothelioma and other cancers (BAP1 cancer syndrome) elucidated some of the key pathogenic mechanisms, and treatments targeting these molecular mechanisms and/or modulating the immune response are being tested. The role of surgery in pleural mesothelioma is controversial as it is difficult to predict who will benefit from aggressive management, even when local therapties are added to existing or novel systemic treatments. Treatment outcomes are improving, however, for peritoneal mesothelioma. Multidisciplinary international collaboration will be necessary to improve prevention, early detection, and treatment.
Nature International Weekly Journal of Science (2017) - doi:10.1038/nature22798
A mechanistic rationale for the ability of BAP1 to regulate gene-environment interaction in human carcinogenesis
A Review of our Projects, Publications, and Discoveries
Journal of Thoracic Oncology, December 24, 2016
There is concern that a proportion of MM diagnoses in China may be incorrect because most Chinese physicians do not have experience diagnosing this rare cancer. We recently reported an unusual high incidence of peritoneal MM among Eastern Chinese female patients. Here, we review the accuracy of MM diagnoses in China and provide suggestions to improve the accuracy of diagnosis.
Association of Asbestos Exposure With Malignant Mesothelioma Incidence in Eastern China
The reported incidence of malignant mesothelioma (MM) in China is 1.5 cases per million population, much lower than in other countries. In China, the prevalence of MM in different regions is unknown, and only 15% of MMs have been associated with asbestos exposure compared with more than 70% in most of the world