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Peritoneal Mesothelioma and Asbestos: Clarifying the Relationship by Epidemiology

Marty S. Kanarek and Madalyn K. Mandich

Peritoneal mesothelioma has been recognized for over a half century, but causality with asbestos of different fiber types and the incidence of this fatal tumor in relation to asbestos exposure dose still needs clarification. In order to help bring clarity, the most important studies on peritoneal mesothelioma, including a brief history, relationship to asbestos exposures, diagnostic issues and experimental studies are reviewed including case series, case-control, occupational, and registry epidemiology studies. This review concludes that all types of asbestos, including amphiboles and chrysotile, are causative for peritoneal mesothelioma. Many cases have been found in both males and females from asbestos exposures in occupational and neighborhood settings, shown in differing epidemiology study designs. It is clear that there is a causal relationship between all types of asbestos at all dose levels for peritoneal mesothelioma and no threshold of exposure to asbestos appears safe.