Reporting of occupational mesothelioma in Brazil (2007-2024): A comparative analysis between clinical registries and official occupational notification.

Abstract

e23205 Background: Mesothelioma is the primary sentinel cancer for asbestos exposure. Despite its well-known etiology, it remains a significant global public health challenge due to its long latency and frequently unrecognized work association. This study aimed to quantify the surveillance gap in Brazil by comparing official notifications of occupational disease with total mesothelioma diagnoses. Methods: A retrospective, nationwide observational study was conducted, comparing data of occupational mesothelioma notifications in Brazil from 2007 to 2024 (from the Notifiable Diseases Information System database, SINAN) with total mesothelioma diagnoses (from Population-Based Cancer Registries [RCBP, 2007-2020] and Unified Health System Informatics Department [DATASUS, 2021-2024]). The primary objective was to quantify the under-reporting rate of mesothelioma as an occupational disease in Brazil, defined as the ratio between work-related registrations and total clinical diagnoses. Results: From 2007 to 2024, a total of 613 overall mesothelioma diagnoses were identified in Brazil, with no significant variability in frequency over time, except for 2016-2020. During the same period, only 84 cases were officially registered as occupational diseases. Although notifications increased from 6 (2007-2010) to 27 (2021-2024), only 13.7% of all mesothelioma cases were appropriately registered as occupational diseases over 18 years (Table 1). In the latest reported period (2021-2024), only 15.9% of clinical diagnoses were recognized as work-related. The occupational cohort was mostly male (96.4%), black (45.2%), and aged 60-69 years (40.5%), with 42% having a smoking history. The majority had confirmed asbestos exposure (95.2%). Conclusions: A critical disparity was identified between the clinical diagnosis of mesothelioma and its official recognition as an occupational disease in Brazil. As this major underreporting hinders the evaluation of the real impact of asbestos-related cancers, improved awareness of disease association and case reporting are needed to guide public policy development and, thus, provide evidence-based health promotion approaches for at-risk workers. Overall mesothelioma diagnosis versus occupational notification in Brazil (2007-2024). 2007-2010 2011-2015 2016-2020 2021-2024 Total Occupational mesothelioma notification (n) 6 16 35 27 84 Overall mesothelioma diagnosis (n) 166 193 84 170 613 Occupational notification rate (%) 3.6 8.3 41.7 15.9 13.7