Mesothelioma is a rare type of cancer that can develop decades after asbestos exposure. This malignancy is prevalent among veteran populations, with recent data showing that those who worked for the Navy aboard ships packed with asbestos are six times more likely to develop this condition. Notably, asbestos was used by the U.S. Military across all its branches, including in the construction and insulation of army headquarters and sleeping barracks, as well as in components of motor vehicles and aircraft. Veterans performing maintenance and repair on these structures and vehicles were particularly at risk.
Although fewer than 3000 cases of mesothelioma are identified each year in the U.S., around 30% of these cases are seen in veteran populations. According to the Centers for Disease Control and Prevention (CDC), individuals aged 75 and older experience mesothelioma at a significantly higher rate than the national average, with 6 cases per 100,000 compared to 4 per 100,000. With regulations on asbestos developed after 1970, the incidence of mesothelioma significantly dropped. Today, the incidence rate is 0 in people younger than 45, while in those aged 55 to 65 years old, this rate is 0.9.
Nonetheless, despite this progress, people affected experience poor healthcare outcomes. As the condition is so rare, misdiagnosis is a common occurrence. This can be attributed to the limited research on mesothelioma, as well as a lack of clinical experience in this area. Additionally, by the time an accurate diagnosis is made, most patients are in the later stages of the disease, when palliative care rather than systemic therapies are recommended. Presently, studies on the quality of care at the end of life for patients with mesothelioma indicate that more than 60% of these people experience a high symptom burden, with pain and breathlessness present despite medical management.
Improving Care Through the National Mesothelioma Registry
Considering the slow progress of research on developing more accurate diagnosis methods for mesothelioma, the CDC proposed a national registry in 2019. However, to date, this registry remains non-functional. Studies on the feasibility of implementation have been limited, while funding for this project is yet to be secured. Notably, due to the specific characteristics of this data collection instrument, care for patients with mesothelioma could be significantly improved.
The registry is designed to record all newly diagnosed cases in real-time, departing from the current estimates-based system used by national cancer statistics. This simple change could enable researchers to identify samples for research participation at a significantly higher rate, thereby prompting more thorough investigation efforts into better diagnosis and treatment. Additionally, the registry aims to use a case-finding methodology, rather than relying on patient symptoms for detection. As mesothelioma presents with insidious and non-specific manifestations, using regular screenings of at-risk populations may help identify cases early on, when systemic therapies are efficient in improving patients’ life expectancy.
As these changes are much needed for improving care provided to veterans with mesothelioma, advocacy from veteran organizations is crucial to push for implementation. The Department of Veterans Affairs (VA) and the Department of Defense (DoD) could jointly fund this initiative, recognizing their responsibility to improve early detection, care, and outcomes for veterans disproportionately affected by asbestos-related disease.
Mesothelioma Risk in Washoe County Veterans
More than 200,000 veterans reside in Nevada, with over 30,000 of them living in Washoe County. Although just one Air Force base is located here, the county has a death toll caused by asbestos of 314, with an annual rate of 16 casualties from 1999 to 2017. In Nevada, 1,781 asbestos-related deaths were recorded during this time. Of the total number of deaths in this state, 333 of these deaths were caused by mesothelioma. The latest available data from the CDC’s environmental public health tracking network show that 23 asbestos-related deaths occurred in Nevada from 2015 to 2019, averaging a rate of 4.6 deaths per year. These numbers are consistent with a decreasing trend in asbestos mortality, likely due to improved policies and regulations for this material.
Nevertheless, although the rate of mortality caused by asbestos is declining, many still suffer. Establishing the National Mesothelioma Registry would greatly benefit veterans in Washoe County and across Nevada by enabling earlier detection, improving treatment options, and supporting targeted research. With veterans disproportionately affected by asbestos exposure, strong advocacy from veteran organizations is essential to drive progress. By pushing for funding and implementation through the VA and DoD, those who served could receive timely and effective care.
Our Town Reno Citizen’s Forum submission by Jonathan Sharp
About the Author
Jonathan Sharp serves as the Chief Financial Officer at Environmental Litigation Group, P.C., a law firm headquartered in Alabama that specializes in representing individuals impacted by toxic exposure. In addition to overseeing the firm’s financial affairs, he provides strategic insights and consultations on case evaluations related to environmental and occupational health issues.