Guest Editorial – The national mesothelioma registry: A path to better care for Linn County’s veterans
Jonathan Sharp
Asbestos-related diseases take decades to manifest from the time of exposure, and despite recent bans on this material, specific at-risk populations are still affected. Mesothelioma, one of the rarest cancers caused by inhaling asbestos fibers, is six times more common in Navy veterans compared to those who served in other military branches. Across all populations affected, veterans account for approximately 30% of the fewer than 3,000 mesothelioma diagnoses made each year.
Because of the rarity of this condition, diagnosis and treatment are limited. Furthermore, as mesothelioma first manifests with non-specific symptoms, many receive a correct diagnosis when they enter the final stages of this disease. At this point, with a late-stage diagnosis and a survival rate of under a year, the only remaining option is palliative care.
In 2019, the Centers for Disease Control and Prevention (CDC), along with the Department of Health and Human Services (HHS), proposed the implementation of a National Mesothelioma Registry. In practice, this project could prompt research by enabling scientists to access patient data faster and put together a sufficient number of patients for conducting clinical trials that improve diagnosis rates and treatment options.
Other benefits do emerge from this project. For example, to address mesothelioma’s non-specific symptoms and implications for misdiagnosis, a case-finding methodology is proposed here. Periodic screenings of at-risk populations through rapid testing could identify those who already experience symptoms aligned with early-stage mesothelioma and prompt in-depth investigations in specialized clinics.
Advocacy and civic pressure from veteran organizations are crucial to accelerating the implementation of the National Mesothelioma Registry. By raising awareness, lobbying policymakers, and uniting affected communities, these groups can create urgency in pressuring the federal government to adopt this project. A key role in this case is played by the Department of Veterans Affairs (VA) and the Department of Defense (DoD), as they are responsible for supporting affected service members.
Mesothelioma Cases Among Linn County Veterans
Almost 160,000 veterans live in Iowa, and more than 60,000 of them served in the military during peak asbestos use, including during WW2, the Korean War and the Vietnam War, when virtually no regulations on asbestos existed. Today, in old age, these veterans risk developing one of the cruelest diseases, with little hope for early diagnosis, curative treatment, or long-term survival. More than 13,000 veterans live in Linn County, and around 4,800 served in the Vietnam War, making them a key at-risk group for mesothelioma.
From 1999 to 2017, Iowa recorded a total number of 2,765 asbestos-related deaths, of which 525 were attributed to mesothelioma. Linn County has the second-largest death toll of all asbestos-related deaths at 276, with an average of 14 per year. Compared to the state incidence rate of asbestos mortality at 4.8 per 100,000 people, Linn County has almost double this rate at 7.0. These numbers are not surprising, as Linn County was historically influenced by nearby military installations and defense-related industries, where asbestos use was common.
Given the high incidence of asbestos-related deaths in Linn County and the large population of aging, at-risk veterans, the implementation of the National Mesothelioma Registry is essential to improve care for these people. By capturing accurate case numbers and trends, the registry would support timely medical interventions and inform public health strategies, ultimately offering hope to those most vulnerable to this devastating disease.
About the Author
Jonathan Sharp is the Chief Financial Officer at Environmental Litigation Group, P.C., a Birmingham, Alabama-based law firm dedicated to advocating for individuals harmed by toxic exposure.