Late Breaking Abstract - Update on mesothelioma incidence and forecast of future cases in Belgium

<bold>Background</bold>. Belgium has been a “historical champion” in asbestos consumption leading to substantial asbestos-related morbidity and mortality. Although asbestos use was fully banned in 2001, the future course of the mesothelioma epidemic remains uncertain. <bold>Methods</bold>. We used national asbestos consumption data (from 1948) as a proxy for exposure. Data on the yearly incidence of malignant mesothelioma in Belgium were obtained from the Belgian Cancer Registry (2004-2021), Scientific Institute of Public Health (1987-2021) and WHO Mortality Database (1969-2004). We used a Distributed Lag Non-Linear Model to estimate the exposure–lag–response association and to forecast future cases. Additionally, compensation data from the national Asbestos Fund (2007-2023) were obtained. <bold>Results</bold>. Mesothelioma incidence has increased since the 1970s, plateauing in recent years around 300 cases/year (see figure). Our model predicts a decline in the coming decades, estimating 195 cases/year in 2030 (95% prediction interval [PI] 169-224) and 81 cases/year in 2040 (95%PI 65-100). Surprisingly, the number of compensated cases was significantly lower than the registered cases, with 81 cases/year (95%CI 64-98) remaining uncompensated. <fig><object-id>erj;64/suppl_68/PA4901/F1</object-id><object-id>F1</object-id><object-id>F1</object-id><graphic></graphic></fig> <bold>Conclusions</bold>. In countries with earlier asbestos bans, evidence suggests a declining incidence of mesothelioma. While our model predicts such a decline in the coming decades, this trend is not yet evident in the observed data.