Asbestos exposure is associated with an increased risk of cancers of the pleura and peritoneum, lung, larynx and several other organs. The incidence of mesothelial tumours is increased among insulators and shipyardworkers. Consequently, areas with large ports and shipbuilding industry have high incidence rates for malignant pleural mesothelioma. Despite regulations to limit the use of asbestos, the incidence of mesothelioma is not expected to fall before the end of this century.

Since the Rotterdam area contains the world’s largest port, with widespread shipbuilding and ship repair industries, the large number of mesothelioma patients in this area provided an opportunity to study prognostic factors. Generally, the survival of patients with malignant mesothelioma is less than one year from the onset of symptoms. Various treatment strategies have not been able to improve the prognosis for the majority of patients.