A mesothelioma epidemic in Cappadocia: scientific developments and unexpected social outcomesMichele Carbone, Salih Emri, A. Umran Dogan, Ian Steele, Murat Tuncer, Harvey I. Pass and Y. Izzettin Baris
Abstract | In Cappadocia, Turkey, an unprecedented mesothelioma epidemic causes 50% of all deaths in three small villages. Initially linked solely to the exposure to a fibrous mineral, erionite, recent studies by scientists from Turkey and the United States have shown that erionite causes mesothelioma mostly in families that are genetically predisposed to mineral fibre carcinogenesis. This manuscript reports, through the eyes of one of the researchers, the resulting scientific advances that have come from these studies and the social improvements that were brought about by both the scientists and members of the Turkish Government.
Mesothelioma is a cancer arising from the mesothelial cells that line the pleural, pericardial and peritoneal surfaces1,2. Although there are rare benign variants of mesothelioma, such as multicystic mesothelioma or mesothelioma of the atrioventricular node, which are not related to asbestos exposure1,2, this article focuses on the relatively more common malignant mesothelioma. In the United States there are approximately 2,500 cases and deaths per year of malignant mesothelioma, which is often related to asbestos exposure (BOX 1). Median survival is approximately 1 year from diagnosis because current therapies have only marginal effects in altering the natural course of the disease1. Although the link between asbestos exposure and mesothelioma was established in 1960, it is still unclear whether all types of asbestos cause mesothelioma
