OBJECTIVES: Malignant pleural mesothelioma (MPM) is an uncommon cancer with poor survival. The aim of the study is to determine the burden of MPM disease and analyze associations between socioeconomic deprivation and urbanization survival in France. METHODS: Hospital stays with ICD-10 codes C45.0 and C45.9 as principal/related or significantly associated diagnosis (DP/DR/DAS) were extracted from the PMSI-MCO 2011/2012 database MPM incident patients were selected (absence of MPM codes and C34*/C38.4 codes as DP/DR/DAS since 2006 and a medical review was conducted) and were followed for 2 years from their first stay. Cox models were used to express survival at 1 and 2 years in France regarding different indicators as a population density index (PDI) and a social deprivation index (SDI) based on census data aggregated at the municipalities level. RESULTS: The cohort comprised 1,890 incident patients of MPM (men: 76%; age at inclusion: 73.6±10.0 years; presence of comorbidities during the follow-up: 84%). Patients mainly lived in urban zones (57%) and had a low IDS (53%). Only 1% of patients had a surgical specific procedure; 65% at least one chemotherapy administration (42% and 20% on the three and the last month of life, respectively); 5% at least an admission on intensive care unit (6% and 5% on the three and the last month of life, respectively). Survival rate at 1-year and 2-year was 64% and 48%, respectively. In adjusting analysis on age, gender and comorbidities (hypertension, diabetes, renal insufficiency, COPD, pulmonary insufficiency, and other chronic lung diseases), PDI was significantly associated with death at 1-year (HR=0.82 [0.72-0.96]) and 2-years (HR=0.83 [0.73-0.94]) and SDI being non-significant variable in the univariate analysis. CONCLUSIONS: MPM remains a disease with a poor prognostic of survival (64% and 48% at 1 and 2-years, respectively) and significantly associated with comorbidities and PDI.