This report presents the work of an expert group led by Santé publique France, in collaboration with the National Cancer Institute (INCa). Based on an assessment of existing systems and after identifying the key surveillance challenges for the coming years, the group recommends the establishment of a national system for the surveillance of mesotheliomas and their exposures, incorporating medical and social surveillance (DNSM). This new system, which will be implemented by Santé publique France in conjunction with INCa, will ensure the preservation of existing knowledge and address new challenges, particularly the need to expand understanding of extrapleural cases and their exposures. The link between surveillance and research will be strengthened: research teams from the PNSM and MESONAT will partner with the DNSM; opportunities for collaboration with other teams will be expanded. The development of the DNSM will proceed in conjunction with the expansion of the MESOBANK and the accreditation of rare cancer networks in 2018. The knowledge generated will be regularly disseminated and may be incorporated into prevention initiatives, particularly regarding information on asbestos risks among the general population and in the workplace. It will enable monitoring of underreporting of occupational diseases and contribute to improving patient information regarding their rights to recognition, as well as promoting information among healthcare professionals. International visibility will also be a goal. All of this work falls fully within the scope of dedicated initiatives under government plans for cancer, environmental health, and occupational health.