Roberti Sara, Merler Enzo, Bressan Vittoria, Fiore Anna Rita
Registro regionale veneto dei casi di mesotelioma, Servizio prevenzione igiene e sicurezza negli ambienti di lavoro, AULSS 16, Padova.
Epidemiol Prev. 2007 Nov-Dec;31(6):309-16.
The study assesses incidence and trend of malignant mesothelioma (MM), and mortality from primary pleural tumour (PPT) among residents of the Veneto region (North-east of Italy 4,450,000 inhabitants at the last census). The study also aims at identifying areas at high risk, by applying geographical analysis techniques.
The results have been obtained through the activity ofa Mesothelioma Registry, established in 2001, thus collecting largely retrospective data. Incidence and trends are estimated on MM diagnosed between 1988 and 2002 by means of histological or cytological techniques. Deaths from PPT are derived through the availability of mortality records for the period 1988-1999 (latest year available). Direct age-standardization was applied to provincial rates (7 provinces), whereas standardized mortality and incidence ratios according to Kernel estimates and spatial scan statistics have been used to identify clusters at the municipality level (581 municipalities).
the incidence of MM in the Veneto region appears similar to that of other northern Italian regions (904 new MM cases from 1988 to 2002, 650 among males, 819 pleural; age-standardized annual incidence rates x 100,000 in the period 1988-1999): 1.75 (IC 95% 1.59-1.91) among males, based on 460 cases, and 0.67 (IC 95% 0.57-0.77) among females, based on 196 cases, and displays an increasing trend among both genders. Among males incidence doubles during the study period. High risks are detected among males in a cluster formed by the city of Venice and surrounding municipalities (Standardized Incidence Ratio, SIR, for pleural mesothelioma, 1988-1999, 2.94 (p = 0.001) for the cluster based on 110 observed cases), and, in addition to Venice, in the province of Padua among females (SIR from pleural mesothelioma, 1988-1999, 1.98 (p = 0.001) for the cluster based on 95 observed cases). Mortality from TPP turns out to be higher than incidence and tends to approach incidence in more recent years; this may be explained by the increasing application of diagnostic procedures, inclusive of histopathological tests, among old patients.
本研究评估意大利东北部威尼托地区（上次人口普查时有445万居民）恶性间皮瘤（MM）的发病率和趋势，以及原发性胸膜肿瘤（PPT）的死亡率。本研究还旨在通过应用地理分析技术来识别高风险地区。
研究结果是通过2001年建立的间皮瘤登记处的活动获得的，从而收集了大量回顾性数据。1988年至2002年期间通过组织学或细胞学技术诊断的MM的发病率和趋势进行了估计。PPT导致的死亡是通过1988 - 1999年期间（可获得数据的最近年份）的死亡率记录得出的。对省级发病率（7个省）应用了直接年龄标准化，而根据核估计和空间扫描统计的标准化死亡率和发病率比已用于识别市级（581个市）的聚集区。
威尼托地区MM的发病率与意大利其他北部地区相似（1988年至2002年有904例新的MM病例，男性650例，胸膜819例；1988 - 1999年期间年龄标准化年发病率×10万）：基于460例病例，男性为1.75（95%可信区间1.59 - 1.91），基于196例病例，女性为0.67（95%可信区间0.57 - 0.77），并且在两性中均呈上升趋势。在研究期间男性发病率翻倍。在由威尼斯市及其周边市组成的聚集区中检测到男性存在高风险（1988 - 1999年胸膜间皮瘤标准化发病率比，该聚集区基于110例观察病例，为2.94（p = 0.001）），此外，除了威尼斯，在帕多瓦省女性中也存在高风险（1988 - 1999年胸膜间皮瘤标准化发病率比，该聚集区基于95例观察病例，为1.98（p = 0.001））。PPT导致的死亡率高于发病率，并且在最近几年趋于接近发病率；这可能是由于在老年患者中诊断程序（包括组织病理学检查）的应用增加所致。
