Okello Catherine, Treasure Tom, Nicholson Andrew G, Peto Julian, Møller Henrik
King's College London, Thames Cancer Registry, London, UK.
BMC Cancer. 2009 Jan 23;9:28. doi: 10.1186/1471-2407-9-28.
Mesothelioma is a highly fatal cancer that is caused by exposure to asbestos fibres. In many populations, the occurrence of mesothelioma is monitored with the use of mortality data from death certification. We examine certified causes of death of patients who have been diagnosed with mesothelioma, and assess the validity of death certification data as a proxy for mesothelioma incidence.
We extracted mesothelioma registrations in the South East of England area between 2000 and 2004 from the Thames Cancer Registry database. We retained for analysis 2200 patients who had died at the time of analysis, after having excluded seven dead cases where the causes of death were not known to the cancer registry. The 2200 deaths were classified hierarchically to identify (1) mesothelioma deaths, (2) deaths certified as lung cancer deaths or (3) deaths from unspecified cancer, and (4) deaths from other causes.
87% of the patients had mesothelioma mentioned on the death certificate. 6% had no mention of mesothelioma but included lung cancer as a cause of death. Another 6% had no mention of mesothelioma or lung cancer, but included an unspecified cancer as a cause of death. Lastly, 2% had other causes of death specified on the death certificate.
This analysis suggests that official mortality data may underestimate the true occurrence of mesothelioma by around 10%.
间皮瘤是一种由接触石棉纤维引起的高致死性癌症。在许多人群中，间皮瘤的发病情况通过死亡证明中的死亡率数据进行监测。我们研究了已被诊断为间皮瘤的患者的死亡证明病因，并评估死亡证明数据作为间皮瘤发病率替代指标的有效性。
我们从泰晤士癌症登记数据库中提取了2000年至2004年英格兰东南部地区的间皮瘤登记信息。在排除了癌症登记处不知道死因的7例死亡病例后，我们保留了分析时已死亡的2200例患者用于分析。对这2200例死亡病例进行分层分类，以确定（1）间皮瘤死亡病例，（2）被证明为肺癌死亡的病例或（3）不明癌症死亡病例，以及（4）其他原因导致的死亡病例。
87%的患者死亡证明上提到了间皮瘤。6%的患者未提及间皮瘤，但将肺癌列为死因。另外6%的患者既未提及间皮瘤也未提及肺癌，但将不明癌症列为死因。最后，2%的患者死亡证明上列出了其他死因。
该分析表明，官方死亡率数据可能会低估间皮瘤的实际发病率约10%。
