Barbiero Fabiano, Giangreco Manuela, Pisa Federica Edith, Negro Corrado, Bovenzi Massimo, Rosolen Valentina, Barbone Fabio
Dipartimento di Scienze Mediche e Biologiche, Università di Udine, Udine, Italia Dipartimento di Medicina Clinica e Sperimentale, Università di Parma, Parma, Italia Servizio Prevenzione Igiene e Sicurezza negli Ambienti di Lavoro (SPISAL), ULSS n. 12, Mestre, Italia.
Med Lav. 2016 Jul 26;107(4):307-14.
The incidence of mesothelioma in Italy shows wide geographical variation, with the highest incidence rates in Genoa and Friuli Venezia Giulia (FVG). For mesothelioma, national standard incidence rates are not available prior to the calendar year 2006.
To estimate the Standardized Incidence rate Ratio (SIR) of mesothelioma in a cohort of former workers undergoing health surveillance because of previous asbestos exposure, when sex-, age-, and calendar year-specific rates of the national standard are not available and the number of expected cases calculated from the regional rates is biased by the size of the study cohort.
We conducted a sensitivity analysis in a cohort of 2,488 men. We considered every Italian cancer registry available with complete data in the period 1995-2007 (N=14). We calculated, for each year and age group, the corresponding weighted mean rate of 10 registries of North-Italy (Mean W10), the weighted mean rate of all 14 registries available (Mean W14) and considered FVG standard rate.
During the period 1995-2007, we observed 25 incident cases of mesothelioma with expected cases that varied between 2.00 (Mean W14) and 2.56 (FVG standard rate), with a SIR of 12.49 (CI95% 8.08-18.48) and 9.76 (CI95% 6.32-14.45) respectively.
Our results show that the use of FVG rates as standard does not lead to significant distortions in the calculation of the expected cases. However, distortion is remarkable in the SIRs estimation. Using a weighted mean standard incidence rate may be a valid alternative for SIR estimate when national standard rates are not available.
意大利间皮瘤的发病率在地域上差异很大，热那亚和弗留利-威尼斯朱利亚（FVG）的发病率最高。对于间皮瘤，2006年之前没有国家标准发病率。
在一组因既往接触石棉而接受健康监测的前工人队列中，当无法获得按性别、年龄和历年划分的国家标准发病率，且根据区域发病率计算的预期病例数因研究队列规模而有偏差时，估计间皮瘤的标准化发病率比（SIR）。
我们对2488名男性队列进行了敏感性分析。我们考虑了1995 - 2007年期间有完整数据的每个意大利癌症登记处（N = 14）。我们为每个年份和年龄组计算了意大利北部10个登记处的相应加权平均发病率（平均W10）、所有14个可用登记处的加权平均发病率（平均W14），并考虑了FVG标准发病率。
在1995 - 2007年期间，我们观察到25例间皮瘤新发病例，预期病例数在2.00（平均W14）和2.56（FVG标准发病率）之间变化，标准化发病率比分别为12.49（95%置信区间8.08 - 18.48）和9.76（95%置信区间6.32 - 14.45）。
我们的结果表明，使用FVG发病率作为标准在预期病例数的计算中不会导致显著偏差。然而，在标准化发病率比的估计中偏差很明显。当没有国家标准发病率时，使用加权平均标准发病率可能是估计标准化发病率比的有效替代方法。
