Lehnert Martin, Kraywinkel Klaus, Heinze Evelyn, Wiethege Thorsten, Johnen Georg, Fiebig Julia, Brüning Thomas, Taeger Dirk
Institute for Prevention and Occupational Medicine of the German Social Accident Insurance, Institute of the Ruhr-Universität Bochum (IPA), Buerkle-de-la-Camp-Platz 1, 44789, Bochum, Germany.
German Centre for Cancer Registry Data (ZfKD) at Robert Koch-Institute, Berlin, Germany.
Cancer Causes Control. 2017 Feb;28(2):97-105. doi: 10.1007/s10552-016-0838-y. Epub 2016 Dec 27.
The malignant mesothelioma is a rare malignancy and mainly caused by occupational exposure to asbestos. German cancer registries are providing a national database to investigate temporal and regional patterns of mesothelioma incidence. These may be of interest for healthcare planning and for surveillance programs aiming at the formerly exposed workforce.
We analyzed population-based incidence data of malignant mesothelioma by site, type, sex, age, as well as district and state of patient's residence. Age-standardized incidence rates (AIRs40+) were calculated according to the European standard population truncated to the age of 40 years and older. We present rates at national, state, and district level and trends of incidence of northern states of Germany.
In total, 7,547 malignant mesotheliomas were reported to German cancer registries diagnosed between 2009 and 2013-90% located to the pleura. On average, 1,198 men and 312 women were affected each year. We estimated AIR40+ of 4.77 in 100,000 German men and 0.98 in 100,000 German women. Regional clusters were predominantly located to the seaports of West Germany. The highest regional AIR40+ was 20 per 100,000 men. Corresponding rates in northeast Germany were between 2 and 4 per 100,000 men.
Regional clusters of high incidence indicate districts with former shipyards and steel industry, but predominantly in the western part of Germany. The West-to-East difference corresponds to patterns of mortality. Twenty years after banning asbestos in Germany, Bremen and Hamburg are presenting the highest mesothelioma incidence but show steadily decreasing trends.
恶性间皮瘤是一种罕见的恶性肿瘤，主要由职业性接触石棉引起。德国癌症登记处提供了一个全国性数据库，用于调查间皮瘤发病率的时间和区域模式。这些模式可能对医疗规划以及针对以前接触过石棉的劳动力的监测项目具有重要意义。
我们按部位、类型、性别、年龄以及患者居住的地区和州分析了基于人群的恶性间皮瘤发病率数据。年龄标准化发病率（AIRs40+）根据截断至40岁及以上的欧洲标准人群进行计算。我们呈现了全国、州和地区层面的发病率以及德国北部各州的发病率趋势。
2009年至2013年期间，德国癌症登记处共报告了7547例恶性间皮瘤病例，其中90%位于胸膜。平均每年有1198名男性和312名女性患病。我们估计德国男性的AIR40+为每10万人4.77例，德国女性为每10万人0.98例。区域聚集主要位于德国西部的海港。最高的区域AIR40+为每10万男性20例。德国东北部的相应发病率为每10万男性2至4例。
高发病率的区域聚集表明这些地区曾有造船厂和钢铁行业，但主要集中在德国西部。从西到东的差异与死亡率模式相符。在德国禁止使用石棉20年后，不来梅和汉堡的间皮瘤发病率最高，但呈稳步下降趋势。
