Department Epidemiology, School of Public Health, University of São Paulo, São Paulo-SP 01246-904, Brazil.
Division of Medicine, Fundação Jorge Duprat e Figueiredo (Fundacentro), São Paulo-SP 05409-002, Brazil.
Int J Environ Res Public Health. 2019 Jul 17;16(14):2548. doi: 10.3390/ijerph16142548.
There are scarce epidemiological studies on lung cancer mortality in areas exposed to asbestos in developing countries. We compared the rates and trends in mortality from lung cancer between 1980 and 2016 in a municipality that made extensive use of asbestos, Osasco, with rates from a referent municipality with lower asbestos exposure and with the rates for the State of São Paulo. We retrieved death records for cases of lung cancer (ICD-9 C162) (ICD-10 C33 C34) from 1980 to 2016 in adults aged 60 years and older. The join point regression and age-period-cohort models were fitted to the data. Among men, there was an increasing trend in lung cancer mortality in Osasco of 0.7% (CI: 0.1; 1.3) in contrast to a mean annual decrease for Sorocaba of -1.5% (CI: -2.4; -0.6) and a stable average trend for São Paulo of -0.1 (IC: -0.3; 0.1). Similar increasing trends were seen in women. The age-period-cohort model showed an increase in the risk of death from 1996 in Osasco and a reduction for Sorocaba and São Paulo State during the same period. Our results point to a need for a special monitoring regarding lung cancer incidence and mortality in areas with higher asbestos exposure.
在发展中国家，针对暴露于石棉的地区的肺癌死亡率，仅有少数流行病学研究。我们比较了一个广泛使用石棉的城市（奥萨斯科）与一个石棉暴露水平较低的参照城市以及圣保罗州在 1980 年至 2016 年期间的肺癌死亡率的比率和趋势。我们从 1980 年至 2016 年检索了 60 岁及以上成年人的肺癌（ICD-9 C162）（ICD-10 C33 C34）死亡记录。我们使用了连接点回归和年龄-时期-队列模型来分析数据。在男性中，奥萨斯科的肺癌死亡率呈上升趋势，每年上升 0.7%（95%CI：0.1; 1.3），而索罗卡巴的平均年下降率为-1.5%（95%CI：-2.4; -0.6），圣保罗州的平均趋势则保持稳定，为-0.1（95%CI：-0.3; 0.1）。女性也出现了类似的上升趋势。年龄-时期-队列模型显示，奥萨斯科的死亡风险从 1996 年开始上升，而同期索罗卡巴和圣保罗州的死亡风险则有所下降。我们的研究结果表明，在石棉暴露水平较高的地区，需要对肺癌发病率和死亡率进行特殊监测。
