Biomedical Center, Faculty of Medicine and Biomedical Center in Pilsen, Charles University in Prague, 30605, Pilsen, Czech Republic.
Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 580, D-69120, Heidelberg, Germany.
BMC Cancer. 2021 Nov 8;21(1):1189. doi: 10.1186/s12885-021-08913-2.
Malignant pleural mesothelioma (MPM) is a rare but fatal cancer, which is largely caused by exposure to asbestos. Reliable information about the incidence of MPM prior the influence of asbestos is lacking. The nationwide regional incidence trends for MPM remain poorly characterized. We use nationwide MPM data for Denmark (DK), Finland (FI), Norway (NO) and Sweden (SE) to assess incidence, mortality and survival trends for MPM in these countries.
We use the NORDCAN database for the analyses: incidence data were available from 1943 in DK, 1953 in FI and NO and 1958 in SE, through 2016. Survival data were available from 1967 through 2016. World standard population was used in age standardization.
The lowest incidence that we recorded for MPM was 0.02/100,000 for NO women and 0.05/100,000 for FI men in 1953-57, marking the incidence before the influence of asbestos. The highest rate of 1.9/100,000 was recorded for DK in 1997. Female incidence was much lower than male incidence. In each country, the male incidence trend for MPM culminated, first in SE around 1990. The regional incidence trends matched with earlier asbestos-related industrial activity, shipbuilding in FI and SE, cement manufacturing and shipbuilding in DK and seafaring in NO. Relative 1-year survival increased from about 20 to 50% but 5-year survival remained at or below 10%.
In the Nordic countries, the male incidence trends for MPM climaxed and started to decrease, indicating that the prevention of exposure was beneficial. Survival in MPM has improved for both sexes but long-term survival remains dismal.
恶性胸膜间皮瘤（MPM）是一种罕见但致命的癌症，主要由接触石棉引起。在石棉影响之前，关于 MPM 发病率的可靠信息是缺乏的。北欧国家（丹麦、芬兰、挪威和瑞典）的 MPM 全国区域发病趋势仍未得到充分描述。我们使用丹麦（DK）、芬兰（FI）、挪威（NO）和瑞典（SE）的全国性 MPM 数据，评估这些国家 MPM 的发病率、死亡率和生存率趋势。
我们使用 NORDCAN 数据库进行分析：发病率数据自 1943 年在 DK、1953 年在 FI 和 NO 以及 1958 年在 SE 开始，截止到 2016 年。生存率数据自 1967 年至 2016 年可用。年龄标准化采用世界标准人口。
我们记录的 MPM 最低发病率为 1953-57 年 NO 女性为 0.02/100,000，FI 男性为 0.05/100,000，标志着在石棉影响之前的发病率。1997 年 DK 的发病率最高，为 1.9/100,000。女性发病率远低于男性。在每个国家，MPM 的男性发病率趋势首先在 SE 于 1990 年左右达到高峰。区域发病率趋势与早期与石棉有关的工业活动相吻合，FI 和 SE 的造船业、DK 的水泥制造业和造船业以及 NO 的航海业。相对 1 年生存率从约 20%增加到 50%，但 5 年生存率仍保持在 10%以下。
在北欧国家，MPM 的男性发病率趋势达到高峰并开始下降，表明暴露预防是有益的。两性的生存率都有所提高，但长期生存率仍不容乐观。
