Walker-Bone Karen, Benke Geza, MacFarlane Ewan, Klebe S, Takahashi Ken, Brims Fraser, Sim Malcolm Ross, Driscoll Tim R
Monash Centre for Occupational and Environmental Health, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
MRC Versus Arthritis Centre for Musculoskeletal Health and Work, University of Southampton, Southampton, UK.
Occup Environ Med. 2023 Apr;80(4):186-191. doi: 10.1136/oemed-2022-108669. Epub 2023 Feb 8.
Malignant mesothelioma is an uncommon cancer associated with asbestos exposure, predominantly occupational. Asbestos has been banned in Australia since 2003 but mesothelioma has a long latency and incident cases continue to present. The Australian Mesothelioma Registry was incepted to collect systematic data about incidence and mortality alongside asbestos exposure.
Benefiting from the Australian national system of cancer notification, all incident cases of mesothelioma in all states and territories are fast-tracked and notified regularly. Notified patients are contacted asking for consent to collect exposure information, initially by postal questionnaire and subsequently by telephone interview. Age-standardised annual incidence rates and mortality rates were calculated. Asbestos exposure was categorised as occupational, non-occupational, neither or, both; and as low, or high, probability of exposure.
Mesothelioma incidence appears to have peaked. The age-standardised incidence rates have declined steadily since the early 2000s (peaking in males at 5.9/100 000 and in all-persons at 3.2/100 000), driven by rates in males, who comprise the majority of diagnosed cases. Rates in women have remained fairly stable since that time. Age-standardised mortality rates have followed similar trends. Mesothelioma remains the most common in those aged over 80 years. Nearly all (94%) cases were linked with asbestos exposure (78% occupational in men; 6.8% in women).
With effective control of occupational asbestos use, the decline in age-standardised incidence and death rates has occurred. Incidence rates among women, in whom occupational asbestos exposure is rarely detectable, remain unchanged, pointing to the role of household and /or environmental asbestos exposure.
恶性间皮瘤是一种与石棉暴露相关的罕见癌症，主要为职业暴露。自2003年起澳大利亚已禁止使用石棉，但间皮瘤潜伏期长，仍有新发病例不断出现。澳大利亚间皮瘤登记处负责收集有关发病率、死亡率以及石棉暴露情况的系统数据。
得益于澳大利亚国家癌症通报系统，所有州和领地间皮瘤的新发病例都能快速进入通报流程并定期通报。对通报的患者进行联系，请求其同意收集暴露信息，最初通过邮寄问卷，随后通过电话访谈。计算年龄标准化年发病率和死亡率。石棉暴露分为职业性、非职业性、无暴露或两者皆有；以及低暴露概率或高暴露概率。
间皮瘤发病率似乎已达峰值。自21世纪初以来，年龄标准化发病率稳步下降（男性发病率峰值为5.9/10万，所有人发病率峰值为3.2/10万），下降主要源于男性发病率，因为大多数确诊病例为男性。此后女性发病率一直相当稳定。年龄标准化死亡率也呈现类似趋势。间皮瘤在80岁以上人群中最为常见。几乎所有（94%）病例都与石棉暴露有关（男性职业性暴露占78%；女性占6.8%）。
随着职业性石棉使用得到有效控制，年龄标准化发病率和死亡率均出现下降。职业性石棉暴露很少能在女性中检测到，其发病率保持不变，这表明家庭和/或环境中的石棉暴露起到了作用。
