School of Medicine, University of Maryland, Baltimore, MD 21201, USA.
Int J Environ Res Public Health. 2023 Mar 11;20(6):4950. doi: 10.3390/ijerph20064950.
Mesothelioma, a cancer of mesothelial cells that line the chest, lungs, heart, and abdomen, is a relatively rare disease. In the United States, approximately 3000 individuals are diagnosed with mesothelioma annually. The primary risk factor for mesothelioma is occupational asbestos exposure which can occur decades prior to disease development, though in approximately 20% of cases, known asbestos exposure is lacking. While several other countries have developed mesothelioma registries to collect key clinical and exposure data elements to allow better estimation of incidence, prevalence, and risk factors associated with disease development, no national mesothelioma registry exists in the U.S. Therefore, as part of a larger feasibility study, a patient exposure questionnaire and a clinical data collection tool were created using a series of key informant interviews. Findings suggest that risk factor and clinical data collection via an on-line questionnaire is feasible, but specific concerns related to confidentiality, in the context of employer responsibility for exposure in the unique U.S. legal environment, and timing of enrollment must be addressed. Lessons learned from piloting these tools will inform the design and implementation of a mesothelioma registry of national scope.
间皮瘤是一种发生于覆盖胸部、肺部、心脏和腹部的间皮细胞的癌症,是一种相对罕见的疾病。在美国,每年大约有 3000 人被诊断患有间皮瘤。间皮瘤的主要风险因素是职业性石棉暴露,这种暴露可能在疾病发生前几十年就存在,尽管在大约 20%的病例中,已知的石棉暴露是缺乏的。虽然其他几个国家已经建立了间皮瘤登记处,以收集关键的临床和暴露数据元素,以便更好地估计与疾病发展相关的发病率、患病率和风险因素,但美国没有全国性的间皮瘤登记处。因此,作为一项更大的可行性研究的一部分,使用一系列关键知情人访谈创建了患者暴露问卷和临床数据收集工具。研究结果表明,通过在线问卷收集风险因素和临床数据是可行的,但必须解决与雇主在独特的美国法律环境下对暴露负责以及登记时间相关的保密性等具体问题。从这些工具的试点中吸取的经验教训将为全国范围的间皮瘤登记处的设计和实施提供信息。