意大利与职业暴露相关的癌症归因比例。
Attributable Fraction of Cancer Related to Occupational Exposure in Italy.
作者信息
Collatuzzo Giulia, Turati Federica, Malvezzi Matteo, Negri Eva, La Vecchia Carlo, Boffetta Paolo
机构信息
Department of Medical and Surgical Sciences, University of Bologna, 40126 Bologna, Italy.
Department of Clinical Sciences and Community Health (DISCCO), University of Milan, 20122 Milan, Italy.
出版信息
Cancers (Basel). 2023 Apr 10;15(8):2234. doi: 10.3390/cancers15082234.
BACKGROUND
Exposure to occupational carcinogens is an important and avoidable cause of cancer. We aimed to provide an evidence-based estimate of the burden of occupation-related cancers in Italy.
METHODS
The attributable fraction (AF) was calculated based on the counterfactual scenario of no occupational exposure to carcinogens. We included exposures classified as IARC group 1 and with reliable evidence of exposure in Italy. Relative risk estimates for selected cancers and prevalences of exposure were derived from large-scale studies. Except for mesothelioma, a 15-20-year latency period between exposure and cancer was considered. The data on cancer incidence in 2020 and mortality in 2017 in Italy were obtained from the Italian Association of Cancer Registries.
RESULTS
The most prevalent exposures were UV radiation (5.8%), diesel exhaust (4.3%), wood dust (2.3%) and silica dust (2.1%). Mesothelioma had the largest AF to occupational carcinogens (86.6%), followed by sinonasal cancer (11.8%) and lung cancer (3.8%). We estimated that 0.9% of cancer cases (N3500) and 1.6% of cancer deaths (N2800) were attributable to occupational carcinogens in Italy. Of these, about 60% were attributable to asbestos, 17.5% to diesel exhaust, followed by chromium and silica dust (7% and 5%).
CONCLUSIONS
Our estimates provide up-to-date quantification of the low, but persistent, burden of occupational cancers in Italy.
背景
接触职业致癌物是癌症的一个重要且可避免的病因。我们旨在对意大利职业相关癌症负担进行基于证据的评估。
方法
归因分数（AF）是根据无职业性接触致癌物的反事实情景计算得出的。我们纳入了被国际癌症研究机构（IARC）列为1类且在意大利有可靠接触证据的暴露。选定癌症的相对风险估计值和接触患病率来自大规模研究。除间皮瘤外，考虑接触与癌症之间有15至20年的潜伏期。意大利2020年癌症发病率数据和2017年死亡率数据来自意大利癌症登记协会。
结果
最普遍的暴露是紫外线辐射（5.8%）、柴油废气（4.3%）、木尘（2.3%）和矽尘（2.1%）。间皮瘤对职业致癌物的归因分数最高（86.6%），其次是鼻窦癌（11.8%）和肺癌（3.8%）。我们估计，在意大利，0.9%的癌症病例（约3500例）和1.6%的癌症死亡（约2800例）可归因于职业致癌物。其中，约60%可归因于石棉，17.5%可归因于柴油废气，其次是铬和矽尘（7%和5%）。
结论
我们的估计提供了意大利职业性癌症低但持续存在的负担的最新量化数据。
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