Department of Respiratory Medicine, Sir Charles Gairdner Hospital, Perth, Western Australia, Australia.
Curtin Medical School, Curtin University, Perth, Western Australia, Australia.
Respirology. 2024 Apr;29(4):288-294. doi: 10.1111/resp.14648. Epub 2023 Dec 28.
Australia introduced a partial ban on asbestos consumption in 1984. There is continuing concern about exposure to asbestos in the built environment and non-occupational exposures. The aim of this study was to describe epidemiological trends of mesothelioma in Western Australia (WA) over the 60 years since the first case was recorded.
Every case of mesothelioma notified to the WA Cancer Registry is reviewed by an expert panel. Data include demographic and clinical variables including principal mode of asbestos exposure and age at first exposure. Trends over time for survival, latency and pathological subtype of mesothelioma where analysed. Incidence rates for cases exposed during home renovation where calculated.
Two thousand seven hundred ninety-six cases of mesothelioma were identified with males comprising the majority (n = 2368, 84.7%). The median (IQR) age at diagnosis was 70 (62-78) years, and median latency of 47 (38-55) years. Pleural mesothelioma was recorded in 2620 (93.7%) cases with the epithelioid subtype most prevalent (n = 1730, 61.9%). Overall, median survival was 298 (128-585) days and latency 46 (37-54) years, both effectively doubling over the study period. Non-occupational exposures were proportionally higher in females (52.6%), compared with males (9.5%). Home renovation was the primary exposure in 227 (8.1%) cases, with number of cases and incidence rate ratio peaking in 2005/09 but subsequently decreasing.
The annual number of cases of mesothelioma in WA may have hit a plateau. The majority of females have non-occupational exposures and incidence rates from home renovation exposure may have peaked, suggesting the ban on asbestos has been effective.
澳大利亚于 1984 年对石棉消费实行部分禁令。人们仍然担心建筑环境和非职业环境中的石棉暴露。本研究的目的是描述自首例病例报告以来的 60 年间西澳大利亚州（WA）间皮瘤的流行病学趋势。
WA 癌症登记处收到的每例间皮瘤病例均由专家小组审查。数据包括人口统计学和临床变量，包括主要石棉暴露模式和首次暴露年龄。分析了间皮瘤生存率、潜伏期和病理亚型的时间趋势。计算了在家居装修中暴露的病例的发病率。
共发现 2796 例间皮瘤病例，其中男性占多数（n=2368，84.7%）。诊断时的中位（IQR）年龄为 70（62-78）岁，中位潜伏期为 47（38-55）岁。2620 例（93.7%）记录为胸膜间皮瘤，其中上皮样亚型最为常见（n=1730，61.9%）。总体而言，中位生存期为 298（128-585）天，潜伏期为 46（37-54）年，在研究期间均有效翻倍。与男性（9.5%）相比，女性（52.6%）的非职业性暴露比例更高。227 例（8.1%）病例的主要暴露源为家居装修，2005/09 年病例数量和发病率比值达到峰值，随后逐渐下降。
WA 每年间皮瘤的病例数可能已达到高峰。大多数女性有非职业性暴露，而家居装修暴露的发病率可能已达到峰值，这表明石棉禁令是有效的。
