Gogou Evdoxia, Hatzoglou Chryssi, Siachpazidou Dimitra, Zarogiannis Sotirios G, Gourgoulianis Konstantinos I
Department of Physiology, Faculty of Medicine, School of Health Sciences, University of Thessaly, BIOPOLIS, 41500, Larissa, Greece.
Department of Respiratory Medicine, Faculty of Medicine, School of Health Sciences, University of Thessaly, BIOPOLIS, 41110, Larissa, Greece.
BMC Public Health. 2024 Apr 26;24(1):1177. doi: 10.1186/s12889-024-18030-x.
BACKGROUND: Malignant mesothelioma is a rare form of cancer that mostly affects the pleura and has a strong link to asbestos exposure. Greece banned the use of asbestos in 2005, however, the public was already aware of this substance in the 1980s. This research aims to present an overview of Greece's mesothelioma age-standardized mortality rates (ASMR) from 1983 to 2019 by age, gender, and geographic region and to determine whether the actions to ban asbestos impacted these rates. METHODS: Data were retrieved by the Hellenic Statistical Authority (HSA) from death certificates that mentioned mesothelioma as the cause of death from 1983 to 2019 with details on the residence, gender, and age. Statistical analysis was performed using PRISM 6.0 software, a two-way ANOVA test, Trend analysis was conducted using Joinpoint Regression Program 5.0 software. The linear and non-linear model was used to calculate the age-standardized rates of annual percentage change (APC) and its 95% confidential interval (95% CI). RESULTS: From 1983 to 2019, 850 total mesothelioma deaths were recorded, the majority of whom were males (634). A rate of 74.6% accounts for males and 25.4% for females, and the ratio of Males: Females was 3:1. Males' ASMR and the whole population's ASMR reached their highest levels in 2011 (0.93/100000person-years and 0.53/100000person-years, respectively). To look for potential changes between the first two decades of the 21st century, we compared the mean ASMR of each geographic region in Greece between two different 10-year subperiods (2000-2009 and 2010-2019). Except for Epirus, all regions of Greece had elevated regional ASMRs, particularly in those with the highest asbestos deposits. Notably, the ASMR in Epirus decreased from 0.54/100000person-years (2000-2009) to 0.31/100000person-years (2010-2019). After 2011, the ASMR for men and the general population stabilized. This stability is important since mesothelioma in men is associated with occupational asbestos exposure. The intriguing discovery of a lower ASMR in Epirus emphasizes the need to raise awareness of the condition and implement effective public health measures. CONCLUSIONS: In Greece, the annual ASMR for males and the whole population reached its highest level in 2011, which is positive and encouraging and may be a sign that the rate will stabilize during the following years. Moreover, this study showed that the actions made in the 1980s regarding public awareness and surveillance directly impacted the decrease in Epirus rates. Future research, continual awareness, information, and recording are needed to monitor the mesothelioma epidemic. The possible benefit of a mesothelioma registry and the epidemiological surveillance of asbestos-related diseases, particularly mesothelioma mortality, need to be addressed. TRIAL REGISTRATION: Not applicable.
背景:恶性间皮瘤是一种罕见的癌症形式,主要影响胸膜,且与接触石棉有密切关联。希腊于2005年禁止使用石棉,然而,公众在20世纪80年代就已经知晓这种物质。本研究旨在概述1983年至2019年希腊按年龄、性别和地理区域划分的间皮瘤年龄标准化死亡率(ASMR),并确定禁止石棉的行动是否对这些比率产生了影响。 方法:希腊统计局(HSA)从1983年至2019年提及间皮瘤为死亡原因的死亡证明中检索数据,其中包含居住地址、性别和年龄的详细信息。使用PRISM 6.0软件进行统计分析,采用双向方差分析测试,使用Joinpoint回归程序5.0软件进行趋势分析。使用线性和非线性模型计算年度百分比变化(APC)的年龄标准化率及其95%置信区间(95%CI)。 结果:1983年至2019年期间,共记录了850例间皮瘤死亡病例,其中大多数为男性(634例)。男性占比74.6%,女性占比25.4%,男女比例为3:1。男性的ASMR和总体人群的ASMR在2011年达到最高水平(分别为0.93/100000人年和0.53/100000人年)。为了寻找21世纪前二十年之间的潜在变化,我们比较了希腊每个地理区域在两个不同的10年子时期(2000 - 2009年和2010 - 2019年)的平均ASMR。除伊庇鲁斯外,希腊所有地区的区域ASMR都有所上升,特别是在石棉储量最高的地区。值得注意的是,伊庇鲁斯的ASMR从2000 - 2009年的0.54/100000人年降至2010 - 2019年的0.31/100000人年。2011年之后,男性和总体人群的ASMR趋于稳定。这种稳定性很重要,因为男性间皮瘤与职业性石棉接触有关。伊庇鲁斯ASMR较低这一有趣发现强调了提高对该疾病的认识并实施有效公共卫生措施的必要性。 结论:在希腊,男性和总体人群的年度ASMR在2011年达到最高水平,这是积极且令人鼓舞的,可能表明该比率在接下来的几年中将趋于稳定。此外,本研究表明,20世纪80年代在公众意识和监测方面所采取的行动直接影响了伊庇鲁斯地区发病率的下降。未来需要进行研究、持续提高认识、提供信息和记录,以监测间皮瘤的流行情况。需要探讨间皮瘤登记处以及对石棉相关疾病,特别是间皮瘤死亡率进行流行病学监测的可能益处。 试验注册:不适用。
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