Pleural mesothelioma incidence in Europe: evidence of some deceleration in the increasing trends.
OBJECTIVE
To summarize the geographical and temporal variations in incidence of pleural mesothelioma in Europe, using the extensive data available from European general cancer registries, and consider these in light of recent trends in asbestos extraction, use and import in European countries.


METHODS
The data were extracted from the European Cancer Incidence and Mortality database (EUROCIM). The inclusion criteria was acceptance in Volume VII of Cancer Incidence in Five Continents. Truncated age-standardized rates per 100,000 for the ages 40-74 were used to summarise recent geographical variations. Standardized rate ratios and 95% confidence intervals for the periods 1986-1990 and 1991-1995 were compared to assess geographical variations in risk. To investigate changes in the magnitude of most recent trends, regression models fitted to the latest available 10-year period (1988-1997) were compared with trends in the previous decade. Fitted rates in younger (40-64) and older adults (65-74) in the most recent period were also compared.


RESULTS
There was a great deal of geographical variation in the risk of mesothelioma, annual rates ranging from around 8 per 100,000 in Scotland, England and The Netherlands, to lower than 1 per 100,000 in Spain (0.96), Estonia (0.85), Poland (0.85) and Yugoslavia, Vojvodina (0.56) among men. The rank of the rates for women was similar to that observed for men, although rates were considerably lower. Between 1978 and 1987, rates in men significantly increased in all countries (excepting Denmark). In the following 10 years, there was a deceleration in trend, and a significant increase was detectable only in England and France. In addition, the magnitude of recent trends in younger men was generally lower than those estimated for older men, in both national and regional cancer registry settings.


CONCLUSIONS
While mesothelioma incidence rates are still rising in Europe, a deceleration has started in some countries. A decrease may begin in the next few years in certain European populations considering the deceleration of observed trends in mesothelioma and asbestos exposure, as well as the recent ban on its use.
Montanaro
Fabio
F
Mesothelioma Registry of Liguria, Unit of Environmental Epidemiology and Applied Biostatistics, National Cancer Research Institute (IST), Genova, Italy. fabio.montanaro@ti.ch
Bray
Freddie
F
Gennaro
Valerio
V
Merler
Enzo
E
Tyczynski
Jerzy E
JE
Parkin
Donald Maxwell
DM
Strnad
Marija
M
Jechov'a
Marie
M
Storm
Hans H
HH
Aareleid
Tiiu
T
Hakulinen
Timo
T
Velten
Michel
M
Lef'evre
Hacina
H
Danzon
Arlette
A
Buemi
Antoine
A
Daur'es
Jean-Pierre
JP
Ménégoz
François
F
Raverdy
Nicole
N
Sauvage
Martine
M
Ziegler
Hartwig
H
Comber
Harry
H
Paci
Eugenio
E
Vercelli
Marina
M
De Lisi
Vincenzo
V
Tumino
Rosario
R
Zanetti
Roberto
R
Berrino
Franco
F
Stanta
Giorgio
G
Langmark
Frøydis
F
Rachtan
Jadwiga
J
Mezyk
Ryszard
R
Blaszczyk
Jerzy
J
Ivan
Plesko
P
Primic-Zakelj
Maja
M
Martínez
Alvaro Cañada
AC
Izarzugaza
Isabel
I
Borràs
Joan
J
Garcia
Carmen Martínez
CM
Garau
Isabel
I
Sánchez
Navarro Carmen
NC
Aicua
Ardanaz
A
Barlow
Lotti
L
Torhorst
Joachim
J
Bouchardy
Christine
C
Levi
Fabio
F
Fisch
Thomas
T
Probst
Nicole
N
Visser
Otto
O
Quinn
Mike
M
Gavin
Anna
A
Brewster
David
D
Mikov
Marica
M
D001194:Asbestos; D004781:Environmental Exposure / Q000009:adverse effects; D005060:Europe / Q000453:epidemiology; D005544:Forecasting; D006801:Humans; D015994:Incidence; D016014:Linear Models; D008654:Mesothelioma / Q000453:epidemiology* / Q000209:etiology; D016273:Occupational Exposure / Q000009:adverse effects; D010997:Pleural Neoplasms / Q000453:epidemiology* / Q000209:etiology; D012307:Risk Factors
D001194:Asbestos