title: Pleural mesothelioma incidence in Europe: evidence of some deceleration in the increasing trends.
abstract: 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.
authors.affiliation: Mesothelioma Registry of Liguria, Unit of Environmental Epidemiology and Applied Biostatistics, National Cancer Research Institute (IST), Genova, Italy. fabio.montanaro@ti.ch
authors.forename: Fabio
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authors.lastname: Montanaro
authors.forename: Freddie
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authors.forename: Vincenzo
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authors.lastname: De Lisi
authors.forename: Rosario
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authors.lastname: Zanetti
authors.forename: Franco
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authors.lastname: Berrino
authors.forename: Giorgio
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authors.lastname: Stanta
authors.forename: Frøydis
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authors.forename: Ryszard
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authors.lastname: Blaszczyk
authors.forename: Plesko
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authors.lastname: Ivan
authors.forename: Maja
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authors.lastname: Primic-Zakelj
authors.forename: Alvaro Cañada
authors.initials: AC
authors.lastname: Martínez
authors.forename: Isabel
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authors.lastname: Izarzugaza
authors.forename: Joan
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authors.lastname: Borràs
authors.forename: Carmen Martínez
authors.initials: CM
authors.lastname: Garcia
authors.forename: Isabel
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authors.lastname: Garau
authors.forename: Navarro Carmen
authors.initials: NC
authors.lastname: Sánchez
authors.forename: Ardanaz
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authors.forename: Lotti
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authors.lastname: Barlow
authors.forename: Joachim
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authors.lastname: Torhorst
authors.forename: Christine
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authors.lastname: Bouchardy
authors.forename: Fabio
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authors.lastname: Levi
authors.forename: Thomas
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authors.lastname: Fisch
authors.forename: Nicole
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authors.lastname: Probst
authors.forename: Otto
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authors.lastname: Visser
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mesh_terms: 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
chemical_list: D001194:Asbestos