Trend Of Mesothelioma Incidence In Lombardy, Italy, 2000-2029

Dario CONSONNI, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Italy
DE MATTEIS S. 2 , DALLARI B. 1 , RIBOLDI L. 1 , BERTAZZI P. 1 , PESATORI A. 1,3 , MENSI C. 1

1 Department of Preventive Medicine, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
2 National Heart & Lung Institute, Respiratory Epidemiology, Occupational Medicine and Public Health, Imperial College London, London, UK
3 EPIGET, Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy

Purpose: In Italy, where asbestos has been extensively used from 1946 to 1992, mortality from pleural mesothelioma is expected to peak in 2012-24. Using data of the MM registry of the Lombardy Region, North-West Italy, the most populated and industrialised Italian region, we analysed time patterns in the period 2000-2012 and made projections for the period 2013-2029.
Methods: We selected all incident cases of MM with first diagnosis between 2000 and 2012. We fitted categorical Poisson age-cohort models using 5-year categories for age at diagnosis and birth cohort. The gender-specific age and cohort regression coefficients were then applied to population data to calculate projections of the numbers of MM cases in the years 2013 to 2029. Statistical analyses were performed with Stata 13.
Results: In 2000-2012 we recorded 4,435 MM cases, 2,846 in men and 1,589 in women. Occupational asbestos exposure was more frequent in men (73.6%) than in women (38.2%). The average number of MM cases per year was still increasing (+2.6% in men, +3.3% in women). A maximum of 416 MM cases (266 men, 150 women) is expected in 2019. We forecast there will be 6,809 more cases (4,379 in men, 2,430 in women) in the period 2013-2029, for a total of 11,244 MM cases (7,225 in men, 4,019 in women) in 30 years.
Conclusions: This study documented a high MM burden in both genders in the Lombardy Region, reflecting extensive asbestos exposure in the past. Incidence rates are still increasing and a downturn of MM occurrence is expected to occur after 2019. Documenting mesothelioma occurrence may help to increase awareness of dangers of asbestos exposure in countries that still use it but where its health effects are still overlooked.
Funding source: Lombardy Region; Ministry of Health and INAIL; Associazione Italiana per la Ricerca sul Cancro.