Pleural cancer mortality in Spain: time-trends and updating of predictions up to 2020

BMC Cancer

Gonzalo López-Abente¹  Montserrat García-Gómez⁴  Alfredo Menéndez-Navarro³  Pablo Fernández-Navarro¹  Rebeca Ramis²  Javier García-Pérez¹  Marta Cervantes¹  Eva Ferreras¹  María Jiménez-Muñoz⁴  Roberto Pastor-Barriuso¹ 

[1] Consortium for Biomedical Research in Epidemiology and Public Health (CIBER en Epidemiología y Salud Pública - CIBERESP), Madrid, Spain

[2] Division of Health Research, Faculty of Health and Medicine, Lancaster University, Lancaster LA1 4YB, UK

[3] Departament of History of Science, Granada University, Avda. de Madrid 11, Granada 18012, Spain

[4] Ministry of Health, Social Services and Equality, Paseo del Prado 18-20, Madrid 28014, Spain

关键词: Mesothelioma;    Pleural cancer;    Epidemiology;    Asbestos;    Age-period-cohort;   

Others  :  1079465
DOI  :  10.1186/1471-2407-13-528

 received in 2013-06-18, accepted in 2013-11-05,  发布年份 2013

【 摘 要 】

Background

A total of 2,514,346 metric tons (Mt) of asbestos were imported into Spain from 1906 until the ban on asbestos in 2002. Our objective was to study pleural cancer mortality trends as an indicator of mesothelioma mortality and update mortality predictions for the periods 2011–2015 and 2016–2020 in Spain.

Methods

Log-linear Poisson models were fitted to study the effect of age, period of death and birth cohort (APC) on mortality trends. Change points in cohort- and period-effect curvatures were assessed using segmented regression. Fractional power-link APC models were used to predict mortality until 2020. In addition, an alternative model based on national asbestos consumption figures was also used to perform long-term predictions.

Results

Pleural cancer deaths increased across the study period, rising from 491 in 1976–1980 to 1,249 in 2006–2010. Predictions for the five-year period 2016–2020 indicated a total of 1,319 pleural cancer deaths (264 deaths/year). Forecasts up to 2020 indicated that this increase would continue, though the age-adjusted rates showed a levelling-off in male mortality from 2001 to 2005, corresponding to the lower risk in post-1960 generations. Among women, rates were lower and the mortality trend was also different, indicating that occupational exposure was possibly the single factor having most influence on pleural cancer mortality.

Conclusion

The cancer mortality-related consequences of human exposure to asbestos are set to persist and remain in evidence until the last surviving members of the exposed cohorts have disappeared. It can thus be assumed that occupationally-related deaths due to pleural mesothelioma will continue to occur in Spain until at least 2040.

【 授权许可】

   
2013 López-Abente et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

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