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Mesothelioom in Zuid Oost Engeland 1985-2002

03-10-2007 00:00

De ziekte maligne mesothelioom komt in Zuid Oost Engeland onder mannen 5 keer vaker voor dan onder vrouwen, het meest onder mannen tussen de 70 en 80 jaar. In de periode 1985-2002 is de incidentie gestegen met 4% per jaar. De ziekte komt vooral voor in gebieden waar in het verleden met asbest is gewerkt, bijvoorbeeld langs de rivier de Theems. Mensen die een gecombineerde behandeling van operatie en chemotherapie hadden gehad overleefden vaker langer dan vijf jaar dan degenen die uitsluitend é.é.n vorm van behandeling hadden gehad of andere combinaties van behandelingen. Bron: Mak, V. et al., (2007). The epidemiology and treatment of mesothelioma in South East England 1985-2002. Thorax online, 3 aug 2007. doi:10.1136/thx.2006.066886.
Mak, V. et al., (2007). The epidemiology and treatment of mesothelioma in South East England 1985-2002. Thorax online, 3 aug 2007. doi:10.1136/thx.2006.066886.
Abstract
Objectives
To describe trends in the incidence of mesothelioma for men and women in South East England and the geographical variation at the level of primary care trust. To describe treatment patterns by cancer network of residence, and relative survival by cancer
network, disease stage and treatment modality.
Methods
5753 cases were extracted from the Thames Cancer Registry database. We calculated age-standardised incidence rates for each year, age-specific incidence rates in 10 year age groups, and we used linear regression to compute the average annual percentage change in age-standardised incidence. We used Poisson regression to analyse generational trends in incidence.
Results
The incidence of mesothelioma was five times higher in men than in women. In men, there was an overall 4% increase per year between 1985 and 2002. Over the same period, the overall increase in incidence for women was 5% per year. The incidence was highest
in men aged over 70 years and men aged over 80 years had the highest increase of 8% per year. The incidence rate ratio increased for men born between 1892 and 1942 and started to slow for those born from 1947 onwards. Areas along the Thames and its estuary had the highest incidence. There was some variation by cancer network in the proportion of patients receiving cancer surgery, radiotherapy and chemotherapy. There were no
discernable difference in relative survival by cancer network of residence or disease stage but those receiving combined treatment had a higher 5-year survival.
Conclusions
Mesothelioma incidence has increased in South East England, particularly for men aged over 70 years. The highest incidence occurs along the Thames and its estuary reflecting areas of asbestos use in shipbuilding and industry in the past. More research is needed to understand the interrelationships of prognostic factors, treatment choices, and survival
and to determine the best care and support for these patients and their families.