Detailed mapping of mesothelioma cases in Denmark to identify areas with elevated risk: a nationwide population-based study
本研究将丹麦胸膜间皮瘤病例精确到教区级别，识别出5个高风险区域，这些区域靠近曾使用石棉的工业区，对公共卫生和职业暴露研究有参考价值。
OBJECTIVES: Previous studies mapping pleural mesothelioma in Denmark have found that the risk varies between Danish regions. However, evaluating disease risk for such relatively large geographical units ignores any heterogeneity within the unit and can thus diminish more local spikes in risk, missing smaller areas of excess risk. In this study, we examined the distribution of pleural mesothelioma in Denmark on an unprecedented detailed scale, mapping cases to each of the Danish parishes. METHODS: We identified individuals diagnosed with pleural mesothelioma between 1990 and 2021 in the Danish Cancer Registry. Considering age- and sex-standardized incidence rate ratios (IRR), we used a conditional autoregressive random effects model to smooth IRR across parishes. Parishes with a smoothed parish-to-national IRR >1.25 or >2.0 with a posterior probability of >95% were flagged as parishes with an excess risk of pleural mesothelioma. RESULTS: We identified 3105 incident cases of pleural mesothelioma in the study period. A total of 74 and 14 parishes were flagged with IRR significantly above 1.25 and 2.0, respectively. These parishes had posterior mean smoothed IRR of 1.82-4.13. CONCLUSIONS: We provided a detailed mapping of pleural mesothelioma cases in Denmark and found five distinct areas, each covering several parishes, with a significantly elevated risk. All these areas were in the proximity of previous asbestos-using industries.