Incidence and asbestos exposure of malignant mesothelioma in the North Italian Region

This study aims to describe the incidence of malignant mesothelioma (MM) in the period 1996-2022 and report the related exposure to asbestos. The study includes all cases of MM with a certain or a probable diagnosis (with microscopic confirmation) and possible cases (without microscopic confirmation) collected by the Regional Mesothelioma Registry (ReM) which represents one of the 21 CORs (Regional Operational Centers) in Italy.
For each case, information on age, sex, tumor site, morphology, date of diagnosis, follow-up, and province of residence was collected. Data on previous occupational and non-occupational exposure to asbestos, by type of sector and activity, was also collected through an analytical questionnaire, administered to the patient or his closest relatives.
Between 1996 and 2022 were registered, 3,357 cases of MM classified as certain (2,870 cases, 85.5%), probable (174 cases, 5.2%), and possible cases (313 cases, 9.2%). The greatest number of cases were recorded for the pleura (3,081) and the peritoneum (245). The province of Bologna (741 cases), Reggio Emilia (508 cases), Parma (390 cases), and Modena (370 cases) recorded the highest number of cases, most of them were registered at age 75+ (1,575 cases).
Concerning exposure, 70.5% were defined as professional, 5.9% familiar, 2.2% as environmental, and 1.4% as extra professional. The majority of males had occupational exposure (83.3%) in comparison with 34.3% of women, who showed also family exposure in 20.3% of cases.
Bologna confirms the primacy for professional and environmental exposure cases, Reggio Emilia for familiar, and Parma and Bologna for extra-professional exposure.

This paper provides 27 years of information on MM diagnosis and asbestos exposure, by age, sex, and province of residence.

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