Despite predictions of decline in mesothelioma following the ban of asbestos in most industrial countries, the incidence is still increasing globally, particularly in women. Because occupational exposure to asbestos is the main cause of mesothelioma, it occurs four- to eightfold more frequently in men than women, at a median age of 74 years. When mesothelioma is due to an environmental exposure, the M:F sex ratio is 1:1 and the median age at diagnosis is ~60 years. Studying environmental risk of mesothelioma is challenging because of the long latency period and small numbers, and because this type of exposure is involuntary and unknown. Individual-based methods cannot be used, and new approaches need to be found. To better understand the most recent trends of mesothelioma in the United States, all mesothelioma deaths reported to the Centers for Disease Control and Prevention (CDC) during 1999-2010 were analyzed. Among all mesothelioma deaths in the United States, the 1920s birth cohort significantly predominated, and the proportion of younger cohorts constantly decreased with time, suggesting a decline in occupational exposure in these cohorts. The M:F mesothelioma sex ratio fell with time, suggesting an increased proportion of environmental cases. Environmental exposures occur in specific geographic areas. At the large scale of a state, mesotheliomas related to environmental exposure are diluted among occupational cases. The spatial analysis at a smaller scale, such as county, enables detection of areas with higher proportions of female and young mesothelioma cases, thus indicating possible environmental exposure, where geological and environmental investigations need to be carried out.

中文翻译：

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美国间皮瘤的环境风险：流行病学问题。

尽管在大多数工业化国家中，石棉禁令后间皮瘤的发病率预计会下降，但全球发病率仍在上升，特别是在女性中。由于职业性接触石棉是间皮瘤的主要原因，因此男性的发病率是女性的四到八倍，中位年龄为74岁。当间皮瘤是由于环境暴露引起时，M：F性别比为1：1，诊断时的中位年龄为〜60岁。研究间皮瘤的环境风险具有挑战性，因为潜伏期长且数量少，并且由于这种暴露是非自愿的并且是未知的。不能使用基于个人的方法，因此需要找到新的方法。为了更好地了解美国间皮瘤的最新趋势，分析了1999-2010年间报告给疾病控制与预防中心（CDC）的所有间皮瘤死亡病例。在美国所有间皮瘤死亡中，1920年代出生的队列明显占主导地位，年轻队列的比例随时间不断减少，这表明这些队列的职业暴露水平下降。M：F间皮瘤性别比随时间下降，表明环境病例的比例增加。环境暴露发生在特定的地理区域。在一个州的大规模情况下，与环境暴露相关的间皮瘤在职业病例中被稀释。通过较小规模的空间分析（例如县级分析），可以检测出女性和年轻间皮瘤病例所占比例较高的区域，从而表明可能存在环境暴露，