ONKOLOŠKI INŠTITUT LJUBLJANA EPIDEMIOLOGIJA IN REGISTER RAKA ZALOŠKA 2, 1000 LJUBLJANA INCIDENCA RAKA NA DRAVSKEM POLJU Geografska analiza incidence raka na Dravskem polju s poudarkom na občini Rače-Fram in okoliških naseljih Zaključno poročilo Ljubljana, februar 2019 Raziskava INCIDENCA RAKA NA DRAVSKEM POLJU Geografska analiza incidence raka na Dravskem polju s poudarkom na občini Rače-Fram in okoliških naseljih Zaključno poročilo Naročnik ODVETNICA VESNA GORJUP ZUPANČIČ, Ulica škofa Maksimilijana Držečnika 11, 2000 Maribor Izvajalci ONKOLOŠKI INŠTITUT LJUBLJANA, EPIDEMIOLOGIJA IN REGISTER RAKA Sonja Tomšič, dr. med., specialistka javnega zdravja izr. prof. dr. Vesna Zadnik, dr. med., specialistka javnega zdravja Katarina Lokar, prof. zdr. vzg. dr. Tina Žagar, univ. dipl. fiz. Tjaša Kovačević, dipl. mat. doc. dr. Andreja Kukec, dipl. san. inž. Tanja Rejc, dipl. san. inž. Jona Blatnik, dr. dent. med. Gradivo ni lektorirano. 2 Kazalo SEZNAM SLIK IN PREGLEDNIC ........................................................................................................................... 5 POVZETEK ........................................................................................................................................................ 9 ABCTRACT ...................................................................................................................................................... 11 UVOD ............................................................................................................................................................. 13 DEJAVNIKI TVEGANJA RAKA ........................................................................................................................... 14 ONESNAŽEVALA NA DRAVSKEM POLJU .......................................................................................................... 16 ONESNAŽENOST TAL ............................................................................................................................................... 18 ONESNAŽENOST ZRAKA ........................................................................................................................................... 19 ONESNAŽENOST VODE – PODTALNICA ........................................................................................................................ 20 ONESNAŽENOST VODE – ODPADNE VODE.................................................................................................................... 23 GLIFOSAT IN POVEZAVA Z RAKOM ................................................................................................................. 24 OCENJEVANJE BREMENA RAKA ...................................................................................................................... 32 PODATKI REGISTRA RAKA RS .................................................................................................................................... 32 KAZALNIKI BREMENA RAKA ....................................................................................................................................... 32 PROSTORSKO RAZPOREJANJE RAKA ............................................................................................................................ 33 POSTOPEK ANALIZE ........................................................................................................................................ 34 POJAVLJANJE RAKA V PODRAVSKI REGIJI ....................................................................................................... 39 NAJPOGOSTEJŠI RAKI .............................................................................................................................................. 41 Rak debelega črevesa in danke .................................................................................................................... 42 Nemelanomski kožni rak .............................................................................................................................. 45 Pljučni rak ..................................................................................................................................................... 48 Rak dojk ........................................................................................................................................................ 51 Rak prostate ................................................................................................................................................. 54 RAKI, KATERIH NASTANEK JE LAHKO POVEZAN Z IZPOSTAVLJENOSTJO ONESNAŽEVALOM NA DRAVSKEM POLJU .......................... 57 Jetrni rak ....................................................................................................................................................... 57 NeHodgkinovi limfomi .................................................................................................................................. 60 Levkemije ...................................................................................................................................................... 63 Ledvični rak in rak ledvičnega meha ............................................................................................................. 66 RAZLIKE V POJAVLJANJU RAKA ZNOTRAJ PODRAVSKE REGIJE ........................................................................ 69 NAJPOGOSTEJŠI RAKI .............................................................................................................................................. 72 Rak debelega črevesa in danke .................................................................................................................... 72 Nemelanomski kožni rak .............................................................................................................................. 74 Pljučni rak ..................................................................................................................................................... 76 Rak dojk ........................................................................................................................................................ 78 Rak prostate ................................................................................................................................................. 80 RAKI, KATERIH NASTANEK JE LAHKO POVEZAN Z IZPOSTAVLJENOSTJO ONESNAŽEVALOM NA DRAVSKEM POLJU .......................... 82 Jetrni rak ....................................................................................................................................................... 82 NeHodgkinovi limfomi .................................................................................................................................. 84 Levkemije ...................................................................................................................................................... 86 Ledvični rak in rak ledvičnega meha ............................................................................................................. 88 RAZLIKE V POJAVLJANJU RAKA NA DRAVSKEM POLJU ................................................................................... 90 NAJPOGOSTEJŠI RAKI .............................................................................................................................................. 93 Rak debelega črevesa in danke .................................................................................................................... 93 3 Nemelanomski kožni rak .............................................................................................................................. 95 Pljučni rak ..................................................................................................................................................... 97 Rak dojk ...................................................................................................................................................... 100 Rak prostate ............................................................................................................................................... 102 RAKI, KATERIH NASTANEK JE LAHKO POVEZAN Z IZPOSTAVLJENOSTJO OKOLJSKIM ONESNAŽEVALOM NA DRAVSKEM POLJU ......... 104 Jetrni rak ..................................................................................................................................................... 104 NeHodgkinovi limfomi ................................................................................................................................ 106 Levkemije .................................................................................................................................................... 108 Ledvični rak in rak ledvičnega meha ........................................................................................................... 110 ZAKLJUČEK ................................................................................................................................................... 112 Ugotovitve .................................................................................................................................................. 112 Sklepi .......................................................................................................................................................... 113 LITERATURA ................................................................................................................................................