我们的目的是使用一种新颖的方法来估计意大利伦巴第地区因石棉暴露而导致的卵巢癌死亡比例，该方法利用了卵巢癌石棉暴露与胸膜癌和其他乳腺癌风险因素相关的事实。这项生态研究基于意大利国家统计研究所的死亡率数据。我们制定了三变量贝叶斯关节疾病模型，根据 2000 年至 2018 年各市级卵巢癌、胸膜癌和乳腺癌死亡率的地理分布，估计归因于石棉暴露的卵巢癌死亡的归因分数 (AF) 和人数。 预期死亡并使用区域比率计算标准化死亡率。我们发现卵巢癌和胸膜癌之间存在共同的依赖性，捕获了两种疾病共同的风险因素（石棉暴露），并且卵巢癌和乳腺癌之间共享空间结构的聚类成分，捕获了其他风险因素。基于 10 462 例卵巢癌死亡，我们估计其中 574 例（95% 可信区间 388-819）可归因于石棉（AF 5.5%；95% 可信区间 3.7-7.8）。在一些已知石棉污染严重的城市，AF 达到 34%-47%。石棉对卵巢癌发生的影响可能是相关的，特别是在石棉暴露量高的地区。只有使用高级贝叶斯模型来考虑卵巢癌的其他危险因素，才能估计归因病例。这些发现有助于制定公共卫生监测计划以及实施补偿和预防政策。© 作者（或其雇主）2024。根据 CC BY-NC 允许重复使用。禁止商业再利用。请参阅权利和权限。英国医学杂志出版。

We aimed to estimate the fraction of deaths from ovarian cancer attributable to asbestos exposure in Lombardy Region, Italy, using a novel approach that exploits the fact that ovarian cancer asbestos exposure is associated with pleural cancer and other risk factors for breast cancer.This ecological study is based on the Italian National Institute of Statistics mortality data. We formulate a trivariate Bayesian joint disease model to estimate the attributable fraction (AF) and the number of ovarian cancer deaths attributable to asbestos exposure from the geographic distribution of ovarian, pleural and breast cancer mortality at the municipality level from 2000 to 2018. Expected deaths and standardised mortality ratios were calculated using regional rates.We found shared dependencies between ovarian and pleural cancer, which capture risk factors common to the two diseases (asbestos exposure), and a spatially structured clustering component shared between ovarian and breast cancer, capturing other risk factors. Based on 10 462 ovarian cancer deaths, we estimated that 574 (95% credibility interval 388-819) were attributable to asbestos (AF 5.5%; 95% credibility interval 3.7-7.8). AF reaches 34%-47% in some municipalities with known heavy asbestos pollution.The impact of asbestos on ovarian cancer occurrence can be relevant, particularly in areas with high asbestos exposure. Estimating attributable cases was possible only by using advanced Bayesian modelling to consider other risk factors for ovarian cancer. These findings are instrumental in tailoring public health surveillance programmes and implementing compensation and prevention policies.© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.