Abstract
Objective: Hungary has one of the highest incidences and mortality rates of lung cancer (LC), therefore the objective of this study was to analyse and compare LC incidence and mortality rates between the main Hungarian regions.Methods: This nationwide, retrospective study used data from the National Health Insurance Fund and included patients aged ≥20 years who were diagnosed with lung cancer (ICD-10 C34) between Jan 1, 2011 and Dec 31, 2016. Age-standardized incidence and mortality rates were calculated and compared for the main regions.Results: The highest incidence rate in males was recorded in Northern Hungary (146.8/100,000 person-years [PY]), while the lowest rate was found in Western Transdanubia (94.7/100,000 PY in 2011). All rates showed a declining trend between 2011 and 2016, with the largest decrease in the Northern Great Plain (−20.0%; p = 0.008). LC incidence and mortality rates in women both showed a rising tendency in all regions of Hungary, reaching the highest in Central Hungary (59.86/100,000 PY in 2016). Lung cancer incidence and mortality rates in males correlated with the level of education and smoking prevalence (p = 0.006 and p = 0.01, respectively) in the regions. A correlation with GDP per capita and Health Development Index (HDI) index could also be observed in the Hungarian regions, although these associations were not statistically significant. No correlations could be detected between these parameters among females.Conclusion: This analysis revealed considerable differences in the epidemiology of LC between the 7 main Hungarian regions. LC incidence and mortality rates significantly correlated with smoking and certain socioeconomic factors in men, but not in women. Further research is needed to explain the regional differences.
Highlights
Lung cancer (LC) accounts for almost 1 in 5 cancer-related deaths and is a leading cause of cancer worldwide, including Eastern Europe [1]
We aimed to investigate whether there was a correlation between the incidence and mortality of LC and Gross Domestic Product (GDP) per capita, levels of income and education, Health Development Index (HDI) and smoking prevalence in the seven main Hungarian regions
Male LC incidence showed a declining trend between 2011 and 2016, and the largest and significant decrease in incidence was detected in the Northern Great Plain (−20.0%; 95% CI: −36.7 to −8.6; p 0.008)
Summary
Lung cancer (LC) accounts for almost 1 in 5 cancer-related deaths and is a leading cause of cancer worldwide, including Eastern Europe [1]. Despite the leading LC rates reported in previous publications, results from a recent retrospective study suggest that Hungarian LC incidence and mortality rates are high, they are likely to be lower than previously described. The report showed a decrease in the age-adjusted incidence rate of LC in Hungary from 115.7 to 101.6/100,000 PY in men, and an increase from 48.3 to 50.3/100,000 SPYs in women between 2011 and 2016 (using ESP1976) [3]. The differences between previous reports could be attributed to the use of different data sources: while earlier studies used WHO GLOBOCAN annual reports which received mortality data from the Hungarian Central Statistical Office (CSO), this recent study gathered more accurate data on LC incidence and mortality among patients with LC from the comprehensive Hungarian National Health Insurance Fund (NHIF) database
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