Cancer In Poland Research Articles

Physical activity, screening cancer, and savings rate as indicators of health responsibility

Introduction: The health of individuals can change gradually over time as a result of the choices they make. Aim: The study aimed to examine indicators such as physical activity levels, screening participation, and household savings in the context of their role as potential measures of individual health responsibility. The second aim was to identify cognitive barriers and motivations influencing physical activity, breast and cervical cancer screening participation, and money-saving habits. Material and methods: The analysis used available data on physical activity, the screening level (for breast and cervical cancer), and household savings rates. Then, the data for Poland were presented against the background of available averages for the European Union. The data came from Eurostat, Eurobarometer - the official survey instrument used by the European Parliament. Results: According to Eurobarometer data, 65% of respondents in Poland have never been physically active in 2022 (vs in the European Union 45%). In 2022, the percentage of women who were screened for cervical cancer in Poland was 34% of women. And the cervical cancer program (cytology) was used by 10.9% of people. In 2022, the household saving rate was 12.7 % in the EU, and in Poland -2.89%, where the lowest rate occurred in Greece and the highest in Germany (Eurostat data). Conclusion: The low level of physical activity and participation in screening tests in Poland, compared to EU countries, highlights the need to intensify public health promotion activities. Additionally, promoting saving as an important element of health responsibility can not only improve the financial well-being of citizens but also have a positive impact on their mental health.

Changing Clinical Presentation of Pediatric Differentiated Thyroid Cancer in Poland: A Retrospective Cohort Study Spanning 45 Years.

Background: Differentiated thyroid carcinoma (DTC) in children is uncommon; clinical presentation over recent decades is incompletely characterized. Methods: This retrospective cohort study analyzed demographic and disease characteristics of consecutive juveniles with DTC treated from 1970 to 2015 at Poland's largest pediatric DTC referral center, Maria Sklodowska-Curie National Research Institute of Oncology, Gliwice, who had available records. Sex, age, histopathological characteristics, and DTC stage were documented. We aimed to identify changes in these variables over time and independent risk factors for lymph node or distant metastases. Trends in these variables were assessed using the Cochran-Armitage test and Spearman correlation. Multivariable logistic regression was performed to identify risk factors associated with lymph node or distant metastases. Results: 475 of 479 patients (99.2%) were included in the analysis; roughly half were age ≥15 years, 10%, <10 years. Papillary thyroid carcinoma (PTC) represented 88% of cases and follicular thyroid carcinoma (FTC) 11%. Tumors ≤2 cm constituted 56% of cases with relevant data; those >4 cm accounted for 12%. Multifocality was observed in 37% and extrathyroidal invasion in 22%. Lymph node metastases were noted in 59% and distant metastases in 16%. Over the observation period, significant trends among new cases included: increased proportion of adolescents >15 years; increased frequency of tumors ≤2 cm, decreased multifocality rates, and increased proportion of PTC versus FTC. Extrathyroidal invasion rates remained appreciable throughout, ranging from 17 to 28% during the 5-year study subperiods after 1990. Lymph node metastases significantly increased in frequency in the central neck, remaining consistently common in lateral sites; presence of distant metastases significantly decreased. In multivariable analysis, multifocality, extrathyroidal invasion, and tumor size were independently associated with lateral lymph node metastases and multifocality, larger tumor size, and N1b metastases with distant spread. Conclusions: Our observations of a rising proportion of diagnoses in adolescence, reductions in primary tumor size, and decreased frequency of multifocality and distant metastases may reflect increased detection of patients with less aggressive DTC at earlier disease stages. Nonetheless, we found persistently substantial rates of locoregionally advanced disease features (multifocality, extrathyroidal invasion, and lymph node metastases), which multivariable analyses suggested have significant associations with lateral lymph node and/or distant metastases.

PECULIARITIES OF ORAL CANCERS IN POLAND - A REVIEW OF THE LITERATURE

Oral cancers are seen frequently. By 2040, according to the Global Cancer Observatory (GCO), their number will increase by around 40%. Exposure to alcohol, tobacco smoke, human papillomavirus (HPV) or a diet low in fibre is often part of everyday life, which is a risk factor for developing oral cancer. The most common of these is oral squamous cell carcinoma. The most common treatment is primary surgical resection with or without postoperative adjuvant therapy. In addition, various combination therapies including chemotherapy with radiotherapy or immunotherapy are used. Oral cancers are usually detected early but delayed treatment can lead to a bad prognosis and require facial reconstructive surgery. Aim: The aim of the publication was to bring together the latest information on oral cancer in Poland. We wanted to present the division, the most commonly observed symptoms and the proposed treatment. Methods: Analysis of information on oral cancer using PubMed sources, including classification of cancer types, symptoms and possible treatments. Conclusions: Oral cancers are a common problem for the population of Poland. Their incidence is likely to increase over the next decade. The environment, lifestyle and diet have a key influence on their formation. The most common treatment is their resection combined with radiation therapy, chemotherapy or immunotherapy.

Epidemiology of penile cancer in Poland compared to other European countries.

To examine the epidemiology of penile cancer in Poland compared to other European countries. Incidence and mortality data were acquired from the national cancer registries in Europe and WHO Mortality Database, respectively. The data are presented as age-standardised morbidity and mortality rates, calculated according to the standard population of the world. We utilised Joinpoint analysis to assess the trends in morbidity and mortality and calculated the average rate of increase or decrease (Annual Percentage Change, Average Annual Percentage Change). Additionally, we estimate the proxy survival rates for each country. Our study is the first to cover the incidence of penile cancer in many European countries and estimates an approximate survival rate for large populations, which is rarely cited in the literature. The 40+ age group presented graphically in the article covered more than 90% of penile cancer cases and deaths. In the countries examined, there was an excess of deaths over incidence in the oldest age groups (75 years or older). Poland had intermediate incidence and mortality rates. Unlike many European countries, Poland is witnessing an increasing trend of penile cancer mortality. The higher death toll among those aged 75 years or older may suggest a lack of recognition of cancer symptoms and inadequate attention to elderly patients by the healthcare system. There is also evidence of underreporting penile cancer cases. Establishing centralised healthcare systems for rare cancers is a commendable development that should be emulated by other European countries, including Poland.

Cardiovascular risk factors and cardiovascular diseases in patients with newly diagnosed most common cancers in Poland. Preliminary data from the CONNECT-POL registry.

Cardiovascular risk factors and cardiovascular diseases in patients with newly diagnosed most common cancers in Poland. Preliminary data from the CONNECT-POL registry.

Cervical cancer in Poland — epidemiology, prevention, and treatment pathways

Cervical cancer in Poland — epidemiology, prevention, and treatment pathways

Disability, quality of life and emotional problems within a few days after surgery in patients operated due to colorectal cancer in Poland

Disability, quality of life and emotional problems within a few days after surgery in patients operated due to colorectal cancer in Poland

The epidemiology of the most frequent cancers in Poland in 2015–2021 and the impact of the COVID-19 pandemic on cancer incidence

BackgroundThe late diagnosis, despite the improving availability and accessibility of diagnostic procedures during the last decade in Poland and cooperation between specialist cancer centres, remains an unsolved problem. Moreover, the accessibility to healthcare resources and diagnostic procedures has been drastically reduced because of the COVID-19 pandemic in 2019–2020. The study aimed to present the epidemiology of the most frequent cancers diagnosed in Poland as well as the impact of the COVID-19 pandemic on cancers’ incidence.MethodsDepersonalized, epidemiological data was obtained from the National Health Fund of Poland. In this retrospective study, the epidemiological analysis was performed and divided into subregions, according to patients’ domicile. For each of the subregions, we have calculated the incidence rate per 100,000 standardized to the European Standard Population 2013. The time points of providing the first healthcare service were considered as the time of cancer diagnosis.ResultsIn the 2015–2019 period, before the COVID-19 pandemic occurred, the nationwide incidence of analysed cancers remained stable or slightly decreased (as the lung cancer). Simultaneusly, during the same period the prevalence of the prostate cancer has increased and the large differences between subregions with the least and the highest incidence were observed. Subsequently, the incidences of all analyzed cancers decreased in 2020, compared to the period before the COVID-19 pandemic occurred. Then, in 2021 a disproportionate increase in cancers’ incidence rates was noted.ConclusionsOur results show a significant decrease in the incidence rate of the most frequent cancers diagnosed in Poland in 2020 compared to 2019. Subsequently, in 2021 the increase of the incidence ratios was noted, most likely due to the gradual reduction of epidemic restrictions.

Neurological Paraneoplastic Syndromes in most Common Cancers in Poland

INTRODUCTION: Paraneoplastic Neurological Syndromes (PNS) represent a heterogeneous group of diseases associated with the presence of neoplasm. The appearance of PNS can precede cancer diagnosis. The estimated frequency amongst cancer patients is about 1%. Malignant tumors represent a serious health problem and are the second leading cause of death in Poland. The aim of this study is to collect information about PNS focusing on cancers mostly diagnosed in Polish adults. REVIEW METHODS: The analysis was conducted based on information regarding PNS gathered from PubMed and Google Scholar within the context of selected cancers. THE STATE OF KNOWLEDGE: PNS develop from an autoimmune reaction in which onconeural antibodies are produced. The recent classification divides PNS to high risk, indicating a likely paraneoplastic origin and intermediate risk, if this association is less evident. Diagnosis is difficult and usually relies on exclusion methods. The symptoms described are non-specific and the diagnostic process may require the involvement of various specialists. The main approaches include cancer treatment, especially tumor removal and immunotherapy, which in certain may prove to be effective. SUMMARY: Although PNS is relatively rare, its detectability has recently increased. Many syndromes are especially associated with lung cancer (mainly small cell carcinoma). Breast and prostate cancers have also shown associations with certain syndromes. They can present with nonspecific symptoms related to different organ systems. Awareness and understanding of this phenomenon can be helpful amongst many specialists.

Estrogen Receptor (ER) and Progesterone Receptor (PgR) Expression in Endometrial Cancer—An Immunohistochemical Assessment

Endometrial cancer (EC) is one of the most common types of cancer in Poland and worldwide. Many risk factors lead to the pathogenesis of this disease, such as lifestyle choices, BMI, the medicines used in breast cancer therapy, and Lynch syndrome. EC cells show the expression of estrogen receptors (ERs) and progesterone receptors (PgR). These receptors occur in multiple isoforms and have a significant influence on the operation of cells. The loss of ER and PgR expression is associated with a poor prognosis. We assessed tissue slides that were obtained from 103 women with EC diagnoses of various grades, stages, and histological types. In this study, we used computer image analyses to increase the objectivity of the assessment. We proved that, in the tissue of patients with high-grade (G3) EC, the expression of PgR is significantly lower than that in the tissues of patients with low-grade EC. We also observed that PgR is significantly expressed in EC with a low FIGO stage and in the endometroid type of EC (which rarely becomes malignant compared to serous type). The expression of ERb1 was lower in patients with EC at the IV FIGO stage than in patients with stage III EC. These findings confirm that the loss of ER and PgR expression is connected with a poor prognosis.

Breast cancer in Poland – the urgent need for effective prevention

Breast cancer in Poland – the urgent need for effective prevention

Geographical disparities in survival rates for urological cancers in Poland from 2000 to 2015

Geographical disparities in survival rates for urological cancers in Poland from 2000 to 2015

Colorectal Cancer: Is it Still a Disease of the Elderly?

&lt;b&gt;&lt;br&gt;Introduction:&lt;/b&gt; Colorectal cancer is becoming an increasingly significant health issue, being one of the more commonly diagnosed malignancies. Colorectal tumors account for 10% of all malignant cancers in women and 12% in men. Incidence is higher in the male population, especially among younger individuals. It is commonly believed that colorectal cancer is predominantly associated with advanced age. However, colorectal surgeons, who specialize in the treatment of this type of cancer, are observing a growing number of cases among middle-aged and younger individuals.&lt;/br&gt; &lt;b&gt;&lt;br&gt;Aim:&lt;/b&gt; The aim of our study was to investigate whether colorectal cancer still predominantly affects elderly individuals, how frequently it is diagnosed in younger patients, and whether the location of tumors in the intestines of younger patients aligns with data from elderly individuals.&lt;/br&gt; &lt;b&gt;&lt;br&gt;Materials and methods:&lt;/b&gt; The study was conducted retrospectively and included a cohort of 1771 patients who underwent surgical procedures due to colorectal cancer between 2012 and 2015 at the Department of General and Colorectal Surgery at the Medical University of Łódź and between 2014 and 2017 at the Department of General Surgery with a Division of Surgical Oncology at the District Health Center in Brzeziny. Data were analyzed regarding the frequency of colorectal cancer occurrence by age, tumor location in different age groups, and disease stage according to age. Age groups included &lt;40 years, 41-50 years, 51-70 years, and &gt;70 years.&lt;/br&gt; &lt;b&gt;&lt;br&gt;Results:&lt;/b&gt; The study encompassed a total of 1771 patients, with 988 (55.79%) being males and 783 (44.21%) females. The mean age of the patients was 65.27 11.12 years. The highest number of cases was observed in the age range of 60-70 years and 70-80 years. It was found that colorectal tumors in males more frequently occurred on the left side of the colon and rectum, while in females, they were more commonly located on the right side of the colon, which was statistically significant (P = 0.007). Younger age groups of patients (&lt;40 years, 40-50 years) had a similar male-to-female ratio, whereas in age groups above 50 years, males significantly outnumbered females (P = 0.049). The study revealed that in the group of patients below 40 years of age, an advanced stage of colorectal cancer was significantly more common; stage D occurred over twice as often as in the 51-70 age group and over three times as often as in the &gt;70 age group.&lt;/br&gt; &lt;b&gt;&lt;br&gt;Conclusions:&lt;/b&gt; The incidence of colorectal cancer in Poland is steadily increasing, with a growing number of diagnoses in younger individuals. Research findings demonstrate that males, especially those in younger age groups, are at a higher risk of developing colorectal cancer. A higher disease stage is more frequently observed in younger patients, possibly due to delayed diagnosis and symptomatic treatment. Screening programs should be adjusted to the changing age groups at higher risk. Our study underlines the need to raise public awareness regarding colorectal cancer, particularly among the younger population.&lt;/br&gt.

Real-life data of abiraterone acetate and enzalutamide treatment in post-chemotherapy metastatic castration-resistant prostate cancer in Poland.

Abiraterone acetate (ABI) and Enzalutamide (ENZA) are second-generation hormone drugs that show breakthrough activity in post-chemotherapy, metastatic castration-resistant prostate cancer (mCRPC). The leading oncological and urological guidelines indicate both drugs with the same strong recommendation. There is a lack of randomized trials which compare the efficacy of ABI and ENZA. The current study aimed to compare the effectiveness of the drugs with an analysis of prognostic factors related to those drugs. The study included 420 patients with docetaxel (DXL) pretreated mCRPC from seven Polish cancer centers. Patients were treated according to inclusion and exclusion criteria in the Polish national drug program (1000 mg ABI and 10 mg prednisone, n=76.2%; ENZA, 160 mg; n=23.8%). The study retrospectively analyzed the overall survival (OS), time to treatment failure (TTF), PSA 50% decline rate (PSA 50%) and selected clinic-pathological data. In the study group, the median OS was 17 months (95% CI: 15.6-18.3). The median OS (26.1 vs. 15.7 mo.; p<0.001), TTF (14.2 vs. 7.6 mo.; p<0.001) and PSA 50% (87.5 vs. 56%; p<0.001) were higher in ENZA than in ABI treatment. Multivariate analysis shows that ENZA treatment and PSA nadir <17.35 ng/mL during or after DXL treatment were related to longer TTF. ENZA treatment, DXL dose ≥750 mg, PSA nadir <17.35 ng/mL during or after DXL treatment was related to longer OS. ENZA treatment may be related to more favorable oncological outcomes than ABI treatment in the studied Polish population of patients. A 50% decline in PSA is an indicator of longer TTF and OS. Due to the non-randomized and retrospective nature of the analysis, the current results require prospective validation.

Treatment Patterns, Testing Practices, and Outcomes in Patients with EGFR Mutation-Positive Advanced Non-Small-Cell Lung Cancer in Poland: A Descriptive Analysis of National, Multicenter, Real-World Data from the REFLECT Study.

Non-small-cell lung cancer (NSCLC) represents 85% of new cases of lung cancer. Over the past two decades, treatment of patients with NSCLC has evolved from the empiric use of chemotherapy to more advanced targeted therapy dedicated to patients with an epidermal growth factor receptor (EGFR) mutation. The multinational REFLECT study analyzed treatment patterns, outcomes, and testing practices among patients with EGFR-mutated advanced NSCLC receiving first-line EGFR tyrosine kinase inhibitor (TKI) therapy across Europe and Israel. The aim of this study is to describe the Polish population of patients from the REFLECT study, focusing on treatment patterns and T790M mutation testing practice. A descriptive, retrospective, non-interventional, medical record-based analysis was performed on the Polish population of patients with locally advanced or metastatic NSCLC with EGFR mutations from the REFLECT study (NCT04031898). A medical chart review with data collection was conducted from May to December 2019.The study involved 110 patients. Afatinib was used as the first-line EGFR-TKI therapy in 45 (40.9%) patients, erlotinib in 41 (37.3%), and gefitinib in 24 (21.8%) patients. The first-line EGFR-TKI therapy was discontinued in 90 (81.8%) patients. The median progression-free survival (PFS) on first-line EGFR-TKI therapy was 12.9 months (95% CI 10.3-15.4). A total of 54 patients started second-line therapy, of whom osimertinib was administered to 31 (57.4%). Among 85 patients progressing on first-line EGFR-TKI therapy, 58 (68.2%) were tested for the T790M mutation. Positive results for the T790M mutation were obtained from 31 (53.4%) tested patients, all of whom received osimertinib in the next lines of therapy. The median overall survival (OS) from the start of first-line EGFR-TKI therapy was 26.2 months (95% CI 18.0-29.7). Among patients with brain metastases, the median OS from the first diagnosis of brain metastases was 15.5 months (95% CI 9.9-18.0). The results of the Polish population from the REFLECT study highlight the need for effective treatment of patients with advanced EGFR-mutated NSCLC. Nearly one-third of patients with disease progression after first-line EGFR-TKI therapy were not tested for the T790M mutation and did not have the opportunity to receive effective treatment. The presence of brain metastases was a negative prognostic factor.

Modelling benzo(a)pyrene concentrations for different meteorological conditions – Analysis of lung cancer cases and associated economic costs

Air pollution originating from the household presents a significant burden to public health, especially during the wintertime in countries, such as Poland, where coal substantially contributes to the energy market. One of the most hazardous components of particulate matter is benzo(a)pyrene (BaP). This study focusses on the impact of different meteorological conditions on BaP concentrations in Poland and associated impacts on human health and economic burdens. For this study, we used the EMEP MSC-W atmospheric chemistry transport model with meteorological data from the Weather Research and Forecasting model to analyze the spatial and temporal distribution of BaP over Central Europe. The model setup has two nested domains, with the inner domain at 4 km × 4 km over Poland, which is a hotspot for BaP concentrations. The outer domain covers countries surrounding Poland in coarser resolution (12 × 812 km), to ensure that transboundary pollution is properly characterized in the modelling. We investigated the sensitivity to variability in winter meteorological conditions on BaP levels and impacts using data from 3 years: 1) 2018, which represents average meteorological conditions during the winter season (BASE run), 2) 2010 with a cold winter (COLD), and 3) 2020 with a warm winter (WARM). The ALPHA-RiskPoll model was used to analyze the lung cancer cases and associated economic costs. The results show that the majority of Poland exceeds the target level of benzo(a)pyrene (1 ng m−3) mainly due to high concentrations during the cold months. High concentrations of BaP have serious health implications and the number of lung cancers in Poland due to BaP exposure varies from 57 to 77 cases for the WARM and COLD years, respectively. It is reflected in the economic costs, which ranged from 136, through 174 to 185 million euros/year for the WARM, BASE and COLD model runs, respectively.

Abstract P6-05-47: Preimplantation genetic testing for BRCA gene mutation carriers - the future of health care in Poland?

Abstract Introduction Genetic background is rarely the cause of breast cancer incidence. Mutations in genes that increase the risk of breast cancer (most commonly BRCA1/2) are diagnosed in about 5-10% of patients. The lifetime risk of breast cancer in BRCA1/2 gene mutation carriers is 80%, and for ovarian cancer from 40-60%, while the chance of passing the mutation to offspring is 50%. The use of pre-implantation genetic testing (PGT-M) of the embryo during in vitro treatment prevents the transfer of mutated gene associated with an increased risk of cancer to the child. The significantly limited availability and high cost of PGT-M in Poland prevent its widespread use. The aim of the survey was to assess interest in PGT-M by female carriers of mutations in genes that increase cancer risk in Poland. Material and Methods The survey covered 103 persons, 102 with diagnosed mutations in genes that increase cancer risk. The questionnaire consisted of 22 questions regarding: age and gender of the patients, carriage of mutations in genes that increase the risk of cancer (age of mutation diagnosis, type of mutation, preventive measures taken, carriage of mutations in the family, incidence of cancer among relatives, and care of relatives during illness), and knowledge of pre-implantation diagnosis and attitudes regarding the use of PGT-M to avoid passing the defective gene to offspring. Results The study included 101 women (98.1%) and 2 men (1.9%), with a median age of 38 years (22-74). Fifty-two (50.5%) were diagnosed with cancer: 50 with breast cancer and 2 with ovarian cancer. Eighty-one subjects (78.6%) were diagnosed with a mutation in the BRCA1 gene, seventeen (16.5%) in the BRCA2 gene, three (2.9%) in the CHEK2 gene, two (1.9%) in the TP53 gene and one (1%) in the PALB gene. The median age of mutation diagnosis was 34 years (18-66). A significant proportion of patients took prophylactic measures, sixty-one (59.2%) underwent risk-reducing mastectomy (RRM), and forty-six (44.7%) risk-reducing salphingo-oophorectomy (RRSO). Ninety-five subjects (92.2%) declared regular visits to a genetic counseling center. Thirty-two persons (31.1%) had a family history of cancer (1-5 members in the family), mainly in 1st degree relatives – parents and siblings (about 60% of cases), the predominant cancers were breast cancer (106 cases), ovarian cancer (38 cases) and prostate cancer (7 cases); eighty-two family members died of cancer, seventy-five (72.8%) respondents accompanied family members in the dying process. Twenty-six individuals (25.2%) knew what PGT-M was, information was obtained from an oncologist (11), gynecologist (7), geneticist (6), other patients (6) and most often from the Internet (17). Seventy-four respondents (71.8%) had children. Thirty-three (32%) declared that information about carrying a mutation in a gene that increases cancer risk influenced their decision to have offspring. Sixty-eight (64.1%) of the respondents, with prior knowledge of PGT-M and with the availability of the method, would have used the diagnosis in combination with in vitro fertilization to avoid passing the defective gene to offspring. Fifty subjects (48.5%) were willing to cover the costs of this procedure. Conclusions PGT-M in combination with in vitro fertilization is a safe and effective method of preventing the transfer of a defective gene to offspring. Due to the lack of availability and high cost of the procedure, it is not available in daily clinical practice among carriers of mutations in genes that increase the risk of cancer in Poland. Their own incidence of cancer, multiple incidences in family members and involvement in the dying process may influence patients’ decisions to have offspring and motivate them to seek out centers offering PGT-M. The results of this survey indicate the need to offer pre-implantation testing to patients despite the lack of reimbursement and to increase its availability in Poland. Citation Format: Joanna Kufel-Grabowska, Amira Podolak, Mikołaj Bartoszkiewicz, Daniel Maliszewski, Dominika Ossowska, Robert Spaczynski. Preimplantation genetic testing for BRCA gene mutation carriers - the future of health care in Poland? [abstract]. In: Proceedings of the 2022 San Antonio Breast Cancer Symposium; 2022 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2023;83(5 Suppl):Abstract nr P6-05-47.

Delays in the diagnosis of lung cancer patients in Poland

Introduction. Lung cancer is the most common cause of death from malignant tumors in the world, with more than 2 million patients diagnosed every year. The most common symptoms of lung cancer are cough and shortness of breath. However, they appear late when the cancer is at an advanced stage. The standard measure of the correct diagnostic path in cancer patients is the time from the first symptoms of the disease to the final diagnosis. The aim of the study is to identify reasons for late diagnosis of patients with symptoms of lung cancer in Poland. Material and methods. We performed an analysis of a survey conducted among 149 patients with lung cancer from the Department of Pneumonology, Oncology and Allergology at the Medical University of Lublin. The SPSS software was used to perform the analysis of these data. Males accounted for 56.4% of the patients, and the median age of the patients was 66.8 ± 7.2 years. The mean time from the first symptoms to the first appointment with a doctor was 5.3 weeks and from the first symptoms to diagnosis was 14.7 weeks. Results. The time from the onset of symptoms and treatment initiation was significantly (p = 0.04) longer in patients living at a greater distance from cancer centers (24.1 weeks) than in patients living nearby (18.3 weeks). In patients who were treated with antibiotics before diagnosis, the time from the onset of the symptoms to the start of treatment was significantly longer (p = 0.003) than in patients who did not use antibiotics (26.8 weeks vs. 18.1 weeks). Conclusions. The results of our study showed that Polish patients with suspected lung cancer are diagnosed too late, which has an impact on the stage at which the tumor is diagnosed.

Changes in the survival of patients with breast cancer: Poland, 2000–2019

PurposeThe main aim of this study was to estimate breast cancer survival in Poland over the period from 2000 to 2019 in both sexes.MethodsData were obtained from the Polish National Cancer Registry. The presented metrics included age-standardized 5- and 10-year net survival (NS), median survival times, years of life lost (YLLs), and standardized mortality ratios (SMRs).ResultsBetween 2000 and 2019, 315,278 patients (2353 men and 312,925 women; male-to-female ratio 1/100) were diagnosed with breast cancer in Poland. In this period, 721,987 YLLs were linked to breast cancer. Women presented a higher 5- and 10-year age-standardized NS than men (5-year NS: 77.33% for women and 65.47% for men, P < 0.001, common language effect size (CL) 1.00; 10-year NS: 68.75% for women and 49.50% for men, P < 0.001, CL 1.00). Between the earliest and latest studied period, namely 2000–2004 and 2015–2019, there was a statistically significant increase only in female survival (+ 7.32 pp, P < 0.001, CL 1.00). SMRs were significantly higher for women than for men (3.35 vs. 2.89, respectively).ConclusionOver the last two decades, breast cancer survival in Poland has improved significantly. Nonetheless, special attention should be given to the disparities between sexes and the gap in overall improvement of survival rates compared with other European countries.

The Direct and Indirect Costs of Breast Cancer in Poland: Estimates for 2017–2019

In Poland, breast cancer (BC) is the most frequently diagnosed cancer in women and the second most common cause of death after lung cancer. This disease has important economic implications for patients, public payers, and the whole Polish economy. This study aimed to estimate the total National Health Fund (NHF) expenditures on the diagnosis and treatment of patients with breast cancer. In addition, the costs of productivity losses were also calculated. Cost estimation was prepared using a top-down approach. Direct cost calculations were based on data reported by NHF for patients with the diagnosis of breast cancer. Medical care costs included the following components: screening program, oncological package, surgical treatment, hospitalization, drug program, chemotherapy, radiotherapy, and outpatient care. Indirect costs in the form of absenteeism costs were calculated based on data from Statistics Poland (gross domestic product, number of employees) and the Social Insurance Institution database (the number of sick leave days). Total expenditures for BC including direct costs and indirect costs amounted to EUR 305,371, EUR 332,998, and EUR 344,649, respectively in 2017, 2018, and 2019. Total healthcare costs in 2019 were EUR 4114 lower than in 2018, which resulted from the reduction in expenditure on the drug program (decrease of EUR 13,527), despite the observed increase in all remaining resources. From direct costs, the highest expense was spent on the drug program (nearly 50% of total direct costs), but this expense dropped significantly in 2019. For the remaining parameters, the costs increased year by year, of which the most expensive were surgical treatment (15%), radiotherapy (12%), and the screening program (10%). BC generated over EUR 120 thousand of social costs in 2019 and compared to 2017, there was an increase in productivity loss by 26%. Our results from 2017-2019 demonstrated that total expenditure for BC in Poland increased from year to year. Breast cancer generated almost EUR 345 thousand expenses in 2019, which translates into a significant burden on the public payer's budget and the society in Poland.