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Tittmann J, Ágh T, Erdősi D, Csanády B, Kövér E, Zemplényi A, Kovács S, Vokó Z. Breast cancer stage and molecular subtype distribution: real-world insights from a regional oncological center in Hungary. Discov Oncol 2024; 15:240. [PMID: 38907840 PMCID: PMC11193705 DOI: 10.1007/s12672-024-01096-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2023] [Accepted: 06/12/2024] [Indexed: 06/24/2024] Open
Abstract
OBJECTIVE Examining the distribution of breast cancer (BC) stage and molecular subtype among women aged below (< 45 years), within (45-65 years), and above (> 65 years) the recommended screening age range helps to understand the screening program's characteristics and contributes to enhancing the effectiveness of BC screening programs. METHODS In this retrospective study, female patients with newly diagnosed BC from 2010 to 2020 were identified. The distribution of cases in terms of TNM stages, severity classes, and subtypes was analysed according to age groups. RESULTS A total of 3282 women diagnosed with BC were included in the analysis. Among these cases 51.4% were detected outside the screening age group, and these were characterized by a higher TNM stage compared to those diagnosed within the screening age band. We observed significantly higher relative frequency of advanced BC in the older age group compared to both the screening age population and women younger than 45 years (14.9% vs. 8.7% and 7.7%, P < 0.001). HR-/HER2- and HER+ tumours were relatively more frequent among women under age 45 years (HR-/HER2-: 23.6%, HER2+: 20.5%) compared to those within the screening age range (HR-/HER2-: 13.4%, HER2+: 13.9%) and the older age group (HR-/HER2-: 10.4%, HER2+: 11.5%). CONCLUSIONS The findings of our study shed light on potential areas for the improvement of BC screening programs (e.g., extending screening age group, adjusting screening frequency based on molecular subtype risk status) in Hungary and internationally, as well.
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Affiliation(s)
- Judit Tittmann
- Center for Health Technology Assessment, Semmelweis University, Üllői Str 25, Budapest, 1091, Hungary.
- Center for Health Technology Assessment and Pharmacoeconomic Research, University of Pécs, Pécs, Hungary.
| | - Tamás Ágh
- Center for Health Technology Assessment and Pharmacoeconomic Research, University of Pécs, Pécs, Hungary
- Syreon Research Institute, Budapest, Hungary
| | - Dalma Erdősi
- Center for Health Technology Assessment, Semmelweis University, Üllői Str 25, Budapest, 1091, Hungary
- Center for Health Technology Assessment and Pharmacoeconomic Research, University of Pécs, Pécs, Hungary
| | - Bettina Csanády
- Center for Health Technology Assessment and Pharmacoeconomic Research, University of Pécs, Pécs, Hungary
| | - Erika Kövér
- Department of Oncotherapy, Medical School and Clinical Center, University of Pécs, Pécs, Hungary
| | - Antal Zemplényi
- Center for Health Technology Assessment and Pharmacoeconomic Research, University of Pécs, Pécs, Hungary
- Syreon Research Institute, Budapest, Hungary
| | - Sándor Kovács
- Center for Health Technology Assessment and Pharmacoeconomic Research, University of Pécs, Pécs, Hungary
- Syreon Research Institute, Budapest, Hungary
| | - Zoltán Vokó
- Center for Health Technology Assessment, Semmelweis University, Üllői Str 25, Budapest, 1091, Hungary
- Syreon Research Institute, Budapest, Hungary
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Trojanowski M, Radomyski P, Kycler W, Michalek IM. The impact of the COVID-19 pandemic on incidence gap in screen-detectable cancers: a cohort study in Greater Poland, Poland. Rep Pract Oncol Radiother 2024; 29:131-140. [PMID: 39143965 PMCID: PMC11321766 DOI: 10.5603/rpor.99354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Accepted: 02/05/2024] [Indexed: 08/16/2024] Open
Abstract
Background The global COVID-19 pandemic has had a significant impact on healthcare systems. This study aimed to assess the incidence gap in screening-detectable cancers in the Greater Poland (Poland) in 2020. Materials and methods Data on breast, cervix uteri, and colorectal cancer cases diagnosed from 2010 to 2020 were obtained from the regional cancer registry. Standardized incidence ratios (SIR) and incidence rate differences (IRD) were calculated to estimate the change in incident cancer cases during the pandemic. The number of observed cases was extracted from the registry database. Simple linear regression analysis was used to predict the expected number of incident cancer cases in 2020 and the age-standardized incidence rate based on registry data from the preceding ten years (2010-2019). Results In 2020, the registered number of incident female breast cancer cases decreased by 12% [SIR 0.88, 95% confidence interval (CI): 0.88-0.92, observed: 1,848, expected: 2,101], resulting in an IRD of -6.3 per 100 K. The number of registered cervical cancers decreased by 15% (SIR 0.85, 95% CI: 0.73-0.98, observed: 181, expected: 213), with an IRD of -0.8 per 100 K. For colorectal cancer, there was a 16% decrease in new cases among females (SIR 0.84, 95% CI: 0.78-0.90) and a 15% decrease among males (SIR 0.85, 95% CI: 0.80-0.91), resulting in IRDs of -3.04 and -5.29 per 100K, respectively. Conclusions The COVID-19 pandemic led to a significant, 15% decrease in newly diagnosed screening-detectable cancer cases in 2020. Further studies are needed to investigate the impact of delayed cancer diagnoses on stage at diagnosis and survival rates.
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Affiliation(s)
- Maciej Trojanowski
- Greater Poland Cancer Registry, Greater Poland Cancer Centre, Poznan, Poland
| | - Piotr Radomyski
- Radiology Department, Greater Poland Cancer Centre, Poznan, Poland
- Electroradiology Department, Poznan University of Medical Sciences, Poznan, Poland
| | - Witold Kycler
- Gastrointestinal Surgical Oncology Department, Greater Poland Cancer Centre, Poznan, Poland
| | - Irmina Maria Michalek
- Department of Cancer Pathology, Maria Sklodowska-Curie National Research Institute of Oncology (MSCI), Warsaw, Poland
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Gálffy G, Szabó GT, Tamási L, Müller V, Moldvay J, Sárosi V, Kerpel-Fronius A, Kardos T, Csada E, Pápai-Székely Z, Szász Z, Király Z, Hódi G, Kovács Z, Balogh É, Kovács KA, Darida M, Buga V, Rokszin G, Abonyi-Tóth Z, Kiss Z, Vokó Z, Bogos K. Decreasing incidence and mortality of lung cancer in Hungary between 2011 and 2021 revealed by robust estimates reconciling multiple data sources. Pathol Oncol Res 2024; 30:1611754. [PMID: 38887697 PMCID: PMC11181153 DOI: 10.3389/pore.2024.1611754] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/29/2024] [Accepted: 05/17/2024] [Indexed: 06/20/2024]
Abstract
Objective Hungary has repeatedly been shown to have the highest cancer-related mortality and incidence in Europe. Despite lung cancer being the most abundant malignant diagnosis in Hungary, numerous concerns have been raised recently regarding the bias inherent to reported incidence estimates. Re-analysis of reimbursement claims has been suggested previously by our group as an alternative approach, offering revised figures of lung cancer incidence between 2011 and 2016. Leveraging on this methodology, we aimed at updating Hungarian lung cancer incidence estimates with an additional 5 years (2017-2021), including years affected by the COVID-19 pandemic. Additionally, we also attempted to improve the robustness of estimates by taking additional characteristics of the patient pathway into account. Methods Lung cancer patients between 2011 and 2021 were identified based on reimbursement-associated ICD-10 codes, histology codes and time patterns. Multiple query architectures were tested for sensitivity and compared to official estimates of the Hungarian National Cancer Registry (HNCR). Epidemiological trends were estimated by Poisson-regression, corrected for age and sex. Results A total of 89,948 lung cancer patients diagnosed in Hungary between 2011 and 2021 have been identified by our study. In 2019 alone, 7,887 patients were diagnosed according to our optimized query. ESP2013 standardized rate was estimated between 92.5/100,000 (2011) and 78.4/100,000 (2019). In 2019, standardized incidence was 106.8/100,000 for men and 59.7/100,000 for women. Up until the COVID-19 pandemic, lung cancer incidence was decreasing by 3.18% (2.1%-4.3%) yearly in men, while there was no significant decrease in women. Young age groups (40-49 and 50-59) featured the largest improvement, but women aged 60-79 are at an increasing risk for developing lung cancer. The COVID-19 pandemic resulted in a statistically significant decrease in lung cancer incidence, especially in the 50-59 age group (both sexes). Conclusion Our results show that using an optimized approach, re-analysis of reimbursement claims yields robust estimates of lung cancer incidence. According to this approach, the incidence rate of male lung cancer is declining in Hungary, in concordance with the trend observed for lung cancer mortality. Among women aged 60-79, the incidence of lung cancer has risen, requiring more attention in the near future.
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Affiliation(s)
- Gabriella Gálffy
- Department of Pulmonology, Pulmonology Center of the Reformed Church in Hungary, Törökbálint, Hungary
| | | | - Lilla Tamási
- Department of Pulmonology, Semmelweis University, Budapest, Hungary
| | - Veronika Müller
- Department of Pulmonology, Semmelweis University, Budapest, Hungary
| | - Judit Moldvay
- Department of Pulmonology, National Korányi Institute of Pulmonology, Budapest, Hungary
- Department of Pulmonology, University of Szeged Albert Szent-Györgyi Medical School, Szeged, Hungary
| | | | - Anna Kerpel-Fronius
- National Korányi Institute of Pulmonology, Department of Radiology, Budapest, Hungary
| | - Tamás Kardos
- Department of Pulmonology, University of Debrecen, Debrecen, Hungary
| | - Edit Csada
- Department of Pulmonology, University of Szeged Albert Szent-Györgyi Medical School, Szeged, Hungary
| | - Zsolt Pápai-Székely
- Fejér County Szent György, University Teaching Hospital, Székesfehérvár, Hungary
| | - Zoltán Szász
- Department of Pulmonology, Petz Aladár University Teaching Hospital, Győr, Hungary
| | - Zsolt Király
- Veszprém County Pulmonary Hospital Farkasgyepű, Farkasgyepű, Hungary
| | - Gábor Hódi
- MSD Pharma Hungary Ltd., Budapest, Hungary
| | | | - Éva Balogh
- MSD Pharma Hungary Ltd., Budapest, Hungary
| | | | | | | | | | - Zsolt Abonyi-Tóth
- RxTarget Ltd Szolnok, Szolnok, Hungary
- Department of Biostatistics, University of Veterinary Medicine, Budapest, Hungary
| | - Zoltán Kiss
- MSD Pharma Hungary Ltd., Budapest, Hungary
- 2nd Department of Medicine and Nephrology-Diabetes Center, University of Pécs Medical School, Pécs, Hungary
| | - Zoltán Vokó
- Center for Health Technology Assessment, Semmelweis University, Budapest, Hungary
- Syreon Research Institute, Budapest, Hungary
| | - Krisztina Bogos
- National Korányi Institute of Pulmonology, Budapest, Hungary
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Kovačević IN, Vujović A, Stanišić M, Vuković-Leković J, Lansdorp-Vogelaar I, Mlakar DN, Senore C, Józwiak-Hagymásy J, Széles G, Vokó Z, Csanádi M. Roadmap to improve the organized cancer screening programs - The case of colorectal cancer screening in Montenegro. J Cancer Policy 2024; 39:100464. [PMID: 38104712 DOI: 10.1016/j.jcpo.2023.100464] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2023] [Revised: 12/01/2023] [Accepted: 12/12/2023] [Indexed: 12/19/2023]
Abstract
BACKGROUND Implementation of organized cancer screening programs comes with many challenges and barriers, which may inhibit the achievement of the screening activities' desired benefits. In this paper we outline a plan for improving the colorectal cancer (CRC) screening system in Montenegro. METHODS We formulated a roadmap, which was generally defined as a country-specific strategic plan to improve cancer screening programs. The roadmap development was an iterative, step-by-step process. First, we described the current screening program, then identified and described key barriers, and finally proposed actions to overcome them. Multiple sources of information (e.g., documents, expert opinions) were collected and processed by local and international stakeholders. RESULTS The CRC screening program was implemented between 2013-2019 by gradually increasing the invitation of the target population. Key barriers of the implementation were defined: 1) Lack of colonoscopy capacity in the northern part of the country; 2) Inadequate information technology systems; 3) Inadequate public promotion of screening. The defined actions were related to overcoming lack of available resources (e.g., financial, human and technological), to improve the policy environment and the knowledge, and to facilitate information sharing. CONCLUSION The collaboration between local stakeholders of CRC screening and researchers experienced in planning and evaluating screening programs resulted in the first comprehensive description of CRC screening in Montenegro, detailed understanding of key barriers that emerged during implementation and a carefully designed list of actions. The implementation of these actions and the evaluation of whether barriers were solved will be captured in the upcoming period by maintaining this collaboration.
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Affiliation(s)
| | | | | | | | - Iris Lansdorp-Vogelaar
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | | | - Carlo Senore
- Epidemiology and screening Unit - CPO, University Hospital Città della Salute e della Scienza, Turin, Italy
| | | | | | - Zoltán Vokó
- Syreon Research Institute, Budapest, Hungary; Center for Health Technology Assessment, Semmelweis University, Budapest, Hungary.
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Trojanowski M, Radomyski P, Kycler W, Michalek IM. Decrease in the number of new cancer diagnoses during the first year of the COVID-19 pandemic - cohort study of 3.5 million individuals in western Poland. Front Oncol 2023; 13:1230289. [PMID: 38179170 PMCID: PMC10765942 DOI: 10.3389/fonc.2023.1230289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Accepted: 11/13/2023] [Indexed: 01/06/2024] Open
Abstract
Introduction The COVID-19 pandemic has considerably affected healthcare systems worldwide and is expected to influence cancer incidence, mortality, stage at diagnosis, and survival. This study aimed to assess COVID-19-related changes in cancer incidence observed in 2020 in the Greater Poland region. Materials and methods Data from the Greater Poland Cancer Registry on cancer patients diagnosed between 2010 and 2020 were analysed. To quantify the change in the number of incident cancer cases during the COVID-19 pandemic, we calculated the standardized incidence ratio (SIR) and the incidence rate difference (IRD) to assume the pandemic-attributable gap in cancer incidence. Results In 2020, in Greater Poland, the expected number of new cancer cases was 18 154 (9 226 among males and 8 927 among females), while the observed number was 14 770 (7 336 among males and 7 434 among females). The registered number of cancer cases decreased in 2020 by 20% (SIR 0·80, 95% CI 0·78 to 0·81) and 17% (SIR 0·83, 95% CI 0·81 to 0·85) in males and females, respectively. Among men, the most significant difference was reported for myeloma (SIR 0·59, 95% CI 0·45 to 0·77), among women for bone cancer (SIR 0·47, 95% CI 0·20 to 0·93). In females the observed incidence was higher than expected for cancer of an unspecified site (SIR 1·19, 95% CI 1·01 to 1·38). In our study, the decrease in new cancer cases was greater in males than in females. Discussion The observed incidence was affected in most cancer sites, with the most significant deviation from the expected number in the case of myeloma. An increase in the observed incidence was reported only in women diagnosed with cancer of an unspecified site, which might reflect shortages in access to oncological diagnostics.
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Affiliation(s)
- Maciej Trojanowski
- Greater Poland Cancer Registry, Greater Poland Cancer Centre, Poznan, Poland
| | - Piotr Radomyski
- Radiology Department, Greater Poland Cancer Centre, Poznan, Poland
- Electroradiology Department, Poznan University of Medical Sciences, Poznan, Poland
| | - Witold Kycler
- Gastrointestinal Surgical Department, Greater Poland Cancer Centre, Poznan, Poland
| | - Irmina Maria Michalek
- Cancer Epidemiology and Primary Prevention Department, Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw, Poland
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Eijkelboom AH, de Munck L, Larsen M, Bijlsma MJ, Tjan-Heijnen VCG, van Gils CH, Broeders MJM, Nygård JF, Lobbes MBI, Helsper CW, Pijnappel RM, Strobbe LJA, Wesseling J, Hofvind S, Siesling S. Impact of the COVID-19 pandemic on breast cancer incidence and tumor stage in the Netherlands and Norway: A population-based study. Cancer Epidemiol 2023; 87:102481. [PMID: 37897970 DOI: 10.1016/j.canep.2023.102481] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Revised: 10/05/2023] [Accepted: 10/19/2023] [Indexed: 10/30/2023]
Abstract
BACKGROUND Comparing the impact of the COVID-19 pandemic on the incidence of newly diagnosed breast tumors and their tumor stage between the Netherlands and Norway will help us understand the effect of differences in governmental and social reactions towards the pandemic. METHODS Women newly diagnosed with breast cancer in 2017-2021 were selected from the Netherlands Cancer Registry and the Cancer Registry of Norway. The crude breast cancer incidence rate (tumors per 100,000 women) during the first (March-September 2020), second (October 2020-April 2021), and Delta COVID-19 wave (May-December 2021) was compared with the incidence rate in the corresponding periods in 2017, 2018, and 2019. Incidence rates were stratified by age group, method of detection, and clinical tumor stage. RESULTS During the first wave breast cancer incidence declined to a larger extent in the Netherlands than in Norway (27.7% vs. 17.2% decrease, respectively). In both countries, incidence decreased in women eligible for screening. In the Netherlands, incidence also decreased in women not eligible for screening. During the second wave an increase in the incidence of stage IV tumors in women aged 50-69 years was seen in the Netherlands. During the Delta wave an increase in overall incidence and incidence of stage I tumors was seen in Norway. CONCLUSION Alterations in breast cancer incidence and tumor stage seem related to a combined effect of the suspension of the screening program, health care avoidance due to the severity of the pandemic, and other unknown factors.
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Affiliation(s)
- Anouk H Eijkelboom
- Department of Health Technology and Services Research, University of Twente, Drienerlolaan 5, 7522 NB, Enschede, the Netherlands; Department of Research and Development, Netherlands Comprehensive Cancer Organisation (IKNL), Godebaldkwartier 419, 3511 DT Utrecht, the Netherlands.
| | - Linda de Munck
- Department of Research and Development, Netherlands Comprehensive Cancer Organisation (IKNL), Godebaldkwartier 419, 3511 DT Utrecht, the Netherlands
| | - Marthe Larsen
- Section for Breast Cancer Screening, Cancer Registry of Norway, P.O. Box 5313, 0304 Oslo, Norway
| | - Maarten J Bijlsma
- Department of Research and Development, Netherlands Comprehensive Cancer Organisation (IKNL), Godebaldkwartier 419, 3511 DT Utrecht, the Netherlands; PharmacoTherapy, -Epidemiology and -Economics, Groningen Research Institute of Pharmacy, University of Groningen, P.O. Box 196, 9700 AD Groningen, the Netherlands
| | - Vivianne C G Tjan-Heijnen
- Department of Medical Oncology, School for Oncology and Reproduction (GROW), Maastricht University Medical Centre, P. Debyelaan 25, 6229 HX Maastricht, the Netherlands
| | - Carla H van Gils
- Department of Epidemiology, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Universiteitsweg 100, 3584 CG Utrecht, the Netherlands
| | - Mireille J M Broeders
- Department for Health Evidence, Radboud University Medical Center, Geert Grooteplein Zuid 10, 6525 GA Nijmegen, the Netherlands; Dutch Expert Centre for Screening, Wijchenseweg 101, 6538 SW, Nijmegen, the Netherlands
| | - Jan F Nygård
- Department of Register Informatics, Cancer Registry Norway, P.O. Box 5313, 0304 Oslo, Norway
| | - Marc B I Lobbes
- Department of Medical Imaging, Zuyderland Medical Center Sittard-Geleen, Dr. H. van der Hoffplein 1, 6162 BG Sittard-Geleen, the Netherlands; Department of Radiology and Nuclear Medicine, Maastricht University Medical Center, P. Debyelaan 25, 6229 HX Maastricht, the Netherlands; School for Oncology and Reproduction (GROW), Maastricht University Medical Centre, Universiteitssingel 40, 6220 ER, Maastricht, the Netherlands
| | - Charles W Helsper
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Universiteitsweg 100, 3584 CG, Utrecht, the Netherlands
| | - Ruud M Pijnappel
- Dutch Expert Centre for Screening, Wijchenseweg 101, 6538 SW, Nijmegen, the Netherlands; Department of Radiology, University Medical Centre Utrecht, Utrecht University, Heidelberglaan 100, 3584 CX, Utrecht, the Netherlands
| | - Luc J A Strobbe
- Department of Surgical Oncology, Canisius Wilhelmina Hospital, Weg door Jonkerbos 100, 6532 SZ, Nijmegen, the Netherlands
| | - Jelle Wesseling
- Divisions of Diagnostic Oncology and Molecular Pathology, Netherlands Cancer Institute-Antoni van Leeuwenhoek, Plesmanlaan 121, 1066 CX, Amsterdam, the Netherlands; Department of Pathology, Leiden University Medical Center, Albinusdreef 2, 2333 ZA, Leiden, the Netherlands
| | - Solveig Hofvind
- Section for Breast Cancer Screening, Cancer Registry of Norway, P.O. Box 5313, 0304 Oslo, Norway; Department of Health and Care Sciences, UiT The Arctic University of Norway, P.O. 6050, 9037 Tromsø, Norway
| | - Sabine Siesling
- Department of Health Technology and Services Research, University of Twente, Drienerlolaan 5, 7522 NB, Enschede, the Netherlands; Department of Research and Development, Netherlands Comprehensive Cancer Organisation (IKNL), Godebaldkwartier 419, 3511 DT Utrecht, the Netherlands
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7
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Kiss Z, Kocsis J, Nikolényi A, Horváth Z, Knollmajer K, Benedek A, Várnai M, Polányi Z, Kovács KA, Berta A, Köveskuti I, Karamousouli E, Szabó TG, Rokszin G, Fábián I, Bartókné Tamás R, Surján O, Fürtős D, Surján G, Kenessey I, Weber A, Barcza Z, Berki T, Vokó Z, Dózsa C, Dank M, Boér K. Opposite trends in incidence of breast cancer in young and old female cohorts in Hungary and the impact of the Covid-19 pandemic: a nationwide study between 2011-2020. Front Oncol 2023; 13:1182170. [PMID: 37795445 PMCID: PMC10545848 DOI: 10.3389/fonc.2023.1182170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Accepted: 05/19/2023] [Indexed: 10/06/2023] Open
Abstract
Background This nationwide study examined breast cancer (BC) incidence and mortality rates in Hungary between 2011-2019, and the impact of the Covid-19 pandemic on the incidence and mortality rates in 2020 using the databases of the National Health Insurance Fund (NHIF) and Central Statistical Office (CSO) of Hungary. Methods Our nationwide, retrospective study included patients who were newly diagnosed with breast cancer (International Codes of Diseases ICD)-10 C50) between Jan 1, 2011 and Dec 31, 2020. Age-standardized incidence and mortality rates (ASRs) were calculated using European Standard Populations (ESP). Results 7,729 to 8,233 new breast cancer cases were recorded in the NHIF database annually, and 3,550 to 4,909 all-cause deaths occurred within BC population per year during 2011-2019 period, while 2,096 to 2,223 breast cancer cause-specific death was recorded (CSO). Age-standardized incidence rates varied between 116.73 and 106.16/100,000 PYs, showing a mean annual change of -0.7% (95% CI: -1.21%-0.16%) and a total change of -5.41% (95% CI: -9.24 to -1.32). Age-standardized mortality rates varied between 26.65-24.97/100,000 PYs (mean annual change: -0.58%; 95% CI: -1.31-0.27%; p=0.101; total change: -5.98%; 95% CI: -13.36-2.66). Age-specific incidence rates significantly decreased between 2011 and 2019 in women aged 50-59, 60-69, 80-89, and ≥90 years (-8.22%, -14.28%, -9.14%, and -36.22%, respectively), while it increased in young females by 30.02% (95%CI 17,01%- 51,97%) during the same period. From 2019 to 2020 (in first COVID-19 pandemic year), breast cancer incidence nominally decreased by 12% (incidence rate ratio [RR]: 0.88; 95% CI: 0.69-1.13; 2020 vs. 2019), all-cause mortality nominally increased by 6% (RR: 1.06; 95% CI: 0.79-1.43) among breast cancer patients, and cause-specific mortality did not change (RR: 1.00; 95%CI: 0.86-1.15). Conclusion The incidence of breast cancer significantly decreased in older age groups (≥50 years), oppositely increased among young females between 2011 and 2019, while cause-specific mortality in breast cancer patients showed a non-significant decrease. In 2020, the Covid-19 pandemic resulted in a nominal, but not statistically significant, 12% decrease in breast cancer incidence, with no significant increase in cause-specific breast cancer mortality observed during 2020.
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Affiliation(s)
| | - Judit Kocsis
- Department of Oncology, Bács-Kiskun County Teaching Hospital, Kecskemét, Hungary
| | - Alíz Nikolényi
- Department of Oncotherapy, University of Szeged, Szeged, Hungary
| | - Zsolt Horváth
- Department of Oncology, Bács-Kiskun County Teaching Hospital, Kecskemét, Hungary
| | | | | | | | | | | | | | | | | | | | | | - Ibolya Fábián
- RxTarget Ltd., Szolnok, Hungary
- University of Veterinary Medicine Budapest, Department of Biostatistics, Budapest, Hungary
| | - Renáta Bartókné Tamás
- Department of Deputy Chief Medical Officer II., National Public Health Center, Budapest, Hungary
| | - Orsolya Surján
- Department of Deputy Chief Medical Officer II., National Public Health Center, Budapest, Hungary
| | - Diána Fürtős
- Department of Deputy Chief Medical Officer II., National Public Health Center, Budapest, Hungary
| | - György Surján
- Department of Deputy Chief Medical Officer II., National Public Health Center, Budapest, Hungary
- Institute of Digital Health Sciences, Semmelweis University, Budapest, Hungary
| | - István Kenessey
- National Institute of Oncology, National Tumorbiology Laboratory project (NLP-17), Budapest, Hungary
- Department of Pathology, Forensic and Insurance Medicine, Semmelweis University, Budapest, Hungary
| | - András Weber
- National Institute of Oncology, National Tumorbiology Laboratory project (NLP-17), Budapest, Hungary
- Cancer Surveillance Branch, International Agency for Research on Cancer, Lyon, France
| | - Zsófia Barcza
- Syntesia Medical Communications Ltd, Budapest, Hungary
| | - Tamás Berki
- Center for Health Technology Assessment, Semmelweis University, Budapest, Hungary
| | - Zoltán Vokó
- Center for Health Technology Assessment, Semmelweis University, Budapest, Hungary
| | - Csaba Dózsa
- Department of Theoretical Health Sciences, University of Miskolc Faculty of Health Sciences, Miskolc, Hungary
| | - Magdolna Dank
- Cancer Center, Semmelweis University, Budapest, Hungary
| | - Katalin Boér
- Department of Clinical Oncology, St. Margaret Hospital, Budapest, Hungary
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