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Gulácsi L, Békássy S, Bittner N, Feith HJ, Ficzere A, Horváth L, Horváth Z, Tóth I, Zrubka Z, Tóth E, Kovács LG. [Personalized medicine and healthcare: where are we now, where should we go?]. Orv Hetil 2023; 164:202-209. [PMID: 36774631 DOI: 10.1556/650.2023.32711] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2022] [Accepted: 12/04/2022] [Indexed: 02/13/2023]
Abstract
The authors of this manuscript are representatives of different subdisciplines of medicine, all of them are experienced researchers. As of their origin, they are practicing doctors from the primary care and from the clinical/hospital setting, diagnostics experts, researchers from healthcare management, health economics, representatives of patients' rights and patient organizations. They are all devoted to the implementation of personalized medicine and personalized healthcare in Hungary. The current manuscript - also meant to be a keynote message provoking further discussion in the medical community - is devoted to correcting for two false ideas. One is that personalized medicine is not yet ready for practical applications, it is merely a research area of futurologists. The other false idea is that only (or mainly) the lack of financial resources hinders the introduction of personalized healthcare in Hungary. Orv Hetil. 2023; 164(6): 202-209.
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Affiliation(s)
- László Gulácsi
- 1 Óbudai Egyetem, Egyetemi Kutató és Innovációs Központ, Egészségügyi Közgazdaságtan Kutatóközpont Budapest Magyarország.,12 Magyar Személyre Szabott Egészségügy Fejlesztéséért Alapítvány Budapest Magyarország
| | - Szabolcs Békássy
- 2 Országos Kórházi Főigazgatóság, Alapellátásfejlesztési Igazgatóság Budapest Magyarország.,12 Magyar Személyre Szabott Egészségügy Fejlesztéséért Alapítvány Budapest Magyarország
| | - Nóra Bittner
- 3 Uzsoki Utcai Kórház, Onkoradiológiai Osztály Budapest Magyarország.,12 Magyar Személyre Szabott Egészségügy Fejlesztéséért Alapítvány Budapest Magyarország
| | - Helga Judit Feith
- 4 Semmelweis Egyetem, Egészségtudományi Kar, Társadalomtudományi Tanszék Budapest Magyarország.,12 Magyar Személyre Szabott Egészségügy Fejlesztéséért Alapítvány Budapest Magyarország
| | - Andrea Ficzere
- 5 Uzsoki Utcai Kórház, Főigazgatóság Budapest Magyarország.,12 Magyar Személyre Szabott Egészségügy Fejlesztéséért Alapítvány Budapest Magyarország
| | - Lajos Horváth
- 6 Országos Mentális, Ideggyógyászati és Idegsebészeti Intézet Budapest Magyarország.,12 Magyar Személyre Szabott Egészségügy Fejlesztéséért Alapítvány Budapest Magyarország
| | - Zsolt Horváth
- 7 Bács-Kiskun Megyei Oktatókórház, Onkoradiológiai Központ Kecskemét Magyarország.,12 Magyar Személyre Szabott Egészségügy Fejlesztéséért Alapítvány Budapest Magyarország
| | - Icó Tóth
- 8 Mályvavirág Alapítvány Budapest Magyarország.,12 Magyar Személyre Szabott Egészségügy Fejlesztéséért Alapítvány Budapest Magyarország
| | - Zsombor Zrubka
- 1 Óbudai Egyetem, Egyetemi Kutató és Innovációs Központ, Egészségügyi Közgazdaságtan Kutatóközpont Budapest Magyarország.,12 Magyar Személyre Szabott Egészségügy Fejlesztéséért Alapítvány Budapest Magyarország
| | - Erika Tóth
- 9 Országos Onkológiai Intézet, Sebészeti és Molekuláris Patológiai Osztály Budapest, Ráth Gy. u. 7-9., 1122 Magyarország.,12 Magyar Személyre Szabott Egészségügy Fejlesztéséért Alapítvány Budapest Magyarország
| | - L Gábor Kovács
- 10 Pécsi Tudományegyetem, Általános Orvostudományi Kar, Humán Reprodukciós Nemzeti Laboratórium Pécs, Ifjúság útja 20., 7624 Magyarország.,11 Pécsi Tudományegyetem, Szentágothai János Kutatóközpont Pécs Magyarország.,12 Magyar Személyre Szabott Egészségügy Fejlesztéséért Alapítvány Budapest Magyarország
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Kiss Z, Bogos K, Tamási L, Ostoros G, Müller V, Bittner N, Sárosi V, Vastag A, Knollmajer K, Várnai M, Kovács K, Berta A, Köveskuti I, Karamousouli E, Rokszin G, Abonyi-Tóth Z, Barcza Z, Kenessey I, Weber A, Nagy P, Freyler-Fadgyas P, Szócska M, Szegner P, Hilbert L, Géczy GB, Surján G, Moldvay J, Vokó Z, Gálffy G, Polányi Z. Underlying reasons for post-mortem diagnosed lung cancer cases - A robust retrospective comparative study from Hungary (HULC study). Front Oncol 2022; 12:1032366. [PMID: 36505881 PMCID: PMC9732724 DOI: 10.3389/fonc.2022.1032366] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Accepted: 10/24/2022] [Indexed: 11/27/2022] Open
Abstract
Objective The Hungarian Undiagnosed Lung Cancer (HULC) study aimed to explore the potential reasons for missed LC (lung cancer) diagnosis by comparing healthcare and socio-economic data among patients with post-mortem diagnosed LC with those who were diagnosed with LC during their lives. Methods This nationwide, retrospective study used the databases of the Hungarian Central Statistical Office (HCSO) and National Health Insurance Fund (NHIF) to identify patients who died between January 1, 2019 and December 31, 2019 and were diagnosed with lung cancer post-mortem (population A) or during their lifetime (population B). Patient characteristics, socio-economic factors, and healthcare resource utilization (HCRU) data were compared between the diagnosed and undiagnosed patient population. Results During the study period, 8,435 patients were identified from the HCSO database with LC as the cause of death, of whom 1,203 (14.24%) had no LC-related ICD (International Classification of Diseases) code records in the NHIF database during their lives (post-mortem diagnosed LC population). Post-mortem diagnosed LC patients were significantly older than patients diagnosed while still alive (mean age 71.20 vs. 68.69 years, p<0.001), with a more pronounced age difference among female patients (difference: 4.57 years, p<0.001), and had significantly fewer GP (General Practitioner) and specialist visits, X-ray and CT scans within 7 to 24 months and 6 months before death, although the differences in GP and specialist visits within 7-24 months did not seem clinically relevant. Patients diagnosed with LC while still alive were more likely to be married (47.62% vs. 33.49%), had higher educational attainment, and had more children, than patients diagnosed with LC post-mortem. Conclusions Post-mortem diagnosed lung cancer accounts for 14.24% of total lung cancer mortality in Hungary. This study provides valuable insights into patient characteristics, socio-economic factors, and HCRU data potentially associated with a high risk of lung cancer misdiagnosis.
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Affiliation(s)
| | - Krisztina Bogos
- National Korányi Institute of Pulmonology, Directorate of Institution, Budapest, Hungary
| | - Lilla Tamási
- Department of Pulmonology, Semmelweis University, Budapest, Hungary
| | - Gyula Ostoros
- National Korányi Institute of Pulmonology, Directorate of Institution, Budapest, Hungary
| | - Veronika Müller
- Department of Pulmonology, Semmelweis University, Budapest, Hungary
| | - Nóra Bittner
- Department of Pulmonology, University of Debrecen, Debrecen, Hungary
| | | | | | | | | | | | | | | | | | | | - Zsolt Abonyi-Tóth
- RxTarget Ltd., Szolnok, Hungary
- University of Veterinary Medicine Budapest, Department of Biostatistics, Budapest, Hungary
| | - Zsófia Barcza
- Syntesia Medical Communications Ltd, Budapest, Hungary
| | - István Kenessey
- 1 Department of Pulmonology, National Korányi Institute of Pulmonology, Semmelweis University, 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
| | - Péter Nagy
- National Institute of Oncology, National Tumorbiology Laboratory project (NLP-17), Budapest, Hungary
- Department of Anatomy and Histology, University of Veterinary Medicine, Budapest, Hungary
- Institute of Oncochemistry, University of Debrecen, Debrecen, Hungary
| | - Petra Freyler-Fadgyas
- National Health Insurance Fund, Department of Project Management and Data Services, Budapest, Hungary
| | - Miklós Szócska
- Institute of Digital Health Sciences, Semmelweis University, Budapest, Hungary
- Health Services Management Training Centre, Semmelweis University, Budapest, Hungary
| | - Péter Szegner
- Institute of Digital Health Sciences, Semmelweis University, Budapest, Hungary
- Health Services Management Training Centre, Semmelweis University, Budapest, Hungary
| | - Lászlóné Hilbert
- Hungarian Central Statistical Office, Department of Population Statistics, Budapest, Hungary
| | | | - György Surján
- Institute of Digital Health Sciences, Semmelweis University, Budapest, Hungary
| | - Judit Moldvay
- 2 Department of Pathology, MTA-SE NAP, Brain Metastasis Research Group, Hungarian Academy of Sciences, Semmelweis University, Budapest, Hungary
- National Korányi Institute of Pulmonology, Budapest, Hungary
| | - Zoltán Vokó
- Center for Health Technology Assessment, Semmelweis University, Budapest, Hungary
| | - Gabriella Gálffy
- Pulmonology Hospital Törökbálint, 6th Department, Törökbálint, Hungary
- Department of Thoracic Surgery, Semmelweis University, Budapest, Hungary
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Bencze E, Bogos K, Kohánka A, Báthory-Fülöp L, Sárosi V, Csernák E, Bittner N, Melegh Z, Tóth E. EGFR T790M Mutation Detection in Patients With Non-Small Cell Lung Cancer After First Line EGFR TKI Therapy: Summary of Results in a Three-Year Period and a Comparison of Commercially Available Detection Kits. Pathol Oncol Res 2022; 28:1610607. [PMID: 36277960 PMCID: PMC9579289 DOI: 10.3389/pore.2022.1610607] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Accepted: 09/22/2022] [Indexed: 11/13/2022]
Abstract
EGFR mutation in non-small cell lung cancer (NSCLC) offers a potential therapeutic target for tyrosine kinase inhibitor (TKI) therapy. The majority of these cases, however eventually develop therapy resistance, mainly by acquiring EGFR T790M mutation. Recently, third-generation TKIs have been introduced to overcome T790M mutation-related resistance. Cell free circulating tumor DNA (liquid biopsy) has emerged as a valuable alternative method for T790M mutation detection during patient follow up, when a tissue biopsy cannot be obtained for analysis. In this study, we summarized our experience with Super-ARMS EGFR Mutation Detection Kit (AmoyDx) on 401 samples of 242 NSCLC patients in a 3-year period in Hungary, comprising 364 plasma and 37 non-plasma samples. We also compared the performance of two commercially available detection kits, the cobas EGFR Mutation test v2 (Roche) and the Super-ARMS EGFR Mutation Detection Kit (AmoyDx). The same activating EGFR mutation was detected with the AmoyDx kit as in the primary tumor in 45.6% of the samples. T790M mutation was identified in 48.1% of the samples containing activating EGFR mutation. The detection rate of T790M mutation was not dependent on the DNA concentration of the plasma sample and there was no considerable improvement in mutation detection rate after a second, subsequent plasma sample. The concordance of EGFR activating mutation detection was 89% between the two methods, while this was 93% for T790M mutation detection. The AmoyDx kit, however showed an overall higher detection rate of T790M mutation compared to the cobas kit (p = 0.014). T790M mutation was detected at 29.8% of the patients if only plasma samples were available for analysis, while the detection rate was 70.2% in non-plasma samples. If the activating EGFR was detected in the plasma samples, the detection rate of T790M mutation was 42.4%. Although non-plasma samples provided a superior T790M mutation detection rate, we found that liquid biopsy can offer a valuable tool for T790M mutation detection, when a tissue biopsy is not available. Alternatively, a liquid biopsy can be used as a screening test, when re-biopsy should be considered in case of wild-type results.
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Affiliation(s)
- Eszter Bencze
- Department of Surgical and Molecular Pathology, National Tumour Biology Laboratory, National Institute of Oncology, Budapest, Hungary
| | - Krisztina Bogos
- National Koranyi Institute of Pulmonology, Budapest, Hungary
| | - Andrea Kohánka
- Department of Surgical and Molecular Pathology, National Tumour Biology Laboratory, National Institute of Oncology, Budapest, Hungary
| | - László Báthory-Fülöp
- Department of Surgical and Molecular Pathology, National Tumour Biology Laboratory, National Institute of Oncology, Budapest, Hungary
| | | | - Erzsébet Csernák
- Department of Surgical and Molecular Pathology, National Tumour Biology Laboratory, National Institute of Oncology, Budapest, Hungary
| | - Nóra Bittner
- Department of Oncology Faculty of Medicine, Semmelweis University, Budapest, Hungary
| | - Zsombor Melegh
- Department of Surgical and Molecular Pathology, National Tumour Biology Laboratory, National Institute of Oncology, Budapest, Hungary
| | - Erika Tóth
- Department of Surgical and Molecular Pathology, National Tumour Biology Laboratory, National Institute of Oncology, Budapest, Hungary
- *Correspondence: Erika Tóth,
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Kiss Z, Bogos K, Tamási L, Ostoros G, Müller V, Urbán L, Bittner N, Sárosi V, Vastag A, Polányi Z, Nagy-Erdei Z, Knollmajer K, Várnai M, Nagy B, Horváth K, Rokszin G, Abonyi-Tóth Z, Barcza Z, Moldvay J, Gálffy G, Vokó Z. Increase in the Length of Lung Cancer Patient Pathway Before First-Line Therapy: A 6-Year Nationwide Analysis From Hungary. Pathol Oncol Res 2021; 27:1610041. [PMID: 35002544 PMCID: PMC8734146 DOI: 10.3389/pore.2021.1610041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Accepted: 12/01/2021] [Indexed: 12/24/2022]
Abstract
Objective: This study aimed to examine the characteristics of the lung cancer (LC) patient pathway in Hungary during a 6-years period. Methods: This nationwide, retrospective study included patients newly diagnosed with LC (ICD-10 C34) between January 1, 2011, and December 31, 2016, using data from the National Health Insurance Fund (NHIF) of Hungary. The following patient pathway intervals were examined: system, diagnostic and treatment interval by age, gender, tumor type, study year and first-line LC therapy. Results: During the 6-years study period, 17,386 patients had at least one type of imaging (X-ray or CT/MRI) prior to diagnosis, and 12,063 had records of both X-ray and CT/MRI. The median system interval was 64.5 days, and it was 5 days longer among women, than in men (68.0 vs. 63.0 days). The median system interval was significantly longer in patients with adenocarcinoma compared to those with squamous cell carcinoma or small cell lung cancer (70.4 vs. 64.0 vs. 48.0 days, respectively). Patients who received surgery as first-line treatment had significantly longer median system intervals compared to those receiving chemotherapy (81.4 vs. 62.0 days). The median system interval significantly increased from 62.0 to 66.0 days during the 6-years study period. Conclusion: The LC patient pathway significantly increased in Hungary over the 6-years study period. There were no significant differences in the length of the whole LC patient pathway according to age, however, female sex, surgery as first-line treatment, and adenocarcinoma were associated with longer system intervals.
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Affiliation(s)
- Zoltan Kiss
- MSD Pharma Hungary Ltd., Budapest, Hungary
- *Correspondence: Zoltan Kiss,
| | - Krisztina Bogos
- National Korányi Institute of Pulmonology, Budapest, Hungary
| | - Lilla Tamási
- Department of Pulmonology, Semmelweis University, Budapest, Hungary
| | - Gyula Ostoros
- National Korányi Institute of Pulmonology, Budapest, Hungary
| | - Veronika Müller
- Department of Pulmonology, Semmelweis University, Budapest, Hungary
| | - László Urbán
- Matrahaza Healthcare Center and University Teaching Hospital, Matrahaza, Hungary
| | - Nóra Bittner
- Department of Pulmonology, University of Debrecen, Debrecen, Hungary
| | | | | | | | | | | | | | - Balázs Nagy
- Center for Health Technology Assessment, Semmelweis University, Budapest, Hungary
| | - Krisztián Horváth
- Center for Health Technology Assessment, Semmelweis University, Budapest, Hungary
| | | | - Zsolt Abonyi-Tóth
- RxTarget Ltd., Szolnok, Hungary
- Department of Biomathematics and Computer Science, University of Veterinary Medicine Budapest, Budapest, Hungary
| | - Zsófia Barcza
- Syntesia Medical Communications Ltd., Budapest, Hungary
| | - Judit Moldvay
- 1st Department of Pulmonology, National Korányi Institute of Pulmonology, Semmelweis University, Budapest, Hungary
- 2nd Department of Pathology, MTA-SE NAP, Brain Metastasis Research Group, Hungarian Academy of Sciences, Semmelweis University, Budapest, Hungary
| | | | - Zoltán Vokó
- Center for Health Technology Assessment, Semmelweis University, Budapest, Hungary
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Gálffy G, Vastag A, Bogos K, Kiss Z, Ostoros G, Müller V, Urbán L, Bittner N, Sárosi V, Polányi Z, Nagy-Erdei Z, Daniel A, Knollmajer K, Várnai M, Szegner P, Vokó Z, Nagy B, Horváth K, Rokszin G, Abonyi-Tóth Z, Pozsgai É, Barcza Z, Moldvay J, Tamási L. Significant Regional Differences in Lung Cancer Incidence in Hungary: Epidemiological Study Between 2011 and 2016. Pathol Oncol Res 2021; 27:1609916. [PMID: 34594159 PMCID: PMC8478017 DOI: 10.3389/pore.2021.1609916] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Accepted: 08/27/2021] [Indexed: 12/09/2022]
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.
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Affiliation(s)
- Gabriella Gálffy
- Department of Pulmonology, Pulmonology Hospital Törökbálint, Törökbálint, Hungary
| | | | - Krisztina Bogos
- Department of Pulmonology, National Korányi Institute of Pulmonology, Budapest, Hungary
| | | | - Gyula Ostoros
- Department of Pulmonology, Pulmonology Hospital Törökbálint, Törökbálint, Hungary
| | - Veronika Müller
- Department of Pulmonology, Semmelweis University, Budapest, Hungary
| | - László Urbán
- Department of Pulmonology, Mátraháza Healthcare Center and University Teaching Hospital, Mátraháza, Hungary
| | - Nóra Bittner
- Pulmonology Clinic, University of Debrecen, Debrecen, Hungary
| | - Veronika Sárosi
- Department of Pulmonology, Faculty of Medicine, University of Pécs, Pécs, Hungary
| | | | | | | | | | - Máté Várnai
- MSD Pharma Hungary Ltd, Budapest, Hungary.,Center for Health Technology Assessment, Semmelweis University, Budapest, Hungary
| | - Péter Szegner
- MSD Pharma Hungary Ltd, Budapest, Hungary.,Health Services Management Training Centre, Semmelweis University, Budapest, Hungary
| | - Zoltán Vokó
- Department of Health Policy and Health Economics, Eötvös Loránd University, Budapest, Hungary
| | - Balázs Nagy
- Department of Health Policy and Health Economics, Eötvös Loránd University, Budapest, Hungary
| | - Krisztián Horváth
- Department of Health Policy and Health Economics, Eötvös Loránd University, Budapest, Hungary
| | | | - Zsolt Abonyi-Tóth
- RxTarget Ltd., Szolnok, Hungary.,Department of Biostatistics, University of Veterinary Medicine Budapest, Budapest, Hungary
| | - Éva Pozsgai
- Department of Primary Health Care, University of Pécs Medical School, Pécs, Hungary
| | - Zsófia Barcza
- Syntesia Medical Communications Ltd., Budapest, Hungary
| | - Judit Moldvay
- Department of Tumor Biology, National Korányi Institute of Pulmonology, Semmelweis University, Budapest, Hungary.,MTA-SE NAP, Brain Metastasis Research Group, Hungarian Academy of Sciences, 2nd Department of Pathology, Semmelweis University, Budapest, Hungary
| | - Lilla Tamási
- Department of Pulmonology, Semmelweis University, Budapest, Hungary
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Tamási L, Horváth K, Kiss Z, Bogos K, Ostoros G, Müller V, Urbán L, Bittner N, Sárosi V, Vastag A, Polányi Z, Nagy-Erdei Z, Daniel A, Nagy B, Rokszin G, Abonyi-Tóth Z, Moldvay J, Vokó Z, Gálffy G. Age and Gender Specific Lung Cancer Incidence and Mortality in Hungary: Trends from 2011 Through 2016. Pathol Oncol Res 2021; 27:598862. [PMID: 34257553 PMCID: PMC8262188 DOI: 10.3389/pore.2021.598862] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Accepted: 09/28/2021] [Indexed: 01/10/2023]
Abstract
Objective: No assessment was conducted describing the age and gender specific epidemiology of lung cancer (LC) prior to 2018 in Hungary, thus the objective of this study was to appraise the detailed epidemiology of lung cancer (ICD-10 C34) in Hungary based on a retrospective analysis of the National Health Insurance Fund database. Methods: This longitudinal study included patients aged ≥20 years with LC diagnosis (ICD-10 C34) between January 1, 2011 and December 31, 2016. Patients with different cancer-related codes 6 months before or 12 months after LC diagnosis or having any cancer treatment other than lung cancer protocols were excluded. Results: Lung cancer incidence and mortality increased with age, peaking in the 70–79 age group (375.0/100,000 person-years) among males, while at 60–69 age group for females (148.1/100,000 person-years). The male-to-female incidence rate ratio reached 2.46–3.01 (p < 0.0001) among the 70–79 age group. We found 2–11% decrease in male incidence rate at most age groups, while a significant 1–3% increase was observed in older females (>60) annually during the study period. Conclusion: This nationwide epidemiology study demonstrated that LC incidence and mortality in Hungary decreased in younger male and female population, however we found significant increase of incidence in older female population, similar to international trends. Incidence rates peaked in younger age-groups compared to Western countries, most likely due to higher smoking prevalence in these cohorts, while lower age LC incidence could be attributed to higher competing cardiovascular risk resulting in earlier mortality in smoking population.
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Affiliation(s)
- Lilla Tamási
- Department of Pulmonology, Semmelweis University, Budapest, Hungary
| | - Krisztián Horváth
- Department of Health Policy and Health Economics, Eötvös Loránd University, Budapest, Hungary
| | | | - Krisztina Bogos
- National Korányi Institute of Pulmonology, Department of Pulmonology, Budapest, Hungary
| | - Gyula Ostoros
- National Korányi Institute of Pulmonology, Department of Pulmonology, Budapest, Hungary
| | - Veronika Müller
- Department of Pulmonology, Semmelweis University, Budapest, Hungary
| | - László Urbán
- Mátraháza Healthcare Center and University Teaching Hospital, Mátraháza, Hungary
| | - Nóra Bittner
- Pulmonology Clinic, University of Debrecen, Debrecen, Hungary
| | | | | | | | | | | | - Balázs Nagy
- Department of Health Policy and Health Economics, Eötvös Loránd University, Budapest, Hungary
| | | | - Zsolt Abonyi-Tóth
- RxTarget Ltd., Szolnok, Hungary.,University of Veterinary Medicine, Budapest, Hungary
| | - Judit Moldvay
- Department of Tumor Biology, National Korányi Institute of Pulmonology - Semmelweis University, Budapest, Hungary.,2nd Department of Pathology, MTA-SE NAP, Brain Metastasis Research Group, Hungarian Academy of Sciences, Semmelweis University, Budapest, Hungary
| | - Zoltán Vokó
- Department of Health Policy and Health Economics, Eötvös Loránd University, Budapest, Hungary
| | - Gabriella Gálffy
- Department of Pulmonology, Semmelweis University, Budapest, Hungary.,Pulmonology Hospital, Törökbálint, Hungary
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Bogos K, Kiss Z, Tamási L, Ostoros G, Müller V, Urbán L, Bittner N, Sárosi V, Vastag A, Polányi Z, Nagy-Erdei Z, Daniel A, Vokó Z, Nagy B, Horváth K, Rokszin G, Abonyi-Tóth Z, Barcza Z, Gálffy G, Moldvay J. Improvement in Lung Cancer Survival: 6-Year Trends of Overall Survival at Hungarian Patients Diagnosed in 2011-2016. Pathol Oncol Res 2021; 27:603937. [PMID: 34257563 PMCID: PMC8262181 DOI: 10.3389/pore.2021.603937] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Accepted: 02/24/2021] [Indexed: 12/25/2022]
Abstract
Objective: Lung cancer is one of the most common cancers worldwide and its survival is still poor. The objective of our study was to estimate long-term survival of Hungarian lung cancer patients at first time based on a nationwide review of the National Health Insurance Fund database. Methods: Our retrospective, longitudinal study included patients aged ≥20 years who were diagnosed with lung cancer (ICD-10 C34) between January 1, 2011 and December 31, 2016. Survival rates were evaluated by year of diagnosis, patient gender and age, and morphology of lung cancer. Results: 41,854 newly diagnosed lung cancer patients were recorded. Mean age at diagnosis varied between 64.7 and 65.9 years during study period. One- and 5-year overall survival rates for the total population were 42.2 and 17.9%, respectively. Survival was statistically associated with gender, age and type of lung cancer. Female patients (n = 16,362) had 23% better survival (HR: 0.77, 95% confidence interval (CI): 0.75–0.79; p < 0.001) than males (n = 25,492). The highest survival rates were found in the 20–49 age cohort (5Y = 31.3%) and if the cancer type was adenocarcinoma (5Y = 20.5%). We measured 5.3% improvement (9.2% adjusted) in lung cancer survival comparing the period 2015–2016 to 2011–2012 (HR: 0.95 95% CI: 0.92–0.97; p = 0.003), the highest at females <60 year (0.86 (adjusted HR was 0.79), interaction analysis was significant for age and histology types. Conclusion: Our study provided long-term Lung cancer survival data in Hungary for the first time. We found a 5.3% improvement in 5-year survival in 4 years. Women and young patients had better survival. Survival rates were comparable to–and at the higher end of–rates registered in other East-Central European countries (7.7%–15.7%).
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Affiliation(s)
- Krisztina Bogos
- National Korányi Institute of Pulmonology, Budapest, Hungary
| | | | - Lilla Tamási
- Department of Pulmonology, Semmelweis University, Budapest, Hungary
| | - Gyula Ostoros
- National Korányi Institute of Pulmonology, Budapest, Hungary
| | - Veronika Müller
- Department of Pulmonology, Semmelweis University, Budapest, Hungary
| | - László Urbán
- Matrahaza Healthcare Center and University Teaching Hospital, Matrahaza, Hungary
| | - Nóra Bittner
- Pulmonology Clinic University of Debrecen, Debrecen, Hungary
| | | | | | | | | | | | | | | | | | | | - Zsolt Abonyi-Tóth
- RxTarget Ltd. Szolnok, Budapest, Hungary.,University of Veterinary Medicine Budapest, Budapest, Hungary
| | | | | | - Judit Moldvay
- Ist Department of Pulmonology, National Korányi Institute of Pulmonology, Semmelweis University, Budapest, Hungary.,2nd Department of Pathology, MTA-SE NAP, Brain Metastasis Research Group, Hungarian Academy of Sciences, Semmelweis University, Budapest, Hungary
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8
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Mokánszki A, Bádon ES, Mónus A, Tóth L, Bittner N, Méhes G. Cell-free DNA From Pleural Effusion Samples: Is It Right for Molecular Testing in Lung Adenocarcinoma? Pathol Oncol Res 2021; 27:613071. [PMID: 34257581 PMCID: PMC8262152 DOI: 10.3389/pore.2021.613071] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2020] [Accepted: 02/19/2021] [Indexed: 12/03/2022]
Abstract
Pathogenic molecular features gained specific significance in therapeutic decisions in lung carcinoma in the past decade. Initial and follow up genetic testing requres appropriate amounts and quality of tumor derived DNA, but tumor sampling, especially for disease monitoring is generally limited. Further to the peripheral blood (PB), samples from pleural fluid, accumulating in diverse lung processes might serve as an alternative source for cell-free DNA (cfDNA) for genetic profiling. In our study, cfDNA isolated from the pleural effusion and from the PB, and genomic DNA (gDNA) obtained from tissue/cellular samples were analyzed and compared from altogether 65 patients with pulmonary disease, including 36 lung adenocarcinomas. The quantity of effusion cfDNA yield appeared to be significantly higher compared to that from simultaneously collected PB plasma (23.2 vs. 4.8 ng/μl, p < 0.05). Gene mutations could be safely demonstrated from the effusion cfDNA fraction obtained from adenocarcinoma patients, 3/36 EGFR, 9/36 KRAS and 1/36 BRAF gene variants were detected. In this series, 9/13 samples showed an effusion+/plasma-mutational status, while only 1/13 samples presented with the opposite findings (effusion-/plasma+). gDNA analysis from sediment cell blocks from the identical effusion sample was surprisingly ineffective for lung adenocarcinoma profiling due to the low DNA yield. In conclusion, the cell free supernatant of pleural effusions appears to concentrate cancer derived cfDNA and seems to be particularly suitable for serial genotyping of pulmonary adenocarcinoma.
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Affiliation(s)
- Attila Mokánszki
- Department of Pathology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Emese Sarolta Bádon
- Department of Pathology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Anikó Mónus
- Department of Pathology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - László Tóth
- Department of Pathology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Nóra Bittner
- Department of Pulmonology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Gábor Méhes
- Department of Pathology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
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9
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Bogos K, Kiss Z, Gálffy G, Tamási L, Ostoros G, Müller V, Urbán L, Bittner N, Sárosi V, Vastag A, Polányi Z, Nagy-Erdei Z, Vokó Z, Nagy B, Horváth K, Rokszin G, Abonyi-Tóth Z, Barcza Z, Moldvay J. Lung Cancer in Hungary. J Thorac Oncol 2021; 15:692-699. [PMID: 32340676 DOI: 10.1016/j.jtho.2019.11.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2019] [Accepted: 11/02/2019] [Indexed: 01/30/2023]
Affiliation(s)
- Krisztina Bogos
- IV. Department of Pulmonology, National Korányi Institute of Pulmonology, Budapest, Hungary
| | | | | | - Lilla Tamási
- Department of Pulmonology, Semmelweis University, Budapest, Hungary
| | - Gyula Ostoros
- IV. Department of Pulmonology, National Korányi Institute of Pulmonology, Budapest, Hungary
| | - Veronika Müller
- Department of Pulmonology, Semmelweis University, Budapest, Hungary
| | - László Urbán
- Mátraháza Healthcare Center and University Teaching Hospital, Mátraháza, Hungary
| | - Nóra Bittner
- University of Debrecen, Pulmonology Clinic, Debrecen, Hungary
| | | | | | | | | | | | | | | | | | - Zsolt Abonyi-Tóth
- RxTarget Ltd., Szolnok, Hungary; University of Veterinary Medicine, Budapest, Hungary
| | | | - Judit Moldvay
- Department of Tumor Biology, National Korányi Institute of Pulmonology, Semmelweis University, Budapest, Hungary; MTA-SE NAP, Brain Metastasis Research Group, Hungarian Academy of Sciences, 2nd Department of Pathology, Semmelweis University, Budapest, Hungary
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10
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Bogos K, Kiss Z, Gálffy G, Tamási L, Ostoros G, Müller V, Urbán L, Bittner N, Sárosi V, Vastag A, Polányi Z, Nagy-Erdei Z, Vokó Z, Nagy B, Rokszin G, Abonyi-Tóth Z, Moldvay J. [Novel approaches to the epidemiology of lung cancer in Hungary]. Magy Onkol 2020; 64:175-181. [PMID: 32966347] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Accepted: 09/14/2020] [Indexed: 06/11/2023]
Abstract
In the international publications, in the last decades, incidence and mortality of lung cancer was the highest in Hungary in the ranking of European countries and even worldwide, despite the fact that no lung cancer incidence data were reported from Hungary until 2019. In the studies published by our working group at the end of 2019 and in the first half of 2020, we were the first to publish Hungarian lung cancer incidence and mortality data based on research on the NEAK database. The results of this study showed a significant, 25-30% lower incidence of lung cancer in Hungary than the previously reported data. Based on these findings, it was determined that the previously reported Hungarian lung cancer incidence and mortality data can be compiled due to different methodological applications of inadequately calculated results, and Hungarian lung cancer incidence and mortality are equally high, but not higher than the average in Central European countries. In addition, a decrease in the incidence and mortality of male lung cancer was measured between 2011 and 2016, while increasing values were found for women.
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Affiliation(s)
| | | | | | - Lilla Tamási
- Pulmonológiai Klinika, Semmelweis Egyetem, Budapest, Hungary
| | - Gyula Ostoros
- Országos Korányi Pulmonológiai Intézet, Budapest, Hungary.
| | - Veronika Müller
- Pulmonológiai Klinika, Semmelweis Egyetem, Budapest, Hungary
| | | | - Nóra Bittner
- Tüdőgyógyászati Klinika, Debreceni Egyetem Klinikai Központ, Debrecen, Hungary
| | - Veronika Sárosi
- I. Sz. Belgyógyászati Klinika, Pécsi Egyetem Klinikai Központ, Pulmonológiai Tanszék, Pécs, Hungary
| | | | | | | | | | | | | | | | - Judit Moldvay
- Országos Korányi Pulmonológiai Intézet, Budapest, Hungary.
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11
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Szekanecz Z, Gomez I, Soós B, Bodoki L, Szamosi S, András C, Juhász B, Váróczy L, Antal-Szalmás P, Szodoray P, Bittner N, Árkosy P, Illés Á, Szűcs G, Dankó K, Bender T, Tamási L, Szekanecz É. Eight pillars of oncorheumatology: Crossroads between malignancies and musculoskeletal diseases. Autoimmun Rev 2020; 19:102658. [PMID: 32942035 DOI: 10.1016/j.autrev.2020.102658] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2020] [Accepted: 03/31/2020] [Indexed: 02/07/2023]
Abstract
ONCORHEUMATOLOGY RELATIONSHIP BETWEEN MALIGNANCIES AND MUSCULOSKELETAL DISEASES: Oncorheumatology is the meeting point of tumor formation and rheumatic musculoskeletal diseases (RMD). Multiple interactions exist between these two medical specialties. One major field is the topic of malignancies associated with rheumatic diseases, while the other topic covers the development of musculoskeletal disease in cancer patients. Within the first group, secondary malignancies may be associated with rheumatic diseases. Mostly sustained inflammation is responsible for transition into cancer. Tumor-associated antigens (TAA) with adhesive properties are present on tumor cells. These molecules may also be expressed by inflammatory leukocytes and soluble TAA levels may be elevated in RMDs. There has been continuous debate with respect to the possible carcinogenicity of conventional and targeted antirheumatic drugs. Very recent data from registries suggest that neither biologics, nor JAK inhibitors increase cancer risk in arthritis patients. The issue of physiotherapy in rheumatic patients with recent or current cancer has also been controversial. Some modalities, primarily exercise, may be safely applied to patients with RMD and cancer. The second large topic includes paraneoplastic syndromes. Musculoskeletal paraneoplasias are triggered by tumor-derived mediators. These syndromes are sometimes slightly different from the classical RMDs. Various chemotherapies may also be associated with autoimmune side effects. Recently, these immune-related complications have also been observed in cancer patients treated with immune-checkpoint inhibitors. Sex hormone-deprivation therapies, such as aromatase inhibitors and anti-androgens are widely used for the treatment of breast and prostate cancer, respectively. These compounds may induce bone loss and lead to osteoporosis. Finally, primary and secondary malignancies of the musculoskeletal system may also interest rheumatologists. In this review, the clinical, practical aspects of these eight pillars of oncorheumatology will be discussed.
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Affiliation(s)
- Zoltán Szekanecz
- Division of Rheumatology, Department of Medicine, Faculty of Medicine, University of Debrecen, Debrecen, Hungary.
| | - Izabella Gomez
- Division of Rheumatology, Department of Medicine, Faculty of Medicine, University of Debrecen, Debrecen, Hungary; National Institute of Rheumatology and Physiotherapy, Budapest, Hungary
| | - Boglárka Soós
- Division of Rheumatology, Department of Medicine, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Levente Bodoki
- Division of Rheumatology, Department of Medicine, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Szilvia Szamosi
- Division of Rheumatology, Department of Medicine, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Csilla András
- Department of Oncology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Balázs Juhász
- Department of Oncology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - László Váróczy
- Division of Hematology, Department of Medicine, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Péter Antal-Szalmás
- Department of Laboratory Medicine, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Péter Szodoray
- Division of Clinical Immunology, Department of Medicine, Faculty of Medicine, University of Debrecen, Debrecen, Hungary; Institute of Immunology, Rikshospitalet, Oslo University Hospital, Oslo, Norway
| | - Nóra Bittner
- Department of Pulmonology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Péter Árkosy
- Department of Oncology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Árpád Illés
- Division of Hematology, Department of Medicine, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Gabriella Szűcs
- Division of Rheumatology, Department of Medicine, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Katalin Dankó
- Division of Clinical Immunology, Department of Medicine, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Tamás Bender
- Buda Hospital of the Hospitaller Order of Saint John of God, Budapest, Hungary
| | - László Tamási
- Department of Rheumatology, Borsod-Abaúj-Zemplén County Hospital and University Teaching Hospital, Miskolc;, Hungary
| | - Éva Szekanecz
- Department of Oncology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
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12
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Szekanecz Z, Gomez I, Soós B, Bodoki L, Szamosi S, András C, Juhász B, Váróczy L, Antal-Szalmás P, Szodoray P, Bittner N, Árkosy P, Illés Á, Szűcs G, Dankó K, Bender T, Tamási L, Szekanecz É. Oncorheumatology: relationship between malignancies and musculoskeletal diseases. Orv Hetil 2020; 161:1151-1165. [PMID: 32609623 DOI: 10.1556/650.2020.31800] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2020] [Accepted: 04/06/2020] [Indexed: 11/19/2022]
Abstract
Oncorheumatology is the meeting point of tumour formation and rheumatic diseases. Multiple interactions exist between these two medical specialties. One major field is the topic of malignancies associated with rheumatic diseases, while the other topic covers the development of musculoskeletal disease in cancer patients. In the first group, secondary malignancies associated with rheumatic diseases, role of tumour-associated antigens in rheumatology, the possible carcinogenicity of conventional and targeted antirheumatic drugs and physical therapy of rheumatic patients with recent or current cancer will be discussed. The second large topic includes paraneoplastic syndromes, autoimmune-rheumatic side effects of oncotherapies (chemotherapy and immunotherapy), effects of hormone-deprivation therapies on bone and primary and secondary malignancies of the musculoskeletal system. Orv Hetil. 2020; 161(28): 1151-1165.
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Affiliation(s)
- Zoltán Szekanecz
- Klinikai Központ, Belgyógyászati Intézet, Reumatológiai Tanszék,Debreceni Egyetem, Általános Orvostudományi Kar, Debrecen, Nagyerdei krt. 98., 4032
| | - Izabella Gomez
- Klinikai Központ, Belgyógyászati Intézet, Reumatológiai Tanszék,Debreceni Egyetem, Általános Orvostudományi Kar, Debrecen, Nagyerdei krt. 98., 4032.,Országos Reumatológiai és Fizioterápiás Intézet, Budapest
| | - Boglárka Soós
- Klinikai Központ, Belgyógyászati Intézet, Reumatológiai Tanszék,Debreceni Egyetem, Általános Orvostudományi Kar, Debrecen, Nagyerdei krt. 98., 4032
| | - Levente Bodoki
- Klinikai Központ, Belgyógyászati Intézet, Reumatológiai Tanszék,Debreceni Egyetem, Általános Orvostudományi Kar, Debrecen, Nagyerdei krt. 98., 4032
| | - Szilvia Szamosi
- Klinikai Központ, Belgyógyászati Intézet, Reumatológiai Tanszék,Debreceni Egyetem, Általános Orvostudományi Kar, Debrecen, Nagyerdei krt. 98., 4032
| | - Csilla András
- Klinikai Központ, Onkológiai Klinika,Debreceni Egyetem, Általános Orvostudományi Kar, Debrecen
| | - Balázs Juhász
- Klinikai Központ, Onkológiai Klinika,Debreceni Egyetem, Általános Orvostudományi Kar, Debrecen
| | - László Váróczy
- Klinikai Központ, Belgyógyászati Intézet, Hematológiai Tanszék,Debreceni Egyetem, Általános Orvostudományi Kar, Debrecen
| | - Péter Antal-Szalmás
- Klinikai Központ, Laboratóriumi Medicina Intézet,Debreceni Egyetem, Általános Orvostudományi Kar, Debrecen
| | - Péter Szodoray
- Klinikai Központ, Belgyógyászati Intézet, Klinikai Immunológiai Tanszék,Debreceni Egyetem, Általános Orvostudományi Kar, Debrecen.,Institute of Immunology,Rikshospitalet, Oslo University Hospital, Oslo, Norvégia
| | - Nóra Bittner
- Tüdőgyógyászati Klinika,Debreceni Egyetem, Általános Orvostudományi Kar, Debrecen
| | - Péter Árkosy
- Klinikai Központ, Onkológiai Klinika,Debreceni Egyetem, Általános Orvostudományi Kar, Debrecen
| | - Árpád Illés
- Klinikai Központ, Belgyógyászati Intézet, Hematológiai Tanszék,Debreceni Egyetem, Általános Orvostudományi Kar, Debrecen
| | - Gabriella Szűcs
- Klinikai Központ, Belgyógyászati Intézet, Reumatológiai Tanszék,Debreceni Egyetem, Általános Orvostudományi Kar, Debrecen, Nagyerdei krt. 98., 4032
| | - Katalin Dankó
- Klinikai Központ, Belgyógyászati Intézet, Klinikai Immunológiai Tanszék,Debreceni Egyetem, Általános Orvostudományi Kar, Debrecen
| | | | - László Tamási
- Szent Ferenc Tagkórház, Reumatológiai Osztály,Borsod-Abaúj-Zemplén Megyei Központi Kórház és Egyetemi Oktatókórház, Miskolc
| | - Éva Szekanecz
- Klinikai Központ, Onkológiai Klinika,Debreceni Egyetem, Általános Orvostudományi Kar, Debrecen
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13
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Bogos K, Kiss Z, Gálffy G, Tamási L, Ostoros G, Müller V, Urbán L, Bittner N, Sárosi V, Vastag A, Polányi Z, Nagy-Erdei Z, Vokó Z, Nagy B, Horváth K, Rokszin G, Abonyi-Tóth Z, Moldvay J. Revising Incidence and Mortality of Lung Cancer in Central Europe: An Epidemiology Review From Hungary. Front Oncol 2019; 9:1051. [PMID: 31709174 PMCID: PMC6819432 DOI: 10.3389/fonc.2019.01051] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2019] [Accepted: 09/26/2019] [Indexed: 12/30/2022] Open
Abstract
Objective: While Hungary is often reported to have the highest incidence and mortality rates of lung cancer, until 2018 no nationwide epidemiology study was conducted to confirm these trends. The objective of this study was to estimate the occurrence of lung cancer in Hungary based on a retrospective review of the National Health Insurance Fund (NHIF) database. Methods: Our retrospective, longitudinal study included patients aged ≥20 years who were diagnosed with lung cancer (ICD-10 C34) between 1 Jan 2011 and 31 Dec 2016. Age-standardized incidence and mortality rates were calculated using both the 1976 and 2013 European Standard Populations (ESP). Results: Between 2011 and 2016, 6,996 – 7,158 new lung cancer cases were recorded in the NHIF database annually, and 6,045 – 6,465 all-cause deaths occurred per year. Age-adjusted incidence rates were 115.7–101.6/100,000 person-years among men (ESP 1976: 84.7–72.6), showing a mean annual change of − 2.26% (p = 0.008). Incidence rates among women increased from 48.3 to 50.3/100,000 person-years (ESP 1976: 36.9–38.0), corresponding to a mean annual change of 1.23% (p = 0.028). Age-standardized mortality rates varied between 103.8 and 97.2/100,000 person-years (ESP 1976: 72.8–69.7) in men and between 38.3 and 42.7/100,000 person-years (ESP 1976: 27.8–29.3) in women. Conclusion: Age-standardized incidence and mortality rates of lung cancer in Hungary were found to be high compared to Western-European countries, but lower than those reported by previous publications. The incidence of lung cancer decreased in men, while there was an increase in incidence and mortality among female lung cancer patients.
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Affiliation(s)
- Krisztina Bogos
- Department of Pulmonology, National Korányi Institute of Pulmonology, Budapest, Hungary
| | | | | | - Lilla Tamási
- Department of Pulmonology, Semmelweis University, Budapest, Hungary
| | - Gyula Ostoros
- Department of Pulmonology, National Korányi Institute of Pulmonology, Budapest, Hungary
| | - Veronika Müller
- Department of Pulmonology, Semmelweis University, Budapest, Hungary
| | - László Urbán
- Mátraháza Healthcare Center, University Teaching Hospital, Mátraháza, Hungary
| | - Nóra Bittner
- Pulmonology Clinic, University of Debrecen, Debrecen, Hungary
| | | | | | | | | | - Zoltán Vokó
- Department of Health Policy and Health Economics, Eötvös Loránd University, Budapest, Hungary
| | - Balázs Nagy
- Department of Health Policy and Health Economics, Eötvös Loránd University, Budapest, Hungary
| | - Krisztián Horváth
- Department of Health Policy and Health Economics, Eötvös Loránd University, Budapest, Hungary
| | | | - Zsolt Abonyi-Tóth
- RxTarget Ltd., Szolnok, Hungary.,University of Veterinary Medicine, Budapest, Hungary
| | - Judit Moldvay
- Department of Tumor Biology, National Korányi Institute of Pulmonology, Semmelweis University, Budapest, Hungary.,2nd Department of Pathology, MTA-SE NAP, Brain Metastasis Research Group, Hungarian Academy of Sciences, Semmelweis University, Budapest, Hungary
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Bittner N, Jockwitz C, Moebus S, Pundt N, Bayen UJ, Zilles K, Amunts K, Caspers S. Lifestyle risk and cortical folding of older adults. Gesundheitswesen 2016. [DOI: 10.1055/s-0036-1586524] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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15
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Krull H, Bittner N, Uhrig GS, Manske D, Schnyder AP. Coupling of Higgs and Leggett modes in non-equilibrium superconductors. Nat Commun 2016; 7:11921. [PMID: 27323887 PMCID: PMC4919519 DOI: 10.1038/ncomms11921] [Citation(s) in RCA: 68] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2016] [Accepted: 05/12/2016] [Indexed: 11/17/2022] Open
Abstract
In equilibrium systems amplitude and phase collective modes are decoupled, as they are mutually orthogonal excitations. The direct detection of these Higgs and Leggett collective modes by linear-response measurements is not possible, because they do not couple directly to the electromagnetic field. In this work, using numerical exact simulations we show for the case of two-gap superconductors, that optical pump–probe experiments excite both Higgs and Leggett modes out of equilibrium. We find that this non-adiabatic excitation process introduces a strong interaction between the collective modes, which is absent in equilibrium. Moreover, we propose a type of pump–probe experiment, which allows to probe and coherently control the Higgs and Leggett modes, and thus the order parameter directly. These findings go beyond two-band superconductors and apply to general collective modes in quantum materials. Collective modes of amplitude and phase are decoupled in equilibrium systems, limiting the understanding of competing orders in correlated material. Here, Krull et al. report that a non-adiabatic pump pulse can induce an intricate coupling between Leggett and Higgs modes, providing a way to couple collective modes in non-equilibrium condition.
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Affiliation(s)
- H Krull
- Lehrstuhl für Theoretische Physik I, Technische Univerität Dortmund, Otto-Hahn Strasse 4, D-44221 Dortmund, Germany
| | - N Bittner
- Max-Planck-Institut für Festkörperforschung, Heisenbergstrasse 1, D-70569 Stuttgart, Germany
| | - G S Uhrig
- Lehrstuhl für Theoretische Physik I, Technische Univerität Dortmund, Otto-Hahn Strasse 4, D-44221 Dortmund, Germany
| | - D Manske
- Max-Planck-Institut für Festkörperforschung, Heisenbergstrasse 1, D-70569 Stuttgart, Germany
| | - A P Schnyder
- Max-Planck-Institut für Festkörperforschung, Heisenbergstrasse 1, D-70569 Stuttgart, Germany
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Bittner N, Merrick G, Galbreath R, Butler W, Adamovich E. Treatment outcomes with permanent brachytherapy in high-risk prostate cancer patients stratified into prognostic categories. Brachytherapy 2015; 14:766-72. [DOI: 10.1016/j.brachy.2015.09.003] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2015] [Revised: 08/27/2015] [Accepted: 09/09/2015] [Indexed: 10/22/2022]
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Butler W, Merrick G, Kurko B, Bittner N. SU-E-J-230: Effect of Metal Hip Prosthesis On the Accuracy of Electromagnetic Localization and Tracking. Med Phys 2014. [DOI: 10.1118/1.4888283] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Takács I, Benkő I, Toldy E, Wikonkál N, Szekeres L, Bodolay E, Kiss E, Jambrik Z, Szabó B, Merkely B, Valkusz Z, Kovács T, Szabó A, Grigoreff O, Nagy Z, Demeter J, Horváth HC, Bittner N, Várbíró S, Lakatos P. [Hungarian consensus regarding the role of vitamin D in the prevention and treatment of diseases]. Orv Hetil 2012; 153 Suppl:5-26. [PMID: 22934332 DOI: 10.1556/oh.2012.29410] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
The metabolism of vitamin D is unique in the human body and its diverse effects are present in almost every organ. Vitamin D deficiency is one of the most prominent health issues in the civilized world. For the solution of this concern an extensive collaboration is imperative. Recognizing this necessity the most prominent Hungarian medical associations fighting with the effects of vitamin D deficiency worked out a collective consensus on the importance, diagnosis, prevention and suggested therapy of vitamin D deficiency. Along with the clinical guidelines of the different associations, the result of this consensus could serve as guidance for the practicing doctors in the prevention and therapy of vitamin D deficiency. In addition the consensus aims to direct the attention of decision-makers and the general public on the significance of this issue.
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Affiliation(s)
- István Takács
- Altalános Orvostudományi Kar, I. Belgyógyászati Klinika, Budapest
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Bittner N, Cipkova A, Móciková H, Wojciechowska-Lampka E, Balázs M, Ocvirk J. Current management of chemotherapy-induced anemia with darbepoetin alfa: The APRIORI study. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.e19723] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Helm T, Kartsovnik MV, Sheikin I, Bartkowiak M, Wolff-Fabris F, Bittner N, Biberacher W, Lambacher M, Erb A, Wosnitza J, Gross R. Magnetic breakdown in the electron-doped cuprate superconductor Nd(2-x)Ce(x)CuO4: the reconstructed Fermi surface survives in the strongly overdoped regime. Phys Rev Lett 2010; 105:247002. [PMID: 21231554 DOI: 10.1103/physrevlett.105.247002] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/13/2010] [Indexed: 05/30/2023]
Abstract
We report on semiclassical angle-dependent magnetoresistance oscillations and the Shubnikov-de Haas effect in the electron-overdoped cuprate superconductor Nd(2-x)CexCuO4. Our data provide convincing evidence for magnetic breakdown in the system. This shows that a reconstructed multiply connected Fermi surface persists, at least at strong magnetic fields, up to the highest doping level of the superconducting regime.
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Affiliation(s)
- T Helm
- Walther-Meißner-Institut, Bayerische Akademie der Wissenschaften, Walther-Meißner-Straße 8, D-85748 Garching, Germany
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Helm T, Kartsovnik MV, Bartkowiak M, Bittner N, Lambacher M, Erb A, Wosnitza J, Gross R. Evolution of the Fermi surface of the electron-doped high-temperature superconductor Nd(2-x)Ce(x)CuO(4) revealed by Shubnikov-de Haas oscillations. Phys Rev Lett 2009; 103:157002. [PMID: 19905660 DOI: 10.1103/physrevlett.103.157002] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/19/2009] [Indexed: 05/28/2023]
Abstract
We report on the direct probing of the Fermi surface in the bulk of the electron-doped superconductor Nd(2-x)Ce(x)CuO(4) at different doping levels by means of magnetoresistance quantum oscillations. Our data reveal a sharp qualitative change in the Fermi surface topology, due to translational symmetry breaking in the electronic system which occurs at a critical doping level significantly exceeding the optimal doping. This result implies that the (pi/a, pi/a) ordering, known to exist at low doping levels, survives up to the overdoped superconducting regime.
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Affiliation(s)
- T Helm
- Walther-Meissner-Institut, Bayerische Akademie der Wissenschaften, D-85748 Garching, Germany
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Bittner N, Merrick G, Wallner K, Butler W, Anderson R, Allen Z, Adamovich E. Pre-biopsy Prostate-specific Antigen Velocity does not Predict Gleason Score, Tumor Location or Cancer Volume Following Transperineal-template Guided Prostate Mapping Biopsy: Implications for Prostate Brachytherapy Treatment Planning. Int J Radiat Oncol Biol Phys 2008. [DOI: 10.1016/j.ijrobp.2008.06.1132] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Niehaus A, Merrick G, Bittner N, Butler W, Wallner K, Allen Z, Galbreath R, Lief J. The Role of Trospium Chloride in Brachytherapy-Related Detrusor Overactivity. Int J Radiat Oncol Biol Phys 2007. [DOI: 10.1016/j.ijrobp.2007.07.1477] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Bittner N, Merrick G, Wallner K, Lief J, Butler W, Allen Z, Galbreath R. The Impact of Urinary Storm on Late Urinary Function Following Permanent Prostate Brachytherapy. Int J Radiat Oncol Biol Phys 2007. [DOI: 10.1016/j.ijrobp.2007.07.1969] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Mayadev J, Merrick G, Wallner K, Arthurs-Cutshall S, Bittner N. Dosimetric Parameters of Rectal Toxicity and Fistula Formation After Prostate Brachytherapy. Int J Radiat Oncol Biol Phys 2007. [DOI: 10.1016/j.ijrobp.2007.07.1371] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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