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Mihajlovic J.,University of Groningen | Pechlivanoglou P.,University of Groningen | Miladinov-Mikov M.,Oncology Institute of Vojvodina | Miladinov-Mikov M.,University of Novi Sad | And 2 more authors.
BMC Cancer | Year: 2013

Background: Despite the increase in cancer incidence in the last years in Serbia, no nation-wide, population-based cancer epidemiology data have been reported. In this study cancer incidence and mortality rates for Serbia are presented using nation-wide data from two population-based cancer registries. These rates are additionally compared to European and global cancer epidemiology estimates. Finally, predictions on Serbian cancer incidence and mortality rates are provided.Methods: Cancer incidence and mortality was collected from the cancer registries of Central Serbia and Vojvodina from 1999 to 2009. Using age-specific regression models, we estimated time trends and predictions for cancer incidence and mortality for the following five years (2010-2014). The comparison of Serbian with European and global cancer incidence/mortality rates, adjusted to the world population (ASR-W) was performed using Serbian population-based data and estimates from GLOBOCAN 2008.Results: Increasing trends in both overall cancer incidence and mortality rates were identified for Serbia. In men, lung cancer showed the highest incidence (ASR-W 2009: 70.8/100,000), followed by colorectal (ASR-W 2009: 39.9/100,000), prostate (ASR-W 2009: 29.1/100,000) and bladder cancer (ASR-W 2009: 16.2/100,000). Breast cancer was the most common form of cancer in women (ASR-W 2009: 70.8/100,000) followed by cervical (ASR-W 2009: 25.5/100,000), colorectal (ASR-W 2009: 21.1/100,000) and lung cancer (ASR-W 2009: 19.4/100,000). Prostate and colorectal cancers have been significantly increasing over the last years in men, while this was also observed for breast cancer incidence and lung cancer mortality in women. In 2008 Serbia had the highest mortality rate from breast cancer (ASR-W 2008: 22.7/100,000), among all European countries while incidence and mortality of cervical, lung and colorectal cancer were well above European estimates.Conclusion: Cancer incidence and mortality in Serbia has been generally increasing over the past years. For a number of cancer sites, incidence and mortality is alarmingly higher than in the majority of European regions. For this increasing trend to be controlled, the management of risk factors that are present among the Serbian population is necessary. Additionally, prevention and early diagnosis are areas where significant improvements could still be made. © 2013 Mihajlovic et al.; licensee BioMed Central Ltd.

Jeremic V.,University of Belgrade | Seke K.,Institute of Public Health of Serbia Dr Milan Jovanovic Batut | Radojicic Z.,University of Belgrade | Jeremic D.,University of Belgrade | And 3 more authors.
HealthMED | Year: 2011

We examined the health status of 27 European Union countries by employing statistical I-distance method on various health indicators. Results showed that Ireland tops the list of EU "healthiest countries", while Sweden and Finland are just a small step behind. On the other hand, Bulgaria, Hungary, Poland and Romania are at the bottom of the list. Further on, I-distance method has provided information as to which input variables are crucial for determining a country's health system performance. We emphasize importance of evaluating health system performances and determining key health indicators.

Jovanovic D.,Institute of Public Health of Serbia Dr Milan Jovanovic Batut | Jakovljevic B.,Institute of Hygiene and Medical Ecology | Rasic-Milutinovic Z.,University of Belgrade | Paunovic K.,Institute of Hygiene and Medical Ecology | And 2 more authors.
Environmental Research | Year: 2011

Vojvodina, a northern region of Serbia, belongs to the Pannonian Basin, whose aquifers contain high concentrations of arsenic. This study represents arsenic levels in drinking water in ten municipalities in Serbia. Around 63% of all water samples exceeded Serbian and European standards for arsenic in drinking water. Large variations in arsenic were observed among supply systems. Arsenic concentrations in public water supply systems in Vojvodina were much higher than in other countries in the Pannonian Basin. © 2010 Elsevier Inc.

Seke K.,Institute of Public Health of Serbia Dr Milan Jovanovic Batut | Petrovic N.,University of Belgrade | Jeremic V.,University of Belgrade | Vukmirovic J.,Belgrade Business School | And 2 more authors.
BMC Public Health | Year: 2013

Background: Sustainable development and public health quite strongly correlate, being connected and conditioned by one another. This paper therein attempts to offer a representation of Europe's current situation of sustainable development in the area of public health. Methods. A dataset on sustainable development in the area of public health consisting of 31 European countries (formally proposed by the European Union Commission and EUROSTAT) has been used in this paper in order to evaluate said issue for the countries listed thereof. A statistical method which synthesizes several indicators into one quantitative indicator has also been utilized. Furthermore, the applied method offers the possibility to obtain an optimal set of variables for future studies of the problem, as well as for the possible development of indicators. Results: According to the results obtained, Norway and Iceland are the two foremost European countries regarding sustainable development in the area of public health, whereas Romania, Lithuania, and Latvia, some of the European Union's newest Member States, rank lowest. The results also demonstrate that the most significant variables (more than 80%) in rating countries are found to be "healthy life years at birth, females" (r§ssup§2§ esup§ = 0.880), "healthy life years at birth, males" (r§ssup§2§esup§ = 0.864), "death rate due to chronic diseases, males" (r§ssup§2§esup§ = 0.850), and "healthy life years, 65, females" (r§ssup§2§esup§ = 0.844). Conclusions: Based on the results of this paper, public health represents a precondition for sustainable development, which should be continuously invested in and improved.After the assessment of the dataset, proposed by EUROSTAT in order to evaluate progress towards the agreed goals of the EU Sustainable Development Strategy (SDS), this paper offers an improved set of variables, which it is hoped, may initiate further studies concerning this problem. © 2013 Seke et al.; licensee BioMed Central Ltd.

Boricic K.,Institute of Public Health of Serbia Dr Milan Jovanovic Batut | Simic S.,University of Belgrade | Eric J.M.,University of Belgrade
BMC Public Health | Year: 2015

Background: The aim of this study was to examine the relationships between demographic and socioeconomic characteristics and engaging in multiple risk behaviours among adolescents in Republic of Serbia. Methods: This study presents a cross sectional study of 683 adolescents aged 15 to 19 attending high school. The database from the 2006 National Health Survey was used. As a measure of demographic and socio-economic characteristics: Age, type of settlement, family structure, having one's own room, school success and the household wealth index were used. Multivariate logistic regression model was performed. Results: Boys were more than twice as likely to engage in multiple risk behaviours than girls. Adolescents who were older (OR = 5.82, 95% CI = 3.21-10.54, boys; OR = 3.76, 95% CI =1.77-7.99, girls) and adolescents who achieved low or moderate (OR = 1.82, 95% CI = 1.02-3.26, boys; OR = 3.36, 95% CI =1.51-7.44, girls) school success had significantly higher risk than younger ones and those with high school success. Also, boys who came from a richer class households (OR = 3.14, 95% CI =1.02-9.66) and girls from incomplete family (OR = 5.07, 95% CI = 2.06-12.50) had higher risk than boys from the poorest households and girls from complete family. Conclusions: Further preventive interventions in Serbia should be gender and age specific, oriented towards older adolescents, those who have low or moderate school success, boys from richer class households and girls who live in incomplete families. © 2015 Boricic et al.

Jovanovic D.D.,Institute of Public Health of Serbia Dr Milan Jovanovic Batut | Paunovic K.,University of Belgrade | Manojlovic D.D.,Serbian Institute of Chemistry | Jakovljevic B.,University of Belgrade | And 2 more authors.
Environmental Research | Year: 2012

Background: Arsenic is constantly present in drinking water supply systems of Zrenjanin municipality across decades. It presents a great public health problem in Serbia, but its relationship with acute coronary syndrome (ACS) has not been studied previously. Objectives: The aims of this study were to assess the incidence of ACS in two areas from Zrenjanin municipality consuming different levels of arsenic in drinking water, and to explore the association between arsenic exposure and the probability of fatal outcome of ACS. Methods: The research was a registry-based ecological study of two populations consuming water with different arsenic levels, based on current guidelines (10 μg/L). Median arsenic in the area above national standard was 80 μg/L; median arsenic in the other area was 1 μg/L. Newly diagnosed cases of ACS were obtained from the National Registry for Acute Coronary Syndrome from 2006 to 2010. Results: The two populations were comparable by age, gender, and prevalence of risk factors for ACS. Standardized incidence rates (SIR) of ACS were higher for people consuming arsenic above standard (average five-year SIR was 237.00 per 100.000; 95% CI=214.93-260.74), in comparison to people consuming arsenic within limits (average SIR=124.40 per 100.000; 95% CI=96.00-158.56). Exposure to arsenic above limits was insignificantly associated with fatal outcome of ACS for the whole population, men and women. Conclusions: Consumption of arsenic above national standards was associated with higher risk for the occurrence of acute coronary syndrome and with insignificantly higher probability of fatal outcome of ACS in Zrenjanin municipality. © 2012 Elsevier Inc.

Jovanovic D.,Institute of Public Health of Serbia Dr Milan Jovanovic Batut | Rasic-Milutinovic Z.,University of Belgrade | Paunovic K.,Institute of Hygiene and Medical Ecology | Jakovljevic B.,Institute of Hygiene and Medical Ecology | And 2 more authors.
International Journal of Hygiene and Environmental Health | Year: 2013

Arsenic in drinking water presents a serious public health problem in Serbia, but its relationship with diabetes has not been studied previously. The aim of this study was to explore the association between exposure to arsenic in drinking water and the occurrence of type 2 diabetes in Middle Banat region, Serbia. This cross-sectional study comprised two populations. Exposed population in Middle Banat region consumes drinking water with arsenic (mean = 56. μg/L); unexposed population from six regions in Central Serbia consumes arsenic below detection limit (2. μg/L). Newly diagnosed cases of type 2 diabetes were obtained from the National Registry of Diabetes in 2008. The Registry included age, gender, family history of diabetes, presence of overweight, central obesity, cholesterol and triglyceride levels. In addition, the number of cases of diabetes reported in years 2006, 2007 and 2009 was used to calculate standardized incidence rates for both populations. Two populations were comparable by age, family history of diabetes and prevalence of overweight persons. Unexposed population was more likely to have central obesity, and high total cholesterol and triglycerides. Standardized incidence rates of type 2 diabetes were higher in exposed population. Odds ratios for type 2 diabetes were significantly higher for the exposed population, both men and women, in the period from 2006 to 2009, when compared with the unexposed population. The population from Middle Banat region, consuming drinking water with low levels of arsenic, was at higher risk for the occurrence of type 2 diabetes in comparison to the unexposed population in Central Serbia. © 2012 Elsevier GmbH.

PubMed | University of Belgrade and Institute of Public Health of Serbia Dr Milan Jovanovic Batut
Type: Journal Article | Journal: International journal of public health | Year: 2016

To determine relationship between health behaviour and body mass index (BMI) in a Serbian adult population.Study population included adults aged 20 and more years. A stratified, two-stage national representative random sampling approach was used for the selection of the survey sample.Regarding BMI, out of the 12,461 subjects of both sexes, 2.4% were underweight, 36.5% overweight and 22.4% obese. Multivariate logistic regression analysis showed that both in men and women, risk factors for obesity were former smoking, irregular eating breakfast and low physical activity level, while in women only risk of obesity was associated with alcohol consumption. In both sexes, risk factors for overweight were former smoking and low physical activity level, and in women additionally those were alcohol consumption, irregular eating breakfast, always adding salt to meals and consumption of 2-4 portions of fruit daily. Smoking and irregular eating of breakfast in men were risk factors for underweight.Physical activity, alcohol consumption, smoking, irregular breakfast consumption, adding salt to meals, frequency of vegetable and fruit consumption were related to BMI in adult Serbian population.

PubMed | Institute of Public Health of Serbia Dr Milan Jovanovic Batut and University of Belgrade
Type: Journal Article | Journal: Zdravstveno varstvo | Year: 2016

The pandemic of obesity in adolescents is one of the challenges of public health.The aim of this study was to examine the association of overweight with demographic, socioeconomic and lifestyle factors among Serbian adolescents.A cross-sectional study of 2139 adolescents aged 10 to 19 years was carried out. Data used in this study were from the 2006 Health Survey. In accordance with the international sex- and age-specific Body Mass Index cut-off points, all participants were classified as being normal weight or overweight, including obese. The association between the risk factors and overweight were examined using a multivariate logistic regression model.The study showed that 28.9% of boys and 17.0% of girls were overweight, while 14.5% of boys and 8.1% of girls were obese. Boys were more likely to be overweight/obese, compared with girls. Being younger (p< 0.01 for 14 to 15 years) and (p< 0.01, for 16 to 19 years), engaging in physical activities that last less than 7 hours a week, in such a manner that they breathe quickly and become sweaty, (p< 0.01) and skipping breakfast (p< 0.05) were risk factors significantly associated with overweight among adolescents. No significant association was found with wealth index.These findings should be an integral part of further preventive interventions, especially oriented towards younger adolescents, who are physically inactive, have a habit of skipping breakfast and are boys.

Kilibarda B.,Institute of Public Health of Serbia Dr Milan Jovanovic Batut | Mladenovic I.,Institute of Mental Health | Rakic J.G.,Institute of Public Health of Serbia Dr Milan Jovanovic Batut
Srpski Arhiv za Celokupno Lekarstvo | Year: 2013

Introduction Alcohol is most abused psychoactive substance among youth. Analyzing attitudes on alcohol, patterns and consequences we are getting inputs important for implementing evidence based preventive measures. Objective The aim of this study was to analyze drinking patterns and expectations and alcohol risk perception by gender and region and determine correlation between attitudes and one year prevalence of drinking. Methods The study used data from the European School Survey on Alcohol and Other Drugs, which was then conducted in 2008 in Serbia on a sample of 6,553 students aged 16 years. For data analysis descriptive and analytical statistic were used. Results The results show that nine out of ten students have had at least one alcoholic beverage during life and 5% have at least one alcohol beverage on more than 20 occasions during the last month. Students in Serbia have mainly positive expectations from alcohol, and the strongest potential drinking predictors in the previous year are expectation of having fun and the wish to feel relaxed. According to the participants, drinking 4-5 drinks on weekends (34.6%) is less risky than trying cannabis (52.0%). Boys have experienced problems caused by alcohol drinking more often than girls, while students from Vojvodina have performed badly in school in higher percentage than students from Belgrade and Central Serbia. Conclusion In Serbia, girls drink less and perceive drinking as more risky in comparison to boys, while 16-year-old students from Vojvodina have more positive expectations but also more prominent problems caused by alcohol drinking. Additional education of the young on alcohol risk is recommended.

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