Prevention of cervical cancer - An interdisciplinary problem. Can we improve the situation in Poland and how? [Profilaktyka raka szyjki macicy - problem interdyscyplinarny. Czy i jak możemy poprawić sytuacjȩ w Polsce?]
Nowakowski A.,Klinika Ginekologii i Ginekologii Onkologicznej |
Jackowska T.,Klinika Pediatrii |
Oszukowski P.J.,University of Lodz |
Radowicki S.,Medical University of Warsaw |
And 2 more authors.
Pediatria Polska | Year: 2013
In this manuscript we present a multidisciplinary approach to prevention of cervical cancer (CC) in Poland. We summarized epidemiology of CC and precancerous lesions in the country. We present the current situation in secondary prevention (screening) of CC and propose changes to increase its effectiveness. Primary prevention of CC - the vaccines against human papillomavirus (HPV) - are currently one of the most effective ways of CC prevention. Solutions aimed at increasing access to primary prevention of CC are presented in this article. Reimbursement act provides an opportunity to partially reimburse HPV vaccines from public resources with patients' co-payment which should increase access to primary prevention of CC. We emphasize the role of education and increasing the awareness of the problem, as a key element in realization of both primary and secondary prevention. © 2013 Polish Pediatric Society.
Didkowska J.,Zaklad Epidemiologii i Prewencji Nowotworow |
Wojciechowska U.,Zaklad Epidemiologii i Prewencji Nowotworow
Nowotwory | Year: 2011
Introduction: The term "total prevalence" stands for the number of people living at a given time, who are diagnosed with cancer, regardless of the moment, when the diagnosis was made. Total prevalence may be determined basing on the data from the cancer registry subject to the fact that the registry has been maintaining data collection for a long enough period and is capable of procedures enabling the assessment of the patients' vital status. The most common method applied for the assessment of persons living with a malignant disease is limited-duration prevalence, defined as the number (or relation) of persons living at a given time with a disease diagnosed within a specified number of years. Methods and material: 5-year prevalence was applied as the measure of prevalence. To determine the number of persons alive no more than 5 years from the moment of diagnosis, the method was based on the relative survivals in the population and the number of persons diagnosed annually. The estimation refers to the year 2006. Results: We estimate that in the year 2006 there were about 320 000 people with malignant diseases (148 000 men and 175 000 women), who had been diagnosed within the previous 5 years. Summary: These results are only an estimation of the actual number of patients living with cancer. However, these results may provide the basis for assessing the needs of oncological care in Poland and, in future, the basis for evaluating screening programs.
Improvement in survival of cancer patients in Poland: Analysis of survival of patients diagnosed 2003-2005 [Poprawa przeżyć chorych na nowotwory złośliwe w polsce. Analiza przeżyć pacjentów zdiagnozowanych w latach 2003-2005]
Wojciechowska U.,Zaklad Epidemiologii i Prewencji Nowotworow |
Didkowska J.,Zaklad Epidemiologii i Prewencji Nowotworow
Nowotwory | Year: 2013
Introduction: Population-based survival rates are tools for evaluating the effectiveness of cancer treatment. The observation of changes in rates over time can assess the changes in the effectiveness of treatment resulting from both the introduction of new types of treatment, as well the activities in the field of health prevention programs. The anal ysis shows the survival rates for patients diagnosed in Poland 2003-2005 and this new data was compared with the rates calculated for the period 2000-2002. Material and methods: The survival analysis was based on a set of new cases of cancer in the Polish National Cancer Registry. The analysis included 341,241 patients aged 15-99 years, who were diagnosed with cancer 2003-2005. The analysis excluded cases of cancer in children aged 0-14 years, cases registered on the basis of a death certificate or autopsy (DCO) only, skin cancers other than melanoma (C44) and cancers in situ (D00-D09). The estimated 5-year relative survival rates were calculated using the Hakulinen method by the SURV3 programme. The life tables for the Polish population used in the analysis were provided by the Central Statistical Office in Warsaw. The analysis was performed for the 17 most common cancers in men and women. The results were compared with the rates estimated for patients diagnosed in years 2000-2002 and the survival rates estimated for similar periods of diagnosis by selected regional registries. The results of the current analysis for Poland have not been compared with the European indicators because the survival rates for patients diagnosed after 2003 have not yet been published (EUROCARE-5). Results: The estimated 5-year relative survival rates for patients with all cancers who were diagnosed in 2003-2005 in Poland was 45.5%. The average age of patients at diagnosis was 63 years and the percentage of lost years of life is estimated at nearly 79%. The 5-year survival rates of cancer patients significantly differed between the sexes. Their value was lower in males: 37.3% compared with 53.5% for females. The highest rates in the males were in cancers of the testis (87.6%), thyroid gland (84.4%), Hodgkin's lymphoma (77.8%), prostate (76.4%), and bladder (61.4%). The lowest rates were in cancers of the oesophagus (7.1%), lung (11.9%) and stomach (16.4%). In women the highest rates were estimated for cancers of the thyroid gland (93.3%), Hodgkin's lymphoma (82.7%), uterus (78.7%), breast (77.2%) and melanoma (71.3%). The worst prognosis was in patients with cancers of the lung (16.9%) and stomach (19.8%). In comparison to the previously analyzed period (2000-2002) an improvement in life expectancy was noted among men by 4.4 percentage points and in women by 2.3 percentage points. Comparing the 5-year survival rates of patients living in the three different voivodeships, which were part of the study, the observed variation depending on the location of the tumour with ± 4 percentage points for men and ± 6 percentage points for women. Summary: The analysis of survival of patients diagnosed with cancers in Poland in 2003-2005 showed an increase in survival compared to that observed in previous years. Similar beneficial changes were observed in all regions which estimated survival rates. The increase in survival of cancer patients is due to many reasons, the most important seem to be improved health literacy of patients associated with "epidemiological vigilance", which translates to earlier diagnosis of cancers and a gradual improvement resulting from improved standards of treatment. © Polskie Towarzystwo Onkologiczne.
Wojciechowska U.,Zaklad Epidemiologii I Prewencji Nowotworow |
Didkowska J.,Zaklad Epidemiologii I Prewencji Nowotworow |
Zatonski W.,Zaklad Epidemiologii I Prewencji Nowotworow
Nowotwory | Year: 2010
Introduction. The survival rates are a unique tool allowing for quality evaluation of widely defined health care and the effectiveness of cancer treatment. The presented survival rates are, in fact, the first Polish analysis of cancer survival rates for the entire Polish population. Materials and methods. The analyses of survival rates were conducted basing on the database of new cancer cases registered with the Polish National Cancer Registry in the years 2000-2002. The data, which have been analyzed, included the data on 308 259 patients aged 15-99. The survival rates were calculated using the Hakulinen method according to programme SURV3. The survival rates for Poland were compared with the average European estimated rates obtained in the EUROCARE-4 study for the patients diagnosed in the years 2000-2002. Results. The 5-year relative survival rates, estimated on the basis of cases registered in the years 2000-2002 in Poland, amounted to 33% among men and 52% among women. In the male population the highest 5-year survival rates were registered for the following cancer sites: testis (88.7%), thyroid gland (76.8%), Hodgkin's lymphoma (71.5%), prostate (65.2%) and urinary bladder (57.1%). The lowest rates were observed for the following cancer sites: larynx (5.6%), liver (7.9%), gallbladder (10.8%), lung (10.8%) and stomach (14.9%). For the female population the highest survival rates were registered for the patients with the following cancers: thyroid gland (90.7%), Hodgkin's lymphoma (77.6%), corpus uteri (77.1%), breast (75.0%) and skin melanoma (65.7%). The worst prognosis was for the patients with gall-bladder cancer (8.6%), larynx cancer (9.9%), liver cancer (11.0%), lung cancer (15.7%) and stomach cancer (18.2%). The 5-year survival rates in Poland are lower than the average rates for Europe (EUROCARE-4) by 10 percentage points. The Polish survival rates for particular cancer sites are lower than the average European rates by 0.5 to 26 percentage points. Conclusion. The differences between the survival rates for Poland in comparison to the rates obtained in the EUROCARE-4 study result mainly from the different cancer incidence structure (the higher percentage of cancer with bad prognosis), poorer infrastructure of oncological patient care, short history of prevention and screening programmes, worse access to diagnostic and treatment procedures and no wide-spread use of treatment standards.