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Epidemiologia nowotworów złośliwych narządów płciowych u kobiet w Polsce

100%

Didkowska J., Wojciechowska U.

Current Gynecologic Oncology

2012

vol. 10

issue 1

25-37

Aim of paper: Epidemiological analysis of malignant tumors developing within the female genital system in Polish population. Material and method: Data concerning incidence were obtained in the National Tumor Registry; data on mortality were obtained at the Head Statistical Bureau. Data on mortality in other European countries come from the WHO database (WHO Statistical Information System). Analysis of time trends was based on coefficients standardized with respect to global population. Results: Malignancies of the female genital system account for about 20% of malignant tumors in Polish females. Most common are: endometrial cancer (over 5000 new cases per year), ovarian cancer (about 3500) and cervical cancer (over 3100). Over the past 4 decades, we are witnessing a rapid increase of incidence of endometrial cancer and a trend towards decreasing mortality. A decline in both incidence and mortality is seen in cervical cancer. Ovarian cancer has reached stable coefficients of morbidity and mortality since about two decades. In Poland, 5-year survival indices are worse than mean values reported in most European countries. Conclusions. In the area of female genital malignancies, reduction of incidence is seen only in cervical cancer, while reduction of mortality – both in cervical and in endometrial cancer. Popularization and reorganization of national screening programs designed to early detection of malignant tumors, combined with promulgation of awareness of risk factors of carcinogenesis are fundamental to control the “tumor epidemic”.

Cel pracy: Analiza epidemiologiczna nowotworów złośliwych występujących w obrębie żeńskich narządów płciowych w polskiej populacji. Materiał i metoda: Dane dotyczące zachorowań pochodzą z Krajowego Rejestru Nowotworów, dane dotyczące zgonów pochodzą z Głównego Urzędu Statystycznego. Dane o zgonach w krajach Europy zaczerpnięto z bazy WHO (WHO Statistical Information System). Analizę trendów czasowych oparto na współczynnikach standaryzowanych według populacji świata. Wyniki: Nowotwory żeńskich narządów płciowych stanowią około 1/5 zachorowań na nowotwory wśród kobiet w Polsce. Najczęstszym schorzeniem są nowotwory trzonu macicy (ponad 5000 zachorowań), jajnika (około 3500) i szyjki macicy (ponad 3100). W ciągu ostatnich czterech dekad gwałtownie rosła zachorowalność na nowotwory trzonu macicy przy malejącym trendzie umieralności. Malejąca tendencja zachorowalności i umieralności jest obserwowana w raku szyjki macicy. Rak jajnika mniej więcej od dwóch dekad wykazuje stabilizację wartości współczynników zachorowalności i umieralności. Wskaźniki 5-letnich przeżyć w Polsce są niższe niż średnie obserwowane w krajach europejskich. Wnioski: Pośród nowotworów narządów płciowych kobiecych spadek zachorowalności dotyczy wyłącznie raka szyjki macicy, zaś spadek umieralności – zarówno raka szyjki, jak i trzonu macicy. Popularyzacja lub reorganizacja populacyjnych programów przesiewowych wczesnego wykrywania nowotworów złośliwych w połączeniu z upowszechnianiem wiedzy o czynnikach ryzyka karcinogenezy jest niezbędna do zahamowania „epidemii” nowotworów.

Epidemiology of Cancer in Central and Eastern Europe Versus Western Europe and Poland

81%

Zatoński W., Didkowska J., Wojciechowska U.

issue 10

434-452

The health transformation that took place after the Second World War in Europe was significantly delayed in the Central and Eastern European countries compared to countries of Northern Europe and United Kingdom. However, as death rates from cardiovascular disease have begun to fall since the 1990s, cancer has emerged as the most common cause of death among young and middle-aged adult women (20-64 years old) in the Central and Eastern European countries. In the coming decade it seems likely to be the leading cause of death among young and middle-aged adult men.The aim of the study was to compare the diversity in cancer risk, contrasting the "old" (EU-15) and the "new" Member States of European Union coming from Central and Eastern European (EU-10) and separately Poland.Material and methods. Data on deaths (1959-2002) in each country have been extracted from the World Health Organization database. Population data are from the Population Division of the Department of Economic and Social Affairs of the United Nations. Direct standardization has been undertaken using the World Standard Population.Results. The difference in life expectancy attributable to cancer for group 20-64 years of age is 0.68 of a year (16% of the total gap) among men and 0.35 of a year (24% of the total) among women. Trends in cancer over time differ significantly by gender, age group and time period in Central and Eastern Europe. The predicted mortality rate in Central and Eastern Europe in 2015 equates to 201/105 (95% CI 198.9-204) for men and 105.6/105 (95% CI 104.1-107.0) for women.Conclusions. In the Central and Eastern European countries deficiency of primary prevention is a main reason of poor health consciousness (consequences of smoking, fatty diet, low physical activity) and late introduction of poorly organized secondary prevention is responsible for worse survival of cancer patients, however tertiary prevention (therapy) is implemented in similar way as in Western Europe. Our analysis indicates that the greatest possibilities, but also the greatest unmet need, lie in primary and secondary prevention.

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1 Current Gynecologic Oncology

1 Polish Journal of Surgery

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2 Didkowska J.

2 Wojciechowska U.

1 Zatoński W.

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Epidemiologia nowotworów złośliwych narządów płciowych u kobiet w Polsce

Epidemiology of Cancer in Central and Eastern Europe Versus Western Europe and Poland