Results of the National Breast Cancer Screening Program in Croatia (2006-2016).

AIM: To assess the uptake of the Croatian National Breast Cancer Screening Program from 2006 to 2016. METHODS: The Croatian National Breast Cancer Screening Program, a biennial program targeting women aged 50-69, started in October 2006. From 2006 to 2016, four cycles were completed. One cycle lasted two years, with the exception of the first cycle, which lasted three years. To determine the number of detected cancers in each cycle, the screening program data were merged with the data of the Croatian National Cancer Registry. Our results were compared with the reference values from the European guidelines for quality assurance in breast cancer screening and diagnosis. RESULTS: Around 150 000 mammography exams were performed every year. The response rates for cycle 1, cycle 2, cycle 3, and cycle 4 were 63%, 57%, 60%, and 59%, respectively. Further assessment rate was 6.5%. Breast cancer was identified in 5583 women, with 4.8 cancers detected per 1000 mammography exams. CONCLUSION: The National Breast Cancer Screening Program in Croatia reached a substantial proportion of the target group. Yet, additional efforts are needed to reach at least 70% of the target population.

Clinical characteristics of hospitalized adults and adolescents with herpes zoster in Croatia: more than 20 years of a single-center experience.

AIM: To evaluate the clinical characteristics of adult and adolescent Croatian patients hospitalized for herpes zoster over a period of 21 years in the largest national center for infectious diseases (catchment area approximately 25% of the Croatian population). METHODS: This retrospective chart review included all patients older than 15 years hospitalized for herpes zoster at the University Hospital for Infectious Diseases "Dr. Fran Mihaljevic" between January 1, 1996 and December 31, 2016. RESULTS: The study enrolled 1755 patients (uniform annual hospitalizations), 50% of whom suffered from complicated forms of herpes zoster, mostly generalized zoster (22.0%), infected lesions (14.8%), and meningitis/encephalitis (10.4%). A low percentage of patients experienced Ramsey-Hunt syndrome (3.0%), keratitis (1.5%), and visceral dissemination (0.2%). The majority of patients were older than 55 years (80%, median 70 years). Overall, 61.6% of patients suffered from at least one comorbidity (most frequent: diabetes 14.6%, cardiovascular incidents 24.4%, malignancy 13.0%, other infection 12.9%), and 28.2% suffered from ≥2 comorbidities. All-cause in-hospital mortality was 0.9%. The proportion of patients with any complicated form and of patients with meningitis/encephalitis steadily decreased over time, while the proportion of patients with comorbidities increased. This coincided also with steadily increasing age. No association was observed between comorbidities and complicated forms of zoster. Pharmacological immunosuppression was associated with generalized zoster; younger age was associated with meningitis/encephalitis; and older age was associated with generalized zoster and infected lesions. CONCLUSION: The patients most frequently hospitalized for herpes zoster are elderly people burdened with comorbidities, not necessarily patients with complicated forms of the disease.