The impact of the COVID-19 pandemic on clinical staging, pathological staging and surgical management of breast cancer patients.

Background: This study analyzes the impact of the first six lockdown months during the COVID-19 pandemic on breast cancer (BC) patients at a regional cancer center in western Poland (Greater Poland region). Materials and methods: Patient age, clinical stage, pathological stage, surgical management, and use of neoadjuvant therapy (NT) for patients diagnosed with BC during the pandemic (March-August 2020, n = 290) were compared with pre-COVID-19 data (March-August 2019, n = 405). Results: There were statistically significant differences in the average age (58.2 pre-COVID-19 vs. 55.9 during COVID-19, p = 0.014), clinical stage (p = 0.017) with a stage shift (stage I being dominant pre-pandemic, stage II during the pandemic). Additionally, when comparing the 2019 and 2020 groups, there were statistically significant differences in clinically node-positive cases (27% vs. 37%, p = 0.007), pathologically node-positive cases (26% vs. 34%, p = 0.014), and NT use (27% vs. 43%, p = 0.001). Moreover, there was a notable increase in the prevalence of mastectomies from 44% to 53% (p = 0.017) and axillary lymph node dissections from 27% to 33% (p = 0.029). Conclusions: The first six months of the COVID-19 pandemic had a discernible impact on BC patients in the Greater Poland region. Changes in patient age, clinical stage, pathological stage, and treatment approach were observed during this period. These findings underscore the importance of further research and adaptations in healthcare delivery to address the evolving needs of BC patients during times of crisis.

The impact of the COVID-19 pandemic on incidence gap in screen-detectable cancers: a cohort study in Greater Poland, Poland.

Background: The global COVID-19 pandemic has had a significant impact on healthcare systems. This study aimed to assess the incidence gap in screening-detectable cancers in the Greater Poland (Poland) in 2020. Materials and methods: Data on breast, cervix uteri, and colorectal cancer cases diagnosed from 2010 to 2020 were obtained from the regional cancer registry. Standardized incidence ratios (SIR) and incidence rate differences (IRD) were calculated to estimate the change in incident cancer cases during the pandemic. The number of observed cases was extracted from the registry database. Simple linear regression analysis was used to predict the expected number of incident cancer cases in 2020 and the age-standardized incidence rate based on registry data from the preceding ten years (2010-2019). Results: In 2020, the registered number of incident female breast cancer cases decreased by 12% [SIR 0.88, 95% confidence interval (CI): 0.88-0.92, observed: 1,848, expected: 2,101], resulting in an IRD of -6.3 per 100 K. The number of registered cervical cancers decreased by 15% (SIR 0.85, 95% CI: 0.73-0.98, observed: 181, expected: 213), with an IRD of -0.8 per 100 K. For colorectal cancer, there was a 16% decrease in new cases among females (SIR 0.84, 95% CI: 0.78-0.90) and a 15% decrease among males (SIR 0.85, 95% CI: 0.80-0.91), resulting in IRDs of -3.04 and -5.29 per 100K, respectively. Conclusions: The COVID-19 pandemic led to a significant, 15% decrease in newly diagnosed screening-detectable cancer cases in 2020. Further studies are needed to investigate the impact of delayed cancer diagnoses on stage at diagnosis and survival rates.

Differences between TNM classification and 2-[18F]FDG PET parameters of primary tumor in NSCLC patients.

BACKGROUND: The aim of the study was to compare the TNM classification with 2-[18F]FDG PE T biological parameters of primary tumor in patients with NSCLC. MATERIALS AND METHODS: Retrospective analysis was performed on a group of 79 newly diagnosed NSCLC patients. PET scans were acquired on Gemini TF PET/CT scanner 60-70 min after injection of 2-[18F]FDG with the mean activity of 364 ± 75 MBq, with the area being examined from the vertex to mid-thigh. The reconstructed PET images were evaluated using MIM 7.0 Software for SUVmax, MTV and TLG values. RESULTS: The analysis of the cancer stage according to TNM 8th edition showed stage IA2 in 8 patients, stage IA3 - 6 patients, stage IB - 4 patients, IIA - 3 patients, 15 patients with stage IIB, stage IIIA - 17 patients, IIIB - 5, IIIC - 5, IVA in 7 patients and stage IVB in 9 patients. The lowest TLG values of primary tumor were observed in stage IA2 (11.31 ± 15.27) and the highest in stage IIIC (1003.20 ± 953.59). The lowest value of primary tumor in SUVmax and MTV were found in stage IA2 (6.8 ± 3.8 and 1.37 ± 0.42, respectively), while the highest SUVmax of primary tumor was found in stage IIA (13.4 ± 11.4) and MTV in stage IIIC (108.15 ± 127.24). CONCLUSION: TNM stages are characterized by different primary tumor 2-[18F]FDG PET parameters, which might complement patient outcome.

Lung surgery for metastatic epithelial tumours.

INTRODUCTION: The aim of this study is to evaluate outcomes following the surgical treatment of pulmonary metastases in patients with different types of epithelial cancers, as well as to identify prognostic factors after metastasectomy. MATERIAL/METHODS: We retrospectively reviewed data for 61 patients who underwent 76 curative resections of pulmonary metastases from epithelial tumours during 1997-2002 at our department. Potential prognostic factors affecting survival after lung metastasectomy were analysed: disease-free interval (DFI), gender, age, the size and number of metastases, mono- or bilateral tumour, number of operations and the extent of pulmonary resection. RESULTS: The median survival was 36 months. Three factors were identified as prognostic for survival after metastasectomy: DFI<24 (p=0.0045), unilateral pulmonary metastases (p=0.0062) and no more than one operation (p=0.0065). CONCLUSIONS: We concluded that: i) Resection of epithelial pulmonary metastases may offer a significant survival benefit for selected patients. ii) Good surgical candidates for pulmonary resection are those with a disease-free interval greater than 24 months. iii) The total number of thoracotomies, and metastases confined to one lung are factors defining patients who experience a better outcome after surgery. iv) Lung metastasectomy by conventional surgery is a safe procedure with low perioperative morbidity and mortality rates.

The influence of pH and temperature on the stability of N-[(piperidine)methylene]daunorubicin Hydrochloride and a comparison of the stability of daunorubicin and its four new amidine derivatives in aqueous solutions.

The influence of pH and temperature on the stability of N-[(piperidine)methylene]daunorubicin hydrochloride (PPD) was investigated. Degradation was studied using an HPLC method. Specific acid-base catalysis of PPD involves hydrolysis of protonated molecules of PPD catalyzed by hydrogen ions and spontaneous hydrolysis under the influence of water zwitterions, unprotonated molecules, and monoanions of PPD. The thermodynamic parameters of these reactions, energy, enthalpy, and entropy, were calculated. Also, the stability of daunorubicin and its new amidine derivatives (piperidine, morpholine, pyrrolidine, and hexahydroazepin-1-yl) in aqueous solutions was compared and discussed.

Stability of [(N-piperidine)methylene]daunorubicin hydrochloride and [(N-pyrrolidine)methylene]daunorubicin hydrochloride in solid state.

The influence of temperature and relative air humidity on the stability of two novel derivatives of daunorubicin: [(N-piperidine)methylene]daunorubicin hydrochloride and [(N-pyrrolidine)methylene]daunorubicin hydrochloride was investigated. The process of degradation was studied by using high-performance liquid chromatography with ultraviolet (UV) detection. The kinetic and thermodynamic parameters of degradation were calculated.

Potential of the postoperative lymphocyte-to-monocyte and monocyte-to-red blood cell ratio in predicting locoregional and distant metastases after breast cancer resection - Retrospective study.

PURPOSE: Breast cancer is the most common malignancy with high recurrence and mortality rates in women. There are still insufficient biomarkers to predict disease prognosis. Therefore, the present study aimed to investigate the clinical significance of postoperative hematologic parameters and their derivatives in patients with breast cancer who underwent tumor resection. PATIENTS AND METHODS: The clinicopathological and laboratory data of 90 female breast cancer patients who underwent surgical treatment in the Greater Poland Cancer Center in Poznan from December 2015 to November 2017 were retrospectively analyzed. Postoperative hematologic parameters, including neutrophil-to-lymphocyte ratio (NLR), lymphocyte-to-monocyte ratio (LMR), platelet-to-lymphocyte ratio (PLR), monocyte-to-red blood cell ratio (MRR), lymphocyte-to-red blood cell ratio (LRR), platelet-to-red blood cell ratio (PRR) were evaluated in recurrence and non-recurrence group. Receiver-operating characteristic (ROC) curve analysis was used to assess the optimal cutoff value of postoperative hematologic parameters for tumor recurrence. The association of postoperative hematologic parameters with disease-free survival (DFS) was investigated by the Kaplan-Meier method and Cox regression analysis. RESULTS: Patients with local, regional, or distant metastases accounted for 14% of the total. The postoperative monocyte count and MRR were significantly elevated, whereas postoperative LMR was statistically decreased in the recurrence group. Univariate and multivariate Cox analysis revealed that postoperative LMR ≤3.044 and postoperative MRR >0.1398 were associated with significantly shorter DFS. CONCLUSION: Our results revealed that both postoperative LMR and MRR are independent predictors of DFS in breast cancer patients. Large-scale prospective investigations are needed to validate our findings.

Usability application of multiplex polymerase chain reaction in the diagnosis of microorganisms isolated from urine of patients treated in cancer hospital.

BACKGROUND: THE OBJECTIVE OF THIS STUDY WAS: i) to compare the results of urine culture with polymerase chain reaction (PCR) -based detection of microorganisms using two commercially available kits, ii) to assess antimicrobial susceptibility of urine isolates from cancer patients to chosen antimicrobial drugs and, if necessary, to update the recommendation of empirical therapy. MATERIALS AND METHODS: A one-year hospital-based prospective study has been conducted in Greater Poland Cancer Centre and Genetic Medicine Laboratory CBDNA Research Centre in 2011. Urine cultures and urine PCR assay from 72 patients were examined. RESULTS: Urine cultures and urine PCR assay from 72 patients were examined. Urine samples were positive for 128 strains from which 95 (74%) were identical in both tests. The most frequently isolated bacteria in both culture and PCR assay were coliform organisms and Enterococcus spp. The Gram negative bacilli were most resistant to cotrimoxazol. 77.2% of these bacilli and 100% of E. faecalis and S. agalactiae were sensitive to amoxicillin-clavulanic acid. 4.7% of Gram positive cocci were resistant to nitrofurantoin. CONCLUSIONS: The PCR method quickly finds the causative agent of urinary tract infection (UTI) and, therefore, it can help with making the choice of the proper antimicrobial therapy at an early stage. It appears to be a viable alternative to the recommendations made in general treatment guidelines, in cases where diversified sensitivity patterns of microorganisms have been found.

Decrease in the number of new cancer diagnoses during the first year of the COVID-19 pandemic - cohort study of 3.5 million individuals in western Poland.

Introduction: The COVID-19 pandemic has considerably affected healthcare systems worldwide and is expected to influence cancer incidence, mortality, stage at diagnosis, and survival. This study aimed to assess COVID-19-related changes in cancer incidence observed in 2020 in the Greater Poland region. Materials and methods: Data from the Greater Poland Cancer Registry on cancer patients diagnosed between 2010 and 2020 were analysed. To quantify the change in the number of incident cancer cases during the COVID-19 pandemic, we calculated the standardized incidence ratio (SIR) and the incidence rate difference (IRD) to assume the pandemic-attributable gap in cancer incidence. Results: In 2020, in Greater Poland, the expected number of new cancer cases was 18 154 (9 226 among males and 8 927 among females), while the observed number was 14 770 (7 336 among males and 7 434 among females). The registered number of cancer cases decreased in 2020 by 20% (SIR 0·80, 95% CI 0·78 to 0·81) and 17% (SIR 0·83, 95% CI 0·81 to 0·85) in males and females, respectively. Among men, the most significant difference was reported for myeloma (SIR 0·59, 95% CI 0·45 to 0·77), among women for bone cancer (SIR 0·47, 95% CI 0·20 to 0·93). In females the observed incidence was higher than expected for cancer of an unspecified site (SIR 1·19, 95% CI 1·01 to 1·38). In our study, the decrease in new cancer cases was greater in males than in females. Discussion: The observed incidence was affected in most cancer sites, with the most significant deviation from the expected number in the case of myeloma. An increase in the observed incidence was reported only in women diagnosed with cancer of an unspecified site, which might reflect shortages in access to oncological diagnostics.

Surgical approach to pulmonary metastases from breast cancer.

One of the main characteristics of breast cancer is its capability to disseminate. Solitary pulmonary metastases from breast cancer occur rarely (0.4%). The aim of this study is to check whether or not the outcome following the surgical treatment of pulmonary metastases in patients with breast cancer is in accordance with the data in the literature and based on it to identify prognostic factors. We have reviewed retrospectively data for 33 patients who underwent 43 curative resections of breast cancer pulmonary metastases between 1997 and 2002 at our department. Potential prognostic factors affecting survival, namely survival after lung metastasectomy, assessed were disease-free interval (DFI), the number and location of lung metastases, the diameter in mm of metastases and the extent of pulmonary resection. The median survival for 33 patients with pulmonary breast cancer metastatic lesions after metastasectomy was 73.2 months. Mean 5-year survival was 54.5%. There was a statistically significant difference in survival time with better prognosis for patients with DFI > 36 months (p = 0.0007), complete metastasectomy (p = 0.0153), unilateral pulmonary metastases (p=0.0267) and for patients who underwent multiple operations (p = 0.0211). In multivariate analysis there was significant influence for long-term prognosis for patients with DFI > 36 months (p = 0.0446) and for complete resection of the metastases (p = 0.0275). Analysis of the survival rates for patients with solitary pulmonary metastasis, with different size of tumors and after different types of pulmonary resection showed no significant differences. It was concluded that resection of lung metastases from breast cancer may offer a significant survival benefit for selected patients. The identified prognostic factor for survival after metastasectomy is DFI longer than 36 months and complete resection of the metastases. In our group of patients, DFI longer than 36 months, unilateral pulmonary metastases and number of operations significantly influenced survival. Also, the results showed that lung metastasectomy by conventional surgery is a safe procedure with low perioperative morbidity and mortality rate.

Analysis of O6-methylguanine-DNA methyltransferase methylation status in sporadic colon polyps.

BACKGROUND/AIM: The aim of our study was to check how MGMT methylation status together with known factors influenced the risk of colon cancer development. MATERIALS AND METHODS: We examined patients with colon polyps. Information concerning gender, age, lifestyle, diet, anthropometry and medical information, including cancer and family history of cancer, was analyzed. Polymorphism variety of MGMT gene was investigated in another study. Genetic analysis for MGMT methylation assessment was performed for polyp tissue samples from 143 patients. RESULTS: Positive methylation MGMT status was found in 55 patients. There was no correlation between gender and MGMT methylation status (p = 0.43). We did not find correlation between patients younger and older than 60 (p = 0.87). There was no correlation between smoking and MGMT methylation status (p = 0.36). We did not find correlation between BMI and MGMT methylation status (p = 0.86). We did not find correlation between MGMT methylation status and colon cancer in familial history (p = 0.45). CONCLUSION: Our study showed no correlations between methylation status of MGMT polymorphisms and clinical features like age, gender, polyp localization, smoking status, or obesity. It has been shown previously that MGMT methylation status may show nonspecific methylation in colon polyps. Gene methylation status in adenoma tissues has also been associated by other authors with the adenoma's size, histology, and degree of atypia. In our study, we evaluated the gene methylation status in colon polyps and found no association with adenoma characteristics. The present study showed no correlation for MGMT methylation in polyps in different regions of colon.

Impact of the COVID-19 Pandemic on Breast Cancer Stage at Diagnosis in a Regional Cancer Center in Poland between 2019 and 2021.

The COVID-19 pandemic had a negative effect on oncology healthcare services in Poland, with a reduction in the national breast cancer (BC) screening program coverage rates. This article analyzes the impact of the pandemic on BC stage at diagnosis in a regional cancer center in Poland. Records from BC multidisciplinary team (MDT) meetings that took place in the years 2019-2021 were gathered. BC clinical staging was compared. Age-related subgroups were additionally analyzed to reflect possible screening program disruptions. The total number of BC cases fell by 8% in 2020 compared with 2019, with a 14% fall in the screening age group. In 2021, a stage shift was observed, with stage II BC becoming most frequently diagnosed (as opposed to stage I BC in 2019 and 2020). A statistically significant increase in the number of stage III BC cases was observed in 2021.

Detection of a second primary cancer in a 18F-fluorocholine PET/CT - multicentre retrospective analysis on a group of 1345 prostate cancer patients.

BACKGROUND: Aim of this study was to evaluate the rate of incidental detection of second primary cancer (SPC) at 18F-fluorocholine ([18F]FCH) positron emission tomography/computed tomography (PET/CT) performed in prostate cancer patients. MATERIAL AND METHODS: A retrospective analysis was performed on a group of 1345 prostate cancer patients, who underwent [18F]FCH PET/CT study because of suspicion of recurrence (n = 937) or for initial staging (n = 408). Images were acquired after intravenous injection [18F]FCH with a mean activity of 200 ± 75 MBq (5.4 ± 2 mCi), from the top of the head to the half of the thigh. The confirmation of second primary cancer was obtained from the cancer registry. RESULTS: Based on the [18F]FCH PET/CT scans, a second primary cancer was suspected in 89 patients (6.6%). Of these, a malignancy was histologically confirmed in 26 patients (29% of all suspected findings and 1.9% of the complete cohort). Lung cancer (including adenocarcinoma, neuroendocrine cancer) was diagnosed in 13 patients (50%) and hematologic neoplasm (including chronic lymphocytic leukemia, Hodgkin lymphoma, follicular lymphoma, and multiple myeloma) in 5 patients (19%). 18F-fluorocholine PET/CT also revealed esophageal cancer, mesothelioma, testicular, renal, bladder, and colorectal cancer inindividual patients, non-keratinizing squamous cell carcinoma (SCC) of the skin as well as head and neck SCC with unknown primary. CONCLUSION: We conclude that incidental detection of a second primary cancer in prostate cancer patients using [18F]FCH PET/CT is not very common and that lung cancer and hematologic malignancies are most frequently detected.

The use of the da Vinci Xi robot system in colorectal cancer resections - why is it worth it?

<b>Introduction:</b> Surgery using robotic systems is taking over an increasingly wider field of open surgery and laparoscopy. Recently, this is particularly visible in colorectal surgery, where the advantages include better insight into the hard-to-reach area of the surgical field. Limited access to this method and relatively high costs remain a problem. </br></br> <b>Aim:</b> The aim of the work is to present the results of the introduction of robotic surgery at the regional Oncology Center in Wielkopolska in the field of safety and feasibility and the early oncological results for robotic colorectal surgery. </br></br> <b> Materials and methods:</b> From March 6, 2019 to the end of 2019, we performed 66 robotic colorectal procedures: 54 anterior resections of the sigmoid colon/rectum, 6 right hemicolectomies, 3 left hemicolectomies, 2 abdominoperineal resections, and one Hartmann's procedure. </br></br> <b> Results:</b> The final histopathological examination of all operated patients confirmed the complete resection (R0 procedure). The average age was 64 years and the average duration of surgery was 199 ± 52 min. None of the robotic procedures required conversion to open surgery or laparoscopy once they had started. The average hospitalization time was 6 ± 1 days, including patients with complications. Complications occurred in 8 patients, with the most common being anastomotic leak - 4 (6%). </br></br> <b>Conclusions:</b> The use of the latest da Vinci Xi robot system is a safe and effective alternative to open and laparoscopic surgery. Colorectal surgery confirms its special advantage in the case of low anterior resections of the rectum. Increasing the availability of equipment and training will allow expanding the scope of operations, including upper gastrointestinal tract.

Beneficial Effects of Oral Nutritional Supplements on Body Composition and Biochemical Parameters in Women with Breast Cancer Undergoing Postoperative Chemotherapy: A Propensity Score Matching Analysis.

Aim: Recently, more attention has been paid to the role of nutritional intervention in preventing the side effects of chemotherapy in oncology patients. Therefore, the aim of the present study was to analyze the effects of oral nutritional supplements on the body composition and biochemical parameters in women with breast cancer receiving postoperative adjuvant chemotherapy. Patients and Methods: The study involved women diagnosed with breast cancer who underwent surgical treatment and were qualified for chemotherapy (doxorubicin and cyclophosphamide). Women were divided into two groups, depending on whether oral nutritional supplements were used during chemotherapy. Anthropometric and biochemical parameters were analyzed twice in all patients: before and after six weeks of chemotherapy. Propensity score (PS) matching was performed to select patients balanced in terms of age, BMI, and clinicopathological features of the tumor. Statistical comparisons were conducted in a propensity-matched cohort of patients. Results: The value of BMI was maintained constant in the supplemented women older than 56 years after six weeks of chemotherapy. Regardless of age in the supplemented women, a significant increase in muscle mass, fat free mass (FFM), and fat free mass index (FFMI) was demonstrated. An increase in fat mass (FM) including visceral fat was observed only in the non-supplemented control. Regardless of age or initial FM, supplemented women exhibited a constant level of albumin. Moreover, in the supplemented women with normal initial FM, the stable values of triglycerides and HDL cholesterol were maintained after six weeks of chemotherapy. Conclusion: The present study demonstrated that oral nutritional supplements could improve body composition and prevent hypoalbuminemia and lipid abnormalities in women with breast cancer undergoing chemotherapy.

Association between clinicopathological features of breast cancer with adipocytokine levels and oxidative stress markers before and after chemotherapy.

Adipocytokines and markers of oxidative stress have been shown to exhibit potential for detection of advanced stage, HER2/neu status and lymph node metastases in patients with breast cancer, as well as in determining the efficiency of anti-cancer treatments. In the present study, blood concentrations of apelin (APLN), retinol-binding protein 4 (RBP4), 8-hydroxydeoxyguanosine (8-oxo-dG) and total antioxidant capacity (TAC) in women with breast cancer with different clinicopathological features were measured prior to and following adjuvant chemotherapy. The study included 60 women with breast cancer stratified according to tumor grade and size, HER-2/neu expression, and lymph node and hormone receptor status. Blood samples were taken before and after two cycles of adjuvant chemotherapy. None of the clinicopathological features were associated with the baseline concentrations of RBP4, 8-oxo-dG or TAC. An increased baseline concentration of APLN was observed in HER-2/neu positive patients. Moreover, through multivariate logistical regression analysis, APLN was shown to be independently associated with a positive HER/neu status. Chemotherapy treatment did not affect the levels of RBP4 or APLN, or TAC values when assessing all the patients, and when assessing the stratified groups of patients. Only 8-oxo-dG was found to be significantly decreased following drug administration (P=0.0009). This preliminary study demonstrated that APLN is a significant and independent predictor of HER-2/neu positive breast cancer. A significant reduction in 8-oxo-dG levels following chemotherapy may indicate its potential clinical utility in monitoring the effects of chemotherapy in breast cancer patients.

Tumor embolus due to uterine cancer.

BACKGROUND: Although the majority of arterial emboli are thrombi originating from the heart, emboli of other origin do occur. The purpose of this paper is to report a case of tumor embolus of a brachial artery. CASE REPORT: A 64-year-old woman was referred for vascular surgery due to acute right upper-limb ischemia. ECG showed sinus rhythm without ischemic changes. Four years earlier the patient had undergone total hysterectomy with bilateral adnexotomy for endometrial adenocarcinoma with subsequent radiotherapy. Emergency embolectomy under local anesthesia was performed with uneventful recovery. Because of an atypical appearance resembling fatty tissue, the embolic material was sent for microscopic examination that revealed carcinoma cells. Chest X-ray and CT-guided biopsy showed previously unknown pulmonary metastasis. In spite of chemotherapy, the patient died one year later due to progression of the neoplastic disease. The literature and common features of tumor embolus are reviewed. This may be the first reported case of tumor peripheral arterial embolus caused by endometrial adenocarcinoma CONCLUSIONS: Although tumor emboli are a rarely described cause of acute limb ischemia, pathological examination of the embolic material seems to be indicated, especially in patients with an unknown source of emboli and in every case of an atypical appearance.

The CDKN2a common variants: 148 Ala/Thr and 500 C/G in 3' UTR, and their association with clinical course of melanoma.

Changes in CDKN2a gene are known to be linked with sporadic melanoma and hereditary predisposition to this cancer. In the Polish population mutations in the coding region of the CDKN2a gene are rather rare, therefore the attention has been focused on polymorphisms and alterations in uncoding regions such as 3' UTR. The aim of this study was to analyze two common polymorphisms, Ala148Thr and 500 C/G, and correlate them with the clinical course of melanoma. DNA from 285 patients was analyzed and found polymorphisms were correlated with the clinical parameters employing statistical methods. The obtained results allow us to conclude: (i) survival times of 500 C/G carriers vs. cumulating proportion surviving was not statistically significant; (ii) CDKN2a polymorphism 500 C/G correlated with Ala148Thr; (iii) no correlation was observed between the 500 C/G polymorphism and age of diagnosis, localization of primary melanoma and survival time; (iv) we did not find correlation between 500 C/G and type of cancer in the family; (v) changes in the CDKN2a gene were not found in patients with second cancer.

Impact of selected environmental factors on attendance in the Breast and Cervical Cancer Early Detection Programme in the Wielkopolska Province of Poland during 2007-2012.

Breast and cervical cancer represent a significant health and economic issue for Polish society, although if detected early, both can be cured successfully. For this reason, since 2006, according to the National Cancer Combat Programme, population-based screening programmes have been implemented, aimed at reducing the mortality and morbidity for breast and cervical cancer. The aim of this study is to determine which of the selected four environmental factors affect attendance for screening mammography and cytology. Analysis included data from questionnaires filled in during mammography by 582,959 women aged 50-69 years, and 288,142 women during cytology, aged 25-59 years, in 2007-2012 in the Wielkopolska Province of Poland. It was found that the impact of medical staff on the attendance for cytological screening was the strongest statistically significant factor (p = 0,0001). Invitation by name (p=0,001) and other factors (p= 0,0001) also affected the attendance. In the cytological screening, medical staff was the factor that had the greatest impact on attendance. Other factors, such as self-reporting, increased participation in the next screening rounds, although the factors that affect attendance changed over time. Their constant analysis is essential for the efficient and effective evaluation of screening programsme.