Association of the bitter taste genes TAS2R38 and CA6 and breast cancer risk; a case-control study of Polish women in Poland and Polish immigrants in USA.

It is known that the perception of bitterness is mediated by type 2 bitter taste receptors (TAS2Rs). However, recent reports have suggested that the carbonic anhydrase 6 (CA6) gene may also influence bitterness sensing. Genetic variants in these genes could influence dietary intake of brassica vegetables, whose increased consumption has been observed in the literature, though inconsistently, to decrease breast cancer (BC) risk. We hypothesized that the estimated odds ratios (ORs) for the association between BC and taster diplotype (PAV/PAV) and/or genotype A/A, will be in the direction of increased BC risk, potentially due to reduced consumption of brassica vegetables. Using a case-control study of BC in Polish women in Poland (210 cases and 262 controls) and Polish immigrant women to USA (78 cases and 170 controls) we evaluated the association of the taster diplotypes in TAS2R38 gene and genotypes in the CA6 gene and BC risk in these two populations individually and jointly. No significant increase in risk was observed for the TAS2R38 PAV/PAV diplotype (tasters) in each population individually or in the joint population. For the CA6 gene, in the joint population, we observed an increased BC risk for the combined G/A and G/G genotypes (non-tasters) vs A/A (tasters), OR = 1.41 (95% CI 1.04-1.90, p = 0.026) which after adjustment for False Discovery Rate (FDR), was not significant at p≤0.05 level. However, for the joint population and for the combined genotype of the two genes AVI/AVI+G* (non-tasters) vs. PAV/*+A/A (tasters), we observed a significant increase in BC risk, OR = 1.77 (95%CI 1.47-2.74, p = 0.01), for the non-tasters, which remained significant after FDR adjustment. In conclusion for the joint population and the joint effect for the two bitter sensing genes, we observed an increase in BC risk for the bitterness non-tasters, association which is in the opposite direction to our original hypothesis.

Inequalities in breast cancer incidence and stage distribution between urban and rural female population in Swietokrzyskie Province, Poland.

INTRODUCTION AND OBJECTIVE: One of the main factors determining the burden of breast cancer is the effectiveness of measures taken to combat this cancer including urban-rural differences. The aim of the study was to analyse the differences in breast cancer incidence and disease stage distribution among urban and rural women in the Swietokrzyskie Province as a part of a strategy for breast cancer control. MATERIAL AND METHODS: The study of disease stage distribution included 483 female residents of Swietokrzyskie Province who were diagnosed in 2013 with invasive breast cancer, and reported to Swietokrzyskie Office for Cancer Registration. Urban-rural differences in breast cancer incidence in 2002-2013 were presented using Range Ratio (RR). Changes in incidence trends in urban and rural areas were analysed using joinpoint models. Annual Percentage Change (APC) of the rates was calculated for each time trend. RESULTS: Breast cancer incidence rate in the urban female population was higher than in rural women with RR, amounting to 1.43. However, the analysis of trends showed that the pace and direction of change were developing negatively among inhabitants of rural areas. In 2002-2013, in rural women, the age-standardized rate (ASR) values increased by 2.8% per year (p<0.05). The course of ASR trends showed statistically significant urban-rural differences (p=0.004). Analysis of urban-rural differences in disease stage distribution revealed a non-significantly higher proportion of cases with localised stage in urban than in rural areas, amounting to 51.0% and 43.9%, respectively. CONCLUSIONS: Existing health inequalities indicate the need to intensify activities in rural areas and should be the starting point for making key decisions in combating breast cancer.

Social costs of loss in productivity-related absenteeism in Poland.

OBJECTIVES: The aim of this study was to estimate indirect costs associated with losses in productivity due to sickness absence among registered workers in Poland. MATERIAL AND METHODS: Data on sick leave durations in 2013 was obtained from the Social Insurance Institution (SII) (Zaklad Ubezpieczen Spolecznych - ZUS). Based on the number of assumptions, this data was used for calculating absence durations. The costs of lost productivity were estimated on the basis of the measure of gross value added. RESULTS: Estimated losses in productivity due to absenteeism in 2013 together accounted for 4.33% of gross domestic product (GDP) (17.09 billion euro). In the female population, the total value of losses amounted to 9.66 billion euro, but excluding the costs of pregnancy, childbirth, and puerperium (2.96 billion euro), it was 6.7 billion euro. In the male population, the loss amounted to 7.43 billion euro. The highest overall costs of sickness absence based on age were found in the age group of 30-39 years (5.14 billion euro, including pregnancy, childbirth, and puerperium - 1.474 billion euro; respiratory diseases - 0.632 billion euro, injuries and poisonings - 0.62 billion euro). In the group of people aged > 40 years, the highest cost was generated by bone-muscular diseases (1.553 billion euro) and injuries and poisoning (1.251 billion euro). Higher losses in the productivity of women in addition to pregnancy, childbirth, and puerperium were due to mental and behavioral disorders (0.71 billion euro), diseases of the genitourinary system (0.38 billion euro), and neoplasms (0.35 billion euro). At the same time, in men, compared to women, we observed higher losses due to injuries and poisoning (1.65 billion euro), and diseases of musculoskeletal (1.26 billion euro), nervous (0.79 billion euro), circulatory (0.65 billion euro), and digestive (0.41 billion euro) systems. CONCLUSIONS: Improvement and further development of effective strategies for prevention of complications of pregnancy and chronic diseases in the workplace are necessary. Policies aimed at reduction of sickness absence could potentially increase prosperity and the socioeconomic situation in Poland. Int J Occup Med Environ Health 2017;30(6):917-932.

Expression of IL-1 and IL-6 and their natural regulators in leukocytes of B-cell chronic lymphocytic leukaemia patients.

PURPOSE: The purpose of the study was the assessment of the expression of IL-1ß and IL-6, and the proteins regulating their biological activity, namely IL-1RII, IL-1Ra, as well as sIL-6Rα, sgp-130 in leukemic lymphocytes and autologous neutrophils of B-CLL patients. MATERIAL/METHODS: The study involved a group of B-cell chronic lymphocytic leukemia patients and healthy volunteer blood donors. The presence of chosen proteins and their natural regulators was confirmed by Western blot. RESULTS: Western blot analysis showed a decreased expression of IL-1ß and IL-6 in the leukocytes of B-CLL patients. Decreased expression of sIL-6Rα has been observed in lymphocytes, with a simultaneous increase of expression in PMNs. Lower expression of sgp-130 was found in B cells while its expression was elevated in the neutrophils of patients in early stages of the disease. CONCLUSIONS: The changes observed in the expression of IL-1 and IL-6 seem to exclude their immediate involvement in the progress of B-CLL. However, the presented changes in the expression of proteins regulating IL-1ß and IL-6 in PMNs indicate a potential role of early immune response cells also in advanced stages of the disease.

Trends of potential years of life lost due to main causes of deaths in urban and rural population in Poland, 2002-2011.

The aim of the study was to analyse the level and the trends of Potential Years of Life Lost due to main causes of deaths in Poland in 2002-2011, with consideration of place of residence, urban-rural. The material for the study was the number of deaths due to main causes in Poland in years 2002-2011, based on data from the Central Statistical Office. Premature mortality analysis was conducted with the use of PYLL indicator (PYLL - Potential Years of Life Lost). PYLL rate was calculated according to the method proposed by J. Romeder, according to which the premature mortality was defined as death before the age of 70. Time trends of PYLL rate and the annual percent change (APC) were assessed using the Joinpoint Regression Programme. Rural/urban ratio was used to presented the differences in premature mortality between rural and urban areas . In years2002-2011, the PYLL rate for all-cause deaths decreased by 13.2% among men and 16.0% among women in rural areas, whereas in urban decreased it decreased by 15.7% among men and 14.9% among women. In 2011, the main causes of PYLL among men in rural areas were: external causes (32.3%), cardiovascular diseases (23.5%) and cancers (19.4%); in urban areas: cardiovascular diseases (24.7%), external causes (24.3%) and cancers (20.9%). Among women in rural areas, the leading causes were: cancers (39.9%), cardiovascular diseases (20.1%) and external causes (15.1%). The main causes of premature mortality among women in urban areas were: cancers (41.7%), cardiovascular diseases (19.6%) and external causes (11.1%). Premature mortality among men in rural areas was significantly higher than in urban for all analysed causes of death, with the exception of ischaemic heart diseases and colorectal cancer. Premature mortality among women in rural areas was significantly lower than in urban for all analysed cause of deaths, except of cerebrovascular diseases, external causes, suicides and traffic accidents. The presented epidemiological situation for premature mortality indicate differences in the state of health of the inhabitants in urban and rural areas in Poland. The leading causes of premature mortality are caused by preventable deaths, which leads to a need to intensify measures in primary and secondary prevention.

The breast-conserving surgery of women with breast cancer in Podlaskie Voivodeship (Poland). Population study.

INTRODUCTION: The results of breast cancer treatment depend mainly on better detection in mammography screening and, consequently, a higher proportion of women with early stage of the disease. They depend also on a better access to health care services and the effectiveness of oncological treatment. One of the methods of breast cancer control is a breast-conserving surgery. With a proper patients' classification for the treatment, the results of the breast-conserving surgery do not differ in relation to mastectomy. That's why, the availability of breast-conserving surgical methods is particularly important, especially in a population in which a population screening is conducted. OBJECTIVE: The analysis of the selected aspects of the breast cancer treatment's standard in Podlaskie Voivodeship. PATIENTS AND METHODS: In years 2001-2002, 709 cases of women with breast cancer were reported to the Voivodeship Cancer Registry in Bialystok. 659 women were diagnosed with a primary invasive breast cancer. Based on a cohort of 499 women treated with radical methods the following indicators, recommended by WHO for the evaluation of the breast-conserving surgery's availability, were calculated: a percentage of patients with whom breast-conserving surgery was used, a proportion of breast cancer cases receiving post-operative breast radiotherapy after breast-conserving surgery and a proportion of breast-conserving surgery in pT1 cases. RESULTS: The breast-conserving surgery has been used much less frequently in Podlaskie Voivodeship than in Western Europe, but more frequently than in Poland in general. CONCLUSION: It should be aimed to provide a surgical treatment with the use of breast-conserving surgical methods to the highest possible percentage of patients. The increase of the percentage of patients treated with breast-conserving surgery methods can be a result of an effective screening realisation.

Differences in results of breast cancer curative treatment between urban/rural female population in Podlaskie Voivodship of Poland before introduction of the National Cancer Control Programme.

The aim of the study was to evaluate differences in the results of the curative treatment received by women with breast cancer in urban and rural area in Podlaskie Voivodship in 2001-2002 before the introduction of the National Cancer Control Programme. The analysis was based on 449 women with breast cancer, who received curative treatment in years 2001-2002. Relative 5-year survival rates as function of age and stage among urban and rural women population were calculated. The results showed that survival rates in Podlaskie Voivodship among curatively treated women with breast cancer were 81.9% but they differed between urban and rural areas. Patients living in rural areas had much lower survivals than those living in urban areas at local and regional stage of disease. In all age groups considered in the study survivals in rural areas were lower than in urban ones in which survivals were higher in 55-64 age group. These results indicated the necessity intervention in order to increase the access to the health care system and effectiveness of early detection and also improved treatment standards for more disadvantaged rural areas. These results should be also considered in monitoring of the National Cancer Control Programme introduction in Poland in 2006.

Effect of an anti-tobacco programme of health education on changes in health behaviours among junior high school adolescents in Bialystok, Poland.

INTRODUCTION: School health education programmes are among the instruments for the prevention of tobacco smoking among children and adolescents. Knowledge obtained in evaluation studies of these programmes indicates the degree of their effectiveness and serves to improve their quality. OBJECTIVE: Recognition and evaluation of the effect of two-year anti-tobacco programme of health education on the changes in the level of knowledge, attitudes and behaviours of adolescents. MATERIALS AND METHOD: An intervention study was originated in May 2007, and covered 859 first-year schoolchildren from eight public junior high schools in Bialystok in Poland, from among 3,318 schoolchildren attending 33 schools. The sample was selected by means of two-stage stratified sampling with consideration of two groups: an intervention group covered with educational actions (417 schoolchildren), and a control group (442 schoolchildren), where anti-tobacco education was not carried out. Before the educational programme and after its completion an evaluation of knowledge, attitudes and behaviours of junior high school adolescents was performed with respect to nicotinism, based on a survey. The educational part consisted in conducting within 2 years, 4 educational classes and 2 competitions concerning tobacco-related problems. RESULTS: After two years, in the group of adolescents covered by the educational programme a significant increase was observed - by 11.6% - in the percentage of schoolchildren who were familiar with the negative effects of tobacco smoking, and an increase by 4.4% of those who were convinced that smoking is harmful. With respect to adolescents' attitudes, the effect of the programme was noted in only one of six components analyzed. After completion of the two-year educational programme, both in the group covered by this programme and the control group, the percentage of smokers significantly increased (by 12.8% and 12.7%, respectively). CONCLUSIONS: It is necessary to evaluate the health education programme from the aspect of both the actual hard effects of the anti-nicotine programme (changes in behaviour), and indirect effects - soft (knowledge, skills) which are a basis for the potential verification of the programme in order to increase its effectiveness.

Waiting time for treatment of women with breast cancer in Podlaskie Voivodeship (Poland) in view of place of residence. A population study.

INTRODUCTION: Treatment delay is a major problem of contemporary oncology. Knowing the time interval between diagnosis and initiation of treatment, together with monitoring this adverse prognostic factor, is an important element of the treatment planning process in the population and can contribute to the improvement of patients' curability. OBJECTIVE: To assess the waiting time for first treatment of women diagnosed with breast cancer in 2001-2002 in Podlaskie Voivodeship. MATERIALS AND METHODS: During 2001-2002, there were 709 cases of women with breast cancer who reported to the Voivodeship Cancer Registry in Bialystok. 659 women were diagnosed with a primary invasive breast tumour. A cohort of 499 women who were treated with a curative intent was selected from this group. The waiting time in the created cohort was calculated as the number of days between the date of the breast cancer diagnosis and date of the first treatment. RESULTS: The average time between the date of diagnosis and date of the first treatment was 38 days. The median was 14 days. 28.6% of patients from the selected cohort waited longer than 28 days. The treatment of rural women was initiated faster than the treatment of urban patients.

Differences in the effects of anti-tobacco health education programme in the areas of knowledge, attitude and behaviour, with respect to nicotinism among boys and girls.

INTRODUCTION: Health education used for increasing the effectiveness of intervention actions should cover a number of factors which exert an effect on learning. OBJECTIVE: Recognition of the extent to which gender may determine the effects of an anti-tobacco health education programme. MATERIAL AND METHODS: The intervention study was undertaken in May 2007, and covered 859 first-year schoolchildren in Bialystok. The sample was selected by means of two-stage stratified sampling with consideration of two groups: an intervention group and a control group. RESULTS: In the group of girls, the 2-year educational programme resulted in an increase in knowledge concerning the negative effects of cigarette smoking by 21%, and being familiar with anti-tobacco actions and campaigns carried out in Poland by 24.5%. Among boys, an increase was observed only with respect to the knowledge of anti-tobacco actions and campaigns - by 10.7%. Considering the attitudes of girls after the completion of the programme, changes were noted with respect to three from among the six elements analyzed. However, among boys, after completion of the project, no changes were noted in any of the analyzed elements of attitude. In girls who participated in the anti-nicotine programme, the percentage of smokers did not increase, while an increase in this percentage was observed among girls of the control group and boys in both groups. CONCLUSIONS: Different effects of the 2-year anti-tobacco programme obtained in the area of knowledge, attitude and behaviour should constitute a premise for the modification of educational programmes from the aspect of the variety of methods, techniques and instruments which would be adequate for adolescents' predispositions resulting also from their gender.

The impact of the Polish national Programme of Cardiovascular Disease Prevention on the quality of primary cardiovascular disease prevention in clinical practice.

BACKGROUND: Despite a decline since 1991, cardiovascular diseases (CVD) are the major burden on public health in Poland. AIM: To assess the impact of the national Programme of Cardiovascular Disease Prevention (PCVDP) on the quality of primary CVD prevention in clinical practice. METHODS: Sixty six primary care centres were invited to join the project (2-6 in each province). Half of these centres participated in the PCVDP (in other words, they were 'active' clinics) and the other half was included in the control group. A random sample of 300 patients aged 35-55, free of coronary heart disease, with no history of stroke or peripheral artery disease, and with medical documentation going back at least to 1 January 2005 was selected for the study in each centre. From the total of 3,940 patients in active clinics, 3,162 were judged to be eligible for the study and their medical records were reviewed. All were invited for examination. This was finally attended by 2,314 patients from active clinics and 2,101 from the control group. RESULTS: Before the introduction of the PCVDP, the percentage of patients with available information on risk factors in medical records was similar in the active and in the control clinics, and varied from more than 40% (hypertension) to less than 5% (weight and waist circumference). After the introduction of the PCVDP, the proportion of subjects with available information on risk factors greatly increased in the clinics which took part in the PCVDP. Knowledge of CVD risk factors was similar in the two studied groups. When asked, about 10% of patients in both groups could not list a single CVD risk factor. Smoking was the most frequently recognised risk factor (named by more than 60% of patients) and diabetes the least (less than 15%). No significant difference was found between the active and control clinics in the frequency of counselling as to smoking, diet, weight reduction or exercise. Only about 40% of smoking patients had received advice on smoking cessation. Counselling on diet had been received by about 40% of patients. Less than 20% of patients had been advised to reduce weight, with about 25% having received advice to increase their physical activity. Control of risk factors was poor and there was no significant difference between the active and control clinics in terms of the proportion of patients who reached prevention targets. CONCLUSIONS: 1. The PCVDP appears to be effective in identifying high risk patients. 2. The effectiveness of the routine management of risk factors in primary care is very low. 3. Addressing via the PCVDP all decisions as to the extent and means of intervention on risk factors to primary care physicians appears to be ineffective. 4. There is a need to introduce an effective structured intervention on risk factors and add it to the PCVDP.

Differences in breast cancer incidence and stage distribution between urban and rural female population in Podlaskie Voivodship, Poland in years 2001-2002.

The aim of the study was to evaluate differences in breast cancer incidence and stage of disease between the urban and rural female population in Podlaskie Voivodship in 2001-2002, before the introduction of the Population Screening Programme in 2006. Analysis was based on 696 breast cancer cases diagnosed in years 2001-2002 and registered in the CR in Bialystok (Voivodship Cancer Registry). An average annual number of incidence, as well as crude and standardised incidence rates, were calculated. Age-specific incidence rates for 5-year age groups were also calculated and grouped as follows: < 50, 50-69, > =70 years old. Incidence differences related to place of residence: urban or rural, were presented with the use of u/r (urban/rural) ratio. In order to evaluate the stage of disease, a simplified classification recommended by ENCR (European Network of Cancer Registries) for population registries (localised, regional, metastatic) was applied. The breast cancer incidence rate in the urban population was higher than in rural areas with u/r ratio amounting to 1.4. The highest incidence and largely marked differences between urban and rural areas were among women aged 50-69 years with the u/r ratio amounting to 1.8. Overall, the proportion of stage localised in Podlaskie Voivodship was 33.1 percent and differed between urban and rural areas. The proportion of localised cancer was higher in urban areas, but patients were younger when compared to those living in rural areas. Knowledge of differences in incidence and breast cancer stage in urban and rural women investigated in this research, together with other epidemiological indicators, should be used for monitoring the Population Screening Programmes in these populations.

Breast cancer survival gap between urban and rural female population in Podlaskie Voivodship, Poland, in 2001­2002. Population study.

The aim of the study was to evaluate differences in breast cancer 5-year relative survival rates between the urban and rural female population in Podlaskie Voivodship in 2001-2002, before the introduction of the Population Screening Programme in 2006. The analysis was based on 659 breast cancer cases diagnosed in 2001-2002 and registered in CR in Bialystok (Voivodship Cancer Registry). Relative survival and relative excess of risk of death after 5 years of diagnosis as function of age and stage among urban and rural women population were calculated. The results showed that survival rates in Podlaskie Voivodship were low (69.4%) in comparison to the European average (79.4%), and they differed between urban and rural areas. Patients living in rural areas had a much lower survival rate than those living in urban areas at local and regional stage of disease, whereas survivals were higher at the metastatic stage. In all age groups considered in the study, the survivals in rural areas were lower than in urban areas. The multivariate analysis confirmed that both the cancer stage and place of residence are independent prognostic factors. Relationship with age was not confirmed. The research results indicate low curability of breast cancer in Podlaskie Voivodship, and significant differences between urban and rural areas. These results need to be considered in the planning and monitoring of further intervention in order to increase the effectiveness of prevention and treatment standards for more disadvantaged rural areas. It is particularly significant when implementing the National Cancer Control Programme.

[Evaluation of nutrition and physical activity of students in Gastronomic School in Bialystok]. / Ocena sposobu zywienia i aktywnosci fizycznej uczniów Zespolu Szkól Gastronomicznych w Bialymstoku.

The aim of this study was to estimate nutrition and physical activity of students in Gastronomic School in Bialystok. Questionnaire about nutrition and physical activity took on April 2008 in 74 students. The content of energy and main nutrition values were calculated and compared to the recommended values. Students diet included normal of energy, protein, fats and carbohydrates. Only 58% girls and 61% boys had intensive physical activity. Change of nutrition and moderate in physical activity is recommended for the students.

[Health behaviour of students attending secondary school in the sokolski district. Part II. Smoking cigarettes and drinking alcoholic beverages]. / Zachowania zdrowotne mlodziezy szkól ponadgimnazjalnych w powiecie sokólskim. Cz. II. palenie papierosów i picie napojów alkoholowych.

The purpose of this research was the evaluation of the use of cigarettes and alcohol among secondary school students in the sokolski district. Information about the sample, date and method of research was presented in the first part of the study. This part analyses answers to questions concerning: alcohol and smoking initiation, and the frequency of smoking, drinking and being under the influence of alcohol (intoxication). The research showed that 44.09% of the students in the 17 to 19 age range tried smoking cigarettes. 52.42% of them smoke somehow frequently, 26.49% smoke daily. 80.4% of students declared to have experimented with alcohol. 17.34% of students were under the influence of alcohol (intoxication) at least once during their lifetime. The most frequently consumed alcoholic beverage was beer.

[Changes in smoking frequency in Poland in the years 1923-2003]. / Zmiany czestosci palenia tytoniu w Polsce w okresie lat 1923-2003.

INTRODUCTION: Smoking is a commonly recognized risk factor of civilization diseases. The number of damaging compounds, including carcinogenic, inhaled by a smoker and exhaled, is directly proportional to a number of smoked cigarettes. Health promotion and prevention are bases of fighting strategy with health risk connected with smoking. The aim of the study was to contrast the number of sold cigarettes in one year in Poland, calculated per capita in selected years of 20th century and at the beginning of current century. The details, which are analysed in the study considering a total number of cigarettes sold in Poland, come from The Statistical Yearbooks and The Demographical Yearbooks of the Central Statistical Office. The analysis showed that in the year 2003 the number of cigarettes sold in Poland, calculated per capita were 4.3 times larger in comparison to the number of cigarettes sold in Poland, calculated per capita in the year 1923. In fact, the difference of the number of sold cigarettes is more unfavorable because the details which concerned cigarettes disposal do not include significant illegal cigarettes import. The highest number of cigarettes sold in Poland, calculated per capita in the analysed period of time, was noticed in the years: 1979--2741 cigarettes, 1980--2679 cigarettes and in 1987--2671 cigarettes, and the lowest was at the beginning of the analysed period: in 1923--450 cigarettes, in 1938--600 cigarettes and in 1949--893 cigarettes. Smoking spread in Poland at the beginning of current century which is measured by the number of sold cigarettes and noticed changes in statistics, calculated per capita, although downward trend is still on the high level.

[Does Polish public health strategy give consideration to the manner of nutrition and its consequences for health?]. / Czy strategia zdrowia publicznego w Polsce uwzglednia sposób zywienia i jego skutki zdrowotne?

The aim of the paper is to present the relation between the manner of nutrition, its consequences for [people's] health and the contents of Polish health programmes at the turn of the century. As far as quantity and quality are concerned, the nutrition manners in Poland of the second half of the 20th century were far from the accepted norms and recommendations. Changes of feeding habits which came after 1991 had many different consequences. In the discussed period occurence of diseases dependent on malnutrition, such as: diseases of cardiovascular system and neoplastic diseases and frequent occurence of diabetes and obesity, was intensified. It should be also stated that the nutrition issues in health programmes implemented in Poland of that period at different levels were not given proper consideration. The study ends with a comment and conclusions answering the question posed in the title which point to an urgent necessity to take some measures in the discussed field.