Survival in men diagnosed with prostate cancer in Poland in the years 2000 - 2014 compared to European Countries based on Concord-3.

BACKGROUND: Wealthy countries have observed in recent decades a fast-growing number of prostate patients, who require treatment and long-term cancer care. This trend seems to be connected with some demographic changes such as aging societies, better access to diagnostic methods with high sensitivity as well as large-scale secondary prevention (prostate cancer screening at early stage before clinical manifestation). Secondary prevention is becoming more accessible and widely applied. The expected effect of prevention is to improve overall survival while the mortality trend is decreasing. The prevention success requires highly effective healthcare system that must manage additional burden which is a consequence of the need to provide optimal treatment and healthcare in a big group of cancer patients diagnosed in effective prevention programms. According to the National Cancer Registry (NCR) the number of incidence from year 1980 - 1731 cases rose in year 2013 to 12 162 cases. Apart from incidence and mortality rates, the 5-year survival is a significant factor for the assessment of a population healthcare and healthcare system efficiency. The prognosis related to prostate incidence is 22 344 men in year 2025 in comparison to 12 162 in year 2013 - that would be a double rise in incidence. CONCORD-2 results (years 1995-2009) showed, among the others, that cancer curability for some cancers, including prostate cancer improved. In year 2018 the results of CONCORD-3 were published (years 2000-2014) showing a rising trend in improvement in prostate cancer curability in Poland. OBJECTIVE: The objective was to analyse the 5-year survival in prostate cancer patients in Poland, and in each of 16 voivodships, with the focus on changes in years 2000 - 2014 in comparison to European trends. MATERIAL AND METHODS: The analysis was based on the 5-year net survival (estimated in CONCORD-3) in prostate cancer patients diagnosed in Poland (NCR national data) and in all Polish voivodships. The 5-year survival of prostate cancer patients and its changes in years 2000 - 2014 compared between 16 voivodships, Poland in total and 28 European countries. RESULTS: In Poland in years 2010 - 2014 the 5-year survival in prostate cancer patients was 78.1%, and compared to years 2000 - 2004 rose by 9.3 percentage points. Despite a systematic improvement in survival the differences between individual voivodships in Poland remained. In 6 voivodships the survival was higher than average for Poland and ranged from 80 to 82%. The lowest survival was in Opolskie voivodship - 72.3%. On a European scale, the curability of prostate cancer at that time was over 90% (9 countries), while Poland was among 5 countries whose total survival rate was less than 80% (from 72.3% - Opolskie voivodship to 83.6% -- Pomeranian voivodship). CONCLUSIONS: The 5-year survival in prostate cancer patients in years 2010 - 2014 in Poland was significantly lower in comparison to Western Europe countries, and favourable trends on a regional level in Poland were too slow to overcome high differentiation in Europe. It is expected that changing the structure and organisation of cancer care in Poland into a modern National Oncology Network Comprehensive Cancer Care Network, together with the use of the experiences from European projects, including iPAAC and better financing will contribute to improvement in prostate cancer treatment in Poland.

Survival in women diagnosed with breast and cervical cancer in Poland ­ compared to European countries, based on CONCORD - 3 Programme

INTRODUCTION: The 5-year population-based survival rate, next to cancer incidence and mortality, is a key element for the assessment of effective health care quality provided by OECD in order to establish the condition of health care and set up health care policies. They also apply when assessing breast and cervical cancer prevention in Poland. AIM: The aim of the paper was to analyse the breast and cervical cancer survival in women in Poland in 2010-2014 and its changes in 2000-2014 in comparison to other European countries. RESULTS: The analysis of the 5-year survival rate was performed with the CONCORD-3 programme data. In order to guarantee the comparability of results, the uniform standards for data quality control, all calculations and analyses were performed by a world-leading centre for research, The London School of Hygiene and Tropical Medicine. The absolute value of the survival rate was used to assess survival variations in 2000-2004 and 2010-2014. In 2010-2014 the highest 5-year survival rate in women with breast cancer was in Island (89%), Sweden (89%), Finland (89%) and Norway (88%). Despite its systematic improvement, the 5-year survival rate in Poland was lower than in the majority of European countries, and in the final period amounted to 76,6%. In 2010-2014 the highest survival in women with cervical cancer in Europe was in Island (80%), Norway (73%) and Switzerland (71%). The progress of favourable changes in Poland was not sufficient enough to allow the survival rate (55%) to be significantly closer to the European average. CONCLUSIONS: The 5-year survival rate for breast and cervical cancer in Poland in 2010-2014 was significantly different than in other European countries, and placed Poland among the countries with the lowest survival rate. In 2000-2014 in Poland there was an insignificant progress in survival in women with breast and cervical cancer, which did not contribute to fighting the substantial differences when compared to other European countries.

Analysis of changes in cancer health care system in Poland since the socio-economic transformation in 1989

Background: The transformation period in Poland is associated with a set of factors seen as 'socio-economic stress', which unfavourably influenced cancer treatment and slowed down the progress of the Polish cancer care in the 90's. These outcomes in many aspects of cancer care may be experienced till today. The results of the international EUROCARE and CONCORD studies based on European data prove evidence that there is a substantial potential for improvement of low 5-year survival rates in Poland. Since high survivals are related to notably efficient health care system, therefore, to improve organization and treatment methods seems to be one of the most important directions of change in the Polish health care system. Till today, cancer care in Poland is based on a network outlined by Professor Koszarowski in the middle of the last century, and is a solid foundation for the contemporary project of the Comprehensive Cancer Care Network (CCCN) proposed in the frame of CanCon Project. Objective: Analysis of the structure of health care system and the changes introduced within the network of oncology in Poland since the beginning of the post-commuinist socio-economic transformation in 1989. Materials and Methods: This study was conducted based on the CanCon methods aimed at reviewing specialist literature and collecting meaningful experiences of European countries in cancer care, including the main legal regulations. Results: The analysis provided evidence that the political situation and the economic crisis of the Transformation period disintegrated the cancer care and resulted in low 5-year survival rates. A step forward in increasing efficiency of the cancer treatment care was a proposal of the 'Quick Oncological Therapy' together with one more attempt to organize a CCCN. With this paper the Authors contribute to the CanCon Project by exploration, analysis and discussion of the cancer network in Poland as an example of existing net-like structures in Europe as well as by preparation of guidelines for constructing a contemporary CCCN. Conclusions: (1) 'Socio-economic' stress adversely affected the efficiency of oncological treatment, both by reducing safety and slowing down the development of modern oncology. (2) Changing the current system into the contemporary form - CCCN could be an important step forward to optimise the oncological health care in Poland. (3) Introduction of the mandatory monitoring of organizational changes with the use of health standardized indicators could allow for the assessment of the effectiveness of implemented solutions and their impact on better prognosis for cancer patients. (4) Optimising the organization of the health care system is possible only by implementing necessary legislative corrections.

Occurrence and maintenance of hantavirus infections among rodent populations in their natural habitat--results of a field study from Podkarpackie province, Poland 2010-2012.

UNLABELLED: Human cases of hantavirus infection have been reported annually in Poland's Podkarpackie province, since 2007. In 2014 the number of cases reported significantly increased prompting a rise in studies focusing on the infection. OBJECTIVE: The purpose of this study was to evaluate the prevalence, maintenance and the dynamics of hantavirus infection among rodent species, including the bank vole (Myodes glareolus) and yellow-necked mouse (Apodemus flavicollis) which act as reservoirs of hantavirus in the environment. MATERIAL AND METHODS: Rodent capture was carried out on seven research grids in the Podkarpackie province, from summer 2010 to spring 2012. They were caught in live-capture traps used in accordance with the protocol CMR (Catch-Mark-Release). The population was estimated as MNA (Minimum Number Alive). Blood samples were collected for serological testing on live animals by puncture of saphenous vein. In order to determine the hantavirus infection we used ReaScan Ab-Dect Puumala IgG--Reagena® for bank voles, and for mice ELISA--Mouse Hanta Virus Test ELISA Kit (Version with Control Antigen Wells)--BioCat GmbH®. The relationship between age, gender, seasons, population size and prevalence of hantavirus infection was tested by Pearson's chi-squared test or Fisher's exact test and by calculating the Pearson's correlation coefficient. RESULTS: A total of 854 rodents were captured: 222 bank voles, 592 yellow-necked mice, 4 common voles and 36 striped field mice. Of these, 564 were tested. The presence of specific anti-hantavirus was found in 9.7% of bank voles and 9.5% of yellow-necked mice. There was a statistically significant difference in the frequency of infection between the groups of male and female yellow-necked mice as well as in the groups of adult group in both species. The dynamics of spread of hantavirus infection was clearly evident in the studied area of Sanok. The correlation coefficient between the number of individuals caught and the prevalence of hantavirus infection in yellow-necked mice was -0,87 but for the bank vole it was 0,76. SUMMARY AND CONCLUSIONS: The results of the study indicate that hantavirus infection among yellow-necked mice and bank voles are unevenly distributed in certain hot spots, vary over time, and are most in the spring season. In addition, differences observed in the dynamics of infection depended on the species of animal hosts. It would be advisable to conduct long-term study, which would allow for a risk assessment of the possibility of turning the spot located outbreaks into endemic area of hantavirus occurrence.

The Diversity of Small Mammals along a Large River Valley Revealed from Pellets of Tawny Owl Strix aluco.

The Vistula River is one of the largest European semi-natural rivers of high ecological value that functions as an ecological corridor. To assess the structure of small mammal communities along the Vistula River, an analysis of the diet of an opportunistic predator, the tawny owl Strix aluco, was used. A total of 6355 individuals of 19 species were found, including 5 soricomorph species, 12 rodents, 1 carnivore, and 1 bat species. Tawny owls most frequently caught Apodemus agrarius, Clethrionomys glareolus, Apodemus flavicollis, and Microtus arvalis. Rodents dominated small mammal communities (90%), followed by soricomorphs (8%), and the share of Chiroptera was significant (2%). Using Ward's method in cluster analysis, three clusters of sites with similar mammal communities were identified. The cluster that included 17 study sites with the dominance of agriculture habitats was inhabited by diverse mammal communities with a high number of species. In the cluster composed of three suburban forest sites, mammal communities had the lowest diversity, although the high species richness and the highest shares of the forest species (A. flavicollis, C. glareolus, and Nyctalus noctula). Mammal communities in the cluster were composed of three urban sites were dominated by A. agrarius and M. arvalis. The study indicates the high species richness of small mammals in floodplains of the Vistula River and the adjacent areas in central Poland. The floodplain offers suitable habitats for species associated with forests, water bodies, agricultural land, and developed areas. The data collected confirms earlier model predictions about the presence of well-connected local populations of forest mammals along the Vistula River.

ß-diversity decreases with increasing trophic rank in plant - arthropod food chains on lake islands.

Contrasting trophic theories of island biogeography try to link spatial patterns in species distribution and richness with dietary preferences, arguing that the spatial turnover of species among habitat patches changes with trophic rank causing a systematic change in the proportion of plants, herbivores, and predators across habitats of different size. Here we test these predictions using quantitative surveys of plants, spiders, and herbivores as well as of omnivorous and predatory ground beetles on undisturbed Polish lake islands. We found decreased proportions of predators and habitat generalists on larger islands. Environmental niches and niche overlap were highest in predators. Variability in environmental niche width among species increased at higher trophic levels. Our results confirm models that predict a decrease in spatial species turnover (ß-diversity) with increasing trophic level. We speculate that the major trigger for these differences is a reduced dispersal ability in plants at basal trophic ranks when compared to higher trophic levels.

Bayesian estimates of the incidence of rare cancers in Europe.

BACKGROUND: The RARECAREnet project has updated the estimates of the burden of the 198 rare cancers in each European country. Suspecting that scant data could affect the reliability of statistical analysis, we employed a Bayesian approach to estimate the incidence of these cancers. METHODS: We analyzed about 2,000,000 rare cancers diagnosed in 2000-2007 provided by 83 population-based cancer registries from 27 European countries. We considered European incidence rates (IRs), calculated over all the data available in RARECAREnet, as a valid a priori to merge with country-specific observed data. Therefore we provided (1) Bayesian estimates of IRs and the yearly numbers of cases of rare cancers in each country; (2) the expected time (T) in years needed to observe one new case; and (3) practical criteria to decide when to use the Bayesian approach. RESULTS: Bayesian and classical estimates did not differ much; substantial differences (>10%) ranged from 77 rare cancers in Iceland to 14 in England. The smaller the population the larger the number of rare cancers needing a Bayesian approach. Bayesian estimates were useful for cancers with fewer than 150 observed cases in a country during the study period; this occurred mostly when the population of the country is small. CONCLUSION: For the first time the Bayesian estimates of IRs and the yearly expected numbers of cases for each rare cancer in each individual European country were calculated. Moreover, the indicator T is useful to convey incidence estimates for exceptionally rare cancers and in small countries; it far exceeds the professional lifespan of a medical doctor.