Epidemiology of vulvar cancer in Croatia.

AIM: To assess the incidence and mortality trends of invasive vulvar cancer in Croatia between 2001 and 2019/2020. METHODS: The incidence data for the period 2001-2019 were obtained from the Croatian National Cancer Registry. The number of deaths from invasive vulvar cancer by age groups between 2001 and 2020 was obtained from the Croatian Bureau of Statistics. Joinpoint regression analysis was used to assess the trends and trend changes. RESULTS: Joinpoint regression analysis of vulvar cancer incidence rate showed a non-significant average annual percent increase (APC) of 0.8 (95% confidence interval [CI]=-0.3-2.0) during the whole period. There was also a non-significant increase in women under 60, with an average APC of 1.0 (CI = -1.6-3.7) during the whole period; similar results were obtained in women over 60 years of age (APC=0.9; CI=-0.3-2.1). The average annual percent increase in vulvar cancer mortality rate was 0.2% (CI = -1.0-1.5), with a similar trend in women over 60 years of age (APC=0.1; CI=-1.3-1.5). Mortality in women under 60 years of age was not assessed due to a very small number of deaths observed in the study period. CONCLUSION: In the studied period, the incidence of invasive vulvar cancer in Croatia was stable. Age-standardized rates (for all-ages, under 60, and over 60 years of age) increased, but the increase did not reach the level of statistical significance. The pattern in younger and older age groups was the same. The mortality rates over the last decade were stable.

Undiagnosed hypertension in Croatia.

AIM: To determine the prevalence of undiagnosed hypertension in Croatia, and to assess its association with various demographic, socioeconomic, lifestyle, and health care usage factors. METHODS: We used the data from European Health Interview Survey wave 3, conducted in Croatia in 2019. The representative sample consisted of 5461 individuals aged 15 years and older. The association of undiagnosed hypertension with various factors was assessed with simple and multiple logistic regression models. The factors that contribute to undiagnosed hypertension were identified by comparing undiagnosed hypertension with normotension in the first model and with diagnosed hypertension in the second model. RESULTS: In the multiple logistic regression model, women and older age groups had lower adjusted odds ratio (OR) for undiagnosed hypertension than men and the youngest age group. Respondents living in the Adriatic region had a higher adjusted OR for undiagnosed hypertension than those living in the Continental region. Respondents who did not consult their family doctor in the previous 12 months and those who did not have their blood pressure measured by a health professional in the previous 12 months had a higher adjusted OR for undiagnosed hypertension. CONCLUSION: Undiagnosed hypertension was significantly associated with male sex, age from 35 to 74, overweight, lack of consultation with a family doctor, and living in the Adriatic region. The results of this study should be used to inform preventive public health measures and activities.

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.

Epidemiology of Prostate Cancer in Croatia - Situation and Perspectives.

Prostate cancer represents a significant public health burden in Croatia, as well as in other developed countries. The aim of this paper was to present the current epidemiological situation in Croatia in comparison to other similar countries, using basic indicators such as incidence, mortality, prevalence and survival, and to discuss future possibilities in this field. The incidence of prostate cancer in Croatia has been rapidly increasing since the mid-nineties; recent data indicates that the trend is levelling off. Mortality data show constant increase since the 1960s, but mortality trends seem to be stabilizing in the recent period; however, Croatia is still in the top ten countries regarding prostate cancer mortality in Europe. Five-year prevalence in 2012 was estimated at 7,592 cases (426.7/100,000), ranking Croatia in the middle of European countries in the GLOBOCAN 2012 database. According to the CONCORD-2 study, five-year net survival in Croatia in the 2005-2009 period was 75.1%, which is lower than in similar European countries. The epidemiological pattern of prostate cancer in Croatia indicates a relatively low incidence, with significant room for improvement in mortality and survival data. Given the recent discussions regarding prostate cancer screening modalities, a debate is warranted and should be encouraged regarding the role of PSA testing in Croatia.