Moving forward on tumor pathology research reporting: a guide for pathologists from the WHO Classification of Tumors EVI MAP Group.

Evidence-based medicine (EBM) can be unfamiliar territory for those working in tumor pathology research and there is a great deal of uncertainty about how to undertake an EBM approach to planning and reporting histopathology-based studies. In this article, endorsed by the WHO International Agency for Research on Cancer's (IARC) International Collaboration for Cancer Classification and Research (IC3R), we aim to help pathologists and researchers to understand the basics of planning an evidence-based tumor pathology research study, as well as our recommendations on how to report the findings from these. We introduce some basic EBM concepts, the PICO model, thoughts on study design, and emphasize the concept of reporting standards. There are many study-specific reporting guidelines available, and we provide an overview of these. However, existing reporting guidelines perhaps do not always fit tumor pathology research papers, and so here we collate the key reporting dataset together into one generic checklist that we think will simplify the task for pathologists. The article aims to complement our recent Hierarchy of Evidence for Tumor Pathology and Glossary of Evidence (study) Types in tumor pathology. Together, these articles should help any researcher get to grips with the basics of EBM for planning and publishing research in tumor pathology, as well as encourage an improved standard of the reports available to us all in the literature.

National launch of human papillomavirus (HPV) immunization program in Poland, 2023.

Poland launched a nationwide Human Papillomavirus (HPV) immunization program in June 2023, transitioning from a recommended to publicly funded approach. Targeting mainly 12 to 13-year-olds, the program offers universal and cost-free vaccinations with Cervarix and Gardasil 9. The initiative, aligned with the National Oncology Strategy, involves 4945 healthcare facilities, ensuring accessibility across regions. The streamlined process, empowering parents to choose, includes diverse healthcare professionals.

A New Hierarchy of Research Evidence for Tumor Pathology: A Delphi Study to Define Levels of Evidence in Tumor Pathology.

The hierarchy of evidence is a fundamental concept in evidence-based medicine, but existing models can be challenging to apply in laboratory-based health care disciplines, such as pathology, where the types of evidence and contexts are significantly different from interventional medicine. This project aimed to define a comprehensive and complementary framework of new levels of evidence for evaluating research in tumor pathology-introducing a novel Hierarchy of Research Evidence for Tumor Pathology collaboratively designed by pathologists with help from epidemiologists, public health professionals, oncologists, and scientists, specifically tailored for use by pathologists-and to aid in the production of the World Health Organization Classification of Tumors (WCT) evidence gap maps. To achieve this, we adopted a modified Delphi approach, encompassing iterative online surveys, expert oversight, and external peer review, to establish the criteria for evidence in tumor pathology, determine the optimal structure for the new hierarchy, and ascertain the levels of confidence for each type of evidence. Over a span of 4 months and 3 survey rounds, we collected 1104 survey responses, culminating in a 3-day hybrid meeting in 2023, where a new hierarchy was unanimously agreed upon. The hierarchy is organized into 5 research theme groupings closely aligned with the subheadings of the WCT, and it consists of 5 levels of evidence-level P1 representing evidence types that merit the greatest level of confidence and level P5 reflecting the greatest risk of bias. For the first time, an international collaboration of pathology experts, supported by the International Agency for Research on Cancer, has successfully united to establish a standardized approach for evaluating evidence in tumor pathology. We intend to implement this novel Hierarchy of Research Evidence for Tumor Pathology to map the available evidence, thereby enriching and informing the WCT effectively.

Self-reported participation in cervical cancer screening among Polish women in 2004-2019.

OBJECTIVES: We aimed to assess self-reported participation in cervical cancer screening among Polish women between 2004 and 2019 and to identify the groups with the lowest participation rate. MATERIAL AND METHODS: Data on declared participation in cervical cancer screening were obtained from the European Health Interview Survey from 2004 to 2019. RESULTS: In 2019, 86.7% of Polish women aged ≥ 15 years declared that they had ever undergone a Pap test. Compared to 2004, the coverage of ever-screened women improved by 16.6 percentage points. The proxy population coverage was 72.9%. The highest proportion of women who underwent a Pap smear in the last three years was observed among those aged 35-44 years and 25-34 years (84.0% and 83.2%, respectively), and the lowest among women aged ≥ 75 years (20.5%). The proportion screened within the last three years also varied by education (up to lower secondary education 26.4%, up to post-secondary non-tertiary education 62.8%, and the highest level of education 83.7%), urbanization (large cities 66.7%, suburbs, and smaller cities 62.8%, and rural areas 59.0%), income (poorest households 42.5%, wealthiest households 70.6%), and declared health status (best 68.9%, worst 41.4%). The lowest participation in screening was observed in the southeastern regions and the highest in the northwestern regions of Poland. CONCLUSIONS: In Poland, in 2019, the approximate coverage of cervical cancer screening was high compared to other European countries and has improved over the last 15 years. A complete screening registry is required to confirm questionnaire-based self-reported data. Targeted interventions should be implemented to address low participation in the identified regions and socioeconomic groups.

To push or to pull? A clinical audit on the efficacy and safety of the pull and push percutaneous endoscopic gastrostomy techniques in oncological patients.

BACKGROUND: The peroral "pull" technique and the direct "push" procedure are the two main methods for percutaneous endoscopic gastrostomy (PEG) placement. Although pull-PEG is generally recommended as the first-line modality, many oncological patients require a push-PEG approach to prevent tumor seeding or overcome tumor-related obstruction. OBJECTIVE: We aimed to compare the efficacy and safety of both PEG procedures in cancer patients. METHODS: We retrospectively analyzed all consecutive PEG procedures within a tertiary oncological center. Patients were followed up with the hospital databases and National Cancer Registry to assess the technical success rate for PEG placement, the rate of minor and major adverse events (AEs), and 30-day mortality rates. We compared those outcomes between the two PEG techniques. Finally, risk factors for PEG-related adverse events were analyzed using a multivariable Cox proportional-hazard regression model adjusted for patients' sex, age, performance status (ECOG), Body Mass Index (BMI), diabetes, chemoradiotherapy (CRT) status (pre-/current-/post-treatment), and type of PEG. RESULTS: We included 1055 PEG procedures (58.7% push-PEG/41.4% pull-PEG) performed in 994 patients between 2014 and 2021 (mean age 62.0 [±10.7] yrs.; 70.2% males; indication: head-and-neck cancer 75.9%/other cancer 24.1%). The overall technical success for PEG placement was 96.5%. Although the "push" technique had a higher rate of all AEs (21.4% vs. 7.1%, Hazard Ratio [HR]  = 2.9; 95% CI = 1.9-4.3, p < 0.001), most of these constituted minor AEs (71.9%), such as tube dislodgement. The methods had no significant difference regarding major AEs and 30-day mortality rates. Previous CRT was associated with an increased risk of major AEs (hazard ratio = 2.7, 95% CI = 1.0-7.2, p = 0.042). CONCLUSION: The risk of major AEs was comparable between the push- and pull-PEG techniques in cancer patients. Due to frequent tube dislodgement in push-PEG, the pull technique may be more suitable for long-term feeding. Previous CRT increases the risk of major AEs, favoring early ("prophylactic") PEG placement when such treatment is expected.

Suicide after a Diagnosis of Cancer: Follow-Up of 1.4 Million Individuals, 2009-2019.

Background: The study explores whether Polish cancer patients face elevated suicide risk, emphasizing the vital need to comprehend and mitigate their unique mental health struggles. Methods: We conducted a cohort study based on Polish National Cancer Registry data (diagnosis in 2009-2019). Age-, sex-, and year-standardized mortality ratios (SMR) are presented with 95% confidence intervals (CIs) overall and by sex. Results: The study included 1.43 million individuals diagnosed with cancer. There were 830 suicide cases in this group. The overall SMR for suicide was 1.34 (95% CI 1.25-1.43). The highest risk of suicide death was observed in the first six months after diagnosis (SMR = 1.94, 1.69-2.21): cancers of the heart and pleura (19.15, 2.32-69.18), an unspecified site (3.99, 1.09-10.22), and the esophagus (3.34, 1.08-7.79). The highest overall risk of suicide after cancer diagnosis was observed in esophageal (2.94, 1.47-5.26), gastric (2.70, 2.00-3.57), cervical (2.20, 1.06-4.05), and head and neck cancers (2.06, 1.52-2.72). Conclusions: Patients with cancer face significantly higher suicide risk, peaking within six months post-diagnosis. Urgent integration of suicide risk screening and prevention into cancer care is crucial, supporting mental well-being and guiding proactive healthcare strategies.

Risk of suicide in patients with cancer aged 75 years or more - Follow-up of over 400,000 individuals.

BACKGROUND: It is well established that older patients with cancer have a significantly higher risk of suicide. However, a comprehensive understanding of the risk factors is lacking. In this study, we aimed to identify groups at an increased risk of suicide among patients aged ≥75 years with a previous cancer diagnosis. MATERIAL AND METHODS: All Polish individuals diagnosed with cancer at the age of ≥75 years between 1 January 2009 and 31 December 2019 were included in this study. Standardized mortality ratios (SMRs) and 95 % confidence intervals (CIs) were calculated. RESULTS: A total of 410,440 patients (211,730 men and 198,710 women) were included in this study. SMR for both sexes was 1.64 (95 % CI 1.43-1.87). When analyzed by sex, a significantly higher risk was observed only in men (SMR 1.70, 95 % CI 1.47-1.95). Among them, the risk of suicide was observed after the diagnosis of lymphoma (2.83, 1.14-5.82), lung cancer (2.63, 1.70-3.89), kidney cancer (2.16, 1.03-3.96), colorectal cancer (1.96, 1.41-2.65), urinary tract cancer (1.86, 1.22-2.70), and prostate cancer (1.40, 1.07-1.82). The highest risk of suicide in men was observed within 6 months of diagnosis (2.83, 2.11-3.71). CONCLUSIONS: Men diagnosed with cancer at ≥75 years of age are at a higher risk of suicide than men of the same age in the general population. The observations from this study suggest which are the most vulnerable groups of elderly patients with cancer, and the time at which they should be given special support.

Survival of patients with cancers of the female genital organs in Poland, 2000-2019.

The purpose of this study was to estimate cancer survival in Poland between 2000 and 2019 for malignant neoplasms of female genital organs (FGO). We calculated survival in cancer of vulva, vagina, cervix uteri, corpus uteri, ovary, and other unspecified female genital organs. Data were obtained from the Polish National Cancer Registry. We estimated age-standardized 5- and 10-year net survival (NS) with the life table method and the Pohar-Perme estimator using the International Cancer Survival Standard weights. Overall, 231,925 FGO cancer cases were included in the study. The overall FGO age-standardized 5-year NS was 58.2% (95% confidence interval (CI) 57.9-58.5%) and the 10-year NS 51.5% (51.5-52.3%). Between 2000 and 2004 and 2015-2018, the highest statistically significant increase in age-standardized 5-year survival was noted for ovarian cancer at + 5.6% (P < 0.001). The FGO cancer median survival time was 8.8 years (8.6-8.9 years), with a standardized mortality rate of 6.1 (6.0-6.1), and with cause-specific years of life lost at 7.8 years (7.7-7.8 years). Hazard ratios (HR) increased with age at diagnosis (HR = 1.02, 95% CI 1.01-1.03, P = 0.001). Although FGO cancer survivorship has been consistently improving during the last twenty years, additional efforts need to be undertaken to improve survivorship in several FGO cancers.

Suicide risk among adolescents and young adults after cancer diagnosis: analysis of 34 cancer groups from 2009 to 2019.

PURPOSE: We aimed to identify granular groups with an increased risk of suicide among adolescents and young adult (AYA) patients with a previous malignant neoplasm diagnosis. METHODS: We deployed a cohort of all cases of primary malignant neoplasms diagnosed between the 1st of January 2009 and the 31st of December 2019 among individuals aged 15-39 years registered in the Polish National Cancer Registry. To assess the risk of suicide in comparison with the general AYA population, we calculated sex-age-year standardized mortality ratios (SMR) with 95% confidence intervals (CI). RESULTS: A total of 50,298 cancer patients (22,111 men and 28,187 women) were included in this study. The risk of suicide for AYA after cancer diagnosis was 2.39-fold higher than that for AYA in the general population (SMR 2.39, 95% CI 1.69 to 3.28). The risk in women (SMR 4.18, 95% CI 1.68 to 8.62) was higher than that in men (SMR 2.18, 95% CI 1.48 to 3.09). A significantly higher risk of suicide was observed in men with testicular cancer (SMR 2.46, 95% CI 1.37 to 4.05). CONCLUSIONS: Polish AYA diagnosed with cancer had an almost 2.5-fold higher risk of suicide than the general AYA population. The particular risk group was men with testicular cancer within 2-3 and 5-10 years after cancer diagnosis. IMPLICATIONS FOR CANCER SURVIVORS: To better identify patients at risk of suicide, there is a need to create or adapt screening tools, educate cancer care providers and family physicians, and integrate psychological services into select cancer care specialties.

Favorable changes in the survival of patients with cancers of digestive organs - Poland, 2000-2019.

OBJECTIVE: This study aimed to estimate cancer survival in Poland in 2000-2019 for malignant neoplasms of digestive organs, namely for cancer of the esophagus, stomach, small intestine, colorectum, anus, liver and intrahepatic bile ducts, gallbladder, other and unspecified parts of the biliary tract and pancreas. METHODS: Data were obtained from the Polish National Cancer Registry and age-standardized 5- and 10-year net survival was estimated. RESULTS: Overall, 534 872 cases were included in the study, reflecting a total of 3 178 934 years of life lost within the 2 decades of observation. Colorectal cancer represented both the highest 5-year and 10-year age-standardized net survival (5-year net survival: 53.0%, 95% confidence interval, 52.8-53.3%; 10-year net survival: 48.6%, 48.2-48.9%). Between 2000-2004 and 2015-2019, the highest statistically significant increase in age-standardized 5-year survival was noted for the small intestine at +18.3 percentual points ( P < 0.001). The male-female incidence ratio disparity was the highest for esophageal (4:1) and anus and gallbladder cancer (1:2). The highest standardized mortality ratios were observed in esophageal and pancreatic cancer (23.9, 23.5-24.2 and 26.4, 26.2-26.6, respectively). Overall, death hazard ratios were lower for women (hazard ratio = 0.89, 0.88-0.89, P < 0.001). CONCLUSION: In most cancers, there were statistically significant differences between sexes for all studied metrics. In the last 2 decades, survival for digestive organ cancers has increased considerably. Special attention should be given to liver, esophagus, pancreatic cancer survival and the disparities between sexes.

Melanoma Mortality Trends in 28 European Countries: A Retrospective Analysis for the Years 1960-2020.

BACKGROUND: In 2020, in 27 European Union (EU) Member States, melanoma accounted for 4% of all new cancer cases and 1.3% of all cancer deaths, making melanoma the fifth most common malignancy and placing it in the 15 most frequent causes of cancer deaths in the EU-27. The main aim of our study was to investigate melanoma mortality trends in 25 EU Member States and three non-EU countries (Norway, Russia, and Switzerland) in a broad time perspective (1960-2020) in a younger (45-74 years old) vs. older age group (75+). METHODS: We identified melanoma deaths defined by ICD-10 codes C-43 for individuals aged 45-74 and 75+ years old between 1960-2020 in 25 EU Member States (excluding Iceland, Luxembourg, and Malta) and in 3 non-EU countries-Norway, Russia, and Switzerland. Age-standardized melanoma mortality rates (ASR) were computed using the direct age-standardization for Segi's World Standard Population. To determine melanoma-mortality trends with 95% confidence intervals (CI), Joinpoint regression was applied. Our analysis used the Join-point Regression Program, version 4.3.1.0 (National Cancer Institute, Bethesda, MD, USA). RESULTS: Regardless of the considered age groups, in all investigated countries, in general, melanoma standardized mortality rates were higher for men than women. Considering the age group 45-74, the highest number of countries was characterized by decreasing melanoma-mortality trends in both sexes-14 countries. Contrarily, the highest representation of countries in the age group 75+ was connected with increasing melanoma-mortality trends in both sexes-26 countries. Moreover, considering the older age group-75+-there was no country with a decreasing melanoma mortality in both sexes. CONCLUSIONS: Investigated melanoma-mortality trends vary in individual countries and age groups; however, a highly concerning phenomenon-increasing melanoma-mortality rates in both sexes-was observed in 7 countries for the younger age group and in as many as 26 countries for the older age group. There is a need for coordinated public-health actions to address this issue.

Potential benefits of one­time gastroscopy in search for precancerous conditions.

INTRODUCTION: Precancerous conditions for esophageal (EA) and gastric adenocarcinoma (GA) are Barrett's esophagus (BE) and atrophic gastritis (AG), respectively. Their surveillance is crucial for the detection of early lesions. OBJECTIVES: The study aimed to assess whether one­timeesophagogastroduodenoscopy (EGD) in search for precancerous conditions would be effective in the population with low­to­moderate esophageal and gastric cancer risk. PATIENTS AND METHODS: A total of 5984 individuals who underwent diagnostic EGD in 3 endoscopic centers, from March 2018 to October 2019, were analyzed to assess the age of occurrence of precancerous conditions and cancers. Age distribution of the patients with malignant gastric and esophageal tumors registered in the national cancer registry from 2014 to 2017 was analyzed. RESULTS: In comparison with individuals below 40 years old, the risk of EA and GA diagnosis increased at the age of 60 to 64 years (odds ratio [OR], 12.1; 95% CI, 1.5-98.6), gastric and esophageal dysplasia at the age of 55 to 59 years (OR, 3.6; 95% CI, 1.3-9.7), and BE and AG at the age of 40 to 44 years (OR, 1.6; 95% CI, 1.04-2.4). The number of procedures per 1 cancer that could be potentially avoided was 236, 235, 290, 360, 394, and 344 for the age groups of 40-44 years, 45-49 years, 50-54 years, 55-59 years, 60-64 years, and 65-69 years, respectively. The assessed potential benefit­to­harm ratio was 47, 38, 31, 28, and 32 for the age groups of 40-49 years, 50-54 years, 55-59 years, 60-64 years, and 65-69 years, respectively. CONCLUSIONS: One­time EGD in search for precancerous conditions could be potentially applicable in individuals between 40 and 69 years of age.

Actual and Potential Role of Primary Care Physicians in Cancer Prevention.

Although the role of primary care in cancer prevention has been proven, its assumptions are still insufficiently implemented and the actual rates of cancer prevention advice delivery remain low. Our study aimed to identify the actual and potential role of primary care physicians (PCPs) in the cancer prevention area. Design of the study is a cross-sectional one, based on a survey of 450 PCPs who took part in a nationwide educational project in Poland. Only 30% of PCPs provide cancer prevention advice routinely in their practice, whereas 70% do that only sometimes. PCPs' actual role in cancer prevention is highly unexploited. They inquire routinely about the patient's smoking history (71.1%), breast cancer screening program (43.7%), cervical cancer screening (41.1%), patient's alcohol consumption (34%), patient's physical activity levels (32.3%), body mass index (29.6%), the patient's eating habits (28%) and patient's potential for sun/UV-Ray exposure (5.7%). The potential role of PCPs in cancer prevention is still underestimated and underutilized. Action should be taken to raise awareness and understanding that PCPs can provide cancer prevention advice. Since lack of time is the main obstacle to providing cancer prevention advice routinely, systemic means must be undertaken to enable PCPs to utilize their unquestionable role in cancer prevention.

Comparison of Quality Measures for Detection of Neoplasia at Screening Colonoscopy.

BACKGROUND & AIMS: The proportion of colonoscopies with at least one adenoma (adenoma detection rate [ADR]) is inversely associated with colorectal cancer (CRC) risk and death. The aim of this study was to examine whether such associations exist for colonoscopy quality measures other than ADR. METHODS: We used data from the Polish Colorectal Cancer Screening Program collected in 2000-2011. For all endoscopists who performed ≥100 colonoscopies we calculated detection rates of adenomas (ADR), polyps (PDR), and advanced adenomas (≥10 mm/villous component/high-grade dysplasia [AADR]); and number of adenomas per colonoscopy (APC) and per colonoscopy with ≥1 adenoma (APPC). We followed patients until CRC diagnosed before recommended surveillance, death, or December 31, 2019. We estimated hazard ratios (HRs) and 95% confidence intervals (CIs) using Cox proportional-hazard models. We used Harrell's C statistic to compare the predictive power of the quality measures. RESULTS: Data on 173,287 patients (median age, 56 years; 37.8% male) and 262 endoscopists were used. During a median follow-up of 10 years and 1,490,683 person-years, we identified 395 CRCs. All quality measures were significantly associated with CRC risk and death. The relative reductions in CRC risk were as follows: for ADR ≥24.9% (reference <12.1%; HR, 0.41; 95% CI, 0.25-0.66), PDR ≥42.7% (reference <19.9%; HR, 0.35; 95% CI, 0.24-0.51), AADR ≥9.1% (reference <4.1%; HR, 0.69; 95% CI, 0.49-0.96), APC ≥0.37 (reference <0.15; HR, 0.35; 95% CI, 0.21-0.58), and APPC ≥1.54 (reference <1.19; HR, 0.54; 95% CI, 0.35-0.83). AADR was the only quality measure with significantly lower predictive power than ADR (Harrell's C, 59.7 vs 63.4; P = .001). Similar relative reductions were observed for CRC death. CONCLUSIONS: This large observational study confirmed the inverse association between ADR and CRC risk and death. The PDR and APC quality measures appear to be comparable with ADR.

Changes in the survival of patients with breast cancer: Poland, 2000-2019.

PURPOSE: The main aim of this study was to estimate breast cancer survival in Poland over the period from 2000 to 2019 in both sexes. METHODS: Data were obtained from the Polish National Cancer Registry. The presented metrics included age-standardized 5- and 10-year net survival (NS), median survival times, years of life lost (YLLs), and standardized mortality ratios (SMRs). RESULTS: Between 2000 and 2019, 315,278 patients (2353 men and 312,925 women; male-to-female ratio 1/100) were diagnosed with breast cancer in Poland. In this period, 721,987 YLLs were linked to breast cancer. Women presented a higher 5- and 10-year age-standardized NS than men (5-year NS: 77.33% for women and 65.47% for men, P < 0.001, common language effect size (CL) 1.00; 10-year NS: 68.75% for women and 49.50% for men, P < 0.001, CL 1.00). Between the earliest and latest studied period, namely 2000-2004 and 2015-2019, there was a statistically significant increase only in female survival (+ 7.32 pp, P < 0.001, CL 1.00). SMRs were significantly higher for women than for men (3.35 vs. 2.89, respectively). CONCLUSION: Over the last two decades, breast cancer survival in Poland has improved significantly. Nonetheless, special attention should be given to the disparities between sexes and the gap in overall improvement of survival rates compared with other European countries.

Cancer incidence and mortality in Poland in 2019.

The purpose of this paper is to offer the most important epidemiological indicators of malignant neoplasms in Poland for the year 2019. In 2019, the Polish National Cancer Registry received information on almost 171.2 thousand new cancer cases and 100.3 thousand cancer deaths. The most common male cancers were prostate (20.6%), lung (16.1%), colon (6.8%), bladder (6.4%), and rectal (4.2%) cancers. Age-standardized incidence rates were at 118 per 100,000 for prostate, 89 for lung, 40 for colon, 38 for bladder, and 23 for the rectum. The most prevalent female cancers encompassed breast (22.9%), lung (9.9%), corpus uteri (7.0%), colon (5.9%), and ovary (4.3%). Age-standardized incidence rate was at 95 per 100,000 for breast cancer, 40 for lung 40, 29 for corpus uteri, 24 for colon, and 18 for ovarian cancer. The five leading causes of male cancer deaths were cancer of the lung (27.4%), prostate (10.3%), colon (8.0%), bladder (5.8%), and stomach (5.7%). Age-standardized mortality rates were 100 per 100,000 for lung, 46 for prostate, 32 for colon, 24 for urinary bladder, and 22 for stomach cancer. Most female deaths due to cancer were caused by lung (17.9%), breast (15.1%), colon (7.7%), ovary (6.0%), pancreas (5.7%), and corpus uteri (4.0%) cancers. Age-standardized mortality rates were 39 per 100,000 for lung, 33 for breast, 17 for colon, 13 for ovarian, 13 for pancreatic, and 9 for corpus uteri cancer.

Progress in cancer survival across last two decades: A nationwide study of over 1.2 million Polish patients diagnosed with the most common cancers.

BACKGROUND: The purpose of this study was to estimate the high incidence cancers survival in Poland between 2000 and 2018, with the following aim to monitor the national polish cancer control program 2020-2030 effectiveness. We calculated survival in cancer of lung, breast, prostate, colon, rectum, ovarian, cervical cancers, and skin melanoma. METHODS: Data were obtained from the Polish Cancer Registry (PLCR). We estimated age-standardized 5-year net survival (NS) with the life table method and the Pohar-Perme estimator using the International Cancer Survival Standard weights. The corresponding 95% confidence intervals (95% CI) were estimated with log transformation. RESULTS: Overall, 1,288,944 high incidence cancer cases were included in the study (622,486 men and 666,458 women). In 2015-2018 age-standardized 5-year NS was 85.2% (95% CI = 84.6% to 85.8%) in prostate cancer, 80.0% (79.5% to 80.4%) breast cancer, 77.3% (76.4% to 78.1%) melanoma, 58.5% (57.5% to 59.5%) cervical cancer, 57.9% (57.3% to 58.5%) colon cancer, 52.1% (51.3% to 52.9%) rectal cancer, 43.3% (42.4% to 44.3%) ovarian cancer, and 17.8% (17.4% to 18.1%) for lung cancer. Between the 2000-2004 and 2015-2018 the highest increase in survival was noted for prostate cancer (14.6% points [pp]; from 70.6% to 85.2%) and the lowest for lung cancer (4.5 pp; from 13.3% to 17.8%). CONCLUSION: Cancer survivorship has been consistently improving during the last two decades. Notwithstanding these overall encouraging results, more extraordinary efforts are needed to close the cancer survival gap in Poland.

Improved survival of Burkitt lymphoma/leukemia patients: observations from Poland, 1999-2020.

The aim of this study was to estimate the survival of Polish Burkitt lymphoma/leukemia (BL) patients diagnosed between 1999 and 2017, considering multiple covariates and periods, to reflect changes in BL treatment. We identified all BL patients registered in the Polish National Cancer Registry in 1999-2017. Observed survival (OS) was evaluated deploying the life table method. Univariate and multivariate Cox proportional hazards regression models were fit to generate hazard ratios (HR) and the corresponding 95% confidence intervals (95% CI), describing the association between exposures (sex, age at the diagnosis, year of diagnosis, and region of residence) and time-to-event (death). Two-sided log-rank test was applied to assess the significance of exposures. Overall, 937 BL cases were included in the study (654 men and 283 women). Between the periods 1999-2005 and 2015-2017, the 3-year OS changed from 56.0% (95% CI 50.4 to 62.2%) to 73.8% (68.1 to 80.0%; P < 0.001), and the 5-year OS increased from 53.8% (48.2 to 60.0%) to 73.0% (67.1 to 79.3%; P < 0.001). The death HR was significantly higher in adolescents and young adults' (AYA) and adults' groups than in pediatric patients (HR = 3.00, 95% CI 2.05 to 4.39, P < 0.001, for AYA; and HR = 7.30, 5.14 to 10.3, P < 0.001, for adults). During the last two decades, the survival of Polish BL patients has been systematically improving. The death hazard ratio is most significantly associated with the patients' age at diagnosis and year of diagnosis, and not associated with sex or region of residence.

The COVID-19 Pandemic and Smoking Cessation-A Real-Time Data Analysis from the Polish National Quitline.

Since the outbreak of the COVID-19 pandemic, tobacco research has delivered new evidence on the harmfulness of smoking in the context of SARS-CoV-2 infection and the course of the COVID-19 disease. More and more research proves that smoking is an important risk factor contributing to increased risk of mortality among COVID-19 patients. The aim of this study was to assess whether and how the COVID-19 pandemic impacted decisions about quitting smoking. A total of 4072 records of anonymized data were obtained from the Polish National Quitline. Between 15 April 2020 and 31 May 2021, the callers were asked about the COVID-19 pandemic and its influence on their decisions on smoking continuation or cessation. Our results indicate that smokers are very receptive to communication concerning COVID-19 and smoking risk. This phenomenon can possibly be connected to the immediate potential health consequences of smoking and COVID-19 virus infection. Results may indicate that putting emphasis on arguments combined with short-term health consequences of smoking may result in better outcomes in smoking cessation. There is a need for further and constant education on tobacco-related health harm. Our results showed that an irregular and mass communication on health consequences may result in high effectiveness in smoking cessation.