Assessing the impact of Hungary's public health product tax: an interrupted time series analysis.

OBJECTIVES: Imposing taxes on unhealthy goods can generate income, raise people's health awareness, and eventually decrease the prevalence of chronic diseases. Our aim was to assess the impact of Hungary's public health product tax (PHPT) since its implementation in September 2011. Differences in purchasing habits between households with different income statuses were also compared. METHODS: A retrospective, descriptive analysis of tax bases and income was carried out, and an interrupted time series analysis using the generalised least squares method was performed to examine the changes in trends regarding the purchase of taxable products before and after the implementation of the tax. The amount of tax base (in kilograms or litres), income (in HUF and EUR), and annual purchased quantity of food and beverage groups per household were assessed. Data were derived from the National Tax and Customs Administration of Hungary and the Hungarian Household Budget and Living Conditions Surveys. The study sample was composed of households who participated in the surveys (mean = 8,359, SD = 1,146) between 2006 and 2018. RESULTS: The households' tax bases and incomes increased constantly (with a few exceptions). The total revenue was 19.49 billion HUF (67.37 million EUR) in 2012 and 59.19 billion HUF (168.55 million EUR) in 2020. However, the households' purchasing habits did not change as expected. A significant short-term decrease (between 2012 and 2013) in purchasing unhealthy goods was observed for three groups: soft drinks (p = 0.009), jams (p = 0.047), and fruit juices (p = 0.038). Only soft drinks showed a significant decreasing trend in the post-intervention period between 2012 and 2018 (p < 0.001). CONCLUSIONS: We concluded that the PHPT did not decrease households' unhealthy food purchasing trend, although it has a positive effect as it can create revenue for health care and health-promoting programmes.

[Participation indicators of organized cervical cancer screening in Hungary]. / A szervezett lakossági méhnyakszurés részvételi mutatói Magyarországon.

The aim of this study was to determine the percentage of women in Hungary who underwent gynecological cytological examinations either as part of a screening test or diagnostic examinations. Data derived from the nationwide financing database of the Hungarian National Health Insurance Fund Management and covered the period 2008-2021. We analyzed both diagnostic and screening cytological tests. The number of diagnostic tests has decreased. The number of patients per 10,000 female inhabitants in 2021 was a national average of 840. The highest rate was observed in the counties of Hajdú-Bihar (1464/10,000 female inhabitants), Tolna (1443) and Baranya (1254). In screening, the number of cytological tests is lower compared to smearing. The annual participation rate decreased from 28% to 17%. The number of patients and the participation rate of diagnostic cytology examinations decreased during the examined period. The added value of screening cytology is moderate, the willingness to participate is low, falling short of the expected value.

[Participation indicators of organized mammography screening in Hungary between 2012-2021]. / A szervezett lakossági mammográfiás emloszurés részvételi mutatói 2012­2021 között Magyarországon.

The aim of our study is to analyze the participation indicators of screening rounds Nr. 6-10 (2012-2021) of the organized nationwide mammography screening program. Data derived from the nationwide financing database of the Hungarian National Health Insurance Fund Management and covered the period 2012-2021. We analyzed both diagnostic and screening mammography examinations. Between 2012 and 2019 the coverage (screening and diagnostic mammography) varied between 48.1-51.5, which decreased to 31.8% in 2020-2021. Within total coverage, the organized screening rate declined from 30.3-31.2 to 20.0, while the diagnostic mammography rate decreased from 17.7-20.7% to 11.8%. We can conclude that the number of both the diagnostic and screening mammography declined. In order to reduce the mortality of breast cancer, participation rate of mammography screening program should be increased.

[Participation indicators of colorectal screenings in Hungary between 2008-2021]. / A kolorektális szurések részvételi mutatói Magyarországon 2008­2021 között.

The aim of our study is to analyse the participation indicators of colorectal cancer screening between 2008-2021. Data derived from the nationwide financing database of the Hungarian National Health Insurance Fund Management. We analysed both diagnostic and screening examinations. According to our results, the screening rate was low, varying between 5.1-6.8% in the years examined. Between 2008 and 2019, the number of participating patients increased slightly. The highest number of patients can be observed in 2019 (178,568 people). In 2020 and 2021, we see a significant decrease, which is a consequence of the COVID-19 pandemic. In the number of patients of the entire examined period (2,233,963 people, 938,223 men, 1,295,740 women), the largest proportion was fecal blood detection by immunochemical method (OENO code: 22631). In 2021, at the county level, the highest number of patients can be seen in Csongrád-Csanád county (994 patients/10,000 people), and the least in Békés county (218 patients/10,000 people). The participation rate of women is higher than that of men in all counties. Participation in colorectal screening is very low. In order to prevent colorectal cancer death, it is necessary to increase the participation rate.

Predicting cervical screening and HPV vaccination attendance of Roma women in Hungary: community nurse contribution is key.

BACKGROUND: HPV screening/vaccination has been observed lower for ethic minorities. Understanding factors that predict and can improve attendance is therefore key. Hence, the aim was to identify causes, especially concerning the quality of the patient-provider relationship, that predict past HPV screening and vaccination turnout of Roma women in Hungary. METHODS: Cross-sectional research design with self-developed, culturally sensitive questionnaire. A final, female Roma sample of 368 participants was randomly selected from census register. Community nurses contacted participants and distributed surveys. Surveys were mailed-in by participants. Bivariate logistic regression was used to predict former participation in HPV screening/vaccination. RESULTS: Of the total sample, 17.4% of women attended at least one cervical screening and HPV vaccination in the past. Bad screening experience was positively associated with racially unfair behaviors of physicians. The odds of past attendance were 4.5 times greater if 'no negative earlier experience' occurred, 3.3 times likelier if community nurse performed screening/immunization and 1.6 times more probable if respondent felt 'no shame'. Evaluating the screening/vaccination process painful, being only financially motivated and attendance involving a lot of travel decreased the odds of 'no show' by 50%, 40% and 41%, respectively. CONCLUSIONS: When considering the ratio of past cervical screening attendance, we conclude that our female Roma sample did not behave differently from the general population. We saw no evidence that racial mistreatment made any contribution to explaining cervical screening participation. Past positive screening experience and the quality of patient-provider relationship increased the odds of participation the most. Cancer of friends, pain, financial motivation and travel distance decreased odds of participation to a lesser extent. In order to improve future screening and immunization, community nurses should play more central and advanced role in the organization and implementation of such services specifically targeting Roma populations.

Experience and Attitude of Colorectal Screening Pilot Program Participants Regarding Screening and Screening Programs in Hungary.

Background: In 2015, in Csongrád County (Hungary), a general practitioner based colorectal screening model program was implemented by the financial support of the European Union. Our aim was to evaluate the indicators of screening program and to analyze the experiences and attitude of participants of colorectal screening pilot program. Methods: The colon cancer screening pilot programme was carried out in 2015 involving an average-risk population aged 50-69 in Csongrád county, Hungary (invited 22 130 persons). The screening method was iFOBT, the attendance rate was 51.2%. Overall, 5580 patients out of the 10374 participants completed the self-compiled questionnaire concerning socio-demographic data, current screening programs, stool sampling problems, invitation letters, information sources and future willingness of participation. Results: The response rate was 53%. 46.7% of the respondents had not heard about colorectal screening prior to the screening program. Participants with elementary education level mostly indicated physicians as primary information sources [OR: 2.72 (CI: 1.59-4.66)] than patients higher education level. 67.5% of patients decided alone about participation on screening. Among women, decisions supported by acquaintances were specific [OR: 2.05 (1.06-3.95]. 82.6% determined the iFOB test as an entirely accepted screening method. Medical advice is an important predictor of screening participation. If respondents were to receive an invitation after two years, 91.5% would be involved in the screening. Conclusion: The respondents were satisfied with the screening program. Awareness raising of men, lower educated patients, those living in major cities, and recommendation of the family physician may increase the participation rate in the future.

Epidemiological disease burden and annual health insurance treatment cost of colorectal cancer in Hungary / A vastag- és végbéldaganat okozta országos epidemiológiai és egészségbiztosítási betegségteher Magyarországon.

Összefoglaló. Bevezetés: Magyarországon a vastag- és a végbéldaganat mindkét nem esetében a harmadik leggyakoribb daganatos megbetegedés és a második leggyakoribb halálok. Célkituzés: Elemzésünk célja volt a vastag- és végbéldaganat okozta éves epidemiológiai és egészségbiztosítási betegségteher meghatározása Magyarországon. Adatok és módszerek: Az adatok a Nemzeti Egészségbiztosítási Alapkezelo (NEAK) finanszírozási adatbázisából származnak, és a 2018. évet fedik le. A daganat típusait a Betegségek Nemzetközi Osztályozása (BNO, 10. revízió) szerinti C18-as, C19-es, C20-as, C21-es, D010-D014-es és D12-es kóddal azonosítottuk. Meghatároztuk az éves betegszámokat korcsoportos és nemek szerinti bontásban, a prevalenciát 100 000 lakosra, az éves egészségbiztosítási kiadásokat valamennyi ellátási formára és daganattípusra vonatkozóan. Eredmények: A vastag- és végbéldaganatok kezelésére a NEAK 21,7 milliárd Ft-ot (80,2 millió USD; 68,0 millió EUR) költött 2018-ban. A költségek 58,0%-át az aktívfekvobeteg-szakellátás költségei teszik ki. Az összköltségek megoszlása szerint a legmagasabb költségek a férfiaknál (4,98 milliárd Ft) és a noknél (3,25 milliárd Ft) is a 65-74 éves korcsoportban figyelhetok meg. A legnagyobb betegszámot a járóbeteg-szakellátás esetében találtuk: 88 134 fo, ezt a háziorvosi ellátás (55 324 fo) és a CT, MRI (28 426 fo) követte. A vastagbél rosszindulatú daganata esetében az egy betegre jutó aktívfekvobeteg-kassza alapján az éves egészségbiztosítási kiadás 1,206 millió Ft (4463 USD/3782 EUR) volt a férfiak és 1,260 millió Ft (4661 USD/3950 EUR) a nok esetében. Következtetés: Hazánkban az aktívfekvobeteg-szakellátás bizonyult a fo költségtényezonek, mely magában foglalja az onkoterápiás gyógyszeres költségeket is. Orv Hetil. 2021; 162(Suppl 1): 14-21. INTRODUCTION: Colorectal cancer is the third most common type of cancer and the second most common cause of mortality in Hungary in both sexes. OBJECTIVE: The aim of our study was to determine the annual epidemiological disease burden and health insurance cost of colorectal cancer in Hungary. DATA AND METHODS: Data were derived from the financial database of the National Health Insurance Fund Administration (NHIFA) of Hungary for the year 2018. Types of cancer were identified with the following codes of the International Classification of Diseases, 10th revision: C18, C19, C20, C21, D010-D014, D12. The data analysed included annual patient numbers according to age groups and sex, prevalence of care utilisation per 100 000 population, and annual health insurance costs for all types of care and all cancer types. RESULTS: In 2018, NHIFA spent 21.7 billion HUF (80.2 million USD, 68.0 million EUR) on the treatment of colorectal cancer. 58.0% of the costs was spent on acute inpatient care. Regarding total costs, the highest costs were found in the 65-74 age group in both men (4.98 billion HUF) and women (3.25 billion HUF). The highest patient numbers were in outpatient care: 88 134 patients, general practice care (55 324 patients) and CT, MRI (28 426 patients). The annual health care treatment cost per patient was 1.206 million HUF (4463 USD/3782 EUR) in men and 1.260 million HUF (4661 USD/3950 EUR) in women. CONCLUSION: Acute inpatient care, including the costs of oncotherapeutic pharmaceuticals, was found to be the major cost driver in Hungary. Orv Hetil. 2021; 162(Suppl 1): 14-21.

Annual epidemiological and health insurance burden of cervical cancer in Hungary / A méhnyakrák okozta éves epidemiológiai és egészségbiztosítási betegségteher Magyarországon.

Összefoglaló. Bevezetés: A méhnyakdaganatok kérdése kiemelten fontos, megoldatlan népegészségügyi probléma. A betegség terhe magas, ami elsosorban az alacsony és közepes jövedelmu országokban éloknél jelentkezik. Célkituzés: Elemzésünk célja volt meghatározni a méhnyakdaganatok epidemiológiai és egészségbiztosítási betegségterhét Magyarországon a 2018-as évre vonatkoztatva. Adatok és módszerek: Elemzésünket a Nemzeti Egészségbiztosítási Alapkezelo (NEAK) finanszírozási adatbázisának 2018. évi adatai alapján végeztük az in situ (D06), a jóindulatú (D26.0) és a malignus (C53) méhnyakdaganatokra vonatkozóan. Az elemzés a NEAK által finanszírozott összes szolgáltatóra és ellátási formára kiterjed. Meghatároztuk az éves betegszámokat, a prevalenciát 100 000 lakosra, továbbá az éves egészségbiztosítási kiadásokat betegségcsoportonként és korcsoportos bontásban, valamennyi egészségbiztosítási ellátás tekintetében. Eredmények: A NEAK 2018-ban 1,276 milliárd Ft-ot (4,7 millió USD; 4,0 millió EUR) költött a méhnyakdaganatok kezelésére. A betegek és a finanszírozás dönto többsége a méhnyak rosszindulatú daganatához kapcsolható. A finanszírozásból a malignus méhnyakdaganatok részesedése 97%. Ellátási típusonként vizsgálva a legnagyobb kiadási tétel az aktívfekvobeteg-szakellátásban jelenik meg, éves szinten 763,9 millió Ft, ami az összköltség 59,9%-a. A 100 000 lakosra jutó prevalencia az aktívfekvobeteg-szakellátás igénybevételi adatai alapján 26/100 000 lakos. Következtetés: A méhnyakdaganatok kezelésének meghatározó költségeleme az aktívfekvobeteg-szakellátás. Hazánkban a szervezett méhnyakszurés korszerusítéseként az új szurési stratégiát megfelelo finanszírozási támogatással célszeru bevezetni, a szurovizsgálatoknak, a hozzájuk kapcsolódó további diagnosztikus kivizsgálásnak és terápiának a teljesítményvolumen-korlát alóli mentesítésével. Orv Hetil. 2021; 162(Suppl 1): 22-29. INTRODUCTION: Cervical cancer is a particularly important, unresolved public health problem. The burden of the disease is high, primarily in those living in low- and middle-income countries. OBJECTIVE: Our aim was to determine the annual epidemiological disease burden and health insurance cost of cervical cancer in Hungary in 2018. DATA AND METHODS: Our analysis was made according to the financial database of the National Health Insurance Fund Administration (NHIFA) of Hungary for the year 2018, which covers all service providers and maintenance forms financed by NHIFA. We analysed the in situ (D06), the benignant (D26.0) and the malignant (C53) cervical tumours. The data analysed included annual patient numbers and prevalence of care utilisation per 100 000 population furthermore annual health insurance costs calculated for disease and age groups. RESULTS: In 2018, NHIFA spent 1.276 billion HUF (4.7 million USD, 4.0 million EUR) on the treatment of patients with cervical cancer. The majority of patients and funding can be linked to malignant cervical cancer (97%). Acute inpatient care was the major cost driver: 763.9 million HUF (59.9% of the total health insurance expenditures) annually. The prevalence is 26 per 100 000 population based on acute inpatient care data. CONCLUSION: Acute inpatient care was the major cost driver. In Hungary, as a modernization of organized cervical screening, it is appropriate to introduce a new screening strategy with appropriate financial support, by exempting screening tests, associated additional diagnostic testing, and therapy from the performance volume limit. Orv Hetil. 2021; 162(Suppl 1): 22-29.

[CHEK1 expression and inhibitors in TP53 mutant cancer]. / A checkpoint kinase 1 expressziója és gátlása TP53-mutációt hordozó rosszindulatú daganatokban.

The most frequently mutated gene in human tumors is TP53 and its mutation significantly deteriorates patients' survival. However, to date no targeted therapy is established for TP53 mutated tumors. Here, our aim was to identify druggable kinases with higher expression in TP53 mutated tumors, as well as relate these to altered prognosis. We also aimed to validate a target gene in TP53 wild type and mutant isogenic cell lines using a specific kinase inhibitor. Gene expression and mutation data were collected from 994 lung tumor samples. Samples were separated based on TP53 mutation status, and differential gene expression was compared using Mann-Whitney test between patient cohorts. Prognostic value of identified genes was validated in an array-based lung cancer dataset (n=1926). Survival analysis was performed using Cox proportional hazards regression and Kaplan-Meier survival plots. Effect of TP53 mutations on CHEK1 expression was validated in the A549 isogenic lung cancer cell line. The cell line was also treated using Chk1 protein specific kinase inhibitor to monitor cell functions. Expression of CHEK1 was elevated significantly among targetable kinases and higher expression of CHEK1 related to worse prognosis. Our results confirm the higher expression of CHEK1 kinase associated to TP53 mutations and to shorter survival.

[Quality and performance indicators of colorectal cancer screening pilot program in Csongrád County, Hungary]. / A Csongrád megyei vastagbélszûrési pilot program minõségi indikátorai és teljesítménymutatói.

Colorectal cancer is a major social and economic burden for developed countries. Our analysis aimed to evaluate the quality and performance indicators of colorectal cancer screening pilot program. The colon cancer screening pilot program was carried out in 2015 involving an average-risk population aged 50-69 in Csongrád county, Hungary. The analysis involved data from the Communication module of the Office of the National Chief Medical Officer. We recorded 21.1% invitation rate (22,130 persons), 51.2% attendance and 47.3% participation rates, with a higher female participation rate (p<0.001). Participation rate was far lower than the expected 65%. The rate of non-negative results (13.1%) exceeds the international reference rate. Participation rate on the colonoscopy screening (90.1%) reached the expected value. Compared to the number of actual colonoscopies performed, adenomas were found in 2.5% and malignant lesions in 0.3% of the cases. Our results highlight the deficiencies regarding the follow-up and data recording of screening results in the IT system as well as the lack of communication between the GP and the diagnostic laboratories.

[Quality and performance indicators of the pilot program for cervical cancer screening by health visitors]. / A védõnõi méhnyakszûrési pilotprogram minõségi indikátorai és teljesítménymutatói.

The aim of our analysis was the assessment of the qualitative and performance indicators of a pilot program for health visitors' cervical cancer screening. The analysis involved the data from the Communication module of the Office of the National Chief Medical Officer. In the examined period (October, 2013 - September, 2015) the participation indicators of women aged 25-65, the prevalence rates of human papillomavirus and the cervical intraepithelial neoplasia were determined. In the screening period, the call-in rate was 32.45% nationally, with the compliance of 8.26%. The occurrence of a positive result was 1.85% nationally, with the highest rate in Hajdú-Bihar county (7.24%). HPV infection was detected in 113 cases (0.45%) nationally, HPV prevalence was 37.44/100,000 persons. The willingness for participation among women was low concerning the indicators. Their raising should be an emphasized task for public health in favor of reducing mortality from morbidities.

[Assessment of the pilot program for cervical cancer screening by health visitors]. / A védonoi méhnyakszurési pilot program értékelése.

INTRODUCTION: Within the tender (6.1.3.A-13/1-2013-0001) supported by the European Union, we wished to involve health visitors into the organized cervical cancer screening program. AIM: The aim of our survey was to assess the satisfaction of health visitors, instructors, and that of the teaching aids. Furthermore, we wished to assess whether the teaching materials met the expectations. METHOD: Satisfaction of the health visitors was assessed by a survey, in four groups of questions. These involved the assessment of the instructors, the teaching aids, evaluation of the further training day, and the compliance with the knowledge of training. Period for completion of the questionnaires lasted from October to December in 2014. We used descriptive statistics for data evaluation. RESULTS: Data of 2148 health visitors was evaluated. They rated the performance of gynecologist-obstetricians 4.65, that of health visitors 4.61, that of public health professionals 4.56, and that of IT specialists 4.52. 98% of the teaching aids were useful for them and the acquired knowledge was appropriate with their expectations. CONCLUSION: The health visitors were satisfied with the theoretical instruction within the pilot program. The professionally well prepared health visitors may contribute to the success of the cervical cancer screening program. Orv. Hetil, 2017, 158(12), 461-467.

[The effect of generic price competition on drug consumption and health insurance pharmaceutical expenditures in Hungary]. / A generikus árverseny hatása a gyógyszerforgalomra es a társadalombiztosítási támogatás kiáramláisra Magyarországon.

AIM: The aim of our study was to analyze the Hungarian montelukast sodium drug market. We examined the effect of the appearance of generic drugs on the price and turnover of the brand-name drug, Singulair. DATA AND METHODS: Data derived from the nationwide pharmaceutical database of Hungarian National Health Insurance Fund Administration (2007-2014). We analized the turnover and price of the medicaments containing the active substance montelukast sodium. Accordingly our indicators were: consumer price, social insurance subsidy, patients' co-payment and days of treatment (DOT). RESULTS: First the generics started from a significantly lower price of 18 USD which was lower than the price of brand-name Singulair (32 USD). Then the prices of the generics started to diminish. While in 2007 the DOT was below 2 million, it increased over 10 million days by 2014. The increase of DOT was followed by the increase of health insurance subsidy until 2011. Then the amount of health insurance subsidy decreased from 10,5 million USD to 7 million USD in 2012. In 2013 and 2014 there was a further reduction, the amount of the health insurance subsidy decreased to 4,1 million USD in 2013, and in 2014 it was reduced to 2.2 million USD. CONCLUSIONS: Following the introduction of generic drugs, the price of the medicaments containing montelukast sodium was significantly reduced, while the days on treatment (DOT) increased. The patients' access to drugs containing montelukast sodium increased significantly. The annual health insurance subsidy was significantly reduced as well.

Changes in the health status of the population of Central and Eastern European countries between 1990 and 2010.

OBJECTIVE: The aim of this study was to analyse change in the health status of the population in the countries of Central and Eastern Europe (CEE) since 1990, compared with the 'old' EU-15 member states of the European Union (EU). METHODS: We analysed data from the Health for All Database and the Global Burden of Disease report of the World Health Organization (WHO). Life expectancy at birth and disability-adjusted life years were analysed for 1990-2010. Age-standardised death rates (ASDR) and potential years of life lost (PYLL) were assessed for selected inflammatory diseases. RESULTS: Life expectancy at birth for male individuals improved in CEE by 4.8 years and in the EU-15 by 5.4 years. During the same period, life expectancy at birth for female individuals improved in CEE by 4.0 years and in the EU-15 by 4.2 years. The difference in life expectancy at birth between male and female individuals in the EU-15 decreased by 1.2 years and in CEE by 0.8 years. Comparisons of ASDR and PYLL among the EU-15 and CEE countries were difficult because of the potentially low validity of the available data. CONCLUSIONS: The health status of the CEE population has improved since 1990. However, only a few countries have closed the gap with the EU-15 countries. Inflammatory conditions might represent a significant disease burden in CEE countries; however, a thorough analysis and comparison to the EU-15 is difficult because of a shortage of good-quality data.

[Attendance of the fourth (2008-2009) screening round of the Hungarian organized, nationwide breast cancer screening program]. / A szervezett országos emloszurési program negyedik (2008-2009) szurési körének részvételi arányai.

INTRODUCTION: Organised, nationwide screening for breast cancer with mammography in the age group between 45 and 65 years with 2 years screening interval started in Hungary in January 2002. AIM: The aim of this study is to analyze the attendance rate of nationwide breast screening programme for the 2008-2009 years. METHOD: The data derive from the database of the National Health Insurance Fund Administration. The ratio of women in the age group 45-65 years was calculated having either a screening mammography or a diagnostic mammography in the 4th screening round of the programme. RESULTS: In the years 2000-2001, 7.6% of the women had an opportunistic screening mammography while in 2008-2009 31.2% of the target population had screening mammography within the organized programme. During the same periods 20.2% (2000-2001) and 20.4% (2008-2009) of women had a diagnostic mammography. Thus the total (screening and diagnostic) coverage of mammography increased from 26.6% (2000-2001) to 50.1% (2008-2009). The attendance rate failed to change between 2002 and 2009. CONCLUSIONS: In order to decrease the mortality due to breast cancer, the attendance rate of mammography screening programme should be increased. Orv. Hetil., 154(50), 1975-1983.

[Participation rates in the third round (2006-2007) of the breast cancer screening program in Hungary]. / A szervezett emloszurési program harmadik (2006-2007) szurési ciklusának részvételi arányai.

Organised, nationwide screening for breast cancer with mammography in the age group of 45-65 years with 2 years screening interval started in Hungary in January 2002. The aim of this study is to analyse the attendance rate of breast screening programme for the 2006/2007 years, including the analysis of the ratio of screening and diagnostic mammography examinations. The data derive from the financial database of the National Health Insurance Fund Administration (NHIFA) covering the 8 years period between 2000 and 2007. The ratio of women in the age group of 45-65 years was calculated having either a screening mammography or a diagnostic mammography. The analysis was carried out for the years 2000-2001 before and 2006-2007 after the implementation of nationwide organised programme. In the years 2000-2001 7.26% of the women aged 45-65 years had an opportunistic screening mammography while in 2006-2007 29.4% of the target population had screening mammography within the organised programme. During the same periods 19.8% (2000-2001) and 21.8% (2006-2007) of women aged 45-65 years had a diagnostic mammography. Thus the total (screening and diagnostic) coverage of mammography increased from 26.2% (2000-2001) to 49.7% (2006-2007). The attendance of the Hungarian organised breast cancer screening programme slightly declined in 2006-2007 compared to 2002-2003/2004-2005, and to achieve the expected results in mortality decrease a further improvement of the uptake is necessary.