1. Assessing the impact of waste co-incineration at the Anhovo cement plant (Slovenia) on the regional cancer burden*Vesna Zadnik, Mojca Birk, Teja Oblak, Maja Jurtela, Sonja Tomšič, Katarina Lokar, Ana Mihor, Nika Bric, Miran Mlakar, Amela Duratović Konjević, Tina Žagar, 2025, original scientific article Abstract: This epidemiological study aims to assess the cancer risk potentially associated with environmental exposure resulting from cement production and waste co-incineration at the Anhovo cement plant in Western Slovenia and to develop a strong and reliable methodological framework for the long-term surveillance of environmentally related cancer risks in small geographical areas. Materials and methods We integrated all the available data sources: cancer cases from the population-based Slovenian Cancer Registry; background population; and available measurements on exposure to air PM10 particles and chromium (Cr) in the soil in the municipality of Kanal and the wider Goriška region. Relative risks of cancer in small geographical areas were estimated using Bayesian hierarchical spatial models and the population attributable fractions of the modelled risk factors were calculated. The point source analysis compared the cancer risk near the cement plant to that in more distant areas. Results The analysis did not reveal any excess cancer incidence in the area of the Anhovo cement plant or an association with the PM10 particles and Cr in the soil. The incidence of mesothelioma remains high in the region, but stable in the last two decades. Conclusions In view of the environmental pollution caused by either historical cement production or the potential impact of current waste co-incineration activities in Kanal, we strongly recommend that a follow-up epidemiological study be carried out in the next 10 to 20 years. The methodological framework established in the present study provides a foundation for the ongoing surveillance of the cancer burden in the region.
Keywords: cancer incidence, environmental exposure, cancer data
Published in DiRROS: 05.12.2025; Views: 59; Downloads: 0 |
2. Projekt : priprava epidemioloških podlag za uvedbo novih nacionalnih presejalnih programov za raka v SlovenijTina Žagar, Teja Oblak, Ana Mihor, Barbara Mihevc Ponikvar, Maja Jurtela, Mojca Birk, Nika Bric, Sonja Tomšič, Katarina Lokar, Miran Mlakar, Amela Duratović Konjević, Katja Kolenc, Vesna Zadnik, 2025, published scientific conference contribution Keywords: epidemiologija raka, presejalni programi, onkologija
Published in DiRROS: 05.12.2025; Views: 66; Downloads: 25
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5. Ocena pridobljenih let življenja v populacijskih presejalnih programih za rakaVesna Zadnik, Maja Pohar Perme, Tina Žagar, Bor Vratanar, Katja Jarm, Katarina Lokar, Maja Jurtela, Sonja Tomšič, 2024, professional article Abstract: Zaradi možnih negativnih zdravstvenih posledic presejalnih programov in velikih sredstev, vloženih vanje, je pomembno spremljati njihovo učinkovitost. Umrljivost v ciljni populaciji je eden od kazalnikov, ki služi za prikaz dolgoročne učinkovitosti organiziranih populacijskih presejalnih programov – po 10 do 20 letih se pričakuje padec umrljivosti v ciljni populaciji za 20 % do 30 %. Ena od glavnih omejitev kazalnika umrljivosti je, predvsem pri rakih z dobrim preživetjem, da pokaže učinkovitost presejanja šele v daljšem časovnem obdobju. Mnogokrat se zato za oceno učinkovitosti populacijskih presejalnih programov za raka uporablja analiza preživetja, pri kateri so rezultati dostopni prej. Tudi analiza preživetja ima svoje omejitve, saj se lahko v rezultate prikradejo številne pristranosti (npr. pristranost časa trajanja, prednosti in prediagnosticiranja). Nedavno smo slovenski raziskovalci predlagali nov analitični pristop, ki omogoča primerjavo preživetja pri rakih, ki so oz. niso odkriti v presejalnem programu, z upoštevanjem vseh pomembnih pristranosti. Izračunana preživetja so osnova za izračun pridobljenih let življenja, to je mere, ki izraža dodatno število let življenja, ki bi jih osebe preživele zaradi vključitve v presejalni program.V testnem primeru smo ocenili učinke uvedbe Državnega prese-jalnega program za raka dojk DOR A, ki smo ga prvim prebival-kam ponudili leta 2008, na celotno populacijo pa je bil razširjen leta 2018. Ženske, ki so bile povabljene v program DOR A v obdobju 2008–2018, so do leta 2022 pridobile skupaj 90,6 leta življenja, če bi bile v program DOR A že od leta 2008 vključene vse ženske, pa bi pridobile 552,7 leta življenja. Z vsakim dodatnim letom opazovanja, ko posamezne ženske od vključitve v program DOR A preživijo, se seštevek pridobljenih let življenja poveča.Nova metoda bo v pomoč pri upravljanju obstoječih presejalnih programov za raka, njihovi promociji in vrednotenju učinkov pri spremembah presejalnih politik.
Keywords: presejalni programi, kakovost, register raka
Published in DiRROS: 26.07.2024; Views: 1092; Downloads: 385
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6. Impact of the COVID-19 epidemic on cancer burden and cancer care in Slovenia : a follow-up studyTina Žagar, Sonja Tomšič, Vesna Zadnik, Nika Bric, Mojca Birk, Blaž Vurzer, Ana Mihor, Katarina Lokar, Irena Oblak, 2022, original scientific article Abstract: In Slovenia, cancer care services were exempt from government decrees for COVID-19 containment. Nevertheless, cancer control can be impacted also by access to other health services and changes in health-seeking behaviour. In this follow up study, we explored changes in cancer burden and cancer care beyond the first months after the onset of the COVID-19 epidemic.Materials and methods. We analysed routinely collected data for the period January 2019 through July 2022 from three sources: (1) pathohistological and clinical practice cancer notifications from two major cancer centres in Ljubljana and Maribor (source: Slovenian Cancer Registry); (2) referrals issued for oncological services (source: e-referral system); and (3) outpatient appointments and diagnostic imaging performed (source: administrative data of the Institute of Oncology Ljubljana – IOL). Additionally, changes in certain clinical and demographic characteristics in patients diagnosed and treated during the epidemic were analysed using the Hospital-Based Cancer Registry of the IOL (period 2015–2021).Results. After a drop in referrals to follow-up cancer appointments in April 2020, in June-August 2020, there was an increase in referrals, but it did not make-up for the drop in the first wave; the numbers in 2021 and 2022 were even lower than 2020. Referrals to first cancer care appointments and genetic testing and counselling increased in 2021 compared to 2019 and in 2022 increased further by more than a quarter. First and follow-up outpatient appointments and cancer diagnostic imaging at the IOL dropped after the onset of the epidemic in March 2020 but were as high as expected according to 2019 baseline already in 2021. Some deficits remain for follow-up outpatients’ appointments in surgical and radiotherapy departments. There were more CT, MRI and PET scans performed during the COVID-19 period than before. New cancer diagnoses dropped in all observed years 2020, 2021 and until July 2022 by 6%, 3% and 8%, respectively, varying substantially by cancer type. The largest drop was seen in the 50−64 age group (almost 14% in 2020 and 16% in 2021), while for patients older than 80 years, the numbers were above expected according to the 2015–2019 average (4% in 2020, 8% in 2021).Conclusions. Our results show a varying effect of COVID-19 epidemic in Slovenia for different types of cancers and at different stages on the patient care pathway – it is probably a mixture of changes in health-seeking behaviour and systemic changes due to modifications in healthcare organisation on account of COVID-19. A general drop in new cancer cases reflects disruptions in the pre-diagnostic phase and could have profound long-term consequences on cancer burden indicators.
Keywords: cancer, covid-19, delay in diagnosis
Published in DiRROS: 25.07.2024; Views: 950; Downloads: 551
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7. Trends in population-based cancer survival in SloveniaVesna Zadnik, Tina Žagar, Katarina Lokar, Sonja Tomšič, Amela Duratović Konjević, Branko Zakotnik, 2021, original scientific article Keywords: cancer burden, cancer survival, time trend, cancer registry
Published in DiRROS: 22.07.2024; Views: 867; Downloads: 557
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8. Socioeconomic inequalities in cancer incidence in Europe : a comprehensive review of population-based epidemiological studiesAna Mihor, Sonja Tomšič, Tina Žagar, Katarina Lokar, Vesna Zadnik, 2020, review article Abstract: Background. Since the end of the previous century, there has not been a comprehensive review of European studies on socioeconomic inequality in cancer incidence. In view of recent advances in data source linkage and analytical methods, we aimed to update the knowledge base on associations between location-specific cancer incidence and individual or area-level measures of socio-economic status (SES) among European adults. Materials and methods. We systematically searched three databases (PubMed, Scopus and Web of Science) for articles on cancer incidence and SES. Qualitative synthesis was performed on the 91 included English language studies, published between 2000 and 2019 in Europe, which focused on adults, relied on cancer registry data and reported on relative risk (RR) estimates. Results. Adults with low SES have increased risk of head and neck, oesophagogastric, liver and gallbladder, pancreatic, lung, kidney, bladder, penile and cervical cancers (highest RRs for lung, head and neck, stomach and cervix). Conversely, high SES is linked with increased risk of thyroid, breast, prostate and skin cancers. Central nervous system and haematological cancers are not associated with SES. The positive gap in testicular cancer has narrowed, while colorectal cancer shows a varying pattern in different countries. Negative associations are generally stronger for men compared to women. Conclusions. In Europe, cancers in almost all common locations are associated with SES and the inequalities can be explained to a varying degree by known life-style related factors, most notably smoking. Independent effects of many individual and area SES measures which capture different aspects of SES can also be observed.
Keywords: socioeconomic status, socioeconomic inequality, cancer incidence
Published in DiRROS: 16.07.2024; Views: 895; Downloads: 563
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9. Impact of COVID-19 on cancer diagnosis and management in Slovenia : preliminary resultsVesna Zadnik, Ana Mihor, Sonja Tomšič, Tina Žagar, Nika Bric, Katarina Lokar, Irena Oblak, 2020, original scientific article Keywords: covid-19, oncology, oncology diagnosis, pandemic
Published in DiRROS: 12.07.2024; Views: 1013; Downloads: 568
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10. Breast cancer risk based on adapted IBIS prediction model in Slovenian women aged 40-49 years : coul it be better?Tjaša Oblak, Vesna Zadnik, Mateja Krajc, Katarina Lokar, Janez Žgajnar, 2020, original scientific article Keywords: breast surgery, IBIS, prediction models, risk factors
Published in DiRROS: 12.07.2024; Views: 841; Downloads: 327
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