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Povzetek: 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.
Ključne besede: cancer incidence, environmental exposure, cancer data
Objavljeno v DiRROS: 05.12.2025; Ogledov: 673; Prenosov: 0

Povzetek: 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.
Ključne besede: cancer, covid-19, delay in diagnosis
Objavljeno v DiRROS: 25.07.2024; Ogledov: 1039; Prenosov: 599
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Povzetek: Uvod: Število novih diagnoz raka (incidenca) se v Sloveniji v zadnjem desetletju povečuje za povprečno 1,6 % na leto. V letu 2020, prvem letu omejitvenih ukrepov zaradi epidemije covida19, smo s platformo OnKOvid predvideli 3–8-odstotni padec novih diagnoz raka. Namen je predstaviti uradno incidenco raka za Slovenijo za leto 2020 in ugotoviti, kolikšen je bil dejansko manko novih diagnoz raka. Metode: V Registru raka Republike Slovenije smo v skladu z mednarodnimi pravili registrirali vse nove primere raka pri prebivalcih s stalnim prebivališčem v Sloveniji. Primerjali smo jih z registrirano incidenco za 2019, modelno incidenco za 2020, preliminarnimi rezultati OnKovida in dostopnimi rezultati incidence iz registrov raka iz drugih držav. Rezultati: V letu 2020 je za rakom zbolelo 15.096 oseb v Sloveniji (7.034 žensk, 8.002 moška). Glede na modelno oceno incidence za leto 2020 gre za manko 1.854 oseb (10,9 %; 11,6 % žensk, 10,4 % moških). Pri tem je za 10,5 % manj ugotovljenih rakov v omejenem stadiju, najbolj izrazito v starosti 50–69 let (za 13,2 %). Upad je primerljiv s poročili iz Anglije, ZDA in Kanade ter deloma večji kot na Škotskem in Švedskem. Najbolj izrazit upad novih diagnoz raka ugotavljamo pri nemelanomskem kožnem raku (23 %, najbolj po 50. letu), raku prostate (15,9 %, najbolj v omejenem stadiju), pljučnem raku (8,9 %, 60–64 let, v razširjenem stadiju), raku dojk (8,3 %, 45–64 let), ne-Hodgkinovem limfomu (9 %) in levkemijah (11,6 %). Pri kožnem melanomu, raku debelega črevesa in danke ni bilo primanjkljaja. Zaključek: Upad incidence raka v letu 2020 gre verjetno na račun omejitvenih ukrepov, reorganizacije zdravstva in z zdravjem povezanega vedenja med epidemijo covida-19, beležijo jo v več državah. Med epidemijami je potrebno nemoteno izvajanje onkologije.
Ključne besede: rak, incidenca, register raka, epidemija, covid-19
Objavljeno v DiRROS: 26.02.2024; Ogledov: 1712; Prenosov: 394
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Povzetek: Populacijsko preživetje bolnikov z rakom je sestavljen kazalnik, v katerem se zrcalijo tako značilnosti bolnikov kot tudi organizacija, dostopnost, kakovost in učinkovitost sistema zdravstvenega varstva. Register raka Republike Slovenije je letos izdal že četrto obsežnejše poročilo o preživetju slovenskih bolnikov z rakom zbolelih med letom 1997 in 2016, ki kaže na napredek, ki sta ga v dvajsetih letih zagotovila slovenska onkologija in slovensko zdravstveno varstvo skupaj s celotno družbo. Preživetje slovenskih bolnikov z rakom se s časom povečuje. V zadnjih dvajsetih letih se je petletno čisto preživetje povečalo za dobrih 11 odstotnih točk. Znatno bolj se je povečalo preživetje pri moških. Starost in stadij ob diagnozi sta še vedno ključna za preživetje bolnikov z rakom. Pri obeh spolih se je preživetje bolnikov s kožnim melanomom, rakom debelega črevesa in danke ter pljučnim rakom v zadnjih dvajsetih letih značilno izboljšalo. Napredek je bil dosežen tudi pri najpogostejših rakih pri posameznem spolu: raku dojk pri ženskah in raku prostate pri moških. Izboljšanje preživetja slovenskih bolnikov z rakom, ki ga opazujemo v zadnjih letih, predstavlja osnovo in spodbudo za nadaljnje izboljšave.
Ključne besede: breme raka, preživetje raka, bolniki
Objavljeno v DiRROS: 10.06.2021; Ogledov: 2827; Prenosov: 756
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Ključne besede: onkologija, rak (medicina), registri, zgodovinski pregledi
Objavljeno v DiRROS: 16.03.2021; Ogledov: 2769; Prenosov: 800
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