Introduction and objective. One of the main factors determining the burden of breast cancer is the effectiveness of measures taken to combat this cancer including urban-rural differences. The aim of the study was to analyse the differences in breast cancer incidence and disease stage distribution among urban and rural women in the Świętokrzyskie Province as a part of a strategy for breast cancer control. Materials and method. The study of disease stage distribution included 483 female residents of Świętokrzyskie Province who were diagnosed in 2013 with invasive breast cancer, and reported to Świętokrzyskie Office for Cancer Registration. Urban-rural differences in breast cancer incidence in 2002-2013 were presented using Range Ratio (RR). Changes in incidence trends in urban and rural areas were analysed using joinpoint models. Annual Percentage Change (APC) of the rates was calculated for each time trend. Results. Breast cancer incidence rate in the urban female population was higher than in rural women with RR, amounting to 1.43. However, the analysis of trends showed that the pace and direction of change were developing negatively among inhabitants of rural areas. In 2002-2013, in rural women, the age-standardized rate (ASR) values increased by 2.8% per year (p<0.05). The course of ASR trends showed statistically significant urban-rural differences (p=0.004). Analysis of urban-rural differences in disease stage distribution revealed a non-significantly higher proportion of cases with localised stage in urban than in rural areas, amounting to 51.0% and 43.9%, respectively. Conclusions. Existing health inequalities indicate the need to intensify activities in rural areas and should be the starting point for making key decisions in combating breast cancer.
Nowadays, obesity and its complications are heavy burdens to western civilization. Surgical procedures remain one of the available therapies for obesity and obesity-associated diseases treatment. Among them, sleeve gastrectomy is the most common bariatric procedure. Despite the well-established fact that sleeve gastrectomy results in significant weight loss, some of its other divergent effects still need to be established. To fulfill this knowledge gap, we examined whether sleeve gastrectomy affects lipid metabolism in the plasma and liver of obese rats. We demonstrated that chronic high-fat diet feeding led to an increment in the level of Proprotein Convertase Subtilisin/Kexin (PCSK)—a regulator of plasma cholesterol concentration—in the liver, which was decreased after the gastrectomy. Moreover, we noticed significant increases in both plasma and liver contents of free fatty acids, diacylgycerides and triacylglycerides in the obese animals, with their reduction after the bariatric surgery. In conclusion, we revealed, presumably for the first time, that sleeve gastrectomy affects lipid metabolism in the liver of obese rats.
Wprowadzenie i cel pracy. Stan zdrowia osób w wieku aktywności zawodowej jest jednym z elementów wpływających na rozwój społeczno-ekonomiczny danej populacji. Celem pracy jest ocena zachorowalności na nowotwory złośliwe populacji w wieku aktywności zawodowej w województwie podlaskim w latach 1999-2017. Materiał i metody. Do przeprowadzenia analizy i oceny zachorowalności na nowotwory złośliwe w grupie wieku o najwyższej aktywności zawodowej wśród mieszkańców województwa podlaskiego wykorzystano informacje z Krajowego Rejestru Nowotworów (KRN). Włączono także informacje o zachorowaniach na nowotwory złośliwe w grupie wieku 20-64 lata w województwie podlaskim w latach 1999-2017. Wyniki. W województwie podlaskim w 2017 roku zarejestrowano 837 nowych zachorowań na nowotwory złośliwe u mężczyzn w grupie wieku 20-64 lata, oznacza to blisko 15-proc. wzrost w porównaniu z rokiem 1999. U kobiet liczba nowych zachorowań zwiększyła się o blisko 19% -z 789 zachorowań w 1999 roku do 936 w roku 2017. W analizowanym okresie wzrosła też wartość surowych współczynników zachorowalności (CR) -u mężczyzn o 4,7%, u kobiet o 18,6%. Wartość standaryzowanego współczynnika zachorowalności (ASR) obniżyła się o 18,3% u mężczyzn i 5% u kobiet. Wnioski. W analizowanym okresie odnotowano wzrost liczby i wartości surowego współczynnika zachorowalności na nowotwory złośliwe w grupie wieku 20-64 lata w województwie podlaskim. Wśród kobiet w wieku najwyższej aktywności zawodowej zarówno poziom, jak i przebieg trendu rzeczywistego współczynnika zachorowalności wskazuje na szybki wzrost zagrożenia nowotworami złośliwymi. Wysoki poziom zachorowalności na nowotwory złośliwe w grupie wieku 20-64 lata stanowi jedno z największych wyzwań zdrowia publicznego w Polsce oraz wskazuje na pilną potrzebę podjęcia planowych działań w zakresie ochrony i poprawy stanu zdrowia osób pracujących.
Introduction: Breast cancer is the most common cancer among women in the world. Differences in the treatment of breast cancer may be observed by age, disease stage, place of residence and comorbid conditions. Aim: The aim of the study was to analyse the differences in the use of breast-conserving surgery among women in the Świętokrzyskie Province. Material and methods: The study included 483 female residents of Świętokrzyskie Province who were diagnosed with invasive breast cancer in 2013. Following indicators, recommended to evaluate the compliance with the best oncology practice, were calculated: a proportion of patients receiving post-operative breast radiotherapy after the breast-conserving surgery and a proportion of the breast-conservation surgery in pT1 cases. Results and discussion: The difference in the distribution of surgical procedures by age group (breast-conserving surgery vs. mastectomy) in pT1 cases was statistically significant (P = 0.006). The highest values of both indicators were observed in the age group recommended for breast cancer screening in Poland, while the lowest in women 70 years of age and older. Our study revealed a non-significantly higher proportion of patients receiving post-operative breast radiotherapy after breast conserving-surgery in urban than in rural women, amounting to 36.5% and 29.4%, respectively. Conclusions: Existing inequalities in the use of breast-conserving surgery indicate the need to consider the recommended breast cancer treatment to the highest possible proportion of patients residing in rural areas.
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