Kiss Zoltán, Kocsis Judit, Nikolényi Alíz, Horváth Zsolt, Knollmajer Kata, Benedek Angéla, Várnai Máté, Polányi Zoltán, Kovács Krisztina Andrea, Berta Andrea, Köveskuti István, Karamousouli Eugenia, Szabó Tamás Géza, Rokszin György, Fábián Ibolya, Bartókné Tamás Renáta, Surján Orsolya, Fürtős Diána, Surján György, Kenessey István, Weber András, Barcza Zsófia, Berki Tamás, Vokó Zoltán, Dózsa Csaba, Dank Magdolna, Boér Katalin
MSD Pharma Hungary Ltd, Budapest, Hungary.
Department of Oncology, Bács-Kiskun County Teaching Hospital, Kecskemét, Hungary.
Front Oncol. 2023 Sep 18;13:1182170. doi: 10.3389/fonc.2023.1182170. eCollection 2023.
This nationwide study examined breast cancer (BC) incidence and mortality rates in Hungary between 2011-2019, and the impact of the Covid-19 pandemic on the incidence and mortality rates in 2020 using the databases of the National Health Insurance Fund (NHIF) and Central Statistical Office (CSO) of Hungary.
Our nationwide, retrospective study included patients who were newly diagnosed with breast cancer (International Codes of Diseases ICD)-10 C50) between Jan 1, 2011 and Dec 31, 2020. Age-standardized incidence and mortality rates (ASRs) were calculated using European Standard Populations (ESP).
7,729 to 8,233 new breast cancer cases were recorded in the NHIF database annually, and 3,550 to 4,909 all-cause deaths occurred within BC population per year during 2011-2019 period, while 2,096 to 2,223 breast cancer cause-specific death was recorded (CSO). Age-standardized incidence rates varied between 116.73 and 106.16/100,000 PYs, showing a mean annual change of -0.7% (95% CI: -1.21%-0.16%) and a total change of -5.41% (95% CI: -9.24 to -1.32). Age-standardized mortality rates varied between 26.65-24.97/100,000 PYs (mean annual change: -0.58%; 95% CI: -1.31-0.27%; p=0.101; total change: -5.98%; 95% CI: -13.36-2.66). Age-specific incidence rates significantly decreased between 2011 and 2019 in women aged 50-59, 60-69, 80-89, and ≥90 years (-8.22%, -14.28%, -9.14%, and -36.22%, respectively), while it increased in young females by 30.02% (95%CI 17,01%- 51,97%) during the same period. From 2019 to 2020 (in first COVID-19 pandemic year), breast cancer incidence nominally decreased by 12% (incidence rate ratio [RR]: 0.88; 95% CI: 0.69-1.13; 2020 vs. 2019), all-cause mortality nominally increased by 6% (RR: 1.06; 95% CI: 0.79-1.43) among breast cancer patients, and cause-specific mortality did not change (RR: 1.00; 95%CI: 0.86-1.15).
The incidence of breast cancer significantly decreased in older age groups (≥50 years), oppositely increased among young females between 2011 and 2019, while cause-specific mortality in breast cancer patients showed a non-significant decrease. In 2020, the Covid-19 pandemic resulted in a nominal, but not statistically significant, 12% decrease in breast cancer incidence, with no significant increase in cause-specific breast cancer mortality observed during 2020.
这项全国性研究利用匈牙利国家健康保险基金（NHIF）和中央统计局（CSO）的数据库，调查了2011年至2019年间匈牙利乳腺癌（BC）的发病率和死亡率，以及2020年新冠疫情对发病率和死亡率的影响。
我们的全国性回顾性研究纳入了2011年1月1日至2020年12月31日期间新诊断为乳腺癌（国际疾病分类ICD-10 C50）的患者。使用欧洲标准人口（ESP）计算年龄标准化发病率和死亡率（ASR）。
2011年至2019年期间，NHIF数据库每年记录7729至8233例新乳腺癌病例，乳腺癌患者每年全因死亡3550至4909例，而特定病因死亡记录为2096至2223例（CSO）。年龄标准化发病率在116.73至106.16/10万人口年之间变化，年平均变化为-0.7%（95%CI：-1.21%至-0.16%），总变化为-5.41%（95%CI：-9.24至-1.32）。年龄标准化死亡率在26.65至24.97/10万人口年之间变化（年平均变化：-0.58%；95%CI：-1.31%至0.27%；p = 0.101；总变化：-5.98%；95%CI：-13.36%至2.66%）。2011年至2019年期间，50至59岁、60至69岁、80至89岁和≥90岁女性的年龄别发病率显著下降（分别为-8.22%、-14.28%、-9.14%和-36.22%），而同期年轻女性发病率上升30.02%（95%CI 17.01%至51.97%）。从2019年到2020年（新冠疫情的第一年），乳腺癌发病率名义上下降了12%（发病率比[RR]：0.88；95%CI：0.69至1.13；2020年与2019年相比），乳腺癌患者全因死亡率名义上上升了6%（RR：1.06；95%CI：0.79至1.43），特定病因死亡率未变化（RR：1.00；95%CI：0.86至1.15）。
2011年至2019年期间，老年组（≥50岁）乳腺癌发病率显著下降，年轻女性发病率则相反上升，而乳腺癌患者特定病因死亡率呈非显著下降。2020年，新冠疫情导致乳腺癌发病率名义上下降了12%，但无统计学意义，2020年期间未观察到特定病因乳腺癌死亡率显著上升。
