National Health Fund

Abstract Background Cardiovascular diseases remain the leading cause of premature mortality in Europe, yet contemporary population-level data on modifiable risk factors in adults eligible for primary prevention are limited. Large-scale screening programmes enable detailed assessment of age- and sex-specific patterns relevant to preventive strategies. Purpose To evaluate the prevalence and age- and sex-specific patterns of major modifiable cardiovascular risk factors in a large cohort of adults participating in a preventive screening programme. Methods We analysed adults aged 35–65 years screened between 2022 and 2024. Standardised assessments included blood pressure, fasting glucose, total cholesterol, body-mass index, smoking, and physical activity. Individuals with cardiovascular disease, diabetes, chronic kidney disease, or familial hypercholesterolaemia were excluded. Analyses were stratified by age, sex, and year. Linear and polynomial regression models assessed age-related and temporal trends (p<0.05). Results Among 1 187 168 adults, women constituted 59–63% (p<0.001). Overweight affected 33.3–34.0% of women and 46.9–47.0% of men (p<0.001), while obesity reached 21.3–22.2% and 29.8–30.3% (p<0.001). In women, both increased steadily with age (p<0.05), whereas in men obesity peaked in midlife (p<0.05). Hypertension occurred in 21.0–23.0%, with higher prevalence in men (29.8–31.5%) than women (15.8–17.1%; p<0.001) and increased with age in both sexes (p<0.05). Elevated cholesterol was most frequent (63.5–66.9%) and exceeded 75% in older women, with sex-specific age trajectories (p<0.05); levels increased in men across study years (p=0.047). Newly detected diabetes rose sharply with age, reaching 5.0% in men aged 60–65 years (p<0.001 across groups). Smoking remained common (19–20% of women; 28% of men; p<0.001), while low physical activity affected ~50% and showed opposite age patterns in women (declining) and men (increasing) (both p<0.05). Conclusion This large contemporary cohort demonstrated a high burden of modifiable cardiovascular risk factors, with consistent and clinically relevant sex- and age-specific disparities. Men showed substantially higher levels of hypertension, dyslipidaemia, excess body weight, smoking, and hyperglycaemia, while women exhibited a marked age-related rise in obesity and cholesterol. These findings underscore the need for targeted, sex- and age-adapted primary prevention strategies to improve cardiovascular risk control.

Objective:This ecological study describes population-level trends in obesity, sugar-sweetened beverage (SSB) consumption, per-capita sugar purchases and publicly funded healthcare use for obesity-related conditions in Poland around the introduction of a sugar tax in 2021. Methods:We analyzed nationally aggregated administrative and survey data from the National Health Fund (NHF), the e-Health Center, the Central Statistical Office (CSO) and the National Public Health Institute (NPHI). Annual time series (2014-2024, where available) on per-capita sugar purchases and healthcare use for obesity and major obesity-related comorbidities were evaluated using segmented time-series regression with a 2021 break-point and a COVID-19 (2020) indicator. Survey-based data on SSB and sweets consumption and on overweight and obesity (2018, 2022, 2025), plus cross-sectional BMI data for 2025, were summarized descriptively. Results:Per-capita sugar purchases decreased moderately between 2018 and 2024. Survey data indicated an initial reduction in SSB consumption after 2021, followed by partial rebound by 2025, and a shift towards more frequent sweets consumption, while overweight and obesity continued to rise. For obesity-related conditions, numbers of patients receiving disease-specific healthcare showed a COVID-19-related dip in 2020 and subsequent post-2021 increases, with bariatric surgery and pharmacological treatment of obesity also rising over the study period. Conclusion:In the first 4 years after sugar tax implementation, we observed modest declines in per-capita sugar purchases, transient reductions in SSB consumption and increasing sweets consumption, alongside continued growth in obesity and obesity-related healthcare use. Given the ecological design and short follow-up, these findings represent temporal associations rather than evidence of direct causal effects and underline the need to embed fiscal measures such as a sugar tax within broader, multi-level strategies for obesity prevention, health promotion and access to effective obesity treatment.

OBJECTIVES:This observational case-control study aims to evaluate the prevalence of comorbidities and 10-year overall survival in an LDCT-screened population compared to a propensity score-matched general Polish population. METHODS:Aged 50-75 years (n=43,686) with at least 10 years of follow-up were included. The screening group (n=7281) underwent LDCT lung cancer screening between 2009 and 2011. The control group (n=36,405) was matched from the general population using 32 variables. The primary endpoint was 10-year overall survival; secondary endpoints included comorbidity prevalence and multivariate analysis results. RESULTS:Common comorbidities included hypertension (52.2%), chronic coronary artery disease (20.5%), hypercholesterolemia (13.2%), and diabetes (13.0%). Multivariate analysis showed improved survival associated with LDCT screening (HR=0.653), hypertension (HR=0.882), hypercholesterolemia (HR=0.567), and female sex (HR=0.527). The 10-year overall survival was higher in the screening group by 5.6 percentage points (86.9%) compared with controls (81.3%, p<0.001). CONCLUSIONS:Participation in lung cancer screening using LDCT was associated with longer 10-year overall survival in adults aged 50-75 years. These results support the use of LDCT in high-risk individuals and emphasize the need for prospective studies to elucidate the mechanisms underlying the observed association.

OBJECTIVE:The course of COVID-19 and its mortality rate largely depend on the presence of comorbidities. The aim of the study was to evaluate the association between epilepsy and severe COVID-19 outcomes in a nationwide cohort of hospitalized patients in Poland. METHODS:This retrospective, nationwide, population-based cohort study used National Health Fund data to identify adults hospitalized due to COVID-19 between 1 March 2021 and 31 December 2023. Patients with epilepsy were identified based on neurologist-confirmed diagnosis and antiseizure medication use. Exact matching was applied to ensure comparability between people with epilepsy (PWE) and patients without epilepsy (PWOE). Outcomes included 60-day mortality, intensive care unit (ICU) admission, mechanical ventilation, and length of hospital stay (LOS). RESULTS:A total of 404,639 COVID-19 hospitalizations were analyzed, including 3,362 PWE in the unmatched cohort. After matching, epilepsy was associated with a significantly higher risk of death within 60 days of admission, with odds of death 26.4% higher among PWE compared with PWOE. LOS was also significantly longer in PWE, by approximately 14.6%. Epilepsy was not independently associated with an increased risk of mechanical ventilation or ICU admission. CONCLUSIONS:In this large nationwide cohort, epilepsy was associated with increased mortality and prolonged hospitalization among patients hospitalized with COVID-19 in Poland, although it did not independently increase the likelihood of ICU admission or mechanical ventilation. These findings suggest that PWE - particularly those with substantial comorbidity burden - represent a clinically vulnerable population in the context of COVID-19 and may require heightened clinical attention and preventive strategies.