Background: Pancreatic cancer is characterized by increasing incidence and high mortality in Poland and worldwide. The aim of this study was to assess the relationship between selected risk factors and the age-standardized incidence rate of pancreatic cancer at the voivodeship level in Poland, and to evaluate the accuracy of a prediction model. Methods: Age-standardized incidence rate data for 16 Polish voivodeships in 2011-2023 were obtained from the Polish National Cancer Registry. The risk factor burden for 2011-2019, expressed as disability-adjusted life years (DALYs) per 100,000 population, was obtained from the System Analysis and Implementation Database of the Polish Ministry of Health. A generalized estimating equation model was constructed to predict the age-standardized incidence rate, with multicollinearity addressed using variance inflation factor analysis. Predictions for 2020-2023 were validated against observed data, and forecasts for 2024-2030 were subsequently calculated. Results: The number of new pancreatic cancer cases in Poland increased in eight out of 16 voivodeships. The highest burden was recorded in the Masovian, Subcarpathian, Świętokrzyskie and Greater Poland voivodeships. Air pollution was positively associated with pancreatic cancer incidence. Predictions for 2020-2023 showed satisfactory agreement with observed data, with the largest discrepancy being equal to 4.1 in terms of the age-standardized incidence rate. Based on the models, the incidence of pancreatic cancer was projected for all of 16 voivodeships through to 2030. Conclusions: Air pollution is associated with the regional burden of pancreatic cancer in Poland. The generalized estimating equation prediction approach demonstrated acceptable accuracy and can support monitoring and public health planning at the voivodeship level.

Background/Objectives: Personal values shape appraisal of stress and life satisfaction. We examined the relationship between perceived stress and life satisfaction among uniformed personnel in outpatient mental health care, and the role of a personal values hierarchy in this context. Methods: Cross-sectional study of 183 uniformed personnel (34 females, 149 males, age 30-66 years, M = 44.72, SD = 5.84) diagnosed with bodily distress disorder or post-traumatic stress disorder at a mental health clinic. Participants completed standardized questionnaires assessing perceived stress, satisfaction with life, coping styles, and personal values. For the Personal Value List, each value not selected by a participant was coded as 0 to avoid missing data; scores regarding symbols of happiness were not used. Reliability was evaluated via repeated measurement; two parts of a key instrument showed test-retest correlations of approximately 0.78 and 0.76. For assessing statistical significance, the bootstrap method was used (1000 resamples). Analyses were conducted in jamovi 2.3.28 using snowLatent (latent profile analysis) and medmod 1.1.0 (moderation analysis). Results: Perceived stress was negatively associated with satisfaction with life (B = -0.36, 95% CI [-0.48; -0.24], p < 0.001). Latent profile analysis extracted two personal values hierarchy profiles (AIC = 4237; BIC = 4587). Profile membership was not a significant predictor of satisfaction with life (p = 0.595) and did not moderate the relationship between perceived stress and satisfaction with life (p = 0.907). Distraction seeking was significantly higher in profile 1 (p = 0.010). Conclusions: In treated uniformed personnel, higher perceived stress is linked to lower life satisfaction. The personal values hierarchy did not moderate this relationship and was not associated with satisfaction with life; however, the personal values hierarchy was related to coping, specifically distraction seeking.

Background/Objectives: Melanoma is a major and growing public health concern in Poland, with a five-year survival around 60-70%. While UV radiation and genetic susceptibility are well-known risk factors, lifestyle and environmental exposures may also contribute. This study examined how selected risk factors relate to one-year melanoma prevalence across Poland's 16 voivodeships and assessed whether these factors can support short-term prediction. Methods: Annual melanoma prevalence for 2011-2021 was obtained from the Polish National Cancer Registry, and voivodeship-level estimates of metabolic risk factors, physical inactivity, alcohol consumption, smoking, high BMI, air pollution, water pollution and limited data on UV exposure were used to build a general estimating equations model. Model predictions for 2020-2021 were compared with observed data, and forecasts were generated through 2030. Results: Melanoma cases increased in every voivodeship between 2011 and 2021. Metabolic risk factors, high BMI, low physical activity and smoking were associated with higher melanoma prevalence. When other factors were considered, air pollution showed an inverse association, suggesting complex relationships that warrant further analysis. Forecasts indicated increasing prevalence in all of 16 voivodeships through 2030, although three regions showed large prediction errors for 2020-2021. A key limitation was the lack of sufficient UV exposure data. Conclusions: The findings support further evaluation of public health actions targeting the reduction of unhealthy lifestyle regarding diet, low physical activity, and smoking to help slow the projected rise in melanoma.

Background:Melanoma treatment encompasses surgery, chemotherapy, radiotherapy, immunotherapy, and targeted therapy. Despite declining mortality due to therapeutic advances, increasing incidence underscores the growing importance of cost-effectiveness analyses. The integration of cost-effectiveness evaluation with Bayesian meta-analysis and meta-regression may enhance the synthesis of heterogeneous evidence. Methods:A systematic literature review was conducted to identify studies reporting quality-adjusted life years (QALYs) and direct treatment costs for melanoma in PubMed, MEDLINE, and MEDLINE Ultimate. Bayesian meta-analysis with non-informative priors was applied to derive pooled estimates and quantify uncertainty. Results:A total of 272 studies were identified, of which only a limited subset met the inclusion criteria. The studies exhibited substantial heterogeneity in treatments, populations, time horizons, perspectives, and costs. Meta-analysis based on the effects provided in one study showed that chemotherapy demonstrated lower effectiveness, as measured by QALYs, compared with treatment sequences such as Anti-PD1 → Bi-TT and Bi-TT → Anti-PD1 in both BRAF-mutated and wild-type populations. Lower costs were associated with chemotherapy, ipilimumab, and Anti-PD1 relative to combination and sequential regimens. Meta-analysis based on the effects provided in another study showed that treatment costs increased with advancing disease stage (≥IIIA) and exhibited greater variability in advanced melanoma. Conclusion:The combined methodological approach enhances the robustness and comparability of estimates. The observed variability in both clinical effectiveness and costs, across treatment strategies and disease stages, has important implications for healthcare decision-making and resource allocation.

Pancreatic cancer (PC), with pancreatic ductal adenocarcinoma (PDAC) comprising about 90% of all cases, is one of the most aggressive and lethal solid tumors. PDAC remains one of the most significant challenges of oncology to this day due to its inadequate response to conventional treatment, gradual rise in incidence since 2004, and poor five-year survival rates. As cancer cells are the primary adversary in this uneven fight, they remain the primary research target. Nevertheless, increasing attention is being paid to the tumor microenvironment (TME). The most crucial TME constellation components are immune cells, especially macrophages, stellate cells and lymphocytes, fibroblasts, bacterial and fungal microflora, and neuronal cells. Depending on the particular phenotype of these cells, the composition of the microenvironment, and the cell ratio, patients can experience different disease outcomes and varying vulnerability to treatment approaches. This study aims to present the current knowledge and review the most up-to-date scientific findings regarding the microenvironment of PC. It contains detailed information on the structure and cellular composition of the stroma, including its impact on disease development, metastasis, and response to treatment, as well as the therapeutic opportunities that arise from targeting this tissue.

Breast cancer is the most frequently diagnosed neoplasm in the world. It can be classified into four main subtypes, each of them showing differences in the expression of hormone receptor (HR), human epidermal growth factor receptor 2 (HER2), and in cell metabolism. Since 2015, when The U.S. Food and Drug Administration (FDA) approved the first cyclin-dependent kinase 4 and 6 (CDK4/6) inhibitor that regulates the cell cycle, treatment of HR+/HER2− BC has become much more effective. Currently, palbociclib, ribociclib, and abemaciclib are more often used both in combination with endocrine therapy as well as in monotherapy. Their application has been extensively verified in many clinical trials such as PALOMA-1,2,3, MONALEESA-1,2,3,7, and MONARCH-1,2,3, which allowed the verification of differences in their effectiveness, dosage, and adverse effects. Subsequent studies, MonarchE and NATALEE, examined the role of these inhibitors as adjuvant therapy, as well as at verifying their safety. Moreover, dalpiciclib is being investigated in HR+/HER2− BC treatment. This article will summarize clinical efficacy, recommendations, and differences in toxicity profile between palbociclib, ribociclib, and abemaciclib and will also discuss the possibility of using dalpiciclib in the treatment of breast cancer.

INTRODUCTION AND OBJECTIVE:The diagnosis and treatment of breast cancer result in numerous somatic, psychological, and spiritual challenges, the severity of which depends on the patient's psychological adaptation to the disease. The aim of the study is to assess the psychological adaptation to cancer in women with breast cancer, taking into account selected medical factors. MATERIAL AND METHODS:The study included 522 women diagnosed with breast cancer. The diagnostic survey method was used, with research tools including a Self-Authored Questionnaire and the Mini-Mac Psychological Adaptation to Cancer Scale. Statistical calculations were performed using the Statistica 13.3 software package, with a significance level of p ≤ 0.05. RESULTS:A constructive coping style predominated in the studied group, with the highest intensity observed in positive re-evaluation (M = 22.18). A higher stage of cancer progression correlated with a greater intensity of the 'fighting spirit' strategy (p = 0.016). The longer the time since breast cancer diagnosis, the lower the intensity of anxious preoccupation (p = 0.030), helplessness-hopelessness (p = 0.005), and the destructive coping style (p = 0.009). The destructive coping style was more frequently observed in women who had not undergone chemotherapy (p = 0.001), while surgically treated women exhibited a higher intensity of the helplessness-hopelessness strategy (p = 0.047). In contrast, patients who had undergone radiotherapy had a lower mean level of anxious preoccupation (p = 0.006). CONCLUSIONS:The analyzed medical factors - such as the time since cancer diagnosis, cancer stage, self-assessment of current health status, and applied therapies - determined the psychological adaptation to the disease in women diagnosed with breast cancer.

Background/Objectives: Public health programmes for older adults aim to reduce hospital admissions and improve health outcomes. However, the effects of these programmes on the length of hospital stays for seniors remain unclear. This study aimed to examine the link between the number and type of public health initiatives implemented between 2017 and 2018, and the number of hospitalisations, as well as the duration of hospital stays in 2019 and 2020, among seniors with heart, digestive, and musculoskeletal diseases. Methods: A correlation analysis was conducted to explore the relationship between the number of public health programmes and activities, and the number and length of hospitalisations among older adults. Statistical significance was set at p < 0.05 and p < 0.01. Results: The analysis revealed positive correlations between the number of completed public health tasks and the length of hospital stay across the three disease groups. For heart disease, hospital stay length was correlated with the total number of programmes (r = 0.501, p < 0.05) and those specifically supporting medical services (r = 0.574, p < 0.05). In cases of digestive diseases, correlations were observed with the overall number of programmes (r = 0.623, p < 0.01), as well as programmes in the "general" category and ones supporting medical services (r = 0.544-0.601, p < 0.05). Regarding musculoskeletal diseases, the strongest correlation occurred with programmes that support medical services (r = 0.700, p < 0.01). Conclusions: Our results indicate that increased public health interventions may be associated with longer hospital stays among seniors, likely reflecting the emergence of more complex health needs and increased diagnostic intensity. At the same time, analysis based on ecological data does not allow for the establishment of causal relationships, emphasizing the need for further, more advanced research that controls for confounding factors.

Screening is widely considered one of the most effective methods for the early detection of prostate cancer. Early detection allows for prompt treatment, which increases the likelihood of a full recovery. This review sought to summarize studies on screening methods related to prostate cancer. It examined trends in screening practices and organized the findings into two main categories. The first category focused on strategies to boost screening participation, reach underserved populations, and improve public awareness of health issues. The second category concentrated on refining current diagnostic methods, developing new tests, and testing biomarkers. A significant portion of the research also explored diagnostic techniques aimed at enhancing patient comfort during exams without compromising clinical effectiveness.

Uniformed personnel forms a unique occupational group involving specific tensions in the working environment. The current study evaluates the levels of perceived stress, coping strategies, satisfaction with life and hierarchy of values in the group of 183 uniformed personnel members treated in a mental health clinic and diagnosed with bodily distress disorder or post-traumatic stress disorder. The proportion of participants with elevated level of perceived stress was high. Emotion-oriented coping was the most used approach. Successful family life and good health were particularly valuable for participants. Satisfaction with life was not significantly lower than in the general population. The profile of stress, coping and the values can form a preliminary basis for approaching this specific group of patients when in treatment.

Colorectal cancer (CRC) is the second leading cause of cancer-related deaths globally. The risk of disease increases with age, as most CRC patients are over 50 years old. Due to the progressive aging of societies in high-income countries, the problem of CRC will increase. This makes the development of new early detection methods and the implementation of effective screening programs crucial. Key areas of focus include raising population awareness about the importance of screening, educating high-risk populations, and improving and developing early diagnostic methods. The primary goal of this review is to provide a concise overview of recent trends and progress in CRC secondary prevention based on available information from clinical trials.

BACKGROUND/OBJECTIVES:Cancer is the second most common cause of death in Poland, responsible for 26.7% of deaths in 2023. Our aim was to estimate total direct and indirect costs of cancer in Poland. METHODS:We acquired epidemiological data from the System Analysis and Implementation Database provided Polish Ministry of Health. For estimating the direct costs of medical procedures and chemotherapy, we used statistics of homogeneous groups of patients provided by the Polish National Health Fund. For analyzing the indirect costs in the field of absenteeism we acquired data from Statistical Portal of Polish Social Insurance Institution. RESULTS:The total direct costs of treatment for cancer in the adult population in the period 2021-2023 to be equal to USD 192,935,858, taking purchasing power parity of Polish currency into account. This was equal to 0.00394% of General Domestic Product. The costs associated with absenteeism were equal to USD 3,103,526,321, which was equal to 0.063% of GDP. The sum of Years of Potential Life Lost was equal to 930,962 and the sum of Years of Potential Productive Life Lost was equal to 363,511. Cancer morbidity and incidence in the period 2021-2023 increased by 1.3%. Mortality increased by 2.1%. The total cost of medical services relative to GDP in 2022 was lower than in 2021; in 2023, however, it was higher than both in 2021 and 2022. The cost of chemotherapy, both in absolute numbers and relative to GDP, was significantly lower in 2022 than in 2021. CONCLUSIONS:In 2023, the cost was higher than in 2021 and in 2022. The costs of absenteeism in three consecutive years increased. Years of Potential Life Lost and Years of Potential Productive Life Lost due to cancer increased substantially in the period 2021-2023, both for males and for females, in all three age groups.

Background: Prostate cancer is the second most common malignant cancer among men, and according to the predictions, the estimated number of new cases will substantially grow in the coming years. Therefore, the costs of the disease will increase as well. Methods: We conducted a literature review of the state of knowledge about the costs of treatment and the economic burden of prostate cancer. The vast majority of studies were focused on direct costs only, which clearly shows the literature gap. Results: We focused on the estimates of direct costs, i.e., treatment of prostate cancer, adjuvant and neoadjuvant treatment, and supportive and palliative care, and indirect costs. Cost-effectiveness analyses indicated that docetaxel combined with androgen deprivation therapy (ADT) was the most cost-effective strategy for metastatic hormone-sensitive prostate cancer (incremental cost-effectiveness ratio (ICER): USD 13,647). In contrast, novel therapies such as PARP inhibitors and whole-genome-sequencing-guided treatments were not cost-effective unless drug prices were reduced by 47–70%. In the United States, 5-year cumulative treatment costs ranged from USD 48,000 for conservative management to over USD 91,000 for radiotherapy, while out-of-pocket expenses averaged AUD 1172 in Australia. Indirect costs were also considerable, with Slovakia reporting an increase in sick leave costs from EUR 1.2 million in 2014 to EUR 2.1 million in 2022. Conclusions: Metastatic hormone-sensitive prostate cancer and metastatic castration-resistant prostate cancer were the most frequent categories for various treatment cost evaluations. A few specific combinations of drugs were cost-effective only under the condition of dropping the unit prices of a medication. Further summarizing, reviewing, and developing a methodology for standardized comparisons are needed.

Background/Objectives: Uniformed personnel are highly exposed to occupational stress, which increases the risk of mental health problems. This study examined whether coping styles moderate the relationship between perceived stress and satisfaction with life among uniformed personnel treated for bodily distress disorder or post-traumatic stress disorder. Methods: A cross-sectional study was conducted with 183 participants (81% male, aged 30-66 years). Standardized questionnaires were administered: the Perceived Stress Scale (PSS-10), Satisfaction with Life Scale (SWLS), and Coping Inventory for Stressful Situations (CISS). Pearson correlations with 95% confidence intervals were computed, and moderation analyses were conducted using separate regression models for each coping style with bootstrap estimation (1000 samples). Gender differences were examined using t-tests with Cohen's d. Results: Perceived stress was negatively correlated with life satisfaction (r = -0.43, 95% CI [-0.54, -0.29], moderate effect). Emotion-oriented coping correlated negatively with life satisfaction (r = -0.28, 95% CI [-0.42, -0.14]), while social diversion correlated positively (r = 0.21, 95% CI [0.07, 0.35]). Women reported higher stress (Cohen's d = 0.60) and lower life satisfaction (Cohen's d = -0.50) than men. Moderation analysis revealed that emotion-oriented coping significantly intensified the negative effect of stress on life satisfaction (B = -0.01, p = 0.019). Conclusions: Perceived stress strongly impairs life satisfaction in uniformed personnel, particularly among those relying on emotion-oriented coping. Targeted interventions, such as emotion regulation training, mindfulness, and cognitive restructuring, may enhance resilience and mitigate stress-related declines in well-being in this high-risk occupational group.

Gastrointestinal cancers, especially colorectal cancer, represent a major health care issue. According to the data, the incidence of these cancers exceeds 50/100,000, mainly in high-income countries. Risk factors for the disease include genetic factors (i.e., Lynch syndrome) and lifestyle factors, e.g., overweight and obesity, smoking tobacco products, low-fiber diet, and low physical activity. When diagnosed early, gastrointestinal cancers can, in most cases, be effectively treated. This review focuses on the presentation of research in the area of screening and its results. It provides insights into current trends in research on methods of early cancer detection and improving screening reporting. Differing levels of screening reporting are one of the main challenges faced by researchers in this field. Research on this issue should be conducted in parallel with research on methods of early diagnosis. Finally, the development of diagnostic methods and communication with patients are important elements of public health.

Background: Alcohol use disorder (AUD) is a chronic relapsing brain disorder characterized by compulsive alcohol seeking, loss of control over drinking, and negative emotional states when not using. It has significant psychological, physiological, and social consequences, often co-occurring with mental health disorders such as depression and anxiety. Psychological resilience is gaining more recognition. Sense of coherence (SOC) could be treated as a health factor, and individual predispositions play a crucial role in fighting disease and addiction. Our study examines whether SOC and its components—comprehensibility, manageability, and meaningfulness—predict life satisfaction in patients with AUD and whether perceived stress and health behaviors mediate these relationships. Methods: The study was conducted on a sample of 100 adult patients diagnosed with alcohol use disorder. Results: We found that the higher the manageability and meaningfulness, the lower the level of perceived stress and the higher the level of preventive behavior. Notably, perceived stress emerged as a significant mediator between SOC and satisfaction with life, while health behaviors did not show a mediating effect. Conclusions: The findings emphasize the protective role of SOC in enhancing psychological well-being among individuals with AUD and suggest that interventions aimed at strengthening SOC may reduce stress and improve overall life satisfaction in this population.

BACKGROUND:Colorectal cancer is the third most common malignant cancer, and according to the predictions, the estimated number of new cases will grow in coming years. Therefore, an increase in the costs of the disease will increase as well. Therefore, there is a need for continuous research on the costs and the economic burden of colorectal cancer and for reviewing the research results systematically. The current paper presents a literature review regarding the state of knowledge about the costs of treatment and the economic burden of colorectal cancer. METHODS:A total of 20 papers from MEDLINE database were included in the final analysis. The review is focused on the estimates of direct costs, i.e., treatment of colorectal cancer, screening after treatment, and indirect costs. RESULTS:the vast majority of studies were focused on direct costs only, which clearly shows the literature gap. Metastatic colorectal cancer was the most frequent category for various treatment cost evaluation. The costs associated with the use of bevacizumab in various combinations were calculated most frequently. CONCLUSIONS:Further summarizing review and developing a methodology for standardized comparisons is necessary, specifically addressing indirect costs.

Breast cancer is the most common malignant cancer among women, following lung cancer in the general population [...].

Alcohol addiction is characterized by extensive alcohol consumption that dominates other behaviours previously important to a patient. According to data from The State Agency for Prevention of Alcohol-Related Problems, up to 900,000 people in Poland are addicted to alcohol. On average, approximately 9.7 L of pure alcohol per capita was consumed in 2021. Alcohol addiction may cause severe health problems and is one the key risk factors for various diseases. Stress plays an important role in the process of alcohol addiction and is also a predictor for lower enjoyment in life. On the other hand, sense of coherence may be a stronger protective factor. The aim of our study was to verify the relation between the level of perceived stress among patients with alcohol addiction and satisfaction with life. Because sense of coherence is a disposition that allows for managing stress effectively, the latter should be reflected in the results of multivariate analyses that take both the level of stress and sense of coherence into account. In the present study, sense of coherence and perceived stress were negatively correlated; therefore, strengthening internal resources for managing difficult and stressful situations is recommended.