Ewa Bandurska

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: 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.

Breast ultrasound is a key diagnostic method for breast cancer and relies heavily on the interpretation of visual cues. At the same time, medical education is increasingly being driven by time constraints, which favors rapid pattern recognition, limiting the scope for reflective image analysis and the diagnostic process. Therefore, the aim of this study was to propose and evaluate an artistic and pedagogical teaching model, inspired by the interpretive practices of Italian High Renaissance painting, as a tool to support the development of diagnostic reasoning in breast ultrasound. This model focuses on careful observation, analysis of the relationship between detail and the overall image, and the conscious transformation of visual cues into clinical meaning. This study was conducted during the four-day ARSA Think Tank Meeting (ARSATTM). Medical students worked in four groups; two groups received methodological training based on visual cue analysis, and two did not. All groups performed identical tasks involving the interpretation of breast ultrasound images and ultrasound examinations on real patients. The results indicate that an artistic–pedagogical teaching model to promote more coherent and reflective diagnostic reasoning in breast ultrasound is feasible. Therefore, integrating this approach may be a valuable addition to medical students’ ultrasound education in the realities of limited clinical time.

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: 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.

Background: Laparoscopic cholecystectomy is the standard surgical treatment for symptomatic gallbladder diseases. In clinical practice, it can be followed by drainage or not. The results acquired so far regarding drain insertion are mixed. The current study used data from medical records and aimed to provide results verifying whether there are differences between patients with postoperative drains inserted after laparoscopic cholecystectomy and the group of patients without postoperative drains, with regard to the time from surgery to discharge and the intake of pain relievers, while controlling for patients’ age and gender. Methods: Medical records regarding 209 patients, 151 females, and 58 males aged 20–83 were included in the analysis. Results: The time from surgery to discharge was significantly longer in the group of patients with a postoperative drain inserted, both in terms of days (1.27 vs. 1.05) and in terms of hours (29.48 vs. 23.04). Also, the amount of Pyralgin and Paracetamol used was significantly higher in the group of patients with a postoperative drain inserted (3.33 g vs. 2.41 g, and 3.40 g vs. 2.45 g, respectively). Conclusions: The results acquired are consistent with many other studies. However, some studies do not show these differences. Therefore, to provide a definitive answer, a meta-analysis followed by meta-regression is needed.

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: 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.

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.

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