Cancer burden in slovenia with the time trends analysis

Abstract

Background: The aim of our study was to describe cancer burden and time trends of all cancers combined, the most frequent as well as the rare cancers in Slovenia.

Patients and methods: The principal data source was the population-based Cancer Registry of Republic of Slovenia. The cancer burden is presented by incidence and prevalence for the period 1950-2013 and by mortality for years 1985-2013. The time trends were characterized in terms of an average annual percent change estimated by the log-linear joinpoint regression. The Dyba-Hakulinen method was used for estimation of incidence in 2016 and the projections of cancer incidence for the year 2025 were calculated applying the Globocan projection software.

Results: In recent years, near 14,000 Slovenes were diagnosed with cancer per year and just over 6,000 died; more than 94,000 people who were ever diagnosed with cancer are currently living among us. The total burden of cancer is dominated by five most common cancer sites: skin (non-melanoma), colon and rectum, lung, breast and prostate, together representing almost 60% of all new cancer cases. On average the incidence of common cancers in Slovenia is increasing for 3.0% per year in last decade, but the incidence of rare cancers is stable.

Conclusions: Because cancer occurs more among the elderly, and additionally more numerous post-war generation is entering this age group, it is expected that the burden of this disease will be growing further, even if the level of risk factors remains the same as today.

Keywords: Cancer Registry of Republic of Slovenia; cancer burden; cancer incidence; time trend.

Figure 1

Cancer incidenceten leading cancer sites with percentage distribution by gender, Slovenia 1992−1993, 2002−2003 and 2012−2013.

Figure 2

Cancer mortalityten leading cancer sites with percentage distribution by gender, Slovenia 1992−1993, 2002−2003 and 2012−2013.

Figure 3

Rare cancers categorized in 15 groups, Slovenia 2004−2013.

Figure 4

Trend of crude incidence rates of selected primary cancer sites by gender with average annual percent change in last 10 years, Slovenia 1950−2013.

Figure 5

The age standardised cervical cancer incidence rates (world standard), Slovenia 1961–2015. The timeline of cervical cancer screening modalities and the average annual percent changes (APC) for the statistical significant cervical cancer incidence time trends (1961–1989, 1989–1997 and 2003–2015) are indicated.

Figure 6

The age standardised mesothelioma incidence rates (world standard) with 5-year moving averages, Slovenia 1961–2014. The average annual percent changes (APC) are presented for the most important time segments (1998–2003 and 2003-2014) and critical years of asbestos exposure are marked.

Figure 7

Cancer incidence of some common cancer sites in Slovenia in 2012 with the estimation of the number of expected additional cases in 2025 if only the population ageing is considered.