Incidenca raka v prvem letu epidemije covida-19 Cancer incidence in the first year of COVID-19 epidemic

Abstract

Uvod: Število novih diagnoz raka (incidenca) se v Sloveniji v zadnjem desetletju povečuje za povprečno 1,6 % na leto. V letu 2020, prvem letu omejitvenih ukrepov zaradi epidemije covida- 19, smo s platformo OnKOvid predvideli 3–8-odstotni padec novih diagnoz raka. Namen je predstaviti uradno incidenco raka za Slovenijo za leto 2020 in ugotoviti, kolikšen je bil dejansko manko novih diagnoz raka. Metode: V Registru raka Republike Slovenije smo v skladu z mednarodnimi pravili registrirali vse nove primere raka pri prebivalcih s stalnim prebivališčem v Sloveniji. Primerjali smo jih z registrirano incidenco za 2019, modelno incidenco za 2020, preliminarnimi rezultati OnKovida in dostopnimi rezultati incidence iz registrov raka iz drugih držav. Rezultati: V letu 2020 je za rakom zbolelo 15.096 oseb v Sloveniji (7.034 žensk, 8.002 moška). Glede na modelno oceno incidence za leto 2020 gre za manko 1.854 oseb (10,9 %; 11,6 % žensk, 10,4 % moških). Pri tem je za 10,5 % manj ugotovljenih rakov v omejenem stadiju, najbolj izrazito v starosti 50–69 let (za 13,2 %). Upad je primerljiv s poročili iz Anglije, ZDA in Kanade ter deloma večji kot na Škotskem in Švedskem. Najbolj izrazit upad novih diagnoz raka ugotavljamo pri nemelanomskem kožnem raku (23 %, najbolj po 50. letu), raku prostate (15,9 %, najbolj v omejenem stadiju), pljučnem raku (8,9 %, 60–64 let, v razširjenem stadiju), raku dojk (8,3 %, 45–64 let), ne-Hodgkinovem limfomu (9 %) in levkemijah (11,6 %). Pri kožnem melanomu, raku debelega črevesa in danke ni bilo primanjkljaja. Zaključek: Upad incidence raka v letu 2020 gre verjetno na račun omejitvenih ukrepov, reorganizacije zdravstva in z zdravjem povezanega vedenja med epidemijo covida-19, beležijo jo v več državah. Med epidemijami je potrebno nemoteno izvajanje onkologije.

Abstract (Eng)

Introduction: During the past decade in Slovenia, the number of new cancer diagnoses (incidence) has risen by 1.6% annually. In 2020, the first year of the COVID-19 epidemic, a 3–8% decrease in new cancer diagnoses was projected by the OnCOvid platform. Our aim is to present the official cancer incidence for 2020 for Slovenia and to communicate the actual lack of new cancer diagnose. Methods: In the Slovenian Cancer Registry, all Slovene inhabitants diagnosed with cancer in 2020 were registered following the international rules. The results were compared to the official incidence for 2019, modelled incidence for 2020, OnCOvidˊs preliminary results and available data from other population-based cancer registries. Results: In 2020, 15,096 inhabitants were diagnosed with cancer in Slovenia (7,034 women, 8,002 men). Compared to the modelled incidence for 2020, there was a decrease of 1,854 persons (10.9%; 11.6% in women, 10.4 % in men). The decrease is highest in the localized stage and in patients aged 50–69 years (13.2%). The decrease for Slovenia is comparable to decreases in England, the United States and Canada, but somewhat higher than in Scotland and Sweden. The largest decrease in new cancer cases was found for non-melanoma skin cancer (23%, mostly after age 50), prostate (15.9%, localized stage), lung (8.9%, 60–64 years, regional stage) and breast cancer (8.3%, 45–64 years), non-Hodgkin lymphoma (9%) and leukaemia (11.6%), with no decrease in melanoma and colorectal cancer cases. Conclusions: The decrease in cancer incidence for 2020 is likely due to containment measures, healthcare reorganisation and health-seeking behaviour during the COVID-19 epidemic, which is also reported by other countries. Uninterrupted provision of cancer care during epidemics is needed.