conference prevention of chronic non-communicable … · conference „ prevention of chronic...
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- State Secretary of the Ministry of Health, Slovakia
- National Cancer Registry, Slovakia / National Health Information Center
Conference „ Prevention of chronic non-communicablediseases and healthy lifestyle“
20-21 September 2016, Bratislava
• Initial source for population’s health conditions tracking – mortality statistics (18th century, Maria Theresia)
• Primary international classification related to causes of death only (1856) and afterwards extended to classification of diseases as well
Life StyleDemographic
evolutionHealth
conditions
↑ risk factors prevalence /
RF precaution
aging, changes of life
expectancy
↑ incurrence/ deaths to
circulatory disease, Tumours,
respiratory disease
• Causes of death reflected predominantly infectious diseases – universal vaccination(since the ‘60s of 20th century) = ↓ infectious diseases / ↓ mortality
• Social/political/economic changes impact on:
60 000 40 000 20 000 0 20 000 40 000 60 000
0
4
8
12
16
20
24
28
32
36
40
44
48
52
56
60
64
68
72
76
80
84
88
92
96
Women 2020 Men 2020Women 2001 Men 2001Women 2010 Men 2010
MEN WOMEN
Indicator
Year
1971 1986 2001 2010 2015Prognosis
in 20201 Trend
Population
( in 1 000)4559 5192 5 379 5 431 5 423 5 510 -
Age structure
(%)
0-14 27,0 26,4 19,1 15,3 15,3 15,51 ↓
15-24 18,7 15,0 17,0 14,3 11,9 9,91↓
25-44 25,1 29,3 29,5 31,4 31,6 30,61 ↑
45-64 20,0 19,8 23,0 26,7 26,9 27,21↑
65-74 6,6 5,6 6,9 7,1 8,5 10,61↑
75+ 2,7 4,0 4,5 5,3 5,7 6,11↑
Source: Statistical Office Slovakia1) Mészaroš, INFOSTAT 2011
10,07
12,1413
13,8614,83 14,92
13,29
15,35
16,6417,47
18,2418,92
0
2
4
6
8
10
12
14
16
18
20
1971 1986 2001 2010 2015 2020 1971 1986 2001 2010 2015 2020Years
MEN WOMEN
Source: Statistical Office Slovakia / Mészaroš, INFOSTAT)
pro
gno
sis
pro
gno
sis
MEN
Age group Year All deaths
proportion on all deaths in %
Circulatory
diseasesCancer Accidents
Respiratory
system
Digestive
system
0-85+1971 23 638 41,6 17,4 11,2 14,7 4,8
2015 27 462 42,2 27,8 8,0 7,9 6,3
35-641971 7 361 37,2 23,4 15,4 9,3 7,1
2015 9 252 32,1 29,4 13,4 5,9 11,0
65+1971 13 399 52,0 16,8 3,0 18,1 3,6
2015 17 293 49,5 27,9 3,4 9,1 3,8
WOMEN
Age group Year All deaths
proportion on all deaths in %
Circulatory
diseases
Cancer AccidentsRespiratory
system
Digestive
system
0-85+1971 19 218 51,7 17,0 4,4 11,8 4,0
2015 26 364 54,3 22,8 3,2 7,2 4,1
35-641971 4 059 39,4 31,8 5,7 6,5 6,2
2015 4 002 24,7 44,1 6,8 6,2 9,3
65+1971 13 660 60,7 13,5 2,9 12,3 3,2
2015 21 951 60,6 19,1 2,3 7,3 3,2
Source: Statistical Office Slovakia
The same opinion had a WHO group of experts, who recommended to establish cancer registers of population based on exact agreed criteria in 1976. Having national register of malignant tumours of its patients made Czechoslovak Republic one of the pioneers in this field (even reporting for oncological patient was compulsory since 1952, there wasn’t a unified population register).
National Cancer Registry in SR (NCR SR) was established in 1976 by doc.MUDr. Ivan Pleško, CSc.
Executive doctors – operational POKO + qualified team NCR SR = high data quality, high international credit (international databases/ publications/ projects).
818 627
1968-2010
135 184
2011-2015*
953 811
1968-2015
* estimate
Summary oncological cases
6 9597 616
8 800
9 92010 635
11 415
12 595
14 915
13 515
5 7996 164 6 911
8 040
9 282
10 336
12 068
14 972
13 522
0
2 000
4 000
6 000
8 000
10 000
12 000
14 000
16 000
1971-1975 1976-1980 1981-1985 1986-1990 1991-1995 1996-2000 2001-2005 2006-2010 2011-2015*
Men Women
* Preliminary data from the database hospitalizedSource: NCR SR
0
100
200
300
400
500
0-85+
incidence mortality
0
100
200
300
400
500
0-85+
incidence mortality
0
500
1000
1500
2000
2500
3000
19
71
-19
75
19
76
-1
98
0
19
81
-19
85
19
86
-1
99
0
19
91
-19
95
19
96
-2
00
0
20
01
-20
05
20
06
-20
10
20
11
-20
15
35-64
incidence mortality
0
500
1000
1500
2000
2500
3000
19
71
-19
75
19
76
-1
98
0
19
81
-19
85
19
86
-1
99
0
19
91
-19
95
19
96
-2
00
0
20
01
-20
05
20
06
-20
10
20
11
-20
15
35-64
incidence mortality
0
500
1000
1500
2000
2500
3000
19
71
-19
75
19
76
-19
80
19
81
-19
85
19
86
-19
90
19
91
-19
95
19
96
-20
00
20
01
-20
05
20
06
-20
10
20
11
-20
15
65+
incidence mortality
0
500
1000
1500
2000
2500
3000
19
71
-19
75
19
76
-1
98
0
19
81
-19
85
19
86
-1
99
0
19
91
-19
95
19
96
-2
00
0
20
01
-20
05
20
06
-20
10
20
11
-20
15
65+
incidence mortality
MEN WOMEN
Source: Deaths - Statistical Office Slovakia / Mortality - National Health Information Center / Incidence – NCR SR
n /
per
10
0 0
00
, W
SR
Diagnosis Sex 1971-1980 1981-1990 1991-2000 2001-2010 2011-2015* Trend
C18-C21
Men 8,7 10,4 13,1 14,5 17,3 ↑
Women 9,2 4,7 10,9 11,1 12,6↑
C33-C34
Men 22,1 23,0 18,8 14,1 12,1 ↓
Women 3,6 3,9 3,5 3,8 4,4 ↗
C50 Women 14,5 15,0 16,6 17,6 23,2 ↑
C61 Men 5,4 6,6 7,4 10,3 8,7 ↑
Non-melanom skin carcinomas formed in 1971 to 10%, in 2010 to 16%
Source: NCR SR *Preliminary data from the database hospitalized
MEN WOMEN
0
100
200
300
400
500
600
25-34 35-44 45-54 55-64 65-74 75+
n /
per
10
0 0
00
, WSR
Ages
women 1971-1980 women 2001-2010
0
100
200
300
400
500
600
25-34 35-44 45-54 55-64 65-74 75+
n /
per
10
0 0
00
, WSR
Ages
men 1971-1980 men 2001-2010
0
10
20
30
40
50
60
70
n /
per
10
0 0
00
, WSR
Year
men incidence men mortality
0
10
20
30
40
50
60
70
n /
per
10
0 0
00
, WSR
Yearwomen incidence women mortality
Development of standardized incidence and mortality
Age-standardized incidence
Source: Incidence – NCR SR / Mortality - National Health Information Center / Deaths - Statistical Office Slovakia / /
0
50
100
150
200
250
300
350
400
450
500
25-34 35-44 45-54 55-64 65-74 75+
n /
per
10
0 0
00
, WSR
Ages
men 1971-1980 men 2001-2010
0
50
100
150
200
250
300
350
400
450
500
25-34 35-44 45-54 55-64 65-74 75+
n /
per
10
0 0
00
, WSR
Ages
women 1971-1980 women 2001-2010
0
10
20
30
40
50
60
70
80
90
n /
per
10
0 0
00
, WSR
Year
men incidence men mortality
0
10
20
30
40
50
60
70
80
90
n /
per
10
0 0
00
, WSR
Year
women incidence women mortality
Development of standardized incidence and mortality
Age-standardized incidenceMEN WOMEN
Source: Incidence – NCR SR / Mortality - National Health Information Center / Deaths - Statistical Office Slovakia / /
MEN (C61) WOMEN ( C50)
0
100
200
300
400
500
600
700
25-34 35-44 45-54 55-64 65-74 75+
n /
per
10
0 0
00
, WSR
Ages
women 1971-1980 women 2001-2010
0
10
20
30
40
50
60
70
80
n /
per
10
0 0
00
, WSR
Year
women incidence women mortality
0
100
200
300
400
500
600
700
25-34 35-44 45-54 55-64 65-74 75+
n /
per
10
0 0
00
, WSR
Ages
men 1971-1980 men 2001-2010
0
10
20
30
40
50
60
70
80
n /
per
10
0 0
00
, WSR
Yearmen incidence men mortality
Development of standardized incidence and mortality
Age-standardized incidence
Source: Incidence – NCR SR / Mortality - National Health Information Center / Deaths - Statistical Office Slovakia / /
18,8 18,1 18,6
25,1 27,2 26,4
17,221,6 26,5
23,120,9
26,215,9 12,2
2,3
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
2001 2006 2010
%
Year
Colorectal cancer
Unknown
IV.stage
III.stage
II.stage
I. stage8,0 8,2 7,56,9 5,5 5,6
26,1 23,3 27,2
33,6 43,0
56,2
25,4 20,03,5
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
2001 2006 2010
%
Year
Trachea and lung cancer
Unknown
IV.stage
III.stage
II.stage
I. stage
23,5 26,6 33,4
44,4 39,035,1
14,7 21,4 20,27,5
6,8 9,39,9 6,22,1
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
2001 2006 2010
%
Year
Breast cancer (women)
Unknown
IV.stage
III.stage
II.stage
I. stage11,6 8,3 6,8
25,6
54,0 59,615,8
15,117,7
23,2
13,514,423,8
9,01,5
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
2001 2006 2010
%
Year
Prostate cancer (men)
Unknown
IV.stage
III.stage
II.stage
I. stage
Source: NCR SR
34,4
75
27,3
40,5
14,58,8
42,8
64,6
34,3
50,3
32,9
48,6
19,3
14
52,4
74
0
10
20
30
40
50
60
70
80
1980-1984 2000-2004 1980-1984 2000-2004 1980-1984 2000-2004 1980-1984 2000-2004 1980-1984 2000-2004
C18 C19-C21 C33-C34 C61 C50
%
Men Women
Source: NCR SR: Cancer incidence in the Slovak Republic 2006 - Safaei Diba Ch., Hlava P., Pleško I.
Prostate BreastTrachea and lungRectosigmaColon
Goal 8 – Prevalence decrease of chronic diseases by 2020:
„Tumor mortality“ of any localization below 65 years of age has to be decreased minimum by 15% in average, lungs by 25%.
2015
2015
109,2WRS*
149,0 ERS*
↓ 30%
Men
56,5WRS*
74,9ERS*
↓14,7%
Women
80,4WRS*
108,9ERS*
↓ 24%
Total
15,6WRS*
22,0ERS*
↓ 48,5%
↓ 53,0%
Men
5,1WRS*
7,8ERS*
↑ 15,6%
↑ 8,3 %
Women
10,1WRS*
14,6ERS*
↓ 37,8%
↓ 43,0%
Total
2015/2000
2015/2000
Trachea and Lung cancer( C33-C34)
Overall cancer (C00-D09) in Slovakia
* Standardized according WHO ( WRS – World standard, ERS- European standard)
190,1214,7 223,4 223,9 229,4
248,5 254,6 261,1 274,4 278,9 281,9 300,4 307,8
0
50
100
150
200
250
300
350
400
450
Ukraine Latvia Austria Croatia Estonia Malta Sweden Slovakia Slovenia Norway Finland Denmark CzechRepublic
WOMEN
260,6301,8 308,1 316,8 317,7 321,7 338,6 340,6 345,5 354,6
377,0 378,7420,1
0
50
100
150
200
250
300
350
400
450
Ukraine Sweden Malta Latvia Austria Croatia Denmark Estonia Norway Finland Slovenia Slovakia CzechRepublic
MEN
n /
per
10
0 0
00
, W
SR
Source: IARC Cancer Incidence in Five Continents Vol.IX, / data for Slovakia – NCR SR, Safaei Diba and company
19,2 19,4 19,9 20,9 21,6 21,9 22,8 24,3 25,127,8 28,5 30,5
34,2
0
10
20
30
40
50
60
Ukraine Finland Latvia Malta Estonia Austria Sweden Croatia Slovenia Slovakia CzechRepublic
Denmark Norway
WOMEN
27,1 28,8 29,6 30,8 32 33,438,6
41,9 42,4 44,1 45,8
56,4 57
0
10
20
30
40
50
60
Finland Ukraine Latvia Sweden Malta Estonia Austria Denmark Norway Croatia Slovenia Slovakia CzechRepublic
MEN
n /
per
10
0 0
00
, W
SR
Source: IARC Cancer Incidence in Five Continents Vol.IX, / data for Slovakia – NCR SR, Safaei Diba and company
20,7 20,7
34,4 34,5 36,740,5
45
55,8 56,2 57,5 58,763,4 65,1
0
10
20
30
40
50
60
70
Sweden Ukraine Finland Malta Norway Austria Denmark Estonia Slovakia Slovenia CzechRepublic
Latvia Croatia
MEN
6,4 6,7 8,8 8,9 10,5 10,814 15,2 15,7 16,5 17,2
23,3
35,2
0
10
20
30
40
50
60
70
Ukraine Malta Latvia Estonia Slovakia Finland Croatia Slovenia CzechRepublic
Austria Sweden Norway Denmark
WOMEN
n /
per
10
0 0
00
, W
SR
Source: IARC Cancer Incidence in Five Continents Vol.IX, / data for Slovakia – NCR SR, Safaei Diba and company
18,1
38,7 39,5 42,752 54,8 56,5
69 69,5
83,1
98,5 102,2107,6
0
20
40
60
80
100
120
Ukraine Slovakia Croatia Malta Latvia Slovenia CzechRepublic
Denmark Estonia Austria Norway Finland Sweden
PROSTATA CANCER (C61) - MEN
39,948,4 48,9 51,7
59,4 63,6 64,6 66,972,5 75,9
81,1 83,2 86,1
0
20
40
60
80
100
120
Ukraine Latvia Estonia Slovakia Croatia Slovenia CzechRepublic
Austria Malta Norway Sweden Finland Denmark
BREAST CANCER (C50) - WOMENn /
per
10
0 0
00
, W
SR
Source: IARC Cancer Incidence in Five Continents Vol.IX, / data for Slovakia – NCR SR, Safaei Diba and company
NCR represents fundamental global source of clinico-epidemiological data of malignant tumors prevalence in time and space (regional differences) by:• age, sex, • tumor localization, • cytological/ histo-patological diagnostics • treatments
Data analysis & interpretation should act as basis for effective state health policy in the field with principle goals:• improve primary prevention of known risk factors/ optimize life style,• increase early disease identification / apply respective treatment = successful
prognosis/ health expectancy.
In recent years problems with data collection incurred by reporting units has had direct negative impact on accuracy of data processing. For the first time since it’s establishment NCR Slovakia will not have stated data in publication „Cancer Incidence in Five Continents Vol.X.“ (IARC) due to lack of complexity of primary data from reporting units for years of 2011-2013. However there has been ongoing discussions between Health department SR and it’s chief experts of Ministry of Health about new ways of data collection which would strenghten e-reporting to NCR Slovakia.
Health 21. for European region, Goal 14All government departments should recognize and accept their responsibility for population’s health condition by 2020 (assessment of department’s impact on health).
Health 21... Goal 8- Prevalence decrease of chronic diseasesPublic health depends on interdepartmental approach. Principle target is to have a complex approach for the most important risk factors in human behavior and only that creates environment where multi-departmental initiatives are aligned government directions and particular efforts of each single being
