Objective: While Hungary is often reported to have the highest incidence and mortality rates of lung cancer, until 2018 no nationwide epidemiology study was conducted to confirm these trends. The objective of this study was to estimate the occurrence of lung cancer in Hungary based on a retrospective review of the National Health Insurance Fund (NHIF) database. Methods: Our retrospective, longitudinal study included patients aged ≥20 years who were diagnosed with lung cancer (ICD-10 C34) between 1 Jan 2011 and 31 Dec 2016. Age-standardized incidence and mortality rates were calculated using both the 1976 and 2013 European Standard Populations (ESP). Results: Between 2011 and 2016, 6,996 – 7,158 new lung cancer cases were recorded in the NHIF database annually, and 6,045 – 6,465 all-cause deaths occurred per year. Age-adjusted incidence rates were 115.7–101.6/100,000 person-years among men (ESP 1976: 84.7–72.6), showing a mean annual change of − 2.26% (p = 0.008). Incidence rates among women increased from 48.3 to 50.3/100,000 person-years (ESP 1976: 36.9–38.0), corresponding to a mean annual change of 1.23% (p = 0.028). Age-standardized mortality rates varied between 103.8 and 97.2/100,000 person-years (ESP 1976: 72.8–69.7) in men and between 38.3 and 42.7/100,000 person-years (ESP 1976: 27.8–29.3) in women. Conclusion: Age-standardized incidence and mortality rates of lung cancer in Hungary were found to be high compared to Western-European countries, but lower than those reported by previous publications. The incidence of lung cancer decreased in men, while there was an increase in incidence and mortality among female lung cancer patients.

Objective: No assessment was conducted describing the age and gender specific epidemiology of lung cancer (LC) prior to 2018 in Hungary, thus the objective of this study was to appraise the detailed epidemiology of lung cancer (ICD-10 C34) in Hungary based on a retrospective analysis of the National Health Insurance Fund database.Methods: This longitudinal study included patients aged ≥20 years with LC diagnosis (ICD-10 C34) between January 1, 2011 and December 31, 2016. Patients with different cancer-related codes 6 months before or 12 months after LC diagnosis or having any cancer treatment other than lung cancer protocols were excluded.Results: Lung cancer incidence and mortality increased with age, peaking in the 70–79 age group (375.0/100,000 person-years) among males, while at 60–69 age group for females (148.1/100,000 person-years). The male-to-female incidence rate ratio reached 2.46–3.01 (p < 0.0001) among the 70–79 age group. We found 2–11% decrease in male incidence rate at most age groups, while a significant 1–3% increase was observed in older females (>60) annually during the study period.Conclusion: This nationwide epidemiology study demonstrated that LC incidence and mortality in Hungary decreased in younger male and female population, however we found significant increase of incidence in older female population, similar to international trends. Incidence rates peaked in younger age-groups compared to Western countries, most likely due to higher smoking prevalence in these cohorts, while lower age LC incidence could be attributed to higher competing cardiovascular risk resulting in earlier mortality in smoking population.

Background: The incidence of malignant melanoma has continually increased during the past few decades, however, certain reports suggest a recent change in trends. The aim of our study was to examine the epidemiology of melanoma in Hungary.Methods: This nationwide, retrospective, longitudinal study included melanoma patients diagnosed between 1 January 2009 and 31 December 2019 using the databases of the National Health Insurance Fund (NHIF) and Central Statistical Office (CSO) of Hungary. Age-standardized incidence and cause-specific mortality rates were calculated.Results: We identified 2,426 and 2,414 new melanoma cases in 2011 and in 2019. Age-standardized incidence rates were higher in males and varied between 28.28 and 34.57/100,000 person-years (PYs), and between 22.63 and 26.72/100,000 PYs in females. We found 16.14 and 18.82% increases in male and female incidence rates from 2011 to 2015 (p=0.067 and p<0.001, respectively), and 12.77 and 11.35% decreases from 2015 to 2019 (p=0.062 and p=0.004, respectively). The change of incidence trends (2011–2015 vs. 2015–2019) was significant in females (p=0.002) and in the total melanoma population (p=0.011), but not in the male population (p=0.063). A 16.55% (95% CI: −27.07 to −4.59; p=0.013) decrease in mortality rates was found in the overall melanoma population.Conclusions: We observed a significant trend change in melanoma incidence in the female and total melanoma population, and a significant decrease in mortality in the total melanoma population. These changes may be attributed to intensive melanoma awareness campaigns as well as to the increase in screening and access to modern therapies.

Background: Despite well-documented clinical differences across breast-cancer (BC) molecular subtypes and relevant changes in therapeutic interventions over the past decades, there remains a significant lack of up-to-date epidemiologic data and real-world outcomes, particularly in Central and Eastern Europe.Methods: This was a nationwide, retrospective study using the claims databases of the Hungarian National Health Insurance Fund (NHIF) that included patients who were newly diagnosed with BC between 2011 and 2020. BC subtypes were defined based on the therapies received. Overall survival (OS) and net survival rates were calculated.Results: Between 2011 and 2020, 74,143 patients were newly diagnosed with BC based on ICD-10 diagnostic codes in the NHIF database and 80.1% of the cases could be classified into subtypes based on therapy. The most common subtype was HER2–/HR+ BC, identified in 61.9% of patients, followed by triple negative breast cancer (TNBC) in 8.4%, HER2+/HR+ BC in 6.2%, and HER2+/HR- BC in 3.6% of cases. The proportions of TNBC and HER2+/HR+ were higher among younger patients, than in elderly cohorts. The 5-year OS of the total BC population was 74.2% in patients diagnosed between 2015–2019. Patients with TNBC had the poorest 5-year OS (TNBC: 61.4%; HER2+/HR+: 86.5%; HER2-/HR+: 79.1%; HER2+/HR–: 71.9%). Net survival rates (i.e. survival rates after adjusting the effects of other causes of death) varied across diagnostic periods and molecular subtypes. In most cases, patients diagnosed later during the study period tended to have numerically better survival rates. Patients with HER2–/HR+ BC had the most favorable net survival, with 5-year net survival exceeding 92% during the whole observation period, while TNBC patients had the lowest 5-year net survival rates ranging between 63.6% and 65.8% during the study period.Conclusion: Our nationwide study describes the distribution and survival of BC patients with different subtypes based on a retrospective analysis of the health insurance fund database. There remains a significant room for improvement in the survival of more aggressive molecular subtypes including HR–/HER2+ and triple-negative BC, which are more common in younger age cohorts.

Objective:Hungary has one of the highest incidences and mortality rates of lung cancer (LC), therefore the objective of this study was to analyse and compare LC incidence and mortality rates between the main Hungarian regions.Methods:This nationwide, retrospective study used data from the National Health Insurance Fund and included patients aged ≥20 years who were diagnosed with lung cancer (ICD-10 C34) between Jan 1, 2011 and Dec 31, 2016. Age-standardized incidence and mortality rates were calculated and compared for the main regions.Results:The highest incidence rate in males was recorded in Northern Hungary (146.8/100,000 person-years [PY]), while the lowest rate was found in Western Transdanubia (94.7/100,000 PY in 2011). All rates showed a declining trend between 2011 and 2016, with the largest decrease in the Northern Great Plain (−20.0%;p= 0.008). LC incidence and mortality rates in women both showed a rising tendency in all regions of Hungary, reaching the highest in Central Hungary (59.86/100,000 PY in 2016). Lung cancer incidence and mortality rates in males correlated with the level of education and smoking prevalence (p= 0.006 andp= 0.01, respectively) in the regions. A correlation with GDP per capita and Health Development Index (HDI) index could also be observed in the Hungarian regions, although these associations were not statistically significant. No correlations could be detected between these parameters among females.Conclusion:This analysis revealed considerable differences in the epidemiology of LC between the 7 main Hungarian regions. LC incidence and mortality rates significantly correlated with smoking and certain socioeconomic factors in men, but not in women. Further research is needed to explain the regional differences.

Background: This nationwide study examined breast cancer (BC) incidence and mortality rates in Hungary between 2011–2019, and the impact of the Covid-19 pandemic on the incidence and mortality rates in 2020 using the databases of the National Health Insurance Fund (NHIF) and Central Statistical Office (CSO) of Hungary.Methods: Our nationwide, retrospective study included patients who were newly diagnosed with breast cancer (International Codes of Diseases ICD)-10 C50) between Jan 1, 2011 and Dec 31, 2020. Age-standardized incidence and mortality rates (ASRs) were calculated using European Standard Populations (ESP).Results: 7,729 to 8,233 new breast cancer cases were recorded in the NHIF database annually, and 3,550 to 4,909 all-cause deaths occurred within BC population per year during 2011-2019 period, while 2,096 to 2,223 breast cancer cause-specific death was recorded (CSO). Age-standardized incidence rates varied between 116.73 and 106.16/100,000 PYs, showing a mean annual change of -0.7% (95% CI: -1.21%–0.16%) and a total change of -5.41% (95% CI: -9.24 to -1.32). Age-standardized mortality rates varied between 26.65–24.97/100,000 PYs (mean annual change: -0.58%; 95% CI: -1.31–0.27%; p=0.101; total change: -5.98%; 95% CI: -13.36–2.66). Age-specific incidence rates significantly decreased between 2011 and 2019 in women aged 50–59, 60–69, 80–89, and ≥90 years (-8.22%, -14.28%, -9.14%, and -36.22%, respectively), while it increased in young females by 30.02% (95%CI 17,01%- 51,97%) during the same period. From 2019 to 2020 (in first COVID-19 pandemic year), breast cancer incidence nominally decreased by 12% (incidence rate ratio [RR]: 0.88; 95% CI: 0.69–1.13; 2020 vs. 2019), all-cause mortality nominally increased by 6% (RR: 1.06; 95% CI: 0.79–1.43) among breast cancer patients, and cause-specific mortality did not change (RR: 1.00; 95%CI: 0.86–1.15).Conclusion: The incidence of breast cancer significantly decreased in older age groups (≥50 years), oppositely increased among young females between 2011 and 2019, while cause-specific mortality in breast cancer patients showed a non-significant decrease. In 2020, the Covid-19 pandemic resulted in a nominal, but not statistically significant, 12% decrease in breast cancer incidence, with no significant increase in cause-specific breast cancer mortality observed during 2020.