Vol 73, No 3 (2023)
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Cancer incidence and mortality in Poland in 2020

Urszula Wojciechowska1, Klaudia Barańska12, Marta Miklewska13, Joanna A. Didkowska14
Nowotwory. Journal of Oncology 2023;73(3):129-145.

Abstract

Introduction. Morbidity due to malignant neoplasms has been growing steadily during the last three decades, and cancer has become the second most widespread cause of death. The aim of this article is to present a summary of the epidemiological indicators of malignant neoplasms in Poland in 2020. 

Material and methods. In the following report, we present the latest estimates of morbidity and mortality from cancer in Poland in 2020–2022 and a wide range of information on the occurrence of registered cancer cases and deaths in 2020, according to sex, age, cancer site, or Polish administrative division. Cancer data was collected by the National Cancer Registry and the Central Statistical Office. 

Results. The PNCR received information about 146,181 new cases and 99,871 thousand cancer deaths in 2020. Compared to the previous year, the number of cancer cases decreased by about 12,000 in both sexes. 

Conclusions. An important phenomenon that appeared in 2020 was the COVID-19 pandemic. It more than likely significantly influenced cancer cases under-registration.

Special article

NOWOTWORY Journal of Oncology

2023, volume 73, number 3, 129–145

DOI: 10.5603/NJO.2021.0022

© Polskie Towarzystwo Onkologiczne

ISSN: 0029–540X, e-ISSN: 2300-2115

www.nowotwory.edu.pl

Cancer incidence and mortality in Poland in 2020

Urszula Wojciechowska1Klaudia Barańska12Marta Miklewska13Joanna A. Didkowska14
1Polish National Cancer Registry, Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw, Poland
2Faculty of Biomedical Engineering, Silesian University of Technology, Zabrze, Poland
3Department of Dietetics, Institute of Human Nutrition Sciences, Warsaw University of Life Sciences, Warsaw, Poland
4Department of Epidemiology and Cancer Prevention, Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw, Poland
Introduction. Morbidity due to malignant neoplasms has been growing steadily during the last three decades, and cancer has become the second most widespread cause of death. The aim of this article is to present a summary of the epidemiological indicators of malignant neoplasms in Poland in 2020.
Material and methods. In the following report, we present the latest estimates of morbidity and mortality from cancer in Poland in 2020–2022 and a wide range of information on the occurrence of registered cancer cases and deaths in 2020, according to sex, age, cancer site, or Polish administrative division. Cancer data was collected by the National Cancer Registry and the Central Statistical Office.
Results. The PNCR received information about 146,181 new cases and 99,871 thousand cancer deaths in 2020. Compared to the previous year, the number of cancer cases decreased by about 12,000 in both sexes.
Conclusions. An important phenomenon that appeared in 2020 was the COVID-19 pandemic. It more than likely significantly influenced cancer cases under-registration.
Key words: mortality, morbidity, neoplasms, Poland

How to cite:

Wojciechowska U, Barańska K, Miklewska M, Didkowska JA. Cancer incidence and mortality in Poland in 2020. NOWOTWORY J Oncol 2023; 73: 129–145.

This article is available in open access under Creative Common Attribution-Non-Commercial-No Derivatives 4.0 International (CC BY-NC-ND 4.0) license, allowing to download articles and share them with others as long as they credit the authors and the publisher, but without permission to change them in any way or use them commercially.

Introduction

Cancer is an increasing health problem in Poland. The number of cases has been growing steadily during the last three decades, and cancer has become the second most common cause of death, constituting nearly one-fifth of deaths (21% of deaths in 2020 [1]). At the beginning of the 2nd decade of the the 21st century, over 1.3 million Poles were living with a cancer diagnosis and it was estimated that in 2020, for every 100,000 inhabitants – 381 people were diagnosed with cancer [2]. The aim of the article is to present a summary of the epidemiological indicators of malignant neoplasms in Poland in 2020.

Material and methods

Source of data and identification of cancer cases

Data on cancer cases are derived from the Polish National Cancer Registry. The data is collected on the basis of a unified protocol valid in the whole country, which allows us to maintain the same cancer registration rules in Poland. The source of data on deaths from cancer is the Central Statistical Office. All presented data are collected following the 10th Revision of the International Classification of Diseases and Health Problems [3].

Statistical analysis

In this report, the basic statistical indicators were used: absolute numbers, percentages, crude and age-standardized the World Standard Population (ASW, Segi’s standard [4]), revised European Standard Population (ESP2013 [5]) rates, and 5-years survival rates. Projected data for 2020–2022 were estimated based on linear regression.

Results

Overall national analysis

In Poland, cancer is still a growing social problem and is both an economic and health challenge. The most common cancers in men in 2020 were (listed as the most common):

  • prostate (20%),
  • lung (16%),
  • colon (7%),
  • bladder cancers (7%).

In women, these were:

  • breast (24%),
  • lung (10%),
  • corpus uteri (7%),
  • colon (6%),
  • ovarian (4%),
  • thyroid cancers (4%) (tab. I).

Among the main causes of death, the most common cancer sites were lung cancer (26% in men and 18% in women), prostate cancer (11%) in men and breast cancer in women (15%) (tab. II). Detailed data on morbidity and mortality in women and men are presented in tables I and II, respectively.

Table I. Cancer incidence in Poland in 2020

Cancer site

ICD-10

Absolute number

Crude rate

Stand. rate (ESP2013)

Absolute number

Crude rate

Stand. rate (ESP2013)

males

females

all cancers

C00D09

72,651

391.6

466.6

73,530

371.3

351.5

oral cavity and pharynx

C00–C14

2,792

15.0

16.4

1 ,108

5.6

5.2

  • lip

C00

168

0.9

1.2

78

0.4

0.4

  • tongue

C01–C02

560

3.0

3.2

237

1.2

1.1

  • pharynx

C10–C13

668

3.6

3.8

154

0.8

0.7

digestive organs

C15–C26

16,111

86.8

104.3

12,415

62.7

58.9

  • oesophagus

C15

976

5.3

5.9

343

1.7

1.6

  • stomach

C16

2,856

15.4

18.8

1,649

8.3

7.8

  • small intestine

C17

181

1.0

1.1

166

0.8

0.8

  • colon

C18

4,978

26.8

33.1

4,366

22.0

20.7

  • rectosigmoid junction

C19

823

4.4

5.4

592

3.0

2.8

  • rectum

C20

3,126

16.9

19.9

1,931

9.8

9.2

  • anus and anal canal

C21

83

0.4

0.5

192

1.0

0.9

  • colorectum

C18–C21

9,010

48.6

58.9

7,081

35.8

33.6

  • liver

C22

759

4.1

4.8

505

2.6

2.4

  • gallbladder and biliary tract

C23–C24

506

2.7

3.4

761

3.8

3.6

  • pancreas

C25

1,747

9.4

11.0

1,808

9.1

8.6

respiratory system

C30–C39

13,318

71.8

83.7

7,776

39.3

36.4

  • larynx

C32

1,499

8.1

8.9

260

1.3

1.2

  • trachea and lung

C33–C34

11,534

62.2

73.1

7,309

36.9

34.2

bone and articular cartilage

C40–C41

167

0.9

0.9

145

0.7

0.7

neoplasms of skin

C43–C44

6,702

36.1

48.4

7,135

36.0

33.9

  • melanoma

C43

1 565

8.4

9.9

1,680

8.5

8.1

  • other neoplasms of skin

C44

5,137

27.7

38.5

5,455

27.5

25.7

mesothelial and soft tissue

C45–C49

792

4.3

4.9

679

3.4

3.3

breast

C50

113

0.6

0.7

17,511

88.4

84.4

female genital organs

C51–C58

10,912

55.1

52.4

  • vulva and vagina

C51–C52

547

2.8

2.6

  • cervix uteri

C53

1,920

9.7

9.2

  • corpus uteri

C54

5,238

26.5

25.1

  • ovary

C56

3,012

15.2

14.6

male genital organs

C60–C63

15,691

84.6

99.3

  • penis

C60

273

1.5

1.8

  • prostate

C61

14,244

76.8

91.7

  • testis

C62

1,156

6.2

5.6

urinary tract

C64–C68

7,826

42.2

51.0

3,466

17.5

16.5

  • kidney and renal pelvis

C64–C65

2,892

15.6

17.7

1,878

9.5

9.0

  • urinary bladder

C67

4,815

26.0

32.5

1,516

7.7

7.1

eye

C69

206

1.1

1.2

219

1.1

1.1

central nervous system

C70–C72

1,353

7.3

7.9

1,229

6.2

6.0

  • brain

C71

1,293

7.0

7.5

1,156

5.8

5.6

endocrine glands

C73–C75

648

3.5

3.6

2,788

14.1

13.7

  • thyroid gland

C73

574

3.1

3.1

2,699

13.6

13.3

ill-defined, secondary and unspecified sites

C76–C80

1 494

8.1

10.0

1,402

7.1

6.6

lymphoid, haematopoietic and related tissue

C81–C96

4,235

22.8

26.3

3,896

19.7

18.9

  • Hodgkin lymphoma

C81

340

1.8

1.8

341

1.7

1.7

  • non-Hodgkin lymphoma

C82–C85

1,525

8.2

9.4

1,439

7.3

6.9

  • immunoproliferative diseases

C88

28

0.2

0.2

32

0.2

0.2

  • multiple myeloma

C90

714

3.8

4.6

730

3.7

3.5

  • lymphoid leukaemia

C91

949

5.1

6.1

712

3.6

3.5

  • myeloid leukaemia

C92

550

3.0

3.4

505

2.6

2.4

  • all leukaemias

C91–C95

1,610

8.7

10.2

1,322

6.7

6.4

  • other and unspecified neoplasms of lymphoid, haematopoietic and related tissue

C96

18

0.1

0.1

32

0.2

0.1

primary multiple sites

C97

0

0.0

0.0

0

0.0

0.0

cancers in situ

D00–D09

1,203

6.5

8.1

2,849

14.4

13.7

Table II. Cancer deaths in Poland in 2020

Cancer site

ICD-10

Absolute number

Crude rate

Stand. rate (ESP2013)

Absolute number

Crude rate

Stand. rate (ESP2013)

males

females

all cancers

C00D09

54,370

293.1

377.7

45,501

229.8

213.9

oral cavity and pharynx

C00–C14

2,253

12.1

13.4

764

3.9

3.6

  • lip

C00

79

0.4

0.6

37

0.2

0.2

  • tongue

C01–C02

430

2.3

2.5

141

0.7

0.7

  • pharynx

C10–C13

609

3.3

3.6

137

0.7

0.6

digestive organs

C15–C26

16,133

87.0

111.3

12,066

60.9

56.7

  • oesophagus

C15

1,227

6.6

7.6

355

1.8

1.7

  • stomach

C16

3,115

16.8

21.6

1,657

8.4

7.8

  • small intestine

C17

126

0.7

0.8

105

0.5

0.5

  • colon

C18

4,415

23.8

32.3

3,535

17.9

16.6

  • rectosigmoid junction

C19

424

2.3

3.0

326

1.6

1.5

  • rectum

C20

2,213

11.9

15.6

1,345

6.8

6.3

  • anus and anal canal

C21

129

0.7

0.9

115

0.6

0.5

  • colorectum

C18–C21

7,181

38.7

51.8

5,321

26.9

24.9

  • liver

C22

1,265

6.8

8.3

875

4.4

4.1

  • gallbladder and biliary tract

C23–C24

592

3.2

4.1

988

5.0

4.7

  • pancreas

C25

2,431

13.1

15.7

2,542

12.8

12.0

respiratory system

C30–C39

15,926

85.8

104.3

8,404

42.4

39.2

  • larynx

C32

1,409

7.6

8.9

195

1.0

0.9

  • trachea and lung

C33–C34

14,229

76.7

93.5

8,009

40,4

37.3

bone and articular cartilage

C40–C41

167

0.9

1.1

145

0.7

0.7

neoplasms of skin

C43–C44

1,432

7.7

11.5

1,401

7.1

6.4

  • melanoma

C43

762

4.1

5.4

668

3.4

3.1

  • other neoplasms of skin

C44

670

3.6

6.1

733

3.7

3.3

mesothelial and soft tissue

C45–C49

570

3.1

3.7

460

2.3

2.2

breast

C50

77

0.4

0.6

6,956

35.1

32.9

female genital organs

C51–C58

6,811

34.4

32.3

  • vulva and vagina

C51–C52

409

2.1

1.9

  • cervix uteri

C53

1,511

7.6

7.2

  • corpus uteri

C54

1,811

9.1

8.5

  • ovary

C56

2,688

13.6

12.8

male genital organs

C60–C63

6,010

32.4

48.4

  • penis

C60

110

0.6

0.8

  • prostate

C61

5,748

31.0

46.7

  • testis

C62

137

0.7

0.7

urinary tract

C64–C68

4,802

25.9

35.4

1,967

9.9

9.3

  • kidney and renal pelvis

C64–C65

1,521

8.2

10.4

1,001

5.1

4.8

  • urinary bladder

C67

3,202

17.3

24.4

915

4.6

4.3

eye

C69

57

0.3

0.4

54

0.3

0.3

central nervous system

C70–C72

1,621

8.7

10.0

1,432

7.2

6.8

  • brain

C71

1,571

8.5

9.7

1,365

6.9

6.5

endocrine glands

C73–C75

187

1.0

1.2

283

1.4

1.4

  • thyroid gland

C73

125

0.7

0.8

222

1.1

1.1

ill-defined, secondary and unspecified sites

C76–C80

1,768

9.5

12.5

1,775

9.0

8,2

lymphoid, haematopoietic and related tissue

C81–C96

3,304

17.8

23.5

2,945

14.9

13.9

  • Hodgkin lymphoma

C81

102

0.5

0.6

65

0.3

0.3

  • non-Hodgkin lymphoma

C82–C85

921

5.0

6.5

769

3.9

3.6

  • immunoproliferative diseases

C88

27

0.1

0.2

13

0.1

0.1

  • multiple myeloma

C90

680

3.7

4.8

770

3.9

3.7

  • lymphoid leukaemia

C91

706

3.8

5.3

578

2.9

2.7

  • myeloid leukaemia

C92

666

3.6

4.6

586

3.0

2.8

  • all leukaemias

C91–C95

1,509

8.1

11.0

1,280

6.5

6.0

  • other and unspecified neoplasms of lymphoid, haematopoietic and related tissue

C96

65

0.4

0.4

48

0.2

0.2

primary multiple sites

C97

60

0.3

0.4

37

0.2

0.2

cancers in situ

D00–D09

3

0.0

0.0

1

0.0

0.0

Table IV. Cancer deaths in Poland in 2019 and estimates for 2022. Data for 2022 is estimated on the basis of the trend from 2010–2019

Cancer site

ICD-10

2019 observed

2022 expected

Absolute number

Crude rate

Standardized rate (ESP2013)

Absolute number

Crude rate

Standardized rate (ESP2013)

males

Cancer site

ICD-10

2019 observed

2022 expected

Absolute number

Crude rate

Standardized rate (ESP2013)

Absolute number

Crude rate

Standardized rate (ESP2013)

males

all cancers

C00D09

54,370

292.8

382.6

54,601

298.7

382.2

oesophagus

C15

1,311

7.1

8.2

1,262

6.9

7.7

stomach

C16

3,116

16.8

21.7

2,816

15.4

19.5

colorectum

C81–C21

7,047

37.9

51.9

7,357

40.2

53.6

pancreas

C25

2,435

13.1

16.1

2,455

13.4

16.2

larynx

C32

1,267

6.8

7.9

1,327

7.3

8.4

lung

C33–C34

14,921

80.4

99.7

14,383

78.7

95.0

melanoma

C43

788

4.2

5.8

812

4.4

6.1

prostate

C61

5,618

30.3

46.4

6,202

33.9

50.5

kidney

C64

1,504

8.1

10.5

1,524

8.3

10.6

urinary bladder

C67

3,131

16.9

24.2

3,305

18.1

25.6

brain

C71

1,462

7.9

9.3

1,511

8.3

9.5

Hodgkin lymphoma

C81

89

0.5

0.5

88

0.5

0.5

non-Hodgkin lymphomas

C82–C85 + C96

1,022

5.5

7.2

1,134

6.2

8.0

leukaemias

C91–C95

1,553

8.4

11.5

1,555

8.5

11.4

females

all cancers

C00D09

45,954

231.9

219.3

47,467

242.8

221.0

stomach

C16

1,716

8.7

8.2

1,653

8.5

7.7

colorectum

C81–C21

5,343

27.0

25.5

5,478

28.0

25.6

gallbladder

C23–C24

1,176

5.9

5.6

1,026

5.2

4.7

pancreas

C25

2,633

13.3

12.5

2,663

13.6

12.4

lung

C33–C34

8,215

41.5

38.9

9,133

46.7

41.8

melanoma

C43

676

3.4

3.2

720

3.7

3.3

breast

C50

6,951

35.1

33.3

7,549

38.6

35.5

cervix uteri

C53

1,569

7.9

7.5

1,484

7.6

6.9

corpus uteri

C54

1,859

9.4

8.9

2,214

11.3

10.3

ovary

C56

2,777

14.0

13.4

2,845

14.6

13.5

kidney

C64

947

4.8

4.5

909

4.7

4.2

urinary bladder

C67

1,017

5.1

4.8

1,082

5.5

5.0

brain

C71

1,288

6.5

6.3

1,312

6.7

6.2

thyroid gland

C73

181

0.9

0.9

231

1.2

1.1

Hodgkin lymphoma

C81

84

0.4

0.4

74

0.4

0.4

non-Hodgkin lymphomas

C82–C85+C96

882

4.5

4.2

951

4.9

4.5

leukaemias

C91–C95

1,308

6.6

6.3

1,357

6.9

6.3

Predictions for 2020 and 2022

The precise number of cancer cases in 2022 is still unknown due to collecting data method (a 2 year delay to ensure completeness of data). The prediction of the incidence in 2020 and 2022 was made based on the trend from 2010–2019. The results of the morbidity and mortality are presented in tables III and IV, respectively.

Table III. Cancer cases in Poland in 2019 and estimates for 2022. Data for 2022 is estimated on the basis of the trend from 2010–2019

Cancer site

ICD-10

2019 observed

2022 expected

Absolute number

Crude rate

Standardized rate (ESP2013)

Absolute number

Crude rate

Standardized rate (ESP2013)

males

Cancer site

ICD-10

2019 observed

2022 expected

Absolute number

Crude rate

Standardized rate (ESP2013)

Absolute number

Crude rate

Standardized rate (ESP2013)

males

all cancers

C00D09

85,559

460.75

563.73

89,699

490.7

575.4

oesophagus

C15

1,139

6.13

6.95

1,214

6.6

7.2

stomach

C16

3,230

17.39

21.59

3,063

16.8

20.1

colorectum

C81–C21

10,397

55.99

69.92

11,155

61.0

73.2

pancreas

C25

1,920

10.34

12.16

1,868

10.2

11.7

larynx

C32

1,688

9.09

10.19

1,638

9.0

9.8

lung

C33–C34

13,819

74.42

89.24

12,659

69.2

79.8

melanoma

C43

1,749

9.42

11.28

2,073

11.3

13.1

prostate

C61

17,638

94.98

117.93

21,093

115.4

133.5

kidney

C64

3,214

17.31

19.71

3,372

18.4

20.3

urinary bladder

C67

5,482

29.52

38.04

5,696

31.2

38.3

brain

C71

1,382

7.44

8.24

1,291

7.1

7.6

Hodgkin lymphoma

C81

365

1.97

1.98

346

1.9

1.9

non-Hodgkin lymphomas

C82–C85 + C96

1,682

9.06

10.71

1,732

9.5

11.0

leukaemias

C91–C95

1,995

10.74

13.06

2,044

11.2

13.1

females

all cancers

C00D09

85,659

432.25

413.26

89,815

459.50

425.99

stomach

C16

1,870

9.44

9.01

1,862

9.53

8.77

colorectum

C81–C21

8,117

40.96

39.04

8,554

43.76

40.39

gallbladder

C23–C24

892

4.50

4.24

746

3.82

3.45

pancreas

C25

1,932

9.75

9.20

1,990

10.18

9.28

lung

C33–C34

8,480

42.79

40.15

9,198

47.06

41.97

melanoma

C43

1,940

9.79

9.41

2,282

11.67

10.95

breast

C50

19,620

99.01

95.23

20,413

104.44

97.79

cervix uteri

C53

2,407

12.15

11.58

2,085

10.67

9.87

corpus uteri

C54

6,023

30.39

29.16

6,581

33.67

31.30

ovary

C56

3,710

18.72

18.12

3,786

19.37

18.30

kidney

C64

2,000

10.09

9.75

2,108

10.78

9.95

urinary bladder

C67

1,851

9.34

8.76

2,083

10.66

9.60

brain

C71

1,172

5.91

5.72

1,115

5.70

5.42

thyroid gland

C73

3,490

17.61

17.19

4,206

21.52

20.83

Hodgkin lymphoma

C81

334

1.69

1.70

333

1.71

1.73

non-Hodgkin lymphomas

C82–C85+C96

1,702

8.59

8.21

1,722

8.81

8.18

leukaemias

C91–C95

1,567

7.91

7.67

1,637

8.37

7.86

It is estimated that in 2022 the number of cancer cases will increase and the most frequently diagnosed cancer in men will be:

  • prostate (24%),
  • lung (14%),
  • colorectal cancer (C18–C21 – 12%),

and in women:

  • breast (23%),
  • lung (10%),
  • colorectal cancer (C18–C21 – 10%).

There will be cancers, which will also be the main causes of death. Estimated incidence and death rates for the most common cancers in 2022 are presented in table V. However, a noticeable reduction in the incidence of stomach, lung and brain cancers in men and gallbladder, cervix uteri and brain cancers in women is expected. Unfortunately, in man, colorectal, prostate and bladder and in woman, lung, breast, and corpus uteri cancer-related mortality is expected to increase in 2020.

Table V. Estimated cancer cases and deaths numbers in 2022 from the most common cancers in women and men

Cancer site

Cancer cases

Cancer deaths

males

all cancers

89,699

100%

all cancers

54,370

100%

prostate

21,093

24%

lung

14,921

27%

lung

12,659

14%

colorectum

7,047

13%

colorectum

11,155

12%

prostate

5,618

10%

urinary bladder

5,696

6%

urinary bladder

3,131

6%

kidney

3,372

4%

stomach

3,116

6%

stomach

3,063

3%

leukaemias

1,553

3%

melanoma

2,073

2%

kidney

1,504

3%

leukaemias

2,044

2%

larynx

1,267

2%

non-Hodgkin lymphomas

1,732

2%

non-Hodgkin lymphomas

1,022

2%

larynx

1,638

2%

melanoma

788

1%

females

all cancers

89,815

100%

all cancers

47,467

100%

breast

20,413

23%

lung

9,133

19%

lung

9,198

10%

breast

7,549

16%

colorectum

8,554

10%

colorectum

5,478

12%

corpus uteri

6,581

7%

ovary

2,845

6%

ovary

3,786

4%

corpus uteri

2,214

5%

melanoma

2,282

3%

stomach

1,653

3%

kidney

2,108

2%

cervix uteri

1,484

3%

cervix uteri

2,085

2%

leukaemias

1,357

3%

urinary bladder

2,083

2%

urinary bladder

1,082

2%

stomach

1,862

2%

non-Hodgkin lymphomas

951

2%

non-Hodgkin lymphomas

1,722

2%

kidney

909

2%

leukaemias

1,637

2%

melanoma

720

2%

The observed number of cancer cases in 2020 compared to the predicted values is lower in all cancer groups (tab. VI). Comparing the observed mortality rates in 2020 to the expected ones, it can be seen that they are lower in almost all presented cancer groups (except for laryngeal cancer in men and brain cancer in both sexes) – table VII. Therefore, there is a noticeable change in the trend of both morbidity and mortality in 2020.

Table VI. The incidence of the most common cancers in 2020 – observed and expected values (estimation based on the trend from 2010–2019)

Cancer site

ICD–10

2020 observed

2020 expected

Absolute number

Crude rate

Standardized rate (ESP2013)

Absolute number

Crude rate

Standardized rate (ESP2013)

males

Cancer site

ICD–10

2020 observed

2020 expected

Absolute number

Crude rate

Standardized rate (ESP2013)

Absolute number

Crude rate

Standardized rate (ESP2013)

males

all cancers

C00D09

72,651

391.6

466.6

88,772

478.5

573.5

oesophagus

C15

976

5.3

5.9

1,203

6.5

7.2

stomach

C16

2,856

15.4

18.8

3,252

17.5

21.5

colorectum

C81–C21

9,010

48.6

58.9

11,049

59.6

73.1

pancreas

C25

1,747

9.4

11.0

1,887

10.2

11.9

larynx

C32

1,499

8.1

8.9

1,762

9,5

10.5

lung

C33–C34

11,534

62.2

73.1

13,508

72.8

85.6

melanoma

C43

1,565

8.4

9.9

1,963

10.6

12.4

prostate

C61

14,244

76.8

91.7

19,333

104.2

125.0

kidney

C64

2,727

14.7

16.6

3,340

18.0

20.2

urinary bladder

C67

4,815

26.0

32.5

5,720

30.8

38.8

brain

C71

1,293

7.0

7.5

1,340

7.2

7.9

Hodgkin lymphoma

C81

354

1.9

1.9

354

1.9

1.9

non-Hodgkin lymphomas

C82–C85 + C96

1,543

8.3

9.5

1,726

9.3

10.9

leukaemias

C91–C95

1,610

8.7

10.2

2,023

10.9

13.0

females

all cancers

C00D09

73,530

371.3

351.5

88,162

445.21

419.8

stomach

C16

1,649

8.3

7.8

1,911

9.65

9.1

colorectum

C81–C21

7,081

35.8

33.6

8,508

42.96

40.4

gallbladder

C23–C24

761

3.8

3.6

894

4.5

4.2

pancreas

C25

1,808

9.1

8.6

1,965

9.9

9.2

lung

C33–C34

7,309

36.9

34.2

8,759

44.23

40.5

melanoma

C43

1,680

8.5

8.1

2,157

10.89

10.4

breast

C50

17,511

88.4

84.4

19,907

100.53

95.7

cervix

C53

1,920

9.7

9.2

2,288

11.55

10.9

uterus

C54

5,238

26.5

25.1

6,451

32.58

30.8

ovary

C56

3,012

15.2

14.6

3,798

19.18

18.4

kidney

C64

1,755

8.9

8.4

2,093

10.57

10.0

urinary bladder

C67

1,516

7.7

7.1

1,983

10.01

9.2

brain

C71

1,156

5.8

5.6

1,179

6.0

5.7

thyroid

C73

2,699

13.6

13.3

3,848

19.4

18.9

Hodgkin lymphoma

C81

341

1.7

1.7

343

1.7

1.7

non-Hodgkin lymphomas

C82–C85 + C96

1,471

7.4

7.1

1,694

8.56

8.1

leukaemias

C91–C95

1,322

6.7

6.4

1,619

8.17

7.8

Table VII. Deaths from the most common cancers in 2020 – observed and expected values (estimation based on the trend from 2010–2019)

Cancer site

ICD-10

2020 observed

2020 expected

Absolute number

Crude rate

Standardized rate (ESP2013)

Absolute number

Crude rate

Standardized rate (ESP2013)

males

Cancer site

ICD-10

2020 observed

2020 expected

Absolute number

Crude rate

Standardized rate (ESP2013)

Absolute number

Crude rate

Standardized rate (ESP2013)

males

all cancers

C00D09

54,370

293.1

377.7

55,999

301.9

390.1

oesophagus

C15

1,227

6.6

7.6

1,275

6.9

7.8

stomach

C16

3,115

16.8

21.6

3,062

16.5

21.2

colorectum

C81–C21

7,181

38.7

51.8

7,342

39.6

53.4

pancreas

C25

2,431

13.1

15.7

2,500

13.5

16.5

larynx

C32

1,409

7.6

8.9

1,370

7.4

8.6

lung

C33–C34

14,229

76.7

93.5

15,242

82.2

100.6

melanoma

C43

762

4.1

5.4

809

4.4

5.9

prostate

C61

5,748

31.0

46.7

6,010

32.4

48.8

kidney

C64

1,434

7.7

9.8

1,589

8.6

11.0

urinary bladder

C67

3,202

17.3

24.4

3,284

17.7

25.2

brain

C71

1,571

8.5

9.7

1,535

8.3

9.7

Hodgkin lymphoma

C81

102

0.5

0.6

94

0.5

0.6

non-Hodgkin lymphomas

C82–C85 + C96

986

5.3

6.9

1,105

6.0

7.7

leukaemias

C91–C95

1,509

8.1

11.0

1,595

8.6

11.6

females

all cancers

C00D09

45,501

229.8

213.9

47,325

239.0

221.4

stomach

C16

1,657

8.4

7.8

1,743

8.8

8.2

colorectum

C81–C21

5,321

26.9

24.9

5,529

27.9

25.9

gallbladder

C23–C24

988

5.0

4.7

1,117

5.6

5.2

pancreas

C25

2,542

12.8

12.0

2,652

13.4

12.4

lung

C33–C34

8,009

40.4

37.3

8,719

44.0

40.3

melanoma

C43

668

3.4

3.1

719

3.6

3.3

breast

C50

6,956

35.1

32.9

7,305

36.9

34.4

cervix

C53

1,511

7.6

7.2

1,549

7.8

7.3

uterus

C54

1,811

9.1

8.5

2,039

10.3

9.5

ovary

C56

2,688

13.6

12.8

2,832

14.3

13.5

kidney

C64

946

4.8

4.5

948

4.8

4.4

urinary bladder

C67

915

4.6

4.3

1,025

5.2

4.7

brain

C71

1,365

6.9

6.5

1,351

6.8

6.5

thyroid

C73

222

1.1

1.1

226

1.1

1.1

Hodgkin lymphoma

C81

65

0.3

0.3

75

0.4

0.4

non-Hodgkin lymphomas

C82–C85 + C96

817

4.1

3.9

938

4.7

4.4

leukaemias

C91–C95

1,280

6.5

6.0

1,364

6.9

6.4

Incidence time-trends

The number of cases in men for the first three analyzed decades was higher than the number of cases in women. In 2007, this changed and the number of cases in both sexes is similar. The number of deaths in men had an upward trend until 2012, after which it stabilized. For women, the number of deaths has been steadily increasing since 1965.

The standardized rate of incidence in women and men shows an upward trend throughout the observed period. Since 1992, the trend has been flattening for men. The standardized rate of death in men had been increasing until 2002, after which it has begun to decrease. Among women throughout the observed period, the standardized death rate remains at a similar level without any particular deviations (fig. 1).

Figure 1. Cancer morbidity and mortality trends in Poland in 1965–2022*

Until 2013, lung cancer was the leading cancer among men. After changing from an ascending to a declining trend in the 1990s, the continued decline led to the prostate becoming the first cancer in 2016. In third place for most of the observed time is colorectal cancer (fig. 2).

Figure 2. Incidence trends of the leading cancer sites for males, Poland 1980–2022 (2021–2022 estimation)

Throughout the observed period, breast cancer has been the main cancer among women. In the last 2–3 years, colorectal cancer and lung cancer rank second ex aequo; previously, colorectal cancer had a higher morbidity than lung cancer (fig. 3).

Figure 3. Incidence trends of the leading cancer sites for females, Poland 1980–2022 (2021–2022 estimation)

Lung cancer is the most common single cause of death in men. Lung cancer mortality had been increasing in the second part of the 20th century, but since the start of the 21st, the death rate has been declining. Colorectal cancer, the second most common cause of death, was characterized by an increasing mortality trend until the mid-first decade of the 21st century, after which there was a clear slowdown in the growth rate. The third common cancer cause of death since the beginning of the 21st century is prostate cancer, with stabilized level of mortality (fig. 4).

Figure 4. Mortality trends of the leading cancer sites for males, Poland 1980–2022 (2021–2022 estimation)

Breast cancer was the most frequent cancer-related cause of death in the female population from the middle of the 1970s through the middle of the 2000s. Since 2007, cancer deaths have been most often caused by lung cancer. It is noteworthy that the decreased trend in breast cancer mortality was reversed in 2010. Lung cancer has replaced breast cancer as the top cause of cancer-related fatalities in women for more than ten years. Since the beginning of the twentieth century, the mortality rate for colorectal cancer in women has been decreasing. In the past 50 years, the mortality rate from stomach cancer has fallen by a factor of four. Additionally, over this time period, there is a declension in cervical cancer mortality (fig. 5). Stomach cancer is characterized by downward trend in both mortality and incidence throughout the observed period (about 40 years) (fig. 2–5).

Figure 5. Mortality trends of the leading cancer sites for females, Poland 1980–2022 (2021–2022 estimation)
Age group analysis

The incidence and mortality of malignant tumors varies with the age of the patient. In children, both among girls and boys, leukaemia is the main diagnosis. In second place are cancers of the brain and central nervous system.

In men, the incidence varies with age. Testicular cancer is the most common cancer diagnosed in young men. In the age group 45–64, the main diagnosis was lung cancer, and in older men over 65, prostate cancer. In men over 45, lung cancer remains the most common cause of death. In women over 20 years of age, the most frequently diagnosed cancer was breast cancer. Between the ages of 20 and 44, it was also the leading cause of cancer death. The highest morbidity and mortality for this cancer site were noted in patients over 65 years of age.

In adult women and men, cancers of the lungs and the second intestine were among the most frequently diagnosed causes of cancer-related deaths, regardless of age. The exact incidence and mortality values for the most common cancers by sex and age are presented in tables VIII and IX, respectively.

Table VIII. The incidence of the 5 most common cancer sites in Poland in 2020, depending on sex and age

Males

age: 019

age: 2044

age: 4564

age: 65+

number

%

number

%

number

%

number

%

all cancers

all cancers

all cancers

all cancers

550

3,578

21,625

46,898

leukaemias (C91–C95)

testis (C62)

lung (C33–C34)

prostate (C61)

173

31%

914

26%

3,599

17%

10,684

23%

brain and CNS (C71–C72)

colorectum (C18–C21)

prostate (C61)

lung (C33–C34)

85

15%

254

7%

3,540

16%

7,840

17%

non-Hodgkin lymphomas (C82–C85 + C96)

melanoma (C43)

colorectum (C18–C21)

colorectum (C18–C21)

44

8%

238

7%

2,774

13%

5,975

13%

Hodgkin lymphoma (C81)

non-Hodgkin lymphomas
(C82–C85 + C96)

urinary bladder (C67)

urinary bladder (C67)

40

7%

231

6%

1,157

5%

3 ,008

8%

connective and soft tissue (C49)

brain and CNS (C71–C72)

kidney (C64)

stomach (C16)

32

6%

233

6%

1,065

5%

1,911

4%

Females

age: 019

age: 2044

age: 4564

age: 65+

aumber

%

number

%

number

%

number

%

all cancers

all cancers

all cancers

all cancers

532

7,421

25,083

40,494

leukaemias (C91–C95)

breast (C50)

breast (C50)

breast (C50)

151

28%

2,170

29%

7,790

31%

7,551

19%

brain and CNS (C71–C72)

thyroid gland (C73)

lung (C33–C34)

lung (C33–C34)

59

11%

1,160

16%

2,160

9%

5,071

13%

Hodgkin lymphoma (C81)

cervix uteri in situ (D06)

corpus uteri (C54)

colorectum (C18–C21)

53

10%

758

10%

2,154

9%

4,848

12%

thyroid gland (C73)

melanoma (C43)

colorectum (C18-C21)

corpus uteri (C54)

46

9%

416

6%

1 ,987

8%

2,920

7%

kidney (C64)

cervix uteri (C53)

ovary (C56)

ovary (C56)

29

5%

378

5%

1,344

5%

1,313

3%

Table IX. The mortality of the 5 most common cancer sites in Poland in 2020, depending on sex and age

Males

age: 019

age: 2044

age: 4564

age: 65+

number

%

number

%

number

%

number

%

all cancers

all cancers

all cancers

all cancers

113

1,038

13,917

39,302

brain and CNS (C71–C72)

brain and CNS (C71–C72)

lung (C33–C34)

lung (C33–C34)

47

42%

146

14%

4,001

29%

10,151

26%

leukaemias (C91–C95)

colorectum (C18–C21)

colorectum (C18–C21)

colorectum (C18–C21)

23

20%

100

10%

1,550

11%

5,531

14%

connective and soft tissue (C49)

lung (C33–C34)

stomach (C16)

prostate (C61)

9

8%

77

7%

839

6%

5,249

13%

bone and articular cartilage

(C40–C41)

testis (C62)

pancreas (C25)

urinary bladder (C67)

6

5%

73

7%

798

6%

2,679

7%

peripheral nerves and autonomic nervous system (C47)

stomach (C16)

brain and CNS (C71–C72)

stomach (C16)

6

5%

70

7%

599

4%

2,206

6%

Females

age: 019

age: 2044

age: 4564

age: 65+

number

%

number

%

number

%

number

%

all cancers

all cancers

all cancers

all cancers

78

1,133

10,500

33,790

brain and CNS (C71–C72)

breast (C50)

lung (C33–C34)

lung (C33–C34)

24

31%

328

29%

2,097

20%

5,869

17%

leukaemias (C91–C95)

colorectum (C18–C21)

breast (C50)

breast (C50)

21

27%

105

9%

1,881

18%

4,747

14%

connective and soft tissue (C49)

cervix uteri (C53)

colorectum (C18–C21)

colorectum (C18–C21)

12

15%

99

9%

972

9%

4,244

13%

bone and articular cartilage

(C40–C41)

ovary (C56)

ovary (C56)

pancreas (C25)

6

8%

88

8%

916

9%

1,952

6%

kidney (C64)

brain and CNS
(C71–C72)

cervix uteri (C53)

ovary (C56)

4

5%

86

8%

568

5%

1,683

5%

Spatial analysis and clustering

In 2020, among men and women, the highest cancer morbidity rates were observed in the western part of Poland, and the lowest cancer morbidity occurred in the southeastern area. In 2020, in most voivodships, the most frequent cancer in men was prostate cancer. In 15 voivodships the most lethal cancers among men are lung cancer, colorectal cancer and prostate cancer (tab. X).

Table X. Standardized rates of morbidity and mortality for the most common malignant neoplasms in men in Poland in 2020 by voivodships

Voivodship

All cancers

Stomach

Colorectum1

Pancreas

Lung

Melanoma

Prostate

Kidney

Bladder

Non-Hodgkin lymphomas2

Leukaemias3

incidence rates (ESP2013)

Dolnośląskie

516.4

20.3

66.9

14.2

80.2

11.3

94.4

19.6

43.0

9.9

12.6

Kujawsko-pomorskie

540.2

22.0

68.6

11.8

101.0

10.5

101.0

23.6

40.9

9.0

6.4

Lubelskie

448.0

16.7

58.0

10.5

62.8

9.0

89.2

17.3

35.6

8.6

10.9

Lubuskie

421.5

16.6

55.3

10.1

60.7

5.6

94.3

18.2

42.7

6.7

8.5

Łódzkie

430.0

20.2

57.2

10.1

69.4

12.1

78.3

13.3

22.5

9.9

17.6

Małopolskie

406.0

15.8

45.6

8.7

67.5

8.5

81.0

10.9

22.3

8.5

9.1

Mazowieckie

401.3

16.4

51.1

10.8

63.7

11.2

71.9

15.0

24.3

11.1

7.4

Opolskie

458.8

15.4

55.3

10.6

65.2

7.7

89.0

16.3

37.2

7.1

7.5

Podkarpackie

467.8

22.4

60.9

11.2

60.9

10.7

84.5

17.1

26.3

11.0

13.0

Podlaskie

420.7

17.8

65.0

9.7

58.1

9.8

92.7

18.5

32.1

7.9

6.7

Pomorskie

465.5

15.7

48.5

9.1

77.4

7.8

103.6

19.7

39.8

10.2

6.5

Śląskie

522.0

22.9

65.2

11.4

82.1

8.6

117.1

16.4

33.9

9.5

10.7

Świętokrzyskie

479.3

15.6

52.4

12.3

72.2

11.7

93.3

13.6

42.0

11.9

15.2

Warmińsko-mazurskie

480.1

22.5

65.6

9.4

88.6

10.1

79.8

14.8

36.1

9.1

15.3

Wielkopolskie

545.7

18.9

75.0

13.8

79.4

10.0

105.4

20.4

32.0

10.4

10.1

Zachodniopomorskie

430.2

17.6

50.6

7.7

67.1

11.4

83.2

13.8

38.4

5.2

7.5

Poland

466.6

18.8

58.9

11.0

73.1

9.9

91.7

16.6

32.5

9.5

10.2

mortality rates (ESP2013)

Dolnośląskie

419.6

24.7

58.8

17.0

105.9

4.8

53.5

14.8

28.3

6.8

11.0

Kujawsko-pomorskie

416.6

24.4

62.7

16.0

106.0

6.0

49.8

8.8

29.3

7.7

11.7

Lubelskie

350.4

21.2

45.1

14.1

95.4

4.2

40.8

9.8

19.0

7.1

11.6

Lubuskie

396.2

23.8

53.9

16.9

101.9

6.8

53.0

10.3

29.2

5.7

6.5

Łódzkie

365.4

20.7

47.5

13.1

91.5

7.9

42.7

8.7

24.8

5.0

13.0

Małopolskie

367.0

21.6

47.5

14.4

85.6

6.1

43.2

9.9

25.1

6.5

11.8

Mazowieckie

363.3

18.5

48.5

15.1

92.0

5.8

47.4

8.7

22.2

7.3

9.3

Opolskie

351.5

17.4

56.1

15.3

75.9

3.7

38.0

10.7

25.6

5.5

10.6

Podkarpackie

323.8

21.1

44.0

16.3

65.0

5.0

48.4

7.5

20.7

8.2

11.5

Podlaskie

351.5

15.8

52.8

14.4

93.5

6.1

44.7

10.7

22.0

5.3

11.9

Pomorskie

383.8

21.5

49.1

18.4

100.0

4.9

48.4

10.8

24.7

7.8

9.0

Śląskie

373.4

23.2

52.9

15.5

84.3

4.8

46.4

9.5

22.6

6.1

10.8

Świętokrzyskie

350.8

20.5

44.1

14.6

92.1

5.2

42.3

7.4

21.1

6.7

10.6

Warmińsko-mazurskie

391.7

25.4

53.2

13.1

97.1

3.1

49.2

10.6

26.0

12.1

12.0

Wielkopolskie

429.9

24.9

63.4

18.2

112.5

5.2

49.9

10.2

28.4

7.8

11.6

Zachodniopomorskie

389.9

20.3

51.3

18.0

100.0

5.1

44.8

9.4

26.0

5.6

12.4

Poland

377.7

21.6

51.8

15.7

93.5

5.4

46.7

9.8

24.4

6.9

11.0

Among women in all voivodships, the leading cancer site is the breast. Two patterns can be identified among the incidences. The first pattern present in mainly central and northern Poland is characterized by the second and third sites of lung cancer and colorectal cancer, respectively. Colorectal cancer takes second place and lung cancer is third in the second pattern found in the rest of Poland.

Among cancer deaths in women, two patterns also noted. In the first pattern, the most lethal is breast cancer, followed by lung cancer and it concerns the southern part of Poland and one voivodship from the eastern-northern part. In the second pattern, in the rest of the country, the situation is reversed – among cancer mortality, lung cancer leads, followed by breast cancer. In both cases, colorectal cancer ranks third among cancer deaths in women (tab. XI).

Table XI. Standardized rates of morbidity and mortality for the most common malignant neoplasms in women in Poland in 2020 by voivodships

Voivodship

All cancers

Colorectum1

Lung

Breast

Cervix uteri

Corpus uteri

Ovary

Kidney

Bladder

non-Hodgkin lymphomas2

Leukaemias3

incidence rates (ESP2013)

Dolnośląskie

388.4

38.8

42.0

90.4

10.6

26.1

15.3

8.0

8.6

7.4

8.8

Kujawsko-pomorskie

421.1

38.4

45.5

89.8

8.6

28.0

17.1

11.8

8.0

8.5

4.3

Lubelskie

322.3

32.6

24.8

74.2

9.2

25.9

14.3

7.2

6.3

6.5

5.7

Lubuskie

319.9

32.2

36.9

77.0

10.3

22.0

17.2

10.1

9.2

3.8

4.8

Łódzkie

343.0

31.2

33.2

91.3

9.6

24.5

16.5

6.1

5.0

7.3

12.1

Małopolskie

293.7

24.2

25.4

60.8

9.0

26.1

12.9

6.1

4.0

6.8

5.7

Mazowieckie

322.4

26.2

32.5

92.2

6.9

20.9

10.5

7.5

5.5

7.8

4.0

Opolskie

308.8

32.4

27.3

67.5

10.7

24.6

13.6

8.2

7.9

4.,4

5.6

Podkarpackie

335.4

31.1

21.0

70.3

6.0

28.9

15.7

8.5

4.6

7.4

8.1

Podlaskie

343.0

35.7

22.4

84.4

11.0

27.2

15.8

8.6

9.0

5.5

5.4

Pomorskie

328.5

28.9

40.3

80.9

8.3

15.9

13.2

9.2

10.1

5.8

3.0

Śląskie

382.4

43.0

38.2

88.4

11.8

32.8

18.5

9.3

8.6

7.2

7.0

Świętokrzyskie

336.5

33.4

26.9

75.0

9.3

24.8

14.2

7.8

8.2

6.1

8.3

Warmińsko-mazurskie

360.0

35.3

42.4

79.9

10.0

19.7

14.2

10.0

7.2

7.3

9.1

Wielkopolskie

408.2

41.3

37.0

101.3

9.7

26.4

14.2

10.1

7.3

9.1

7.0

Zachodniopomorskie

364.0

32.1

42.6

92.2

8.8

19.1

13.2

9.5

10.3

5.1

4.5

Poland

351.5

33.6

34.2

84.4

9.2

25.1

14.6

8.4

7.1

7.1

6.4

mortality rates (ESP2013)

Dolnośląskie

233.1

27.5

46.9

32.1

7.3

7.7

12.3

4.1

5.4

3.1

6.4

Kujawsko-pomorskie

234.5

27.9

47.2

36.1

7.2

10.1

14.0

4.9

6.7

4.7

5.7

Lubelskie

179.0

21.3

29.7

24.3

5.6

6.4

11.1

4.5

3.1

3.9

6.3

Lubuskie

234.2

26.5

49.9

34.0

8.4

7.7

12.0

6.6

3.7

3.5

6.5

Łódzkie

219.1

24.8

37.2

36.1

7.2

8.8

14.9

3.8

4.1

3.2

6.9

Małopolskie

205.3

25.6

29.0

31.4

6.1

8.2

11.7

3.7

4.9

4.1

5.1

Mazowieckie

215.1

24.4

37.6

34.5

6.7

10.6

12.4

3.8

3.7

4.1

5.9

Opolskie

187.3

25.2

28.2

25.3

8.6

6.1

12.6

4.7

3.0

2.7

5.0

Podkarpackie

172.2

20.7

21.3

26.0

5.9

8.5

12.4

3.8

3.0

3.8

6.1

Podlaskie

197.1

23.2

30.2

30.5

6.3

8.0

14.3

6.6

3.6

3.3

5.8

Pomorskie

211.6

23.3

45.0

28.5

6.6

7.3

11.1

3.5

4.6

3.4

6.4

Śląskie

223.9

25.7

35.3

35.9

8.2

8.7

14.3

4.8

3.6

3.9

5.9

Świętokrzyskie

186.9

21.4

31.8

27.4

6.4

8.3

12.7

4.3

4.2

2.9

4.8

Warmińsko-mazurskie

216.2

24.5

37.9

34.6

11.0

6.9

10.6

6.1

3.5

7.6

6.8

Wielkopolskie

242.2

28.3

42.5

40.9

7.7

9.2

13.8

5.6

5.6

4.0

6.5

Zachodniopomorskie

211.2

23.8

44.4

31.0

8.0

8.2

11.8

5.6

4.7

3.4

6.3

Poland

213.9

24.9

37.3

32.9

7.2

8.5

12.8

4.5

4.3

3.9

6.0

In addition to differences in morbidity and mortality at the level of voivodeships, differences in 5-year net survival rates were also observed in Poland (diagnosis from 2015 to 2019, end point of observation on December 31, 2019). The 5-year cancer net survival rate for the whole country was 55.5%, with the highest values recorded in central and eastern Poland. In women, compared to men, higher values were found in all voivodeships (tab. XII).

Table XII. Geographical distribution of 5-year cancer rate in both sexes (2015–2019)

Voivodship

Geographical distribution of 5-year cancer survival rate (%)

males

female

Dolnośląskie

48.8%

57%

Kujawsko-pomorskie

50.5%

55.3%

Lubelskie

53.4%

60.8%

Lubuskie

51.8%

58.7%

Łódzkie

51.1%

61.6%

Małopolskie

53%

59.4%

Mazowieckie

55.1%

61.5%

Opolskie

49%

58.7%

Podkarpackie

55%

61.5%

Podlaskie

50.7%

60%

Pomorskie

57.3%

61.8%

Śląskie

48.9%

55.6%

Świętokrzyskie

50.8%

58.8%

Warmińsko-mazurskie

47.3%

57%

Wielkopolskie

48.9%

56.7%

Zachodniopomorskie

50.3%

59.8%

Poland

51.6%

58.9%

Discussion

Malignant neoplasms are the second leading cause of mortality in Poland. The Polish National Cancer Registry received information about 146,181 new cases and 99,871 thousand cancer deaths in 2020. Compared to the previous year, the number of cases decreased by about 12,000 in both sexes. Mortality in men did not change compared to 2019, and in women it was decreased by about 400 events.

The most common male cancer is prostate cancer (almost 20% of all male cancers). The death rate for prostate cancer has been increasing year by year since 2004.

The second most common cancer among men is lung cancer (16% of all cases), despite the fact that they have been showing a decreasing trend in mortality and morbidity rates for 15 years. Right behind colorectal cancer, in third place is colorectal cancer (11% of all cases). The decrease in incidence and mortality of lung cancer can be attributed to the noticeable reduction of smoking prevalence among Polish men, which has been observed in recent decades. Despite the decrease in the mortality rate, lung cancer is still the dominant cause of male cancer death (26% of all cases), significantly affecting the all cancer mortality curve.

Among women, the three most common cancer sites are: breast, lung and colorectum. The most fatal cancer for this group was lung cancer (18%), followed by breast cancer (15%), which for the last 10 years has been on an upward trend.

Poland’s cancer incidence and death trends are influenced by the population’s age distribution and exposure to carcinogens, particularly cigarette smoking (female population) and poor diet. In 2020, there were more than 1000 more female lung cancer deaths than breast cancer deaths.

The Polish National Cancer Registry has received fewer incident cancer cases in 2020 than in 2019 as a result of the COVID-19 pandemic, there was a decrease of 15% for men and 14% for women. The COVID-19 pandemic (ICD-10 U07.1, U07.2) caused 41,451 deaths in Poland in 2020. 7,043 (17%) of COVID-19 deaths were related to cancer, with men accounting for 61% of these deaths [6]. The COVID-19 pandemic has resulted in limitations in performing planned procedures and diagnostic possibilities in both screening and early diagnosis [6]. It can be seen that the COVID-19 pandemic has significantly changed the trend of cancer detection in Poland, and further effects of this phenomenon will be observed in the coming years.

Conclusions

The decrease in the incidence of cancer in 2020 was probably related to the occurrence of the COVID-19 pandemic. At that time, access to public health care was limited due to the reduction of patient admission in clinics, the development of telemedicine instead of a conventional doctor’s visit, and the transformation of hospitals into specialist hospitals treating only COVID-19, which could have influenced the postponement of the diagnosis of cancer.

Malignant neoplasms constitute a significant health problem, especially in young and middle-aged individuals (25–64 years old). In 2020, the most frequently diagnosed cancers among men in Poland were prostate, lung and colorectal cancers. In the female population, leading cancer sites still remain: breast, lung and colorectum. The highest mortality was observed due to lung cancer, colorectal cancer and, depending on sex, prostate or breast cancer.

Strengths and limitations of the report

The analysis covers the entire population of Poland and is the best source of data on the incidence of cancer. Registration of cancers in the Polish National Cancer Registry (PNCR) is obligatory, which allows for high completeness of data. Unfortunately, the year 2020 caused disturbances in the functioning of health care facilities, which was reflected in the number of applications to the PNCR.

Data availability

The presented data come from the Polish National Cancer Registry (PNCR) and is available at https://onkologia.org.pl/.

Conflict of interest: none declared

Urszula Wojciechowska

Maria Sklodowska-Curie National Research Institute of Oncology

National Cancer Registry

ul. Roentgena 5

02-781 Warszawa, Poland

e-mail: Urszula.Wojciechowska@pib-nio.pl

Received and accepted: 7 Apr 2023

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Nowotwory. Journal of Oncology