Background Evidence is emerging that older women may tolerate breast cancer therapies equally well as the young ones, providing that they receive good supportive care. It has also been reported that these patients remain outside the current therapeutic standards. The aim of this observational study was to assess the access of breast cancer patients to medical procedures. Methods We retrospectively reviewed a database of breast cancer patients registered in the National Cancer Registry in Poland, searching for the numbers of new cases and deaths in the years 2010–2015. We obtained the numbers and costs of key medical procedures provided for these patients from the National Health Fund in Poland. Breast cancer survival in the years 2010–2015 was estimated based on the mortality/incidence ratio. The t -Student test and Spearman correlation coefficient were used for the analysis of data obtained from both databases. Results There was no increase in survival throughout the years 2010–2015 in both analysed subpopulations of all breast cancer patients below and over 65 years of age, despite an unprecedented rise in healthcare funding in Poland. We noted 37% lower probability of 5-year survival in patients older than 65 years. The average number of outpatient visits and surgical procedures per person per year were slightly, yet significantly ( p < 0.01), higher in younger vs. older patients (3.9 vs. 3.4 and 1.18 vs. 1.02, respectively). Outpatient chemotherapy was more common in older patients (6.0 vs. 5.25 cycles a year per person on average, p < 0.01). There were no significant differences in the average numbers of hospitalisations for chemotherapy, frequencies of radiotherapy and in the use of targeted therapy programmes (calculated per person per year), between younger and older patients. Conclusions Older women with breast cancer are treated similarly to younger patients, but have significantly worse chances to survive breast cancer in Poland. A simple increase in healthcare financing will not improve the survival in the elderly with breast cancer without developing funded individualised care and survivorship programmes. Electronic supplementary material The online version of this article (10.1186/s12885-019-5930-8) contains supplementary material, which is available to authorized users.
Introduction. International travel and immigration have led to a rise in the incidence of tuberculosis in European countries, mainly due to migration from Africa and the Middle East.Aim. In this article we point to an additional migration path - from Ukraine - and the threat of tuberculosis associated with this migration and we discuss our preparation for an increase in the incidence of this disease.Discussion. It is estimated that about 1.5-2.5 million Ukrainians work or live in Poland or the EU. This results from the implementation of some EU directives and Polish law regulations, which simplified an access of the Ukrainian citizens to the European labor market. Importantly, Ukraine is one of the 18 high-priority countries to fight tuberculosis in the WHO European Region and among the top 20 highest drug-resistant tuberculosis burden countries in the world. More importantly, there is no unitary tuberculosis screening program for migrants in the EU member states. For this reason, we have no reliable data on tuberculosis burden in any nationality group of immigrants in Europe, including Ukrainians.Conclusions. Nurses have always dealt with infectious diseases, they have always been and will be the last line of defense against the epidemic. Any epidemic, including tuberculosis. Perhaps, in the absence of an integrated tuberculosis policy in Europe, our only future are the experience, skills and dedication of nurses.
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