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Marcin Piechocki,1 Wojciech Kozio&lstrok;ek,1 Damian Sroka,1 Anna Matrejek,1 Paulina Mizio&lstrok;ek,1 Nazarii Saiuk,1 Monika Sledzik,1 Adriana Jaworska,1 Krzysztof Bereza,2 Elzbieta Pluta,3 Tomasz Banas1 1Department of Gynecology and Oncology, Jagiellonian University Medical College, Krakow, Poland; 2Department of Mother and Child Health;Faculty of Health Sciences;Institute of Nursing and Midwifery;Jagiellonian University Medical College, Krakow, Poland; 3Department of Radiotherapy, Maria Sklodowska–Curie Institute - Oncology Centre, Krakow, PolandCorrespondence: Tomasz BanasDepartment of Gynecology and Oncology, Jagiellonian University Medical College, 2nd Jakubowskiego Str, Krakow, Poland, Tel +48 12 424 8584, Fax +48 12 424 8560, Email tomasz.1.banas@uj.edu.plBackground: This study aimed to analyze and determine the incidence and mortality trends in gynecological and breast cancers (BCs) in Poland. The gynecological cancers assessed were cervical cancer (CC), corpus uteri cancer (CUC), ovarian cancer (OC), vaginal cancer (VAC), and vulvar cancer (VUC).Patients and Methods: Data concerning the incidence and mortality for the period of 1980– 2018 were obtained from the Polish National Cancer Registry (PNCR). Joinpoint regression analysis was performed to identify trends, which were described using the annual percentage change (APC) and the average annual percent change (AAPC).Results: Statistically significant increases were observed in BC incidence (AAPC: 2.3; CI: 1.8 to 2.9; p< 0.05), CUC incidence (AAPC: 2.3; CI: 1.9 to 2.7; p< 0.05), CUC mortality (AAPC: 0.4; CI: 0.1 to 0.7; p< 0.05) and VUC mortality (AAPC: 1.16, CI: 0.1 to 2.2; p< 0.05). VAC mortality decreased (AAPC: − 3.5, CI: − 5.0 to – 2.0; p< 0.05), as did CC incidence and mortality (AAPC: − 2.1, CI: − 2.3 to − 1.8; p< 0.05, AAPC: − 2.0, CI: − 2.2 to – 1.8; p< 0.05, respectively). Between 1980 and 1993, OC incidence initially increased and then stabilized (AAPC: 0.9; CI: 0.7 to 1.1; p< 0.05). After 2007, OC mortality decreased (AAPC: 0.0; CI: − 0.2 to 0.2; p=0.8). Trends in VUC and VAC incidence and BC mortality were not statistically significant.Conclusion: The results of this study showed a significant increase in OC, CUC, and BC incidence, and a decrease in the incidence of CC and VAC. The VUC trends were stable. Mortality trends for BC initially fluctuated and, since 2010, has begun to increase. Throughout the observed period, mortality due to VUC and CUC increased, whereas decreased among patients with CC. OC mortality was stable, but not significant. Furthermore, the study showed a correlation between age group and rate of incidence and mortality of each assessed cancer.Keywords: gynecological cancers, breast cancer, incidence, mortality, average annual percentage change

Michal Mleko,1 Kazimierz Pitynski,1 Elzbieta Pluta,2 Aleksandra Czerw,3,4 Katarzyna Sygit,5 Beata Karakiewicz,6 Tomasz Banas1 1Department of Gynecology and Oncology, Jagiellonian University Medical College, Krakow, Poland; 2Department of Radiotherapy, Maria Sklodowska–Curie Institute - Oncology Centre, Krakow, Poland; 3Department of Health Economics and Medical Law, Medical University of Warsaw, Warsaw, Poland; 4Department of Economic and System Analyses, National Institute of Public Health – NIH, Warsaw, Poland; 5Calisia University, Kalisz, Poland; 6Subdepartment of Social Medicine and Public Health, Department of Social Medicine, Pomeranian Medical University, Szczecin, PolandCorrespondence: Tomasz BanasDepartment of Gynecology and Oncology, Jagiellonian University Medical College, 2nd Jakubowskiego Street, Krakow, PolandTel +48 12 424 8584Fax +48 12 424 8560Email tomasz.1.banas@uj.edu.plAbstract: Systemic inflammatory reaction (SIR) is an unfavorable prognostic factor in many malignancies and has a role in all stages of the neoplastic process: initiation, promotion, and disease progression. Analysis of SIR can be performed by assessing indicators (eg, lymphocyte-to-neutrophil, platelet-to-lymphocyte, and monocyte-to-neutrophil ratios) and products of neutrophils and lymphocytes (ie, the systemic immune-in&fllig;ammation index), or by examining the relationship between levels of C-reactive protein and albumin (based on the Glasgow Prognostic Score, modified Glasgow Prognostic Score, and C-reactive protein-to-albumin ratio). Risk stratification is essential in the clinical management of cancer; hence, the evaluation of these factors has potential applications in the clinical management of patients with cancer and in the development of new therapeutic targets. This review summarizes the current knowledge on SIR indicators and presents their clinical utility in malignancies of the female genital organs.Keywords: breast cancer, cervical cancer, corpus uteri cancers, C-reactive protein, monocyte-to-lymphocyte ratio, neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, systemic inflammatory reaction, vulvar cancer, vaginal cancer

Systemic inflammatory reaction (SIR) is an unfavorable prognostic factor in many malignancies and has a role in all stages of the neoplastic process: initiation, promotion, and disease progression. Analysis of SIR can be performed by assessing indicators (eg, lymphocyte-to-neutrophil, platelet-to-lymphocyte, and monocyte-to-neutrophil ratios) and products of neutrophils and lymphocytes (ie, the systemic immune-inflammation index), or by examining the relationship between levels of C-reactive protein and albumin (based on the Glasgow Prognostic Score, modified Glasgow Prognostic Score, and C-reactive protein-to-albumin ratio). Risk stratification is essential in the clinical management of cancer; hence, the evaluation of these factors has potential applications in the clinical management of patients with cancer and in the development of new therapeutic targets. This review summarizes the current knowledge on SIR indicators and presents their clinical utility in malignancies of the female genital organs., Competing Interests: The authors report no conflicts of interest in this work., (© 2021 Mleko et al.)

Objectives: This study aimed to analyze incidence and mortality trends in breast cancer (BC), corpus uteri cancer (CUC), and ovarian cancer (OC) in Poland in the context of sociodemographic changes., Materials and Methods: Incidence and mortality data (1980-2013) were retrieved from the Polish National Cancer Registry, while socioeconomic data (1960-2013) were obtained from the World Bank. Age-standardized incidence and mortality rates were calculated by direct standardization, and join-point regression was performed to describe trends using the average annual percentage change (AAPC)., Results: A significant decrease in birth and fertility rates and a large increase in gross domestic product were observed together with a decrease in the total mortality rate among women, as well as an increase in life expectancy for women. A large, significant increase in BC incidence was observed (AAPC1980-1990 2.14, AAPC1990-1996 4.71, AAPC1996-2013 2.21), with a small but significant decrease in mortality after a slight increase (AAPC1980-1994 0.52, AAPC1994-2013 -0.66). During the period 1980-2013, a significant increase in CUC incidence (AAPC1980-1994 3.7, AAPC1994-2013 1.93) was observed, with an initial mortality-rate reduction followed by a significant increase (AAPC1980-2006 -1.12, AAPC2006-2013 3.74). After the initial increase of both OC incidence and mortality from 1994, the incidence rate decreased significantly (AAPC1980-1994 2.98, AAPC1994-2013 -0.49), as did the mortality rate (AAPC1980-1994 0.52, AAPC1994-2013 -0.66)., Conclusion: After 1994, a decrease in OC incidence was found, while the incidence of BC and CUC continued to increase. A reduction in mortality rate was observed for BC and OC predominantly at the end of the study period, while for CUC, after a long decreasing mortality trend, a significant increase was observed.