The COVID-19 pandemic and epidemiology of the most common cancers in the Subcarpathian and Silesian Provinces of Poland.

INTRODUCTION AND OBJECTIVE: The study aimed to assess the effect of the COVID-19 pandemic and slow cancer burden on the healthcare system of the most frequent cancers in the Subcarpathien and Silesian Provinces of southern Poland in the period 2015-2020. MATERIAL AND METHODS: Depersonalized, epidemiological data were obtained from the branches of the National Health Founf of Poland (NFZ) in the Subcarpathian and Silesian Province. The database contained 7,814,870 healthcare services granted to 385,845 patients with disease entities classified as C00-C97, according to the ICD-10. RESULTS: In the period 2015-2020, cancer diseases were diagnosed in 3,445 per 100,000 citizens of the Subcarpathian Province and 5248 per 100,000 citizens of the Silesian Province. The changes in SMR values due to cancer diseases found in the Subcarpathian Province were characterized by temporal and spatial differentiation. In the period 2016-2019, unencumbered by the COVID-19 pandemic, the SMR values had decreased on average by -13.2% in most counties of the Subcarpathian Province, but in 2020 the SMR values decreased by -14.7% compared to 2019. In the Silesian Province, similar to the Subcarpathian Province, the values of SMR decreased in the period 2016-2019 in all counties (with the exception of the town of Piekary Slaskie), on average, by -11.5%. Subsequently, in 2020, a significant reduction of SMR compared to 2019 was observed on average by -7.9%. CONCLUSIONS: In 2020, a significant reduction in the diagnosis of patients with cancer was found in the one-year perspective study in both Provinces, which suggests the limitation of availability of the specialistic oncologic healthcare services due to the fight against the COVID-19 pandemic. An increased burden of cancers shortly should be expected. Thus, regional and nationwide screening programmes should be introduced to enable diagnosis at the earliest possible stage.

The cut-off value for HOMA-IR discriminating the insulin resistance based on the SHBG level in women with polycystic ovary syndrome.

Introduction: The study aimed to estimate the cut-off value for homeostatic model assessment for insulin resistance (HOMA-IR) discriminating the insulin resistance based on the sex hormones binding globulin (SHBG) level in women with polycystic ovary syndrome (PCOS). Materials and methods: Data from medical records of 854 Caucasian women diagnosed with PCOS were analyzed. Anthropometric data, fasting plasma glucose, insulin and SHBG levels were measured. HOMA-IR was calculated with a standard formula. The cut-off value was calculated using receiver-operating characteristics. Results: Circulating SHBG levels below the normal range (26.1 nmol/L) were found in 25.4% of study participants. This subgroup had a significantly higher BMI, fasting glucose and insulin concentrations and HOMA-IR values. Empirical optimal cut-off values for HOMA-IR corresponding to low SHBG levels was ≥2.1 [area under the curve (AUC) 0.73, accuracy 0.65, sensitivity 72.3%, specificity 63.1%, positive predictive value (PPV) 40.0%, negative predictive value (NPV) 87.0%]. Conclusions: Our study suggests that the cut-off point for HOMA-IR discriminating the insulin resistance based on the SHBG level, in young Caucasian women with polycystic ovary syndrome is 2.1, and is consistent with the cut-off value adopted by the European Group for the Study of Insulin Resistance (above 2.0).