CANCER BURDEN ATTRIBUTABLE TO MODIFIABLE RISK FACTORS IN HUNGARY: INCORPORATING THE HUN-CANCER EPIDEMIOLOGICAL DATABASE INTO GLOBAL FRAMEWORKS
Author(s)
Zoltan Kiss, PhD1, Anikó C. Maráz, PhD2, Zsolt Horvath, PhD3, Gergo Molnár, PhD4, Miklós Darida, MD1, István Köveskuti, MSc1, Natali Neuhauser, MSc1, Tamas G. Szabo, PhD1, György Rokszin, PhD5, Valéria Kovács, MSc5, Lilla Tamási, PhD6, Krisztina Bogos, PhD7, Zoltán Vokó, PhD8.
1MSD Pharma Hungary, Budapest, Hungary, 2Department of Oncotherapy, University of Szeged, Szeged, Hungary, 3Department of Oncology, Bács-Kiskun County Teaching Hospital, Kecskemét, Hungary, 4Second Department of Medicine and Nephrology-Diabetes Centre, University of Pécs Medical School, Pécs, Hungary, 5RxTarget Ltd, Szolnok, Hungary, 6Department of Pulmonology, Semmelweis University, Budapest, Hungary, 7National Korányi Institute of Pulmonology, Budapest, Hungary, 8Center for Health Technology Assessment, Semmelweis University, Budapest, Hungary.
1MSD Pharma Hungary, Budapest, Hungary, 2Department of Oncotherapy, University of Szeged, Szeged, Hungary, 3Department of Oncology, Bács-Kiskun County Teaching Hospital, Kecskemét, Hungary, 4Second Department of Medicine and Nephrology-Diabetes Centre, University of Pécs Medical School, Pécs, Hungary, 5RxTarget Ltd, Szolnok, Hungary, 6Department of Pulmonology, Semmelweis University, Budapest, Hungary, 7National Korányi Institute of Pulmonology, Budapest, Hungary, 8Center for Health Technology Assessment, Semmelweis University, Budapest, Hungary.
OBJECTIVES: To evaluate the absolute site-specific cancer incidence in Hungary for 2023 and to quantify the potential preventable burden by applying recently published population attributable fractions (PAFs) for key lifestyle and environmental risk factors.
METHODS: National sex-stratified cancer incidence data for 2023 were obtained from the HUN-CANCER EPI (HCE) epidemiological database, capturing major malignancies including lung (8,758 cases), colorectal (9,385 cases), breast (8,241 cases), and cervical (888 cases) cancers. PAFs for individual modifiable risk factors were extracted from the Fink et al. (2026) Nature Medicine framework. Individual risk factor impact was calculated for each major oncological site. To avoid linear overestimation, a multiplicative multi-causal joint PAF model
was utilized to estimate the combined preventable burden across the entire national dataset.
RESULTS: Individual-level risk projections reveal a considerable actionable burden across The Hungarian population. For lung cancer, tobacco smoking is responsible for n=3,764 cases (80.3%) among males and n=2,707 cases (66.5%) among females, while ambient PM2.5 air pollution independently accounts for n=145 cases (3.1%) and n=110 cases (2.7%), respectively. Based on the multiplicative multi-causal framework, the estimated cumulative preventable lung cancer burden reaches n=3,909 cases (83.4%) for men and n=2,817 cases (69.2%) for women. For colorectal cancer, major individual drivers include tobacco smoking with n=1,131 cases (21.4%) in males and n=525 cases (12.8%) in females, alcohol consumption with n=978 cases (18.5%) in males and n=176 cases (4.3%) in females, and high BMI with n=608 cases (11.5%) in males and n=131 cases (3.2%) in females. Among women, all 888 cervical cancer cases are attributable to HPV infection and theoretically fully preventable, while breast cancer cases are primarily driven by high BMI (n=972 cases, 11.8%) and alcohol intake (n=618 cases, 7.5%).
CONCLUSIONS: Linking the HCE database with localized PAF matrices demonstrates that a substantial proportion of Hungarian cancer incidence is attributable to modifiable risk factors.
METHODS: National sex-stratified cancer incidence data for 2023 were obtained from the HUN-CANCER EPI (HCE) epidemiological database, capturing major malignancies including lung (8,758 cases), colorectal (9,385 cases), breast (8,241 cases), and cervical (888 cases) cancers. PAFs for individual modifiable risk factors were extracted from the Fink et al. (2026) Nature Medicine framework. Individual risk factor impact was calculated for each major oncological site. To avoid linear overestimation, a multiplicative multi-causal joint PAF model
was utilized to estimate the combined preventable burden across the entire national dataset.RESULTS: Individual-level risk projections reveal a considerable actionable burden across The Hungarian population. For lung cancer, tobacco smoking is responsible for n=3,764 cases (80.3%) among males and n=2,707 cases (66.5%) among females, while ambient PM2.5 air pollution independently accounts for n=145 cases (3.1%) and n=110 cases (2.7%), respectively. Based on the multiplicative multi-causal framework, the estimated cumulative preventable lung cancer burden reaches n=3,909 cases (83.4%) for men and n=2,817 cases (69.2%) for women. For colorectal cancer, major individual drivers include tobacco smoking with n=1,131 cases (21.4%) in males and n=525 cases (12.8%) in females, alcohol consumption with n=978 cases (18.5%) in males and n=176 cases (4.3%) in females, and high BMI with n=608 cases (11.5%) in males and n=131 cases (3.2%) in females. Among women, all 888 cervical cancer cases are attributable to HPV infection and theoretically fully preventable, while breast cancer cases are primarily driven by high BMI (n=972 cases, 11.8%) and alcohol intake (n=618 cases, 7.5%).
CONCLUSIONS: Linking the HCE database with localized PAF matrices demonstrates that a substantial proportion of Hungarian cancer incidence is attributable to modifiable risk factors.
Conference/Value in Health Info
2026-11, ISPOR Europe 2026, Vienna, Austria
Value in Health, Volume 29, Issue 12S
Code
EPH28
Topic
Epidemiology & Public Health, Health Policy & Regulatory, Study Approaches
Disease
Oncology