编者按：由中国抗癌协会主办，天津医科大学肿瘤医院、天津市抗癌协会、中国整合医学发展战略研究院承办的“2023中国整合肿瘤学大会（2023 CCHIO）”将于2023年11月16～19日在天津举办。匈牙利抗癌协会主席Rozványi Balázs教授将在会上带来题为“匈牙利抗癌协会作为民间组织在癌症防治中的作用（The role of the Hungarian League Against Cancer as a civil organization in cancer control）”的演讲。《肿瘤瞭望》特邀采访了Rozványi教授，请他分享匈牙利的癌症流行特征以及匈牙利抗癌协会的癌症防治经验。

 

The 2023 Chinese Congress of Holistic Integrative Oncology(2023 CCHIO)will be held in Tianjin from November 16th to 19th，2023.Mr.Balázs Rozványi，who is the President of the Hungarian League Against Cancer(HLAC)，will deliver a speech entitled‘The role of the Hungarian League Against Cancer as a civil organization in cancer control’at 2023 CCHIO.Oncology Frontier interviewed Mr.Rozványi to share the cancer epidemic characteristics in Hungary and the experience of the HLAC in cancer control.

 

 

Oncology Frontier:Could you please introduce the epidemic characteristics and diagnosis and treatment status of cancer in Hungary?

 

Mr.Rozványi：我这里有一些匈牙利的相关统计数据，以及与欧洲的对比数据。这些数据主要参考了今年出版的，由欧盟委员会和经济合作与发展组织（OECD）共同编写的《2023年欧盟国家癌症概况》（EU Country Cancer Profiles 2023）。这也是目前可获取的最新数据。数据显示，2020年匈牙利的癌症发病率比欧洲平均水平高了约10%，就该数据而言，情况相当糟糕。按平均年龄标准化率计算，匈牙利的癌症发病率为每10万人628例，死亡率为每10万人328例，比欧洲平均水平高出33%，总体情况很不理想。

 

匈牙利男性最常见的癌症是前列腺癌（20%），随后是肺癌（18%）和结直肠癌（17%）；欧洲的情况类似。女性最常见的三种癌症分别是乳腺癌（24%）、肺癌（14%）和结直肠癌（14%）；欧洲的情况略有不同，第二位是结直肠癌（12%），第三位是肺癌（9%）。死亡率方面，肺癌、结直肠癌、乳腺癌和胰腺癌是导致死亡的主要原因。肺癌的死亡率为每10万人84例，结直肠癌为每10万人51例。

 

我们也有一些好消息。在2011年至2019年的大约十年间，匈牙利的癌症死亡率有所下降。匈牙利男性死亡率降幅为11%，欧洲男性为10%，匈牙利女性为6%，欧洲女性为5%。因此在这方面，匈牙利要比欧洲国家的平均水平稍好一些，但各国之间还存在较大差异。

 

我们按照西方国家的普遍做法，在匈牙利进行了一些公共健康筛查，包括乳腺癌、宫颈癌和结直肠癌筛查。建议45～65岁的女性进行乳腺癌筛查，25～65岁的女性进行宫颈癌，而结直肠癌筛查适用于50～70岁之间的所有人群。参与率方面，在乳腺癌筛查中，有不到40%的参与者接受了乳腺钼靶筛查；宫颈癌筛查的参与率相当低，仅不足10%，但需要强调的是，还有更多女性进行了相关筛查，但不是在公共健康筛查项目中；至于结直肠癌筛查，参与率在30%～40%之间。

 

另外，匈牙利已开始在年轻人群（12或13岁）中进行人乳头瘤病毒（HPV）疫苗接种。自2014年以来，匈牙利开始为13岁的女孩免费接种HPV疫苗，2021年起接种范围扩大到同龄男孩。目前，女孩和男孩都可以接种HPV疫苗，女孩接种率为80%，男孩为70%。我认为这是个不错的结果。

 

Mr.Rozványi:I prepared some statistical data of Hungary and how it is compared to Europe.There was a publication about Hungary(EU Country Cancer Profiles 2023)and it was published in this year.So the up-to-date data is reachable.It was prepared by the European Commission and the Organization for Economic Co-operation and Development(OECD).According to this the incidence in Hungary in 2020 was about 10%higher than the average Europe incidence，so we are in not a good position about these statistical numbers.In Hungary，the incidence was 628 per 100，000 population.It’s an average age standardised rate.The mortality was 328(per 100，000 population)，which is 33%higher than the average Europe data.So，we are in a bad position.

 

The most common cancers are in Hungary between men is the prostate cancer，it’s about 20%，lung cancer is 18%and colorectal cancer is 17%.In Europe the situation is almost the same.The first three most common cancers are in women，the breast cancer with 24%，second is lung cancer with 14%and the third one is colorectal cancer with 14%.In Europe a little bit differs because the second is the colorectal(12%)and the third one is the lung cancer(9%).About the death rates，lung，colorectal，breast and pancreatic cancers are the leading causes of death.Lung is 84 per 100，000 population and colorectal is 51 per 100，000 population.

 

We also have some good news，because there is a reduction in cancer mortality in the last decade between 2011 and 2019.In Hungary，the reduction is 11%for men in Hungary and 10%for men in Europe.In women it’s 6%in Hungary and 5%.in Europe.So in this field we are a little better than the average European countries but there is a big difference between the countries.

 

We have some public health screenings in Hungary，following the common practice in the Western countries，including breast cancer，cervical cancer and colorectal cancer screening.Specifically，breast cancer screenings are recommended for women aged 45 to 65，while cervical cancer screenings are advised for women between the ages of 25 and 65.For colorectal cancer，screening is recommended for individuals of both genders who fall within the age range of 50 to 70 years.In terms of the participation rates，for breast cancer screening，approximately less than 40%of the invited women attend mammography screenings.The participation rate for cervical cancer screening is below 10%，which is quite low.But is has to be emphasized that more women have this screening，but not in the public health screening program.As for colorectal cancer screening，it falls somewhere between 30%and 40%.

 

We started HPV vaccination between young people about 12 or 13 years old.We started with girls in 2014 and with boys in 2021.And nowadays both girls and boys can get this HPV vaccination，and the vaccination rate is 80%between girls and 70%between boys.I think it’s not bad at all.

 

 

Oncology Frontier:What role has the Hungarian League Against Cancer(HLAC)played in cancer prevention and treatment?Please share your experience.

 

Mr.Rozványi：匈牙利抗癌协会（HLAC）成立于1990年，已经有33年的历史。HLAC会员遍布匈牙利全国各地，可以说是迄今为止匈牙利规模最大的癌症患者组织。虽然会员总数只有3000名，但匈牙利是一个小国家，如果按照中国人口基数进行比例计算，约有40万到45万名会员。HLAC也是许多国际组织的成员，如国际抗癌联盟（UICC）、欧洲癌症联盟协会（ECL）、欧洲癌症患者联盟（ECPC）、欧洲前列腺癌联盟（Europa Uomo）、国际淋巴瘤联盟（Lymphoma Coalition）等。HLAC是这些国际专业组织的成员之一，在国际信息传播和教育材料传递方面起着重要作用，其中就包括《欧洲抗癌守则》（European Code Against Cancer）。

 

《欧洲抗癌守则》的内容来自国际癌症研究机构（IARC）的建议，该机构隶属于世界卫生组织（WHO）。《欧洲抗癌守则》的第一版出版于1987年，如今已经更新至第四版。该守则主要提供关于癌症领域健康生活方式的相关建议，涵盖了预防和健康生活方式的方方面面，比如戒烟、保持家庭和工作场所无烟、参与体育活动、饮食、接种疫苗等等。我们在匈牙利推广和传播了ECAC。在IARC的网站上有ECAC的电子学习板块，我们将其翻译成了匈牙利语，以便匈牙利人接触。目前，我们正在开发一个以ECAC为主题的手机应用程序。我们是ECL领导的国际联盟的成员，该联盟负责管理开发工作。

 

我们的愿景是，在我们的努力下，未来的健康人群能够保持健康，癌症患者能够得到最高专业标准的治疗，并有尊严地过上高质量的生活。为了这个实现这一目标，我们在全年开展了大量提高健康意识的宣传活动。从一月份的世界癌症健走活动（World Cancer Walk）开始，随后是欧洲宫颈癌预防周（1月第3周）、世界癌症日（2月4日）、匈牙利国家癌症日（4月10日）、欧洲抗癌周（5月最后一周）、男性健康周（6月第2周）。在世界淋巴瘤宣传日（World Lymphoma Awareness Day，9月15日）这一天，我们通常会在布达佩斯组织一次骑行活动，我们身着绿色T恤，骑着绿色的自行车，从一个血液病研究中心骑到另一个研究中心，行程约8公里。这一骑行活动提供了一个绝佳的契机，来向公众宣传淋巴瘤的相关知识。在9月的最后一个周六，身着印有“抗击乳腺癌”粉色T恤的摩托车手从各个城市和小镇出发，游行直至抵达布达佩斯。10月，我们会在全国各地举办各种乳腺癌宣传活动，包括书籍、讲座、艺术展示等等。我们还有一个患者学院，在11月我们会举办以前列腺癌为主题的“十一胡子月”活动。

 

我们为患者和志愿者提供了许多活动项目，包括志愿者培训和教育。我们为前列腺癌患者提供了一个包含理疗的万步健走计划（10，000-step program）。还有一项旨在促进患者进行体育锻炼的“保持运动”计划（Keep Moving program），参与者可通过活动来累积健康生活的公里数，同时我们还会举行一次全国骑行来推广这项计划。我们为患者及其家属建立了约80个俱乐部（如果按照中国人口基数进行比例计算，则约有12 000个俱乐部），其中包括以患者为主题的"医生见面会（Meet-the-Doctor）"、心理健康俱乐部、艺术治疗和创意俱乐部、运动俱乐部，如瑜伽、徒步、骑行、健走、北欧式健走、民间舞蹈、康复舞蹈、经络锻炼，还有关于饮食的“木勺（wooden spoon）”俱乐部，因为做饭要用木勺。

 

我们还设有热线服务和信息咨询服务，为幼儿和学龄前儿童提供健康教育项目，向青少年传递健康的生活方式、自我检查等知识。我们会印制宣传单和信息手册，组织筛查活动，包括一些最简单的筛查项目，如黑色素瘤筛查或前列腺特异性抗原（PSA）检测等。我们组织了很多筹款活动。我们为癌症患者购买了许多医疗器械，如6台乳腺钼靶设备和各种其他仪器。

 

Mr.Rozványi:This organisation was established in 1990.That means it’s 33 years old and we have members all over the country.And I can say that this is the far biggest cancer patient organisation in Hungary.We have 3，000 members，but we are a small country.It means if I multiply with your numbers，it would mean about 400，000-450，000 members all over China.

 

We are members of a lot of international organisations，as the UICC，the ECL，the European Cancer League，the ECPC，the European Cancer Patient Coalition，Europa Uomo，this is specialised for prostate cancer patients，and the Lymphoma Coalition.And I can say that the Hungarian League Against Cancer is a member of the international professional organisations，and we play a main role in international information and disseminating educational materials.One of these is the European Code Against Cancer.

 

This is a recommendation of the IARC，the International Agency for Research on Cancer，an institution of the WHO.The first edition of the European Code Against Cancer was launched in 1987.Nowadays，we are at the fourth edition，and these are recommendations for the healthy lifestyle in the field of cancer.These are about prevention and lifestyle，don’t smoke，keep your home and workplace smoke-free，or about physical activity，or diet，or helping vaccinations，and so on.We are on this topic the partner of the IARC，the International Agency for Research on Cancer.We made the Hungarian implementation of the ECAC promote and disseminate it.There are e-learning modules of ECAC at the IARC website，and we translated it to Hungarian to be reachable for the Hungarian people.And now a mobile phone application is under construction on the topics of ECAC.We are a member of the international consortium led by ECL that is managing the development.

 

Our vision is that we work for a future in which healthy people preserve their health，and cancer patients are treated with the highest professional standards，and they live a good quality of life in dignity.We have a lot of awareness programs all over the year.It begins in January with the World Cancer Walk.It’s an international event at the very beginning of January.The European Cervical Cancer Prevention Week is in the third week of January.We celebrate the World Cancer Day on the 4th of February and the Hungarian National Cancer Day on the 10th of April.The European Week Against Cancer is in the last week of May.Men’s Health Week，is in the second week of June.World Lymphoma Awareness Day is on the 15th of September.On this day，we usually organize a bicycle tour in Budapest.The color of the lymphoma is green，that is why we wear green T-shirts and ride green bicycles across the city from one hospital to another.These are the most important hematological centers in the country.It’s not a long ride，about 8 kilometers，but it’s a very good event to communicate about lymphoma，why is it important.In October，we organize a lot of breast cancer awareness events all over the country.It begins with a motorbike ride from many cities and towns.A lot of motorbikers come to Budapest，and they have a parade across the city in pink T-shirts written‘Against breast cancer by motorbike’.It’s on the last Saturday of September，and after it，in October，we have the breast cancer awareness events all over the country，as I mentioned.We have a patient academy，and we also celebrate the Movember movement about prostate cancer in November.

 

We have a lot of programs and sessions for patients and volunteers.We train our volunteers and educate them.We have a 10，000-step program with physiotherapy for prostate cancer patients.Our Keep Moving program is about physical activity with collecting kilometers by the participants for a healthy lifestyle.Usually，we have a cycle tour across the country to promote this Keep Moving program.We have about 80 clubs for patients and for their families(if we multiply with your numbers，it would mean about 12.000 clubs all over in China).There are clubs for patient groups with Meet-the-Doctor Sessions about the topics of the patients，mental health clubs，art therapy and creative clubs，exercise clubs as yoga，hiking，cycling，walking，Nordic walking，folk dance，rehabilitation dance club，meridian exercises，and about diet，called‘Wooden spoon’，because you cook with wooden spoon.

 

We run the nationwide helpline and information service.We have school programs and kindergarten programs for the very young，where we teach the healthy lifestyle，the self-examination for the teenagers.We print leaflets and information booklets.We organize screenings.That means practically the simplest screenings as a melanoma screening or a PSA test.We have organized a lot of fundraising programs.We have bought many medical instruments such as six mammography machines and different instruments for the cancer patients.

 

 

Oncology Frontier:Hungary has deeply participated in‘the Belt and Road’.What are your expectations for the cooperation between CACA and HLAC?

 

Mr.Rozványi：虽然两国及其癌症组织之间有许多差异，但我认为这是一次交流经验、求同存异、互相学习的好机会。据我了解，吸烟在中国和匈牙利都是一个大问题。每四个成年人中就有一个是吸烟者，并且每天都会吸烟。在五年内，这个数字可能将从1/4下降至1/5。两国均有公共场所控制吸烟条例，几乎所有公共场所都是禁止吸烟的，比如工作场所、餐厅、酒吧、电影院、剧院、公交、火车以及车站等，吸烟者只能在远离建筑入口的街道上吸烟，不能靠近学校、公交站、火车站等地。因为吸烟是导致大多数癌症的原因。虽然我不了解其在所有癌症中的具体比例，但有82%的肺癌是由吸烟引起的，在喉癌中也超过80%。我不确定中国是否有针对这些癌症类型或其他癌症类型的人群筛查或医疗机构组织的筛查，这可能是有益的。我认为分享良好的临床实践也是此次合作的重要组成部分。

 

Mr.Rozványi:There are many differences between our countries and the cancer organizations.But I think we can learn from each other a lot.We can change experiences and find useful similarities and differences for both partners.As I know well，in your country，in China，smoking is a big problem.In Hungary it was also a big problem.Every fourth adult person was a smoker，a daily smoker.And in five years，it could reduce to every fifth person.We have anti-smoking legislation.That means that smoking is forbidden practically in all public places as in workplaces，restaurants，pubs，movies，theaters，bus，train and train stops.You can smoke only on the street if you are not very close to an entry of a building，or there is no school，no bus stop，no train stop，and so on.Smoking causes most of the cancers:82%of lung cancers are caused by smoking;and at laryngeal cancers，it’s over 80%also.I don’t know that in China is there a population-based or a healthcare-organized screening about these cancer types，or other cancer types，but maybe it would be useful.And the sharing of good practices can also be part of this cooperation.