Onkologija : Slovenian Journal of Oncology

Cancer burden in Kanal ob Soči Municipality and Goriška Statistical Region (Slovenia) and potential association with environmental pollutants due to waste co-incineration

Vesna Zadnik — 2025-08-27

Background: In the municipality of Kanal ob Soči, residents are exposed to historical asbestos pollution and current emissions from waste co-incineration in a cement plant. This paper discusses the trends over time in the cancer burden with a focus on mesothelioma and assesses the association between environmental pollutants and cancer incidence.
Methods: Using data from the Slovenian Cancer Registry, we present the trends in the age-standardised incidence and mortality rates (ASRs) for all cancers (2001–2020) and mesothelioma (2001–2022) in Kanal ob Soči, the Goriška statistical region, and in Slovenia as a whole. We summarise the findings from an umbrella review on the association between cancer and pollutants from co-incineration (1980–2023), and from a descriptive-correlational geographical analysis of cancer risk (all cancers, lung cancer, non-Hodgkin lymphoma and sarcomas) in the 2011–2020 period in relation to the estimated PM10 levels and chromium (Cr) in the soil across four municipalities (Kanal ob Soči, Tolmin, Nova Gorica and Brda).
Results: The cancer incidence in Kanal ob Soči is higher than in the Goriška region and in Slovenia as a whole, mainly due to a higher number of mesothelioma cases. However, the ASR remains stable in Kanal ob Soči, while it is increasing in the Goriška region and in Slovenia. The peak of mesothelioma incidence in Slovenia occurred around 2004; from 2014 to 2022, we can observe an annual decline of 3.1%. There is no evidence of an association between cancer and emissions from co-incineration. No links were found with the PM10 or Cr levels.
Conclusion: The excess cancer burden in Kanal ob Soči is primarily due to historical asbestos exposure; the impact of waste co-incineration was not confirmed. The developed methodology enables continued environmental impact monitoring. Based on this, we propose some public health measures.

Physical activity, muscle, and clinical nutrition

Nada Rotovnik Kozjek — 2025-12-18

Physical activity and nutrition are inextricably linked in maintaining muscle and overall health, metabolic resilience, and preventing age-related muscle loss. Exercise is a powerful physiological stressor that acutely triggers metabolic, endocrine, and immune responses, posing a major challenge to homeostasis. To better manage this stress, regular exercise induces numerous metabolic adaptations in the body that attempt to reduce it. Metabolic changes triggered by physical exercise include increased energy requirements, adaptation of metabolic fuel use, and hormonal fluctuations. Regular physical exercise leads to structural and functional adaptations at the muscular, cardiovascular, and whole-body levels. Proper nutritional strategies, tailored to the type, intensity, and duration of activity, provide the necessary substrates for work, optimize recovery, promote muscle protein synthesis, and strengthen the immune response. This not only improves athletic performance, but also contributes significantly to the health benefits of exercise, including the prevention and management of many chronic diseases, including some forms of cancer. Since these health benefits are also essential in cancer treatment, knowledge of the principles and application of clinical sports nutrition is becoming increasingly important in oncology. The integration of knowledge in the fields of exercise physiology, metabolic support, and nutritional therapy enables more effective preservation of muscle mass, reduction of metabolic complications, and improvement of response to treatment. The implementation of a clinical sports nutrition approach in oncology practice thus represents an important step towards comprehensive patient care based on scientific evidence and interdisciplinary collaboration.

Two Decades of the Department of Molecular Diagnostics at the Institute of Oncology Ljubljana

Petra Škerl — 2025-12-18

The Department of Molecular Diagnostics at the Institute of Oncology Ljubljana was established in 2005 at the initiative of Prof. Dr. Srdjan Novaković. Over the past 20 years, it has evolved into the central national laboratory for genetic testing of individuals with a higher risk of hereditary cancer syndromes, as well as for molecular genetic testing of various types of solid tumours, where tumour genotyping plays a key role in diagnosis, treatment planning, and prognosis. A special area of the department’s work involves pharmacogenetic testing, which identifies patients at increased risk of severe adverse drug effects. In terms of the complexity and quality of its diagnostic services, the Department of Molecular Diagnostics is comparable to internationally recognized centres performing molecular diagnostics. This is demonstrated by its extensive range of tests that follow international clinical guidelines for the management of cancer patients, as well as by its regular participation and successful performance in external quality assessment schemes. As a result, Slovenian cancer patients have access to comprehensive molecular genetic testing within the country, without the need for referral abroad. An important step forward has also been the agreement with the Health Insurance Institute of Slovenia (ZZZS) on the funding of these services, ensuring patients have access to high-quality diagnostics and personalized treatment with targeted therapies, in accordance with the most up-to-date international guidelines and without any additional costs to patients. Patients from healthcare institutions across Slovenia may be referred for molecular genetic testing to the Department of Molecular Diagnostics.

20th Anniversary of the Department of Experimental Oncology at the Institute of Oncology Ljubljana

Gregor Serša — 2025-12-18

The twentieth anniversary of the Department of Experimental Oncology marks an important milestone in the history of research activities at the Institute of Oncology Ljubljana. Research activity at the Institute of Oncology Ljubljana has a long and strong tradition, dating back to the establishment of the first laboratory for experimental cancerology at the Brežice Hospital by Asst. Prof. Dr. Cholewa. Since 2005, the small laboratory with six employees has grown into a modern research group of more than 20 researchers who are successfully implementing the vision of translational oncology, particularly in the fields of electrochemotherapy, gene electrotransfer, bleomycin electro-sclerotherapy, radiobiology, and veterinary oncology. With our commitment to translational research, interdisciplinary collaboration, and the transfer of knowledge into clinical practice, we have made an important contribution to the development of modern oncology therapy in Slovenia and beyond. We successfully completed a phase I clinical study, which demonstrated the safety and efficacy of plasmid gene electrotransfer with IL-12 encoding as part of the SmartGene.si project. In addition to scientific and research work, the department is substantially involved in educational activities and is a part of strong domestic and international networks in the field of biomedical applications of electroporation. We look forward to future collaborative efforts in further developing experimental, translational, and clinical oncology.

Optimising patient care in oncology nursing using the McGill Model of Nursing

Valentina Masten — 2025-12-18

Background: The McGill Model of Nursing is a holistic, collaborative approach that emphasises the active role of the patient, the involvement of the family and the strengthening of psychosocial support. Although it has been established in the international literature, its implementation in Slovenian clinical practise has not yet been systematically investigated. The aim of this study was to investigate the extent to which oncology nurses apply the principles of the McGill Model, including patient participation, family involvement and psychosocial support.
Methods: Approximately 400 nurses working in the field of oncology nursing were invited to participate in this quantitative cross-sectional study. A total of 166 began the questionnaire and 126 completed it in full (response rate 31.5 %). Most of the respondents were female (77.8 %). Their mean age was 37.71 years (s = 8.07), with a mean length of professional experience in oncology nursing of 9.66 years (s = 7.93). The analysis was based solely on fully completed questionnaires. Data was collected using a newly developed scale based on the McGill Model of Nursing and on a five-point frequency and agreement scale. Exploratory and confirmatory factor analyses were performed, as well as Wilcoxon signed-rank tests, Mann-Whitney U tests and Spearman correlations.
Results: The factor analysis confirmed a three-factor structure explaining 65.3% of the total variance (KMO = 0.896; Bartlett’s p < 0.001). The empirical medians of all three constructs were significantly higher than the theoretical medians (p < 0.001), suggesting that respondents indicated the use of McGill Model approaches. Participants with access to written protocols or organisational support scored significantly higher (p < 0.001). Moderate to strong positive correlations were found between the use of these approaches and the perceived improvement in the quality of care and the psychosocial well-being of patients (p < 0.001).
Conclusion: The results confirm that approaches based on the McGill Model are commonly used in oncological care and are positively associated with perceived improvements in quality of care. This model has the potential for wider and more formalised implementation in the clinical setting in Slovenia.

Selected chapters on medical emergencies

Iztok Potočnik — 2025-12-18

no English abstract

Summary of the report of the national Registry of Tested Individuals from Families with Hereditary Cancer

Simona Hotujec — 2025-12-18

Background: In order to facilitate the identification of individuals at high risk for cancer, improve the implementation of genetic testing, and enable effective monitoring of carriers of high cancer risk variants, a national database—the National Registry of Tested Individuals from Families with Hereditary Cancer—was established in 2019. The registry is managed by the Institute of Oncology Ljubljana and is based at the Department of Clinical Cancer Genetics. It includes data on individuals tested for germline pathogenic or likely pathogenic variants (PV/LPV) in genes associated with hereditary predisposition for tumour development. This article presents a summary of the report of the National Registry of Tested Individuals from Families with Hereditary Cancer for the period 2000–2023.
Methods: A descriptive statistical analysis was performed, including the analysis of the number of genetic tests performed, the number of individuals tested, and the number of identified germline PV/LPVs in genes associated with hereditary tumour predisposition by year, for the period 2000–2023.
Results: From 2000 to 2023, the registry recorded 12,904 tested individuals from 8,781 families. At least one germline PV/LPV in a gene associated with hereditary tumour predisposition was identified in 3,334 individuals from 1,828 families. Thus, a positive genetic test result was found in about one-quarter (26%) of all tested individuals, the majority within the field of hereditary breast and/or ovarian cancer.
Conclusion: The collection of data of tested individuals from families with hereditary cancer, together with annual analyses in the form of reports, enables comprehensive monitoring of epidemiological trends—particularly the incidence and prevalence of carriers with hereditary predispositions for tumour development—and facilitates better planning of healthcare for these individuals at the national level.