399eP COVID-19-associated disruptions and incomplete recovery of lung cancer incidence and mortality: A nationwide Hungarian analysis (2011-2023)

Results: Between 2011 and 2023, TRC incidence declined significantly among middleaged adults.In ages 40-49, incidence decreased by 56.1% (CI: 51.1-60.5);57.1% in males, 54.5% in females.Ages 50-59 experienced a greater decline of 59.7% (CI: 56.8-62.4);61.0% in males, 56.6% in females.Lung cancer incidence alone declined by 64.8% in males and 54.1% in females aged [50][51][52][53][54][55][56][57][58][59]), with similar reductions in laryngeal, head and neck, and esophageal cancers.Declines in TRC mortality were steeper, falling by 65.5% (CI: 60.4-69.9) in ages 40-49 and by 62.1% (CI: 57.8-65.9) in ages 50-59.Non-TRCs showed substantially smaller declines in incidence (up to 25% change) and mortality over the same period.Excluding COVID years yielded similar findings.Conclusions: Hungary experienced a rapid and substantial reduction in TRC incidence and mortality among middle-aged adults, far exceeding declines in non-TRCs.Findings suggest a strong cohort effect consistent with reduced tobacco exposure following comprehensive national tobacco control policies.Hungary provides a realworld example that substantial reductions in TRC burden can be achieved within a single decade.