The prevalence and demographic associations of primary headache disorders in the adult population of Poland: a national cross-sectional population-based study

Headache disorders are leading causes of ill health worldwide, yet sound epidemiological data from many parts of Central and Eastern Europe are lacking. This study provides the first nationwide, population-based estimates of the prevalence of headache disorders in Poland. A cross-sectional study was conducted as part of the Global Campaign against Headache. Aiming for a population-representative sample, we recruited Polish adults (aged 18–65 years) using a random quota-sampling method. Data were collected via Computer-Assisted Web Interviewing (CAWI) enquiry, following the Headache-Attributed Restriction, Disability, Social Handicap and Impaired Participation (HARDSHIP) questionnaire. Diagnoses were based on the International Classification of Headache Disorders, 3rd edition (ICHD-3) criteria. In response to 30,850 invitations sent, 5,992 individuals completed the survey (first-level participating proportion 19.4%), of whom 862 were ineligible (aged > 65 years) and 681 were excluded (and deemed to be non-participants) following multi-stage quality control (second-level non-participating proportion: 681/(5,992 − 862) = 13.3%; overall participating proportion: 19.4 × (100 − 13.3)/100 = 16.8%). In the final analytical sample of N = 4,449, observed 1-year prevalence of any headache was 81.4% (87.1% among females; 74.9% among males). Tension-type headache (TTH) was the most common type (gender-adjusted 1-year prevalence estimate 45.5%), more prevalent among males than females (observed prevalence 48.9% versus 42.4%; p < 0.001). Gender-adjusted 1-year prevalence of migraine was 31.6% (males 22.8%; females 39.8%), varying with age (peaking among males aged 25–34 years [29.2%] and a decade later among females [43.0%]). Headache on ≥ 15 days/month (H15+) was reported by 6.5% of participants, with 1.6% meeting criteria for probable medication-overuse headache. Migraine prevalence increased with education level (up to 34.6% among university graduates), while H15 + was most frequent among those with only primary education (8.9%). Our findings provide the first comprehensive national dataset as a basis for health policy reforms and resource allocation in Poland. Considering the methodological limitations of CAWI-based surveys, prevalence estimates require cautious interpretation. Since they are higher than those from some neighbouring countries, a likely selection bias must be acknowledged. Estimates of attributed burden (lost health, wellbeing and productivity) are now needed.