scholarly journals Stages of development of the system of objective assessment of the cancer service of Russia, the northwestern Federal district of the Russian Federation (morbidity, mortality, reliability of accounting, primary mortality, median survival, observed and relative survival of patients with malignant neoplasms). Part I.

2021 ◽  
Author(s):  
Vakhtang M. Merabishvili ◽  
Alexey M. Belyaev

The first part of the study includes a brief historical outline on the creation of an objective system for assessing the activities of the oncological service in Russia and the Northwestern Federal District of the Russian Federation.Dynamic series of all types of indicators of the populations morbidity and mortality have been presented, an increasing process of reliability and improvement of the quality of registration of primary patients with malignant tumors has been shown.In Russia, aswell as in the Northwestern Federal District of the Russian Federation, standardized indicators of the malignant tumorsincidence remain at a relatively low level. In the world ranking of Cancer Registries, the Russian Federation is on 300th place among 450 others.The mortality rate of the population in most localizations isrecorded above the average European indicators.

2021 ◽  
Author(s):  
Vakhtang Merabishvili ◽  
Alexey M. Belyaev

To plan anti-cancer measures and to correctly manage its condition, it is necessary to use only reliable sources of its formation. For this purpose, a system of Population-based or territorial Cancer Registries (PCR) has been created in Russia. The first Registry was the St. Petersburg PCR, created by us in 1993, which became the school of methodological preparation of the system in the administrative territories of Russia. The corresponding Order No. 420 of April, 19, 1996 issued by the Ministry of Public Health of the Russian Federation has legitimized a new organizational structure and entrusted it with the supervision of the P. Hertsen Moscow Oncology Research Institute. Unfortunately, to date, the PCR databases are not used, when creating state reports, analytical developments on the PCR database are either not conducted, or are used extremely rarely. The only exception was the St. Petersburg PCR, and now the entire Northwestern Federal District of the Russian Federation (NWFD RF) and 6 more administrative territories operating under our programs. The materials of the real state of the oncological service, prepared on the basis of the St. Petersburg PCR database, have been published by us in more than 20 monographs in St. Petersburg and the Northwestern Federal District of Russia. In this paper, we present the dynamics of analytical indicators calculated according to the PCR database, which sharply differ from the data of the Form No. 7 Annual Reports. The calculated indicators are close to the European average and have a positive trend.


2021 ◽  
Author(s):  
Vakhtang M. Merabishvili

Malignant tumors remain the most important public health problem in the world, being the second or even the leading cause of death in some countries. Cancer incidence is greatly influenced by the ever-increasing environmental hazards. Population-based Cancer Registries (PCRs) provide necessary data to monitor and assess cancer incidence. PCRs collect obligatory data on incidence rate with time series analysis, mortality and survival rates in patients diagnosed with malignant tumors. The study presents the results of the operation of PCRs as exemplified in the analysis of the PCR of Saint Petersburg and the Northwestern Federal District of the Russian Federation.


2021 ◽  
Vol 67 (5) ◽  
pp. 635-639
Author(s):  
Vahtang Merabishvili

Malignant tumors of the skin — visual localization, with a low mortality rate. Despite the fact that malignant tumors of the skin (C44) belong to the group of malignant tumors in many countries, cancer registries did not keep its records, the same attitude to this tumor was developed by doctors, which makes it difficult to conduct comparative studies between countries. When selecting data for the analysis of the prevalence of malignant tumors of the skin, in addition to the heading C44, a part of the heading ICD-10 — C46 — Kaposi's sarcoma — its part C46.0 — Kaposi's sarcoma of the skin is added. In many cases, it is not taken into account, due to its extremely rare occurrence, which does not have any practical impact on all the main analytical indicators. The purpose of this study is: for the first time in Russia, to consider not only the patterns of the prevalence of malignant tumors of the skin, but also to study the specifics of the localization and histological structure of this tumor localization, based on the newly created database of the population cancer Registry (PCR) of the North-Western Federal District of the Russian Federation (NWFD of the Russian Federation).


2017 ◽  
Vol 63 (1) ◽  
pp. 28-37
Author(s):  
Vakhtang Merabishvili ◽  
Aleksey Okeanov ◽  
Pavel Moiseev ◽  
Alesya Yevmenenko ◽  
Igor Krasilnikov ◽  
...  

Background: Colon cancer (CC) refers to a group of malignant tumors (MT) with a high rate of morbidity increase. In Russia, only from 2000 to 2014 the standardized incidence rate has increased from 12.9 to 16.6 0/0000, or by 28.7% among males, and from 10.8 to 13.10/0000, or by 21.9 % among females. In the Republic of Belarus (RB) the level of CC incidence has increased from 12.0 to 18.0 0/0000 (by 50%) among males and from 9.0 to 13.40/0000 (by 44.4%) among females. In the City of Minsk the level of CC incidence was highest in 2000 and 2014 and has increased by 33.5%, while in St. Petersburg it was lower than in a number of regions of the North-West Federal District of the Russian Federation (NWFD RF) and has decreased by 8.8% for 15 years. Purpose of the study: To present a comparative evaluation of the main analytical rates of CC morbidity, its mortality and the state of contemporary diagnosis in RB and NWFD RF. Materials and methods: The basis of this work consisted of materials of population-based cancer registries databases of RB and NWFD RF. Also there were used published data to compare the basic parameters. For the estimation of the rates there were used the traditional methods. Standardized rates were estimated on the basis of the world standard population structure. Cartograms were prepared on the basis of the methodology of geographic information systems (GIS). Analysis of obtained data: There was performed a precise analysis of population-based data on CC, including particularly the 4th sign of ICD-10 and identified a number of patterns of CC incidence at present stage. Conclusion: CC incidence increases in Russia, North-West Federal District of the Russian Federation and in Republic of Belarus. Registering rates and the state of cancer control have improved at all comparable administrative territories. It primarily concerns such parameters as morphological verification level, early diagnosis, one-year lethality and others. Comparative monitoring and a study of experience in various administrative territories and countries with the best rates could be useful for planning effective anti-cancer programs.


2018 ◽  
Vol 5 (4) ◽  
pp. 238-247
Author(s):  
M. Yu. Rykov

Background. Improving the quality of medical care is based on a coordinated policy at the federal, regional and municipal levels in the field of health. The implementation of this goal is based on a regular assessment of the current state of the healthcare system in the Russian Federation.Objective. Our aim was to analyse of the main indicators characterizing medical care for children with cancer in the South Federal District.Methods. The operative reports for 2017 of the executive authorities in the sphere of health protection of 8 subjects of the Russian Federation that are part of the South Federal District of the Russian Federation have been analyzed.Results. The number of children were 3 216 797 people (aged 0–17 years), the number of children’s oncological beds is 272 (0.8 per 10 thousand children aged 0–17 years), the average number of days of berth employment in the year is 289.9 bed days. In 4 (50%) subjects of the department of pediatric oncology are absent, in 1 (12.5%) — there are no children’s oncological beds. The number of doctors providing medical care to children with cancer is 50, of them 42 (84%, 0.1 per 10 thousand children aged 0–17 years) have a certificate of a pediatric oncologist. In 2 (25%) subjects, there are no pediatric oncologists. Incidence of malignant tumors was 13.9 (per 100,000 children aged 0–17 years), prevalence was 86.5 (per 100,000 children aged 0–17 years), mortality was 2.5 (per 100,000 children aged 0–17 years), a one-year mortality rate of 4.7%. 8% of patients were actively detected. 104 (23.2%) of primary patients were sent to medical organizations of federal subordination, 4 (0.9%) of primary patients left the territory of the Russian Federation.Conclusion. The analysis revealed a number of defects: incorrect information contained in the reports, low incidence (detectability) of patients, including during planned preventive examinations, staff shortages and non-rational use of bed facilities.


2020 ◽  
Vol 66 (6) ◽  
pp. 638-644
Author(s):  
Vakhtang Merabishvili ◽  
Elvira Merabishvili

For any research development, we must first make sure that the material selected for research is reliable. Among the six main most reliable criteria for evaluating the performance of cancer services, such as morbidity, mortality, and the level of morphological verification of tumors – the most important indicators are the index of accuracy, primary mortality and survival of patients with malignant tumors. Purpose. To determine the level of index of accuracy for patients with skin melanoma (C43) and its dynamics from 1995 to 2018 in Russia as a whole and in a number of administrative territories. Calculate the 5-year observed and relative survival and typical mortality in the northwestern Federal district of the Russian Federation. Materials and methods of research. The material for the study is statistical collections, including author's ones, and the database of the cancer register of the northwestern Federal district of the Russian Federation. Standard methods of statistical analysis were used. Obtained result. It is important to note that for all administrative territories, whose PCR database were involved in calculating the 5-year observed and relative survival rates, the level of survival rates of patients with melanoma of the skin is significantly lower than the average European (Eurocare–4). Conclusions. Thus, the study revealed a significant improvement in the treatment of patients with malignant melanoma of the skin. At the same time, the estimated 5-year observed and relative survival rates of patients with malignant melanoma of the skin remain relatively low.


Author(s):  
В. М. Мерабишвили ◽  
В. К. Гуркало ◽  
Э. Н. Мерабишвили

Рак печени (РП) - тяжелейшая онкопатология. В России смертность превышает число первично-учтенных больных в среднем. Ежегодно в России регистрируют более 8 тыс. (8 810 - в 2018 г.) случаев рака печени и более 10 тыс. (10 018 - в 2018 г.) случаев смерти от этой причины. Использованы стандартные методы медицинской статистики, все зарегистрированные первичные случаи РП в России. Углубленная разработка материала проведена на основе базы данных Популяционного ракового регистра Северо-Западного Федерального округа РФ. Проанализированы данные всего комплекса доступной информации в целом по России. Установлен прирост заболеваемости РП населения России за 18 лет в «грубых» показателях и абсолютных числах на 20% и в стандартизованных - на 1,22%. У женщин отмечено снижение учтенных случаев РП на 4,55%. Смертность населения России в стандартизованных показателях снизилась за 18 лет практически на 3%. Превышение числа умерших над заболевшими от РП существенно возрастает в старших возрастных группах. Индекс достоверности учета (ИДУ) - это отношение абсолютных чисел или «грубых» показателей смертности населения к заболеваемости. Для всех злокачественных новообразований (ЗНО) величина в среднем по России составила 0,47, практически совпадающая со среднеевропейской. ИДУ у мужчин - 0,55, выше расчетных показателей для женщин - 0,40, что в первую очередь связано с более благоприятной структурой заболеваемости женщин ЗНО. Медиана выживаемости первичных больных РП составляет немногим более 3 мес. Пятилетняя выживаемость больных РП даже на ранних стадиях составляет у лиц моложе 60 лет с I стадией - 25,3%, старше 60 лет - только 17,2%, со II стадией - 17,9 и 11% соответственно. Liver cancer is a severe oncopathology. Mortality exceeds the number of primary-accounted patients in Russia on average. Every year in Russia more than eight thousand (8 810 in 2018) cases of liver cancer and more than 10 000 (10 018 in 2018) deaths from this cause are registered. Used Standard methods of medical statistics, all registered primary cases of liver cancer in Russia. In-depth development of the material was carried out on the basis of the database of the Population cancer register of the North-Western Federal district of the Russian Federation. The analysis of the data of the whole complex of available information in Russia as a whole is carried out. In-depth data development was carried out on the basis of the database of the Population cancer register of the North-Western Federal district of the Russian Federation. The increase in the incidence of liver cancer in Russia over 18 years in «rough» indicators and absolute numbers by 20 % and in standardized by 1,22 % was established. In women, there was a decrease in reported cases of liver cancer by 4,55 %. The mortality rate of the Russian population in standardized indicators has decreased by almost 3 % over 18 years. The excess of the number of deaths over those from liver cancer increases significantly in older age groups. The index of reliability of accounting is the ratio of absolute numbers or «rough» indicators of mortality to morbidity. For all malignant tumors, its value on average in Russia was 0,47, almost coinciding with the average European. The index of reliability of accounting for men is 0,55, higher than the calculated indicators for women - 0,40, which is primarily due to a more favorable structure of the incidence of malignant tumors in women. The median survival of primary liver cancer patients is a little more than three months. The fi ve-year survival rate of patients with liver cancer even in the early stages is in the first among persons younger than 60 years - 25,3 %, over 60 years - only 17,2 %, in the second, respectively, 17,9 and 11%.


2021 ◽  
Vol 5 (11(75)) ◽  
pp. 09-16
Author(s):  
E. Baeva ◽  
M. Burkova ◽  
E. Davidova

The objective of this exercise is to resolve the existing contradiction between the need for an objective assessment of the quality of training of IAO candidates for peacekeeping missions, based on specific training objectives, and the existing system for obtaining specific results of educational activities by means of a quantitative method for evaluating knowledge, skills and skills (pedagogical testing). This article deals with the current problem of assessing the quality of the educational process at the All-Russian Institute for Advanced Training of Staff of the Ministry of Internal Affairs of the Russian Federation when preparing candidates for participation in United Nations peacekeeping missions. The scientific novelty of the work consists in presenting private criteria for the formation of professional competence of the international UN police (motivational, communicative-activity, cognitive and personal-result) and indicators to each of these criteria. As a result, a system of objective and comprehensive evaluation of the educational process has been developed.


Federalism ◽  
2021 ◽  
pp. 25-42
Author(s):  
Е. S. Emelyanova ◽  
L А. Vasiliev

Climate change is a serious, widespread threat and requires an urgent global response, including in the management of environmental risks. The authors of the study, the results of which are presented in this article, first of all, set the task of assessing the ESG risks of Russian companies at the regional level. The methodology of the study was based only on the analysis of environmental risks due to the historical features of the development of the Russian Federation, the approach of S&P Global in the field of corporate sustainability assessment was adopted, and then the initial values of the companies ‘ E-ratings were adjusted using the impact map developed by the United Nations. To test the proposed approach to assessing environmental risks, we used a sample of data on types of economic activity in the context of the subjects of the Russian Federation. As a result of applying the proposed approach to data sampling, companies were assigned to one of the three categories that determine their exposure to E-risk: high, moderate, and low environmental risk. The E-risk exposure was also assessed based on the company’s regional affiliation to the relevant federal district. The main conclusion of the study was the confirmation of the need to improve the quality of analytics of companies ‘ exposure to environmental risks, the need for more detailed information disclosed by companies. 


2019 ◽  
Vol 65 (6) ◽  
pp. 807-815
Author(s):  
Vakhtang Merabishvili ◽  
Aleksey Belyaev

On the second part of the article the main attention is paid to the analysis of survival of patients with malignant tumors calculated on the base of the database of the population cancer register of the northwestern Federal district. The main criterion for assessing the state of oncological service is 1 and 5-years observed and relative survivals of patients with malignant tumors. Unfortunately, the number of cancer registers calculating survival rates of patients with malignant tumors according to international standards is limited in Russia. We present calculations of the dynamic series of the survival median. Defects of its objective assessment are revealed. Positive dynamics of 5-year observed survival of patients with malignant tumors in the Russian Federation is shown. Dynamics of 1 and 5 year survival of cancer patients is considered in pairs taking into account sex, age and stage of disease. There has been some improvement, especially among the female population. As can be seen from the data presented at the first year of observation, about 35 percent of patients die in the region, as in the most European countries.


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