scholarly journals The state of cancer care in Russia: malignant tumors of the skin (C44). Prevalence, index of accuracy, localization and histological structure. Population-based research at the federal district level

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).

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 18 (3) ◽  
pp. 578-583
Author(s):  
V. M. Merabishvili ◽  
E. N. Merabishvili

Objective. In February 2019, we completed work on creating a unified database of the population cancer registry of the NorthWestern Federal district of the Russian Federation. The development of data on the material of a large area significantly increases the reliability of the material under study, especially for RARE localities of malignant tumors, which include tumors of the eye and and adnexa.For the first time in Russia to present an analysis of the effectiveness of anti-cancer activities in relation to malignant tumors of the eye and adnexa (C69) at the Federal district level with calculations of 5-year survival rates of patients taking into account sex, age and histological structure of tumors.Methods. The development of the 5-year survival rate of patients with malignant tumors of the eye (C69) included information from the database created by us Population cancer register of all administrative territories of the North-Western Federal district of Russia for the period from 1999 to 2013, more than 1000 observations (1022).Results. The study revealed a positive dynamics of survival in patients of the North-Western Federal district of Russia with malignant tumors of the eye. The 5-year survival rate increased among males from 58.8 to 63.1 %, and among females from 64.7 to 69.6 %. A significant overestimation of the proportion of early stages among primary patients with malignant tumors of the eye and adnexa (C69) was found, which may be due to medical errors. Calculations of patient survival (with careful tracking of the deceased) allow us to get a more objective picture.Conclusion. Excellent achievements in the treatment of patients of advanced research centers and institutes can be welcomed only if similar successes are recorded at the population level and are available to all patients. Our in-depth development of population data in the Federal district confirmed the success in the treatment of patients with the malignant tumors of the eye and adnexa (C69), and the patterns we found first in the database of the Population cancer register of St. Petersburg, and now in the North-Western Federal district of the Russian Federation. Similar studies in other Federal districts could be an important component in the planning, monitoring and evaluation of anti-cancer measures in relation to the malignant tumors of the eye and adnexa (C69).


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.


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.


2020 ◽  
Vol 66 (6) ◽  
pp. 630-637
Author(s):  
Vakhtang Merabishvili ◽  
Elvira Merabishvili

Malignant melanoma of the skin (MMS) is one of the many types of skin tumors that consists of three layers – the epidermis, dermis and hypoderma. MMS develops from melanocyte cells located in the basal layer of the epidermis and producing the pigment melanin. The melanocyte is a dangerous and vindictive cell, it remembers all sunburns and accumulates them. It is the melanin that gives the skin a brown hue as a result of insolation. It also determines the skin color of African-Americans. Birthmarks are also examples of a cluster of melanocytes. In the structure of cancer incidence in economically developed countries, MMS occupies a fairly modest place, but over the past 30 – 40 years, there has been an unfavorable trend. In Russia, MMS is not even among the top ten main localities of malignant tumors, its even smaller share in the overall structure of malignant tumors in Russia was in the 80s of the XX century. Until 1982, state reporting did not provide a set of data on the MMS in the USSR and in Russia, including. At our suggestion, in 1982, the Ministry of health of the USSR decided to allocate a separate line in the state reporting for malignant tumors. In this study, along with assessing the prevalence of MMS in the world and Russia, we focused on the in-depth development of materials for the North-Western Federal district, mainly based on data from the established population cancer registry (PCR). For many years, the analysis of cancer incidence and survival of patients with malignant tumors was carried out by us on the basis of the PCR of St. Petersburg. In February 2019, the first cancer registry at the Federal district level appeared in Russia – PCR of the NWFD of the Russian Federation. As of 01.02.2019, the PCR of the NWFD of the Russian Federation had more than 1 million cases of malignant tumors (1,067,661), including more than 20,000 (21,428) with MMS (2.0%). The PI on the Federal district level allows for in-depth development of the dynamics of localization and histological structure of malignant tumors fourth sign of ICD–10 to study the characteristics of prevalence and survival of patients malignant tumors in any part of the localization structures (lips, ear, trunk, upper and lower extremities, etc.) that cannot be done on the basis of public reporting, and provide analysis of survival of patients of any localization.


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 67 (3) ◽  
pp. 361-367
Author(s):  
Vakhtang Merabishvili ◽  
Iuliia Iurkova ◽  
Aleksandr Shcherbakov ◽  
Evgenii Levchenko ◽  
Anton Barchuk ◽  
...  

Lung cancer (LC) is the main cause of morbidity and mortality in the population of Russia and many economically developed countries of the world. At the same time, referring to localizations with a high mortality rate, the official data on the number of recorded primary cases (which form the incidence rate) are significantly underestimated, which is confirmed by the registration reliability index, which in many territories is higher than critical values. The aim of our study is to present the real state of the prevalence of PC in Russia, based on the newly created database (DB) of the population cancer register (PRR) of the Northwestern Federal District of the Russian Federation (NWFD RF) — the only one in Russia. We analyzed the loss of the number of primary patients who were not included in the state reporting, showed the real value of the achieved death rate of patients in the first year of dispensary observation, calculated the patterns of annual mortality of patients, the median of survival and 1 and 5-year survival of patients with lung cancer based on the database of the population cancer registry. Northwestern Federal District of the Russian Federation, on the materials of which for the first time in Russia the dynamics of changes in the detailed localization and histological structure of lung cancer was traced.


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.


Author(s):  
В. М. Мерабишвили ◽  
А. М. Беляев

Полностью сформированная база данных Популяционного ракового регистра (БД ПРР) Северо-Западного Федерального округа Российской Федерации (СЗФО РФ) в феврале 2019 г. позволила существенно расширить возможности объективной оценки деятельности онкологической службы на более надежной основе аналитических материалов. В России впервые появилась возможность проводить эпидемиологические исследования злокачественных новообразований по редким локализациям опухолей, любым возрастным группам и расчеты показателей выживаемости больных. БД ПРР насчитывает более 1 млн наблюдений, включает все рубрики и подрубрики МКБ-10 по II классу - коды С00-96. В работе представлена динамика заболеваемости и смертности населения СЗФО РФ в сравнении со среднероссийскими показателями, достоверность учета и выживаемость больных злокачественными новообразованиями. Установлено увеличение онкологической заболеваемости в СЗФО РФ за 8 лет на 10,4% в стандартизованных показателях и снижение смертности населения в СЗФО РФ на 11,4% в тех же показателях. Рассчитана динамика пятилетней наблюдаемой выживаемости больных СЗФО РФ с учетом возрастных групп. Надежность БД ПРР СЗФО РФ подтверждается тем, что материалы трех административных территорий после тщательной проверки включены в монографию МАИР «Рак на 5 континентах», том XI (Санкт-Петербург, Архангельская обл. и Республика Карелия). The completely formed database of the Population Cancer Registry (PCR database) of the North-Western Federal district of the Russian Federation in February 2019 has significantly expanded the ability to objectively assess the activities of the cancer service on a more reliable basis of analytical materials. In Russia, for the first time, it was possible to conduct epidemiological studies of malignant tumors for rare tumor locations, any age groups, and calculations of patient survival rates. The PCR database has more than 1 million observations and includes all the headings and subheadings of ICD-10 for class II - codes C00-96. The article will present the dynamics of morbidity and mortality of the population of the northwestern Federal district of the Russian Federation in comparison with the national average, the reliability of accounting and survival of patients with malignant tumors. For 8 years, the growth of cancer incidence in the Northwestern Federal district of the Russian Federation by 10,4 % in standardized indicators and a decrease in population mortality in the Northwestern Federal district of the Russian Federation by 11,4 % in the same indicators. The dynamics of the 5-year observed survival rate of patients with Northwestern Federal district of the Russian Federation, taking into account age groups, is calculated. The reliability of the PCR database of the Northwestern Federal district of the Russian Federation is confirmed by the fact that the materials of 3 administrative territories are included in the IARC monograph «Cancer incidence in five continents. Vol. XI» (Saint-Petersburg, Arkhangelsk region and the Republic of Karelia).


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