Introduction. In the current environmental situation in Russia, the organization of early detection of cancer in women of fertile age is of particular importance, which has medical, social and demographic consequences. Among malignant neoplasms in women - breast cancer takes the first place in the Russian Federation. 30% of the cases are women of working age. The increase in the incidence of breast cancer in the Chelyabinsk region from 2008 to 2018 was about 30%. In 2018, the proportion of stage I-II breast cancer is 67.5%. To improve the quality of specialized medical care for patients with suspected and/or established breast cancer on the basis of the state medical institution «Chelyabinsk regional clinical center of Oncology and nuclear medicine» in 2018, a center for diagnosis and treatment of breast tumors (hereinafter - the Center) was established. Purpose of work. Analysis of the first results of the Center’s work. Materials and methods. Patients referred for consultation to the Center from 01.11.2018 to 31.08.2019. Results. As a result of the work of the Center for 10 months, there was a reduction in the time of examination of patients with suspected breast cancer from 30 to 14 calendar days. The share of detected breast cancer in the region at localized stages for 10 months of 2019 was higher (69.5%) compared to the same period of 2018 (66.7%), which is based on an increase in active detection of pathology in the established Center. Discussion. The creation of the Center has increased the availability of specialized care for patients with breast pathology. Reduced time for examination and conduct of trepan-biopsy of the tumor to confirm the diagnosis. Patients with breast cancer have a personalized approach to the treatment program. Conclusion. The establishment of the Center allows to improve the quality of specialized medical care for patients with suspected and/or established breast cancer.

ель исследования. В исследовании предпринимается попытка ответить на вопрос, подвержены ли риску развития отдалѐнных эффектов пациенты, неоднократно обследованные на компьютерном томографе по показаниям, связанным с диагностикой онкологической патологии, в течение последующих лет наблюдения. Материалы и методы. В качестве исследуемого эффекта рассматривалась смертность от злокачественных новообразований. Фактором риска радиационной природы считалось диагностическое облучение, полученное пациентом при прохождении компьютерной томографии. В течение периода наблюдения оценивалась кратность облучения в зависимости от возраста и других факторов. Среди обследованных лиц выделялось две группы: персонал предприятия ядерно-промышленного комплекса, в процессе трудовой деятельности подвергавшийся воздействию ионизирующего излучения от различных источников, и население, проживавшее на прилежащей к предприятию территории, не подвергавшееся его воздействию. Результаты. Получены оценки относительного риска смерти от злокачественных новообразований в зависимости от факторов радиационной и нерадиационной природы. Заключение. Результаты исследования предоставляют дополнительную информацию, необходимую для проведения многофакторного эпидемиологического анализа с целью оценки риска воздействия малых доз облучения непроизводственного характера у персонала предприятий ядерно-промышленного комплекса и населения, проживающего на прилежащей территории. Ключевые слова: КТ, МСКТ, раковый регистр, диагностическое облучение, онкологическая патология, медицинское облучение, радиогенный риск.

The aim of this study was to determine the most effective approach to the treatment of patients with continuous growth of brain glioma.Material and Methods. The study included 200 patients with progression of primary brain glioma, who were treated at the Chelyabinsk Regional Center of Oncology and Nuclear Medicine in the period from 2001 to 2021. The average age of patients was 47.86 ± 11.47 years. The ratio of men to women was 1:1. The continuous growth of high-grade glioma was detected in 125 cases. The progression of lowgrade glioma was observed in 40 patients. Transformation of low-grade glioma into high-grade glioma was found in 35 patients. Re-surgery was performed in 92 patients. Repeated radiation therapy was given to 140 patients. Chemotherapy as the method of choice was administered to 60 patients.Results. The median overall survival (OS) time was 36 months. The 1and 2-year survival rates were 96.0 % and 59.4 %, respectively. The method-specific overall survival time was 15 months. There was a tendency towards an increase in OS in all subgroups of patients who underwent re-surgery. The highest method-specific overall survival rates were observed in patients who received stereotactic radiation therapy (STRT) and combined photon-neutron therapy (CPNT): 23 and 47 months in patients with high-grade glioma and 60 and 72 months in patients with continuous growth of low-grade glioma, respectively (p>0.05). In patients with the transformation of low-grade glioma into high-grade glioma, the method-specific OS was higher in patients who received combination of chemotherapy and radiation therapy compared to those who received chemotherapy or radiation therapy alone: 32, 12, and 24 months, respectively (p>0.05).Conclusion. Repeated surgery is the optimal treatment approach for patients with continuous growth of primary brain glioma. In cases with repeated radiotherapy courses, CPNT or STRT can be the methods of choice. Treatment of patients with transformation of low-grade gliomas

The purpose of the study was to analyze the incidence of primary-multiple cancer (PMC) of the female reproductive system according to the population cancer register of the Chelyabinsk region for 15 years (1999-2013) using the example of PMC of the cervix. Carry out an analysis of the adjusted cumulative survival in the group of patients with PMC of the cervix as compared with solitary cervical cancer.Material and methods. The material was processed using the classification of Zisman I. F. and Kirichenko G. D. (1978) on the sequence of tumors: metachronous, synchronous, mechatronic-synchronous and synchronous-metachronous. The interval of metachronousness is 6 months. The survival rates of cancer patients in the Chelyabinsk region were calculated automatically with the use of the computer program "Calculation of survival rates" — an application to the population-based cancer registry of OOO Novell-SPb. Using the method of continuous sampling, we carried out a retrospective analysis of the case histories of patients with PMC of the female reproductive system treated in the SBEO CRCOD for 15 years (1999-2013).Results. During the period under review, 82 patients with PMC of the cervix uteri were examined, metachronous tumors prevailed in 55 (67.1%), synchronous tumors developed in 27 (33.75%). In the group of metachronous tumors in 12 (21.8%) patients had a combination of three tumors. Three (5.45%) patients had a combination of four tumors. Analysis of combinations of cervical cancer showed that more often, the cervical cancer metachronically met with breast cancer 35% (14 patients), endometrial cancer 17.5% (7 patients), ovarian cancer 7.5% (3 patients). Synchronously cervical cancer was more often combined with breast cancer 42.8% (9 patients), endometrium 28.6% (6 patients), ovaries 23.8% (5 patients) and rectal cancer 4.8% (1 patient).The results of calculation of the index of the adjusted cumulative survival of the study group of the PMC of the cervix showed that in the group of metachronous tumors, survival rates were significantly higher than in the group of synchronous tumors: single-year survival was 84.8 ± 6.3% against 82.4 ± 9.2, three-year survival — 66.8 ± 7.8% against 47, 1 ± 12.1, and five years after the diagnosis, 53.8 ± 8.6% of patients survived.Conclusion. Thus, patients with cervical cancer are at risk of developing cancer of other localizations that share common etiopathogenetic factors, such as HPV infection in women, hormonal disorders.

Онкологические заболевания являются одной из важнейших медико-социальных проблем мирового сообщества. Социальное и экономическое значение злокачественных новообразований (ЗНО) обусловлено повсеместным ростом онкологической заболеваемости, увеличением потерь общего и трудоспособного населения, возрастанием расходов на специальное лечение и социальное страхование онкологических больных вследствие инвалидизации [1-3].

Background. The proportion of malignant neoplasms detected at the IIIIV stages of the disease in Chelyabinsk region is large and 43.9%. Breast cancer in 2018 was detected at stages IIIIV at 24% and cervical cancer at 51.14%. Despite the fact that malignant neoplasms of vulva and vagina are diagnosed annually in isolated cases, the level of neglect reaches 66.7 and 100% respectively, which makes it necessary to develop organizational measures. Aims to increase the level of detection of visual localities OF female reproductive system organs in the early stages with the involvement of oncologists of regional clinics in the primary diagnosis. Materials and methods. Patients with malignant neoplasms of the reproductive system of visual localizations, first identified in the examining cabinet of the polyclinic of the central district hospital, geographically located and functionally subordinate oncologist of the rural municipal district. Comparative assessment of early detection of tumors in an area with high breast cancer and cervical cancer and results following the introduction of a new organizational structure. Results. Patients with malignant neoplasms of the reproductive system of visual localizations, first identified in the examining cabinet of the polyclinic of the central district hospital, geographically located and functionally subordinate oncologist of the rural municipal district. Comparative assessment of early detection of tumors in an area with high breast cancer and cervical cancer and results following the introduction of a new organizational structure. Conclusions. The involvement of oncologist of territorial polyclinics to participate in preventive examinations, which were previously within the competence of the medical assistant of the Examining Cabinet, during the first year of work increased detection and reduced the incidence of breast and cervical cancer by 8.3 and 3.7% respectively. The creation of the Breast Pathology Center in the regional oncology center, at the third level of specialized medical care on the profile of oncology, allowed to reduce the frequency of malignancy of benign and pre-cancer breast diseases.

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The registration system of cancer cases has been established and perfected over the last half a century across the world. A unified approach to the registration of cancer cases and provision of high quality cancer registry data are the key to reliable epidemiological indicators in oncology as the essential basis for development of cancer control programs. Any deviations in the approach to registration of cancer cases can distort the epidemiological pattern and lead to incorrect prioritization and misallocation of resources. The Russian Federation has experienced a number of problems in the cancer registry system that requires thoughtful organizational solutions. Possible improvements are here addressed on the background of the application of Chelyabinsk Population-based Cancer Registry for inclusion in Cancer in Five Continents and other IARC publications.