Incidence of and mortality from cervical cancer in northwest Russia is considerably higher than in developed countries. Increased incidence in recent years may be attributed to increased screening.
Цель исследования. Оценить динамику заболеваемости и доли I стадии подлежащих скринингу злокачественных новообразований (ЗНО) до и после внедрения диспансеризации отдельных групп взрослого населения (ДОГВН) на основе данных Архангельского областного канцер-регистра (АОКР). Материалы и методы. Из базы данных АОКР были взяты анонимизированные данные больных индексными ЗНО (ободочной, прямой кишки, легкого, молочной железы, шейки, тела матки, яичников, предстательной железы, почки), подлежащими обследованию (скринингу) на первом этапе ДОГВН с 2000 по 2018 годы. Оценивали динамику числа новых случаев, грубых, стандартизованных по возрасту показателей заболеваемости и доли I стадии. Интервенционное значение ДОГВН считали положительным в случае обнаружения изменения линейного тренда избранных показателей при сегментированной регрессии в период между 2012 и 2014 гг. Результаты. Итоговая выборка включала 46146 случаев ЗНО. Ежегодное число новых случаев и грубые показатели заболеваемости при всех взятых для анализа ЗНО с 2000 по 2018 гг. возрастали. После стандартизации по возрасту рост заболеваемости наблюдался при всех индексных ЗНО, кроме рака легкого. В модели сегментированной регрессии для большинства ЗНО этот прирост был монотонным с ежегодным изменением от 1,5% (при раке яичников) до 5,0% (рак шейки матки). При раке предстательной железы излом линейного тренда стандартизованной по возрасту заболеваемости с ростом на 8,5% в год обнаружен в 2012 г. Доля I стадии не изменилась либо монотонно возрастала после внедрения ДОГВН при раке тела матки и яичников, ободочной кишки. Увеличение прироста пропорции I стадии обнаружено при раке прямой кишки с 2010 г., молочной железы с 2011 г., шейки матки с 2013 г., предстательной железы с 2014 г., почки с 2006 г. на 7,5%, 9,6%, 9,6%, 40,3%, 13,4% в год в последнем временном сегменте, соответственно. Заключение. Диагностические тесты, использованные в рамках ДОГВН, чувствительны к выявлению ранних стадий рака молочной железы, шейки матки, предстательной железы; при колоректальном раке и раке почки их значение сомнительно. Эффективность ранней диагностики в рамках ДОГВН не подтверждена при раке легкого, тела матки, яичников. При ЗНО, чувствительных к скринингу, необходимо проведение анализа смертности и выживаемости.
An analysis of the gastric cancer incidence, mortality, five-year survival rate and the frequency of early revealing in the Republic of Kazakhstan for the period 2005-2014 was performed. As a result of the study, a statistically significant trend in declining incidence (from 18.9 to 16.4 per 100 000 population) and mortality from (from 15.0 to 11.8 per 100 000 population) was revealed. The frequency of early detection of gastric cancer (I-II stages) increased from 16.8 % to 34.2 %, but the five-year survival rate began to increase only in 2012. The incidence of gastric cancer decreased in 5 regions of Kazakhstan, mortality decreased in 9 regions, the increase in the frequency of early detection was observed in 8 regions of 16.
Objective. Assessment of the rectal cancer (RC) incidence and stage structure trends in the Arkhangelsk region (AR), Russia before and after implementation of national programs for health system reforming based on population data of the Arkhangelsk Regional Cancer Registry (ARCR) over the period 2000–2015.Materials and methods. Anonymized data on all cases of RC (C19.0‑C21.0) in the AR in 2000–2015 were extracted from the database of the ARCR. Over the study period, 3721 cases of the RC were selected. Age-standardized (ASR) RC incidence rate was calculated. Population number and its age distribution were taken from the Regional Bureau of Statistics, Arkhangelskstat. Time trends were analyzed using segmented regression.Results. Over the period, an incidence (ASR) of RC in AR increased from 11.5 to 14.2 per 100000. The incidence rates in the male population were higher than in women: 20.3 vs 12.6 in 2015. The growing trend of male incidence was stable. The ASR of RC incidence in female increased significantly by 4.6% per year in 2011–2015. RC ASRs for both urban and rural populations were growing, 12.3 and 20.4 per 100000 in 2015, respectively. StagesI, II, III and IV were established in 14%, 50%, 9% and 21% of cases, however, the stage I in urban residents was detected 4% more often. The proportion of stage I non-significantly varied from 10.6% to 13.3% in 2000–2015. After the introduction of the National Project “Health”, the proportion of the stage IV non-significantly decreased by 5.4% per year, same after the introduction of the All-national Dispensarization it non-significantly increased by 5.4% per year.Conclusion. Implementation of national programs for health system reforming didn’t provide significant improvement in earlier detection of RC. Introduction of national screening programs is necessary. A higher incidence rates among males and rural population require detailed analysis.
Aim. Assessment of the rectal cancer (RC) incidence and mortality in the Arkhangelsk region (AR), North-Western Russia according to population-based data of the Arkhangelsk Regional Cancer Registry (ARCR) over the period 2000-2015. Methods. Data on all cases of RC in the AR were extracted from the database of the ARCR. 3 721 cases of the RC were selected. For mortality estimation 2 187 cases of RC were taken over the study period. Age-standardized (ASR) RC rates were calculated. Population number and its age distribution were taken from the Regional Bureau of Statistics, Arkhangelskstat. Time trends were analyzed using segmented regression. Results. Incidence of RC in AR increased from 11.5 to 14.2 per 100 000; 18.6 vs 11.8 among men and women in 2015, respectively. The female RC incidence increased significantly by 4.6 % per year in 2011-2015. The incidence of both urban and rural populations was 11.8 and 18.7 per 100 000 in 2015, respectively. Mortality estimates ranged from 10.0 to 12.2 per 100 000 in 2005-2015, respectively. Mortality among males was higher than in females - 19.9 vs 8.4 per 100 000 in 2015, respectively. The trend of male mortality significantly increased by 6.5 % per year in 2011-2015, while in females the mortality has been decreasing by 0.7% per year from 2009 to 2015. Conclusion. Epidemiological model for RC in both AR and Russia shows progressively increasing incidence and mortality rates and substantially differs from that in developed countries. A higher incidence rates among males and rural population require detailed analysis.
Рак прямой кишки (РПК) - это злокачественная опухоль дистального отдела толстой кишки эпителиального происхождения. Ежегодно в России регистрируется более 30 тыс. (30 969 в 2018 г.) новых случаев РПК и 16 тыс. (16 151) случаев смерти. Индекс достоверности учета (отношение числа умерших к заболевшим) составляет 0,52 %. РПК относится к локализациям со средним уровнем летальности. В Северо-Западном Федеральном округе зарегистрировано более 3 тыс. первичных случаев РПК (3 285 в 2018 г.). Государственная статистика РПК представляет данные о заболеваемости и смертности населения по трем рубрикам МКБ-10 вместе (С19-21). Детальная разработка данных не только отдельно по каждой рубрике МКБ-10, но и по четвертому знаку возможна только по материалам баз данных раковых регистров. Созданный нами Популяционный раковый регистр Северо-Западного Федерального округа насчитывал на 01.01.2019 г. более 1 млн (1 067 661) случаев злокачественных новообразований (ЗНО), в том числе РПК - 50 745 случаев, или 4,8 %. Удельный вес РПК близок к среднероссийскому - 4,9 %. В работе представлена детальная структура онкологической патологии по РПК. Ведущая роль из трех указанных рубрик принадлежит ЗНО прямой кишки (С20) - 75,4 %; 19,8 % приходится на ЗНО ректосигмоидного отдела (С19) и только 4,7 % на С21 - ЗНО ануса и анального канала. По всем этим рубрикам представлена динамика структуры, которая оказалась достаточно устойчивой. Rectal cancer is a malignant tumor of the distal colon of epithelial origin. Every year, more than 30,000 (30 969 - 2018) new cases of Rectal cancer and 16,000 deaths (16 151) are registered in Russia. The index of reliability of accounting (the ratio of the number of dead to sick) is 0,52 %. Rectal cancer refers to localities with an average mortality rate. In the North-Western Federal district, more than 3 thousand primary cases of Rectal cancer were registered (3285 - 2018). The state statistics of the Rectal cancer provides data on morbidity and mortality in three categories of ICD-10 together (C19-21). Detailed development of data not only separately for each category of ICD-10, but also for the fourth sign is possible only from the data bases of cancer registers. As of 01.01.2019, the Population cancer register of the North-Western Federal district created by us totaled more than 1 million cases of malignant tumors (1 067 661), including Rectal cancer - 50 745 cases, or 4,8 %. The share of the Rectal cancer is close to the national average - 4,9 %. The article presents a detailed structure of cancer pathology in Rectal cancer. The leading role of the 3 specified categories belongs to the rectal malignant tumors (C20) - 75,4 %, 19,8 % falls on the malignant tumors of the rectosigmoid department (C19) and only 4,7 % on the C21 - malignant tumors of the anus and anal canal. For all these categories, the dynamics of the structure is presented, which proved to be quite stable.
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