Analysis of the ratio of mortality and morbidity in the population of the Republic of Belarus due to malignant neoplasms of various localizations. Trends in population mortality from malignant neoplasms Analysis of deaths from malignant neoplasms

Keywords

NEW FORMATIONS/ MORTALITY / AGE GROUPS/ FORECAST / NEOPLASMS / MORTALITY / AGE GROUPS / PROGNOSIS

annotation scientific article on clinical medicine, author of the scientific work - Askarov R.A., Karelin A.O., Askarova Zagira Fathullovna, Sharipova I.A.

The paper presents the results of an analysis of the dynamics and structure of mortality from malignant neoplasms population of the Republic of Bashkortostan for 2002-2014, calculated according to table data. C51, “Distribution of the dead by gender, age groups and causes of death" of Bashkortostanstat. To calculate statistical indicators, parametric, nonparametric methods and the time series analysis method were used. The dynamics of the indicators are generally comparable with all-Russian ones, i.e. there is a slight decrease in the mortality rate by 2014. The analysis shows that both the “crude” and standardized mortality rates on average in Russia per 100,000 population throughout the entire analyzed period were higher, than in the Republic of Bashkortostan. However, both men and women in the Republic of Bashkortostan have seen an increase in mortality from malignant cancers. neoplasms many localizations. According to forecast estimates, it is possible to reduce the mortality rate of the population of the Republic of Bashkortostan from neoplasms.

The analysis of mortality of malignant neoplasms of population in the Republic of Bashkortostan (2002-2014)

The article presents the results of analysis of dynamics and structure of mortality of malignant neoplasms of the population of the Republic of Bashkortostan in 2002-2014. The results were calculated according to data from table C51 "The distribution of the deceased by gender, age groups and causes of death" of Bashkortostan. To calculate statistical indices parametric, non-parametric and time series techniques were applied. On the whole, the dynamics of indices is comparable with national one i.e. insignificant decreasing of mortality is observed to 2014. The analysis tests that during all analyzed both the "raw" and standardized mortality indices per 100,000 in average were higher in Russia than in the Republic of Bashkortostan. However, in the Republic of Bashkortostan, both in males and females increasing of mortality of malignant neoplasms of many localizations is detected. According to prognosis estimates, decreasing mortality of neoplasms in the population of the Republic of Bashkortostan is possible.

Text of scientific work on the topic “Analysis of mortality from malignant neoplasms of the population of the Republic of Bashkortostan (for the period from 2002 to 2014)”

Health care of the Russian Federation, Russian journal. 2016; 60 (6) DOI http://dx.doi.org/10.18821/0044-197X-2016-60-6-303-307

Health care organization

Askarov R.A.1, Karelin A.O.2, Askarova Z.F.3, Sharipova I.A.3 ANALYSIS OF MORTALITY FROM MALIGNANT NEOPLASMS OF THE POPULATION OF THE REPUBLIC OF BASHKORTOSTAN (FOR THE PERIOD FROM 2002 to 2014)

1 State Budgetary Educational Institution of Higher Professional Education “Russian State Geological Prospecting University named after. S. Ordzhonikidze",

117997, Moscow;

2 State Budgetary Educational Institution of Higher Professional Education “First St. Petersburg State Medical University named after. acad. I.P. Pavlova", 197022, St. Petersburg; 3 State Budgetary Educational Institution of Higher Professional Education “Bashkir State Medical University” of the Ministry of Health of Russia, 450000, Ufa

The paper presents the results of an analysis of the dynamics and structure of mortality from malignant neoplasms of the population of the Republic of Bashkortostan for 2002-2014, calculated according to the data in Table. C51, “Distribution of deaths by gender, age groups and causes of death” of Bashkortostanstat. To calculate statistical indicators, parametric, nonparametric methods and the time series analysis method were used. The dynamics of the indicators are generally comparable with all-Russian ones, i.e. there is a slight decrease in the mortality rate by 2014. The analysis shows that both the “crude” and standardized mortality rates on average in Russia per 100,000 population throughout the entire analyzed period were higher, than in the Republic of Bashkortostan. However, both men and women in the Republic of Bashkortostan have seen an increase in mortality from malignant neoplasms of many locations. According to forecast estimates, it is possible to reduce the mortality rate of the population of the Republic of Bashkortostan from neoplasms.

Key words: neoplasms; mortality; age groups; forecast. For citation: Askarov R.A., Karelin A.O., Askarova Z.F., Sharipova I.A. Analysis of mortality from malignant neoplasms of the population of the Republic of Bashkortostan (for the period from 2002 to 2014). Healthcare of the Russian Federation. 2016; 60(6): 303-307. DOI: http://dx.doi.org/10.18821/0044-197X-2016-60-6-303-307

Askarov R.A.1, Karelin A.O.2, Askarova Z.F.3, Sharipova I.A.3 THE ANALYSIS OF MORTALITY OF MALIGNANT NEOPLASMS OF POPULATION IN THE REPUBLIC OF BASHKORTOSTAN (2002-2014)

"The S. Ordzhonikidze Russian state geological prospecting university, Moscow, 117997, Russian Federation; 2The I.P. Pavlov first St. Petersburg state medical university, St. Petersburg, 197022, Russian Federation; 3The Bashkir state medical university, Ufa, 450000, Russian Federation The article presents the results of analysis of dynamics and structure of mortality of malignant neoplasms of the population of the Republic of Bashkortostan in 2002-2014. The results were calculated according to data from table C51 "The distribution of the deceased by gender, age groups and causes of death" of Bashkortostan. To calculate statistical indices parametric, non-parametric and time series techniques were applied. On the whole, the dynamics of indices is comparable with national one i.e. insignificant decrease in mortality is observed to 2014. The analysis tests that during all analyzed both the "raw" and standardized mortality indices per 100,000 in average were higher in Russia than in the Republic of Bashkortostan. However, in the Republic of Bashkortostan, both in males and females increasing of mortality of malignant neoplasms of many localizations is detected. According to prognosis estimates, decreasing mortality of neoplasms in the population of the Republic of Bashkortostan is possible.

Keywords: neoplasms; mortality; age groups; prognosis.

For citation: Askarov R.A., Karelin A.O., Askarova Z.F., Sharipova I.A. The analysis of mortality of malignant neoplasms of population in the Republic of Baskortostan (2002-2014).

Zdravookhranenie Rossiiskoi Federatsii (Health Care of the Russian Federation,

Russian journal). 2016; 60 (6): 303-307. (In Russ.).

DOI: http://dx.doi.org/10.18821/0044-197X-2016-60-6-303-307

For correspondence: Zagira F. Askarova, doctor of medical sciences, professor, chair of hospital therapy the Bashkir state medical university, Ufa, 450000, Russian Federation. Email: [email protected]

Acknowledgments. The study had no sponsorship. Conflict of interest. The authors declare no conflict of interest.

For correspondence: Askarova Zagira Fatkhullovna, Dr. med. sciences, prof. department hospital therapy No. 2 GBOU VPO "Bashkir State Medical University" of the Ministry of Health of Russia, 450000, Ufa. Email: [email protected]

Introduction

Reducing the mortality rate of the population is one of the main goals of the priority national project “Health” and the Concept of demographic policy of Russia until 2025. It can be achieved by reducing mortality from diseases of the circulatory system, neoplasms, injuries, respiratory organs, which make the greatest contribution to the structure of high male mortality in our country. In this regard, it seems important to study the frequency, structure of mortality from neoplasms and trends in its changes, taking into account medical and demographic processes in different territories, which will provide the necessary information for planning preventive and therapeutic measures at both the state and regional levels, contributing to the improvement of oncological care patients, identifying pathology in the early stages. Mortality rates are of interest primarily in terms of assessing the effectiveness of combating these diseases, since much here depends on timely diagnosis.

In order to identify the main patterns in the dynamics of mortality from malignant neoplasms of the population of the Republic of Bashkortostan (RB), the situation for 2002-2014 was traced. This should help effectively initiate timely, adequate organizational decisions.

Material and methods

The material for the analysis of mortality from neoplasms was the data of Bashkortostanstat (Table C51) “Distribution of deaths by gender, age groups and causes of death”, on the population of the Republic of Belarus for the period 2002-2014, Rosstat. Modern statistical research methods were used in the work. The analysis of causes of death was carried out in accordance with the International Classification of Diseases, 10th revision. Extensive, intensive and standardized indicators of population mortality from malignant neoplasms were calculated based on generally accepted methods using the direct standardization method using the European standard for the age structure of the population. To assess the dynamics of mortality, the average annual growth rate of intensive indicators, as well as the trend (regression coefficient), were calculated.

results

Most medical and demographic indicators in recent years in the Republic of Belarus, as in Russia, have unfavorable trends in all main age groups of the population. Analysis of population dynamics by growth/decrease rates showed a decrease in the number of residents of the republic from 2002 to 2014 by 0.5% (from 4,090,601 to 4,071,987), including the number of children under working age (0-15 years) by 9.1% (from 872,024 to 793,043) and the working-age population by 2.5% (from 2,438,206 to 2,376,053). The number of people over working age increased by 13.8% (from 793,292 to 902,891). The age composition of the population of the Republic of Belarus is characterized by significant gender disproportion. The number of men as of 01/01/14 was 1,908,668, women - 2,163,319 people (there were 1,133 women per 1,000 men). The share of the urban population from 2002 to 2014 in the Republic of Belarus decreased from 65.4 to 61.7%,

Healthcare of the Russian Federation. 2016; 60 (6) RO! http://dx.doi.org/10.18821/0044-197X-2016-60-6-303-307

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which corresponds to an average degree of urbanization. Since 2009, the republic has recorded natural population growth, which in 2014 amounted to 1.7 per 1000 people. The population of the Republic of Belarus with the proportion of people aged 65 years and older is more than 12%, and according to the UN demographic aging scale, the population of the republic is considered old. The average age of residents of the Republic of Belarus in 2014 was 38.3 years (versus 36.4 years in 2002) (in the Russian Federation - 39.4 years), men, respectively, 35.9 years (34.2 years in 2002) (in the Russian Federation - 36.6 years), women - 40.4 years (38.4 years in 2004) (in the Russian Federation - 41.7 years). These indicators characterize the Russian Federation as a state with a relatively “young population.”

To estimate the future population size, forecasting was carried out using the extrapolation method, trend equations and regression analysis. The results of forecast estimates (average absolute growth, average growth coefficient, extrapolation, regression) showed a clear trend towards a decrease in the total population of the Republic of Belarus. The regression equation has the form: y = 4089.657 + (-2.202)x = 4089.657 + (-2.202)26 = 4032.4, which suggests that the total population of the Republic of Belarus will decrease to 4032.4014 thousand by 2025 . people (by 0.9%, or by 37.3 thousand people) (Fig. 1).

Among all causes of mortality in the population of the Republic of Belarus, malignant neoplasms occupy third place (11.0%) after diseases of the circulatory system (52.9%), injuries, poisonings and some other consequences of external causes (12.3%) on average for 2002-2014 gg. In the structure of mortality from malignant neoplasms for 2002-2014. the largest share is made up of neoplasms of the digestive organs (39.8%), while the share of diseases in women (39.5%) does not differ significantly from the same indicator in men (40.2%). The second place is occupied by mortality from tumors of the respiratory organs (20.4%). The maximum number of deaths occurs in the age range of 50-69 years (48.4%) (men - 52.7%, women - 35.3%). The proportion of neoplasms in the age range of 30-49 years in women (13.4%) is slightly higher than in men (10.3%). Among people 70 years of age and older, 35.3% of deaths occurred in men and 41.7% in women.

The leading cancers in the structure of mortality from neoplasms in men were cancer of the trachea, bronchi, lung (27.8%) (in women the proportion of these tumors is 4.6 times lower - 6%), stomach (13.2%), rectum (6 .3%), prostate gland (5.9%), colon and esophagus (5.3 each), pancreas (4.9%), lips, mouth and pharynx (4.0%), kidneys (3 .4%), liver and bile ducts (3.3%), bladder (2.9%), larynx (2.8%). Leukemia makes up 2.5%, tumors of the central nervous system (CNS) - 2.3% (average for 2002-2014). In 2014, the structure of mortality in men was dominated by cancer of the lung (27.8%), stomach (11.8%), and prostate cancer (7.2%) (Fig. 2).

The leading cancers in the structure of mortality in women were cancer of the breast (18.1%), stomach (11.3%), colon and rectum (15.2%), ovary (6.3%), trachea, bronchi, lung (6.0%), pancreas (5.4%), cervix (4.9%), uterine body (4.2%), liver, bile ducts (3.0%). Leukemia was 3.0%, esophageal cancer - 2.7%, central nervous system tumors - 2.5%, kidney tumors - 2.3%. Malignant neoplasms of the or-

Health care of the Russian Federation, Russian journal. 2016; 60 (6)

DOI http://dx.doi.org/10.18821/0044-197X-2016-60-6-303-307_305

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y=-2.2021x+4089.7 R2=0.404

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014

RB-number (thousand people)

Linear (RB-number (thousand people)

Rice. 1. Population dynamics of the Republic of Bashkortostan and linear regression equation (2000-2014).

Bladder

Lymphatic tissue 3% Kidney 3%

Esophagus

Lips, mouth and throat

Rectum

Pancreas 6%

Other 17%

Light 28%

Stomach 12%

Prostate 7%

Colon

Rice. 2. Structure of mortality from neoplasms in men of the Republic of Bashkortostan in 2014.

of Ghana's reproductive system account for 34.7% (for 2002-2014). In 2014, in the structure of mortality in women, the first three places were occupied by breast cancer (17.7%), stomach (9.3%), and colon cancer (8.3%). In contrast to the indicators for Russia, pancreatic cancer (6.9%) and rectal cancer (6.5%) follow next in the mortality structure of the female population (in the Russian Federation - lung and pancreatic cancer) (Fig. 3).

In 2014, 6,189 people died from malignant neoplasms in the Republic of Belarus (44.6% women, 55.4% men), including 1,126 lung cancer, 663 stomach cancer, 815 colorectal cancer, and breast cancer. 489 people. The average age of those who died from neoplasms was 63.60 ± 0.16 years. According to calculations for the period from 2002 to 2014, the average annual absolute decrease in the number of all deaths from neoplasms was 425,267 people, the average annual rate of decrease was 0.23%. According to forecasts, by 2025 the number of deaths may decrease to 5808.8 people per year (by 6.1%). With an estimated population of the Republic of Belarus of 4,032,401 people, the mortality rate should be 144.1 per 100 thousand.

According to calculations for 2002-2014. average annual absolute decrease in the number of deaths of men from new

formations amounted to 243,867, the average annual rate of decline was 0.50%. According to forecasts, by 2025 the number of deaths among men may decrease to 3144.9 people per year. The average annual absolute decrease in women who died from neoplasms was 182.4 with an average annual growth rate of 0.12%. According to forecasts, by 2025 it is possible that the number of women who die will decrease to 2663.9 people per year.

The long-term dynamics of the rates of mortality from malignant neoplasms in the Republic of Belarus is generally comparable to the all-Russian one: there is a downward trend. Thus, in 2014, the mortality rate from neoplasms of the entire population of the Republic of Belarus was 152.0 per 100,000, for men - 179.7, which is lower than the level of 2002 by 2.3 and 4.8%, respectively. Over the same period, there was a slight increase in the mortality rate of women (from 126.0 to 127.5%). However, higher mortality rates are observed in men (1.4 times) (178.9 ± 1.7 and 123.9 ± 0.6%, respectively). In general, mortality from neoplasms ranged from 144.8 (2010) - 156.5% (2009), the standardized rate was 134.9 (2014) - 155.4% (2002), while and the “rough” and standardized indicator on average for the Republic of Belarus per 100,000 population throughout the entire analyzed period was lower than for Russia (p = 0.000) and for the Volga Federal District (p = 0.010) (Kruskal-Wallis test).

As our studies show, an increase in mortality from neoplasms in women is observed in the age intervals of 20-24 years (by 5.3%), 60-64 years (by 4%). The standardized mortality rate for men is 2 times higher than that for women (210.0 ± 3.7 and 104.3 ± 0.97%, respectively) for 2002-2014. From 2002 to 2014 in the Republic of Belarus standardized mortality rates from neoplasms both in men (from 231.7 to 192.9%; in the Russian Federation from 285.8 to 244.2%) and in women (from 109.7 to 100.2%; in the Russian Federation from 136.0 to 125.1%) decreased.

An analysis of the dynamics of mortality from tumors of the main localizations in men of the Republic of Belarus indicates a significant increase in the mortality rate from skin melanoma (by 54.4%), malignant neoplasms of soft tissues (by 47.8%), prostate gland (40.6%), and

Healthcare of the Russian Federation. 2016; 60 (6) DOI http://dx.doi.org/10.18821/0044-197X-2016-60-6-303-307

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colon (by 32.2%), pancreas (by 30.4%), lips, mouth, pharynx (by 23.1%). A significant place in the increase was occupied by malignant neoplasms of lymphatic tissue (from 0.2 to 5.3%o), other urinary organs (from 0.1 to 0.3%), multiple myeloma and malignant plasma cell neoplasms (from 1 to 2°/ %).

The first place in the increase in mortality in women was occupied by bladder cancer (2.2 times). There was an increase in the mortality rate of the female population from non-Hodgkin lymphomas (by 58.9%), pancreatic cancer (by 40.8%), female genital organs (by 27.1%), and uterine body (by 18.8%) , colon (by 17.8%), lips, mouth, pharynx (by 16.5%), breast (by 13.8%). An increase in the mortality rate of the female population was also observed from multiple myeloma (by 10.9%), malignant neoplasms of other digestive organs (by 6.5%), cervix (by 6.4%), ovary (by 5.4%), trachea, bronchi and lung (by 2.2%).

In the structure of the total mortality of the child population (0-14 years), malignant neoplasms account for an average of 4.3%. During the analyzed period in the Republic of Belarus, 431 (0.54%) children died from neoplasms. In the structure of child mortality, 30.4% were due to leukemia; 30.3% - on tumors of the central nervous system; 7.3% - on tumors of mesothelial and soft tissues; 5% - for lymphomas, 4.4% - for bone tumors. The mortality rate decreased by 47.7% (from 6.3 to 3.3°/%).

In the structure of the total mortality of the working age population, the leading places are occupied by injuries, poisoning and some other consequences of external causes (32.4% for 2002-2014), diseases of the circulatory system (29.6%), neoplasms (11.2%) . Among people of working age who died from malignant neoplasms, on average 34.9% were men and 23.9% were women.

The most common form of malignant neoplasms in men of working age is lung cancer, in women - breast cancer (an average of 28.8 and 25.3%, respectively). In 2014, the mortality rate of the working-age population of the Republic of Belarus from neoplasms in general, including men, was 75.0 and 98.6%, respectively, which is 11.1 and 18.1% higher than the 2002 level. Over time, women in this age group showed a slight decrease in the mortality rate (from 51.2 to 49.3%). In general, the mortality rate from neoplasms of the working age population of the Republic of Belarus is lower than the mortality rate in the Russian Federation by 18.3%. The average long-term mortality rate from lung cancer in the working population of the Republic of Belarus as a whole was 14.6 ± 0.4% (for men 26.5 ± 0.7, for women 2.2 ± 0.1%). The mortality rate turned out to be significantly lower than those in the Russian Federation (36.38 ± 0.38, respectively; for men 65.45 ± 0.84, for women 11.27 ± 0.09%). Over time, the proportion of lung cancer in men increased from 24.6 to 29.6%, in women - from 3.4 to 4.7%.

For 2002-2014 in men of working age, the increase in mortality from pancreatic cancer was 93.6%, lip, mouth, pharynx - 75.1%, colon - 39.9%, malignant neoplasms of other digestive organs - 34.9%, kidney cancer - 26.5%; non-Hodgkin's lymphomas - 24.5%; lung cancer - 22.3%, rectal cancer - 21.8%, skin melanoma - 16.8%, stomach cancer - 5.1%. In 2014, compared to 2002, there was also an increase in mortality

Other 25%

Lymphatic tissue

Uterus 5%

Cervix - 5% Ovary 6%

Breast 18%

Stomach 9%

Colon 9%

Pancreas 7%

Rectum

7% Easy

Rice. 3. Structure of mortality from neoplasms in women of the Republic of Bashkortostan in 2014.

from neoplasms of lymphatic tissue (from 0.1 to 3.9%), multiple myeloma and plasma cell neoplasms (from 0.2 to 1.2%), small intestine (from 0.2 to 0.4%), bladder (from 1.0 to 2.2%).

Over time, the proportion of breast cancer in women of working age decreased slightly (from 25.7 to 25.1%; with a mortality rate of 13.1 ± 0.4%). At the same time, from 2002 to 2014, there was a tendency towards an increase in mortality rates from cancer of the lymphatic tissue (from 0.1 to 1.4%); lips, mouth, pharynx (from 0.4 to 1.2%), small intestine (from 0.1 to 0.2%), uterine body (from 1.1 to 2.3%); lung (by 100.3%); there is an increase in the mortality rate from malignant neoplasms of connective and other soft tissues (by 62.4%), esophagus (by 51.6%), pancreas (by 46.5%), kidneys (by 23.7%), and colon (by 20.3%), ovary (by 15.3%), cervix (by 13.2%), non-Hodgkin lymphoma (by 8.3%). In other localities, both men and women of working age showed a slight decrease in the mortality rate.

The proportion of neoplasms in people 70 years of age and older averages 38.1%, while the mortality rate decreased by 14.7% (from 708.1 to 603.8%).

Discussion

A study of the mortality rate of the population of the Republic of Belarus from neoplasms, according to Bashkortostanstat (Table C51) “Distribution of deaths by gender, age groups and causes of death” for the analyzed period revealed a trend towards a decrease in the mortality rate both in general (by 2.3%) and in men (by 4.8%). In women over the same period, there was a slight increase in the mortality rate (from 126.0 to 127.5%). The first places in the structure of mortality from neoplasms of the male population of the Republic of Belarus are distributed as follows: tumors of the trachea, bronchi, lung (27.8%), stomach (13.2%), rectum (6.3%), prostate gland (5.9 %), colon and esophagus (5.3%). The proportion of cancer of the pancreas (4.9%), lip, mouth and pharynx (4.0%), kidney (3.4%), liver and bile ducts (3.3%), bladder (2.9) is significant. %), larynx (2.8%). Leukemia is 2.5%, central nervous system tumors are 2.3% for 2002-2014. In 2014, the structure of mortality in men was dominated by cancer of the lung (27.8%), stomach (11.8%), and prostate cancer (7.2%) (see Fig. 2). For 2002-2014 the leading localizations in the structure of mortality among women are

Health care of the Russian Federation, Russian journal. 2016; 60 (6) DOI http://dx.doi.org/10.18821/0044-197X-2016-60-6-303-307 Health care organization

whether cancer of the breast (18.1%), stomach (11.3%), colon and rectum (15.2%), ovary (6.3%), trachea, bronchi, lung (6.0%) . The proportion of cancer of the pancreas (5.4%), cervix (4.9%), uterine body (4.2%), liver, bile ducts (3.0%) is significant. Leukemia accounts for 3.0%, esophageal cancer - 2.7%, central nervous system tumors - 2.5%, kidney cancer - 2.3%. Malignant neoplasms of the reproductive system account for 34.7%. In 2014, in the structure of mortality in women, the first three places were occupied by breast cancer (17.7%), stomach (9.3%), and colon cancer (8.3%). Next came pancreatic cancer (6.9%) and rectal cancer (6.5%), and in the Russian Federation, lung and pancreatic cancer (see Fig. 3). At the same time, tumors of the genital organs account for 18.0% of all malignant neoplasms in women.

The maximum mortality rate for both men (984.9%) and women (440.6%) is recorded in age intervals of 70 years and older. On average, 34.9% of men and 23.9% of women who died from neoplasms were of working age.

The mortality rate of the population of the Republic of Belarus from malignant neoplasms is lower than in the Russian Federation and the Volga Federal District. However, it was possible to identify some unfavorable trends that require the attention of specialists. Thus, there was an increase in mortality from neoplasms in women in the age intervals of 60-64 years by 4% and, what is especially alarming, in 20-24 years by 5.3%. Although in general the mortality rate from malignant neoplasms of the working-age population of the Republic of Belarus is 18.3% lower than the mortality rate in the Russian Federation, the mortality rate of the working-age population from neoplasms in men in 2014 exceeded that in 2002 by 18.1%. There is an increase in mortality from neoplasms of certain localizations, for example, a significant increase in the mortality rate from skin melanoma, malignant neoplasms of soft tissues, prostate gland, colon cancer, pancreas in men; from cancer of the bladder, pancreas, non-Hodgkin's lymphomas, tumors of the female genital organs in women. In addition, territorial specificity is also visible. The mortality structure of the female population is somewhat different,

where 4th-5th place is occupied by pancreatic cancer (6.9%) and rectal cancer (6.5%), in the Russian Federation lung and pancreatic cancer. The female population is characterized by a moderate upward trend in mortality with an average annual growth rate of 1.0%. The maximum number of deaths occurs in the age range of 50-69 years (48.4%) (men 52.7%, women 35.3%). According to forecast estimates, it is possible to reduce the mortality rate from neoplasms in the population of the Republic of Bashkortostan.

The identified features of mortality from malignant neoplasms must be taken into account when planning long-term treatment and preventive measures and improving oncological care for this category of patients.

Financing. The study had no sponsorship.

LITERATURE

1. Demographic Yearbook of Russia. M.: Rosstat; 2002-2015.

2. Demographic processes in the Republic of Bashkortostan: Statistical collection. Ufa; 2002-2014.

3. Malignant neoplasms in Russia in 2002-2014. (morbidity and mortality) / Ed. HELL. Kaprina, V.V. Starinsky, G.V. Petrova. M.: MNIOI im. P.A. Herzen - branch of the Federal State Budgetary Institution "NMRRC" of the Ministry of Health of Russia; 2003-2015.

4. International statistical classification of diseases and related health problems. X revision (ICD-10). Geneva: WHO; 1995; v. 1.

1. Demographic Yearbook of Russia. . Moscow: Rosstat; 2002-2015. (in Russian)

2. The Demographic Processes in the Republic of Bashkortostan: Statistical Yearbook. . Ufa; 2002-2014. (in Russian)

3. Malignancies in Russia in 2002-2014. (Morbidity and Mortality). /Eds. A.D. Kaprin, V.V. Starinskiy, G.V. Petrova. Moscow; 2003-2015. (in Russian)

ANALYSIS OF MORBIDITY AND MORTALITY FROM MALIGNANT NEOPLASMS OF THE FEMALE REPRODUCTIVE ORGANS IN THE MOSCOW REGION (FOR THE PERIOD 2011-2015)

Sergey Minakov

MD, PhD, The Ministry of Health of Moscow Region

Krasnogorsk, Russia

ANNOTATION

An analysis of morbidity and mortality in the Moscow region from malignant neoplasms of the female reproductive system was carried out. A comparative assessment with similar indicators in the Russian Federation and the Central Federal District is given.

ABSTRACT

The analysis of morbidity and mortality in the Moscow region from malignant neoplasms of the female reproductive system. A comparative assessment with those in the Russian Federation and the Central Federal District.

Keywords: diseases of the female reproductive system; morbidity; mortality; prevalence; uterine cancer; cervical cancer; mammary cancer; ovarian cancer.

Keywords: diseases of the female reproductive system; morbidity; mortality; incidence; uterine cancer; cervical cancer; breast cancer; ovarian cancer.

The existing stable trend of growth in cancer incidence, both throughout the world and in the Russian Federation (hereinafter referred to as the Russian Federation), determines increased attention to this medical and social problem. To truly improve the health status of the population, it is necessary to increase the effectiveness of existing federal and introduce new, including regional, programs aimed at prevention and timely early diagnosis of precancerous diseases and malignant neoplasms (hereinafter referred to as malignant neoplasms).

As a result of the implementation in the European Union of the “Europe against Cancer” program, the main components of which were measures aimed at combating smoking, rationalizing nutrition by increasing the consumption of plant products and reducing the proportion of animal products, preventing the negative effects of ultraviolet rays, as well as strict implementation recommendations for screening and early diagnosis of malignant neoplasms, mortality from cancer decreased by 15% over 10 years.

At the same time, according to medical statistics in the Russian Federation, there is a steady increase in the incidence of cancer. Thus, in 2015, the incidence rate was 241.35 per 100,000 population, which is 10.8% higher than the level in 2006 (217.88). The leading localizations in the overall morbidity structure are: skin (12.5%, with melanoma - 14.2%), mammary gland (11.4%), trachea, bronchi, lung (10.2%), colon (6. 6%), stomach (6.4%).

At the same time, tumors of the reproductive system took first place in the structure of cancer incidence (20.7%).

In the Moscow region (hereinafter – MO) in 2015, 6449 cases of cancer of the female reproductive system (hereinafter – FRS) were registered. More than half of the cases were breast cancer 3526 (54.7%). Uterine cancer – 1369 cases (21.2%), cervical cancer – 875 cases (13.6%). Ovarian cancer was diagnosed in 679 cases (10.5%) (Fig. 1).

Figure 1. Structure of the incidence of malignant tumors of the organs of ironclad workers in the Moscow Region

For the period 2011 – 2015 For these nosologies in the Moscow Region, an increase in morbidity rates is observed. The highest growth rate occurs with ovarian cancer of 13.8%, which significantly exceeds the same figure in the Russian Federation and the Central Federal District (hereinafter referred to as the Central Federal District) (2.9% and 3.8%, respectively). The incidence rate of cervical cancer during this period increased by 7.4% (RF - 9.6%, Central Federal District - 7.2%). Cancer of the breast and uterine body - 5.8% (RF - 10%, Central Federal District - 7.8%) and 4.7%, respectively (RF - 9.8%, Central Federal District - 10.8%).

In the structure of mortality of the population of Russia, cancers occupy second place (15.5%) after diseases of the circulatory system (48.7%). In the structure of mortality of the population of the Russian Federation from cancer, the largest share is made up of diseases of the trachea, bronchi, lung (17.3%), stomach (10.3%), colon (7.9%), breast (7.8%), pancreas (5.9%).

In the structure of female mortality in the Russian Federation, the largest share belongs to cancers of the breast (16.7%), colon (9.8%), stomach (9.3%), diseases of the trachea, bronchi, and lung (6.8%). In the Russian Federation, the share of mortality from malignant neoplasms of the organs of ironclad women in the overall structure of female mortality is 32.0%

Among the causes of mortality among the population, malignant neoplasms occupy second place (17%) after diseases of the circulatory system (61%). In 2015, 7841 women died from cancer. Among all causes of death from malignant tumors, the share of malignant neoplasms of the organs of the female breast cancer was 31.5% (2473 cases).

In the structure of mortality from cancer of the organs of female breast cancer in the Moscow Region, breast cancer has the largest share - 51.5% (1268 cases). Uterine cancer and cervical cancer account for 18.7% and 18.1% (464 and 450 cases), respectively. Ovarian cancer accounts for 11.7% (291 cases) (Fig. 2).

Figure 2. Mortality structure of malignant tumors of the organs of ironclad workers in the Moscow Region

Overall, mortality rates from breast, cervical and ovarian cancer are trending downward. Standardized mortality rates in 2015 from these nosologies were:

breast cancer – 9.65 (RF – 9.09; Central Federal District – 9.19), which is 11.9% lower than in 2011;
cervical cancer – 4.5 (RF – 5.39; Central Federal District – 4.74), which is 4.5% lower than the same indicator in 2011;
ovarian cancer – 5.92 (RF – 5.33; Central Federal District – 5.52), which is 2.6% lower than in 2011.

Against the background of this decrease, there is an increase in the mortality rate from uterine cancer by 6.8% from the 2011 level (in 2015 - 5.53; Russian Federation - 4.24; Central Federal District - 4.44).

Thus, the morbidity and mortality rates from malignant neoplasms of the organs of the iron ore organs in the Moscow Region generally correspond to similar indicators in the Central Federal District and the Russian Federation.

One of the main reasons for the high mortality rate in cancer pathology is untimely diagnosis due to the insufficient prevalence of screening programs for early detection of cancer, including female reproductive organs, despite the fact that effective preclinical diagnostic methods have now been developed and tested in practice, requiring widespread implementation in medical practice.

In the Russian Federation, the Concept of Healthcare Development until 2020 has been formed and is being implemented, which provides for a gradual expansion of screening coverage of the population, improving the quality and availability of diagnostics and treatment, and promoting a healthy lifestyle. The implementation of the Concept’s measures will allow us to achieve a reduction in mortality, including from cancer, and an increase in life expectancy.

Bibliography:

Healthcare in Russia, 2015: Stat. Sat./Rosstat. – M., 2015. – 174 p.
Malignant neoplasms in Russia in 2011 (morbidity and mortality). Ed. IN AND. Chisova, V.V. Starinsky, G.V. Petrova. – M., FSBI “MNIOI im. P.A. Herzen”, Ministry of Health of Russia, 2013. – 289 p.
Malignant neoplasms in Russia in 2015 (morbidity and mortality). Ed. HELL. Kaprina, V.V. Starinsky, G.V. Petrova. – M., MNIOI im. P.A. Herzen - branch of the Federal State Budgetary Institution "FMIC named after. P.A. Herzen" Ministry of Health of Russia, 2017. – 250 p.
Public health and healthcare [Electronic resource]: textbook / Lisitsyn Yu.P., Ulumbekova G.E. - 3rd ed., revised. and additional - M.: GEOTAR-Media, 2013.

The increase in morbidity and mortality for the period from 1991 to 1996 is shown.

By taking into account age, sex, and regional variations, the paper analyzes malignant neoplasm morbidity and mortality in Russia in 1996.

N.N. Trapeznikov, E.M. Axel, N.M. Barmina
Oncological Research Center named after N.N. Blokhin RAMS, Moscow

N.N.Trapeznikov, Ye.M.Axel, N.M.Barmina N.N.Blokhin Cancer Research Center, Russian Academy of Medical Sciences, Moscow

H The number of patients with a newly diagnosed malignant neoplasm increased from 1991 to 1996. by 7% and reached 422 thousand people, which corresponds to the registration of one disease on average every 1.3 minutes. By 2000, the number of new cases of disease is expected to increase to 480 thousand.
Among men with malignant neoplasms, the first places are occupied by lung cancer (26.5%), stomach (14.2%), skin (8.9%), hemoblastosis (4.6%), colon cancer (4.5% ), prostate and bladder (4.0% each), in women - cancer of the breast (18.3%), skin (13.7%), stomach (10.4%), uterine body (6.5 %), colon (6.4%), cervix (5.5%), ovary (5.1%).
Dynamics The structure of morbidity in the population of economic regions of Russia since 1991 in men is expressed in a widespread decrease in the proportion of stomach cancer, a trend towards a decrease or stabilization of lung cancer and, in most regions, cancer of the lip and esophagus. The proportion of non-melanoma skin tumors, prostate cancer, kidney cancer (except for the Northwestern region) and thyroid cancer (except for the Northern and Ural regions) has increased. In women, there is a decrease or a trend towards a decrease in the proportion of cancer of the esophagus, stomach, lung, and cervix (the latter with the exception of the North-Western and East Siberian regions). There was an increase in the proportion of breast cancer (except for the North-Western region and the Kaliningrad region) and in some regions - thyroid cancer.
The incidence of malignant neoplasms per 100,000 male population (in standardized indicators) ranged from 234.9 (North Caucasus region) to 289.6 - 290.5 (Northwestern region and Kaliningrad region); the highest incidence of lip cancer (8.5) - in the Volga region, cancer of the esophagus (13.1) and stomach (42.8) - in the Northern region, liver (8.6) - in the West Siberian region, non-melanoma skin tumors (30 ,0) - in the North Caucasus. Men are 1.2 - 2.3 times more likely than women to get cancer of the stomach, colon and rectum, pancreas, 6.1 - 7.3 times more likely to get cancer of the lip, esophagus and bladder, 9.2 times more likely to get cancer of the lung and 21.9 - laryngeal cancer. In women, the incidence of gallbladder cancer and skin melanoma is 1.2 - 1.3 times higher than in men, and 4.1 times higher for thyroid cancer.
Fluctuations in morbidity rates in women ranged from 158.3 - 158.5 (East Siberian and Volgo-Vyatka regions) to 194.2 - 195.5 (West Siberian and North-Western regions).
The incidence of lip (1.7) and lung (12.6) cancer in women is significantly higher in West Siberian compared to other regions; stomach (19.2), colon (14.6) and mammary gland (43.2) - in North-West; liver (4.1) - in the Far Eastern region, uterine body (13.7) - in the Central region, thyroid gland (7.7) - in the West Siberian region, ovary (11.2) and hemoblastosis (14.0) - in the Kaliningrad region areas.
In certain administrative territories of Russia, the maximum incidence in 1996 was observed in men - in the Saratov (336.5) and Sakhalin (326.9) regions, in women - in the Kemerovo (233.7) region and St. Petersburg (211.0) .
The highest incidence rates of esophageal cancer occurred in the republics of Tuva (23.1 and 22.3, respectively, in men and women) and Yakutia (33.1 and 7.7); stomach - in Tuva (53.9 and 24.3) and Novgorod region (51.8 - in men); rectum - in the Magadan region (17.0 and 15.2), Karelia (21.1 - in men) and the Kaliningrad region (19.2 - in women); lung - among men in the Saratov (98.3) and Tambov (95.8) regions, among women - in Yakutia (23.1) and the Kemerovo region (20.7); breast - in North Ossetia (49.5), cervix - in Tuva (24.1), bladder - in the Jewish Autonomous (17.5) and Kamchatka (17.0) regions - in men; in Samara (2.8) and Kemerovo (2.7) regions - among women.
The increase in standardized incidence rates for the period from 1991 to 1996 in Russia was 2.1 and 10.6%, respectively, for men and women. The most significant indicator was for skin melanoma (35 and 15.4%), prostate cancer (31.4%) and breast cancer (18.5%), hemoblastosis (4.8 and 11.9%), colon cancer (13 .8 and 14.4%) and the body of the uterus (24.2%). The incidence of cancer of the lip (by 14.1 and 9.1%), stomach (by 10.2 and 9.7%), esophagus (by 8.9 and 22.2%), and liver (by 3.3 and 7) decreased. .1%), in men - cancer of the larynx (by 5.1%) and lung (by 5.0%).
In 1991 - 1996 The increase in the number of newly diagnosed diseases with malignant neoplasms in Russia was 4.1% in men and 10% in women. It was most pronounced due to an increased risk of cancer of the kidney (43.6% in men and 40.2% in women), thyroid cancer (16.7 and 51.8%), and bladder cancer (15.2 and 10. 2%) and skin melanoma (31.7 and 20.6%), and in men, in addition, testicular cancer (40.8%) and prostate cancer (34.3%), in women - breast cancer (19 .7%) and the body of the uterus (24.0%). In connection with the change in the risk of getting sick, the number of diseases of stomach cancer in people of both sexes (by 10.3 and 12.3%), esophagus (by 9.5 and 24.2%), in men - malignant neoplasms of the nasal cavity, middle ear and paranasal sinuses (by 11.3%), lips (by 14.3%), in women - liver (9.8%), placenta (by 35.9%), bones and articular cartilage (by 10.2 %).
The probability of developing a malignant neoplasm during the next life for a newborn in Russia in 1996 was 17.4% for a boy and 18.5% for a girl. For boys, the highest risk of developing lung cancer (4.7%), stomach (2.6%), skin (1.6%), for girls - breast cancer (3.5%), stomach cancer (2.1% ), colon (1.3%), skin (2.6%), cervix (1.1%).
The probability of getting sick during working age for people who have lived up to 20 years in Russia is 6.7% for men and 5.4% for women. The share of the probability of getting sick at this age in the overall probability of getting sick with this form of tumor throughout the coming life is highest in Russia among men with malignant neoplasms of the larynx (49.2%), lung (38.3%), bones and soft tissues (47.8 %), hemoblastoses (44.6%), in women - with cancer of the cervix (46.4%), breast cancer (42.9%), bones and soft tissues and hemoblastoses (33.3% each).
The probability for a newborn in Russia in 1996 to die from a malignant neoplasm during the coming life is 14.1% for boys and 11.9% for girls. For all forms of tumors, this figure is higher in men, with the exception of colorectal cancer, as well as malignant skin tumors. In men, it is most pronounced for lung cancer (4.4%) and stomach (2.4%), in women for breast cancer (1.8%), stomach (1.9%) and colon cancer (0.94). %).
At a young age, the likelihood for a patient with a malignant neoplasm to die from this disease is hundreds of times higher than from another cause; at 50 - 54 years old, these differences reach 14-fold, and at 70 - 74 years old they are reduced to 2.5 - 4. In old age, the likelihood of dying from other causes is higher for patients with malignant neoplasms of the skin and breast (at 70 - 74 years old ) or very close for cervical cancer.
In 1996, as in previous years, the average life expectancy of men with malignant neoplasms was lower than that of women, especially with tumors of the skin, bones and soft tissues, rectum, larynx and hematological malignancies.
Average life expectancy is reduced to the greatest extent in people with cancer of the esophagus, stomach and lungs. With colon cancer, the average life expectancy of 40-year-old patients is higher than with rectal cancer, and with cervical cancer it is higher than with breast cancer. The life expectancy of patients with malignant skin tumors aged 40 years and older is approaching similar to that of the general population.
For 1980 - 1996 the number of deaths from cancer increased by 30% and amounted to 291.2 thousand.

Per 100,000 population, the highest mortality rates from malignant neoplasms in 1996 were noted in the North-Western economic region (234.7 and 114.2, respectively, in men and women), from esophageal cancer (12.5 and 2.2) - in the North, colon (15.7 and 11.7), skin (2.6 in men), prostate (9.7) and mammary glands (20.3), leukemia (5.6 in men) - in North-Western region, larynx - in the Central Black Earth (9.7 in men) and in the East Siberian (0.74 in women), in women from cancer of the lip, oral cavity and pharynx (1.7), skin (2 ,1), urinary organs (3.8) - in the Far East. In the Kaliningrad region, men more often died from cancer of the rectum (10.3), lung (80.1) and urinary organs (15.8). In certain administrative territories, the maximum mortality rate from malignant neoplasms in 1996 for men was in the Leningrad, Pskov, Novgorod and Sakhalin regions (238.1 - 259.7), for women - in St. Petersburg, the republics of Tuva and Sakha, Magadan region (122.5 - 144.4); from esophageal cancer - in the republics of Sakha (32.4 and 9.7, respectively, in men and women) and Tuva (25.0 and 22.6), as well as in men in the Chukotka Autonomous Okrug (25.6) and the Magadan Region ( 23.4); for stomach cancer - in Tuva (60.4 and 20.0), Pskov (48.3), Chita (46.6) and Novgorod (45.9) regions - in men, Chukotka Autonomous Okrug (18.7), Kaluga (20.4) and Vladimir regions (18.6) - in women; from colon cancer - in St. Petersburg (17.8 and 13.9) and Moscow (16.7 and 12.6); rectum - in the Chelyabinsk, Sakhalin and Jewish Autonomous Regions (12.6 - 14.4) - in men, in the Republic of Khakassia, Kaliningrad and Magadan Regions (8.9 - 10.9) - in women; from lung cancer - in Sakhalin (89.4) and Astrakhan(85.7) regions and Altai Territory (83.9) - for men, in the republics of Sakha (19.1), Tuva (17.7) - for women. Significantly higher than the Russian average (16.4), mortality from breast cancer in the Magadan region (25.0), St. Petersburg and Moscow (22.4 each), and from cervical cancer (4.8 on average Russia) - in Tuva (16.1), Khakassia (11.7), Sakhalin (10.4) and Tomsk (10.2) regions. Mortality from prostate cancer is 2.7 times higher than the Russian average (7.5) in the Chukotka Autonomous Okrug (20.2), 1.6 times- in the Irkutsk, Tomsk, Astrakhan and Jewish Autonomous Regions.
For 1991 - 1996 in Russia there was an increase in the growth rate of standardized mortality rates from cancer of the lip, oral cavity and pharynx (6.0 and 10.0%), colon (6.8 and 7.5%) and rectum (3.6% in men) , larynx (5% in men), skin (10.5 and 14.3%), urinary organs (14.4 and 10.7%), prostate (18.5%) and mammary (15.4%) glands , cervix (2.0%). There was a decrease in mortality from cancer of the esophagus (by 9.2 and 23.5%, respectively, in men and women), stomach (by 11.3 and 14.5%), lung (by 5.3 and 6.9%) and hematological malignancies (by 6.6 and 6.2%), and in women from cancer of the rectum (by 0.8%), larynx (by 3.9%), bones and soft tissues (by 2.3%).
The conditional elimination of malignant neoplasms as causes of death in the population would increase the average life expectancy of newborns by 2.0 years. The maximum impact on the reduction in the average life expectancy of men is exerted by mortality from lung cancer (by 0.56 years) and stomach cancer (by 0.29 years), hemoblastosis (by 0.13 years); women - from breast cancer (by 0.33 years), stomach (by 0.26 years), colon - (by 0.12 years), hemoblastosis (by 0.13 years) and lung (0.12 years) . On average, one woman who dies from a malignant neoplasm loses more years of life than a man (16.9 versus 14.5 years). The greatest losses are suffered by those who died from hemoblastosis (19.2 and 22.0 years, respectively, men and women), malignant neoplasms of bones and soft tissues (17.3 and 20.4 years), breast cancer (18 .5 years) and cervix (18.4 years).
Due to mortality from malignant neoplasms, the Russian population lost 4.5 million person-years of life in 1996. The greatest damage to society is caused by lung cancer (808.2 thousand person-years), stomach (642.9 thousand), breast cancer (367.0 thousand) and hemoblastosis (287.5 thousand).
Conditional economic losses due to deaths from malignant neoplasms amounted to 3.9 billion rubles in 1996. (in 1990 prices), including 685.9 million rubles. - from lung cancer, 544.8 million rubles. - stomach, 308.1 million rubles. - breast, 375.7 million rubles. - from hemoblastoses.
Analysis and assessment of trends in morbidity, mortality, and their derivatives should be carried out systematically, facilitating the connection between planning and management, on the one hand, and assessment of the effectiveness of measures taken, on the other.

Literature:

1. Dvoirin V.V. Statistics of malignant neoplasms in Russia, 1990 - Bulletin of the Research Center of the Academy of Medical Sciences of Russia. - 1992. - No. 4. - P.3-14.
2. Trapeznikov N.N., Aksel E.M. Morbidity and mortality from malignant neoplasms of the population of the CIS countries in 1996 - M., 1997. - P. 302.
3. Dvoirin V.V., Aksel E.M. Component analysis of the dynamics of incidence of malignant neoplasms: Method. recommendations. - M., 1987.
4. Dvoirin V.V., Aksel E.M. Calculation of the probability of developing malignant neoplasms during the coming life: Method. recommendations. - M., 1988.

Malignant neoplasms are one of the main causes of mortality, affecting the demographic situation in Russia. Despite the continuing increase in mortality in Russia as a whole, its structure does not change significantly (2004-2010).

In first place is mortality from circulatory diseases (42.2%), in second place is mortality from accidents, poisonings and injuries (25.2%), and oncological diseases remain in third place (12.4%).

In the overall structure of population mortality in Russia in 2009 from various causes of death, the proportion of deaths from malignant neoplasms was 14.5%; The male population was 14.9%, the female population – 14.0%. Among those who died of working age (15-59 years), the proportion of those who died from malignant neoplasms reached 14.2%.

Rice. 3.14. Share of causes of mortality in the Russian Federation population in 2009 (%)

It should be noted that in women, malignant neoplasms account for 14.9% of all deaths in the Russian Federation, or second place after cardiovascular pathology (64.8%), in men it is third and accounts for 14.9% in the Russian Federation ( Fig. 3.13,3.14, 3.15.)

Rice. 3.15. Share of deaths from the main causes of death among women in the Russian Federation in 2009 (%)

Consequently, for every sixth woman and every tenth man who died in the republic during the year, malignant tumors are one of the main causes of death.

In the male population, injuries and poisonings (16.5%) moved malignant neoplasms to third place (Fig. 3.16.)

Rice. 3.16. Share of deaths from the main causes of death among men in the Russian Federation in 2009 (%)

In the Russian Federation, there has been a tendency towards worsening mortality rates from malignant neoplasms: the mortality rate per 100 thousand population increased from 192 (in 2004) to 204.9 (in 2009) for men - from 220 to 237.1, for women from 160 up to 171.3. The increase in the mortality rate from malignant neoplasms for the period from 1990 to 2005. amounted to about 6-8%.

In 2004, 287,593 people died from malignant neoplasms in Russia: 53,760 from lung cancer, 39,708 from stomach cancer, 36,062 from colorectal cancer, 23,058 from breast cancer.

In the structure of mortality among men, lung cancer was 29.0%, stomach cancer was 14.5%, in women breast cancer was 17.4%, colon and rectal cancer - 15.0% and stomach cancer - 13.0%.

The average age of men who died from malignant neoplasms was 65 years, women – 67 years. The maximum age was for those who died from cancer of the esophagus, pancreas, prostate glands, stomach, and bladder (67-72 years).

Rice. 3.17. The number of cancer cases and deaths in Russia in 2009.

In the structure of mortality of standardized indicators in Russia for the period from 1990 to 2005. there have been some changes. The first three places in 1990 were occupied by cancer of the lung, stomach, and esophagus. In 2005 in men, colon cancer and liver cancer moved to third and fourth place, respectively; in women, breast cancer moved from fourth to second place, cervical cancer - from 5th to 4th rank place, esophageal cancer - from 3rd to 4th rank. 8th place.

The increase in the number of patients with malignant liver tumors, the difficulties of diagnosis, morphological verification of the diagnosis, the prevalence of viral hepatitis, and the chronicity of the process have brought this pathology to the main positions in the ranking of morbidity and, accordingly, mortality.

The number of deaths from cancer in Moscow in 2004. reached 23,033 people. In men, in the structure of mortality, lung cancer was in 1st place (22.3%), stomach cancer was in 2nd place (14.5%), and colon cancer was in 3rd place (8.3%); in women – cancer of the breast (18.4%), stomach (11.3%) and colon (11.2%), respectively. Every day in Moscow, 63 deaths from malignant neoplasms were registered. The maximum average age of deaths was observed for cancer of the stomach, prostate, bladder, colon and rectum (68-74 years).

Standardized mortality rate from cancer in the male population of Moscow in 2004. amounted to 167.1 per 100 thousand population, female – 107.5 per 100 thousand (7th and 8th places among Russian regions, respectively). High mortality from breast cancer (21.4 per 100 thousand), colon cancer (10.4 per 100 thousand). In men, there was a high mortality rate from prostate cancer (11.0 per 100 thousand) in Moscow. The mortality rate of the male population of Moscow from cancer (37.0 per 100 thousand), larynx (3.7 per 100 thousand) and bladder (5.4 per 100 thousand) was lower than the Russian average. Significantly higher than the average Russian mortality rates for the female population of Moscow from colon cancer (10.5 per 100 thousand in Moscow and 7.3 per 100 thousand in Russia), breast cancer (21.4 per 100 thousand and 6.0 per 100 thousand, respectively), ovarian cancer (7.8 per 100 thousand and 5.8 per 100 thousand, respectively).

In 2008, 23,362 people died from malignant neoplasms in Moscow. In men, in the structure of mortality, lung cancer was in 1st place (21.7%), stomach cancer was in 2nd place (13.2%), and prostate cancer was in 3rd place (8.5%); in women – cancer of the breast (19.2%), stomach (11.0%) and colon (11.0%), respectively. Every day in Moscow, 63 deaths from malignant neoplasms were registered. The maximum average age of deaths was observed for cancer of the lung, esophagus, stomach, prostate, bladder, colon and rectum (68-74 years).

Standardized mortality rate from cancer in the male population of Moscow in 2008. was 150.7 per 100 thousand, female – 106.8 per 100 thousand population (7th and 9th places among 79 regions of Russia, respectively). High mortality among women from cancer of the breast (21.5%), colon (9.9%), and ovarian (6.8%). In men, there was a high mortality rate from prostate cancer (11.0%) in Moscow. The mortality rate of the male population of Moscow from lung cancer (32.8%) and bladder cancer (5.5%) was lower than the Russian average.

From 2003 to 2008 in Moscow, mortality from stomach cancer (by 24.5% in men and 3.5% in women), colon (by 12.5 and 7.8%) and direct (14.6 and 10) decreased. .2%) intestines, lung (by 13% in men), bladder (by 8.3% in men and 18.2% in women). The mortality rate among women from lung and kidney cancer turned out to be stable.

The dynamics of mortality from cancer in the population in the service area of OD No. 2 in Moscow indicates a decrease in the rate from 124.1 per 100 thousand population in 2004. up to 117.6 per 100 thousand population in 2010. (Table 3.6.). High mortality rates were observed for breast cancer (women), cancer of the bronchopulmonary system (mainly men), stomach and colon cancer. (Table 3.7, 3.8.)

Dynamics of mortality from malignant neoplasms of the population (2004 - 2010)

The absolute number of patients who died in the reporting year by location and by year of recording.

Malignant neoplasms	2004	2005	2006	2007	2008	2009	2010
Lips	6	1	2	4		1
Esophagus	62	60	61	57	55	50	52
Stomach	439	442	455	440	429	419	384
Colon	357	365	380	375	311	345	374

Trachea, bronchi, lung	461	452	437	391	422	420	419
Bones and soft tissues	17	33	28	25	19	22	25
Melanoma	41	57	61	73	57	61	71
Other new images. skin	21	30	32	34	26	28	39
Breast	417	464	489	420	446	439	437
Cervix	66	71	75	88	77	74	63
Ovaries	117	128	134	119	106	93	86
Body of the uterus	68	89	111	94	89	83	81
thyroid gland	16	27	20	17	15	18	21
Total	2285	2418	2466	2341	2260	2242	2226

Relative number of patients who died in the reporting year by localization and by year of registration (%)

Malignant neoplasms	2004	2005	2006	2007	2008	2009	2010
Lips	0.3	0.04	0.04	0.08	0.2		0.04
Esophagus	2.7	2.5	2.5	2.5	2.4	2.4	2.2
Stomach	19.2	18.3	18.3	18.5	18.8	19.0	18.7
Colon	15.6	15.1	15.1	15.4	16.0	13.8	15.4
Rectum, rhexigmoid conn. anus
Trachea, bronchi, lung	20.2	18.7	18.7	17.7	16.7	18.7	18.7
Bones and soft tissues	0.7	1.4	1.4	1.1	1.1	0.8	0.9
Melanoma	1.8	2.4	2.4	2.5	3.1	2.5	2.7
Other new images. skin	0.9	1.2	1.2	1.3	1.5	1.1	1.2
Breast	18.2	19.2	19.8	17.9	19.7	19.6	19.6
Cervix	2.9	3.0	3.0	3.8	3.4	3.3	2.8
Ovaries	5.1	5.3	5.4	5.1	4.7	4.1	3.9
Body of the uterus	3.0	3.6	4.5	4.0	3.9	3.7	3.6
thyroid gland	0.7	1.1	0.8	1.7	0.7	0.8	0.9
Total	100	100	100	100	100	100	100

5-year overall survival based on materials from OD No. 2 in Moscow

The five-year survival rate of cancer patients, according to materials from OD No. 2, was 69% for all localizations, which coincides with the data of foreign authors; for some localizations these data are higher (Table 3.9.)

Thus, the analysis of mortality rates in the time interval from 2004 to 2008. in Russia, in Moscow, in the Northern Administrative Okrug and North-West Administrative Okrug of Moscow, indicates that the mortality rate per 100,000 people. in Moscow is lower than in the Russian Federation, and in the Northern Administrative District and North-West Administrative District it is lower than in Moscow, which can be attributed to the fairly effective work of the oncology clinic No. 2 in Moscow.

Biryukov A.P., Ivanova I.N., Gorsky A.I., Petrov A.V., Matyash V.A.
Medical Radiological Research Center of the Russian Academy of Medical Sciences, Obninsk.
Department of Health and Drug Supply of the Government of the Kaluga Region, Kaluga

annotation

This work analyzes information on morbidity and mortality from malignant neoplasms of the digestive system of participants in the liquidation of the consequences of the accident at the Chernobyl nuclear power plant (liquidators), accumulated in the Russian State Medical Dosimetry Register (RGMDR) in the period from 1986 to the beginning of 1998. The work examines data on male liquidators registered in six regional centers of the RSMDR, which annually supply the most verified medical and dosimetric data: North-West, Volga-Vyatka, Central Chernozem, Volga, North Caucasus and Ural. The number of such liquidators is 96,026 people, which is 57% of all participants in the liquidation of the consequences of the accident at the Chernobyl nuclear power plant registered in the RSMDR. The average dose in the studied cohort of liquidators was 108 mGy, the average age at the time of entry into the work area was 34.3 years, the total accumulated number of person-years was 1,011,727. A comparison was made of the levels of cancer morbidity and mortality due to tumors of the digestive system of liquidators and the Russian population as a whole by calculating the standardized incidence ratio (SIR) and mortality ratio (SMR). The SIR and SMR values with 95% confidence intervals for malignant neoplasms of the digestive system were 0.88 (0.80; 0.97) and 0.72 (0.64; 0.80), respectively. For liquidators in 1986, entry into the work zone was 0.97 (0.85; 1.11) and 0.81 (0.70; 0.94), respectively. During the observation period from 1991 to 1997, when the SIR among liquidators became stable, the SIR and SMR values with 95% confidence intervals for malignant neoplasms of the digestive system were 1.00 (0.90, 1.10) and 0.87 ( 0.78; 0.98) respectively. For liquidators in 1986, entry into the work zone was 1.15 (1.00; 1.33) and 1.02 (0.86; 1.19), respectively. An assessment of radiation risks for this class of diseases did not reveal a statistically significant increase in cancer morbidity or mortality with an increase in the external radiation dose of liquidators.

Keywords
Morbidity, mortality, malignant neoplasms, digestive system, participants in the liquidation of the consequences of the accident, Chernobyl nuclear power plant, liquidators, cohort, tumors.

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