Analysis of the ratio of mortality and morbidity of the population of the republic of Belarus with malignant neoplasms of various localization. Trends in mortality from malignant neoplasms Analysis of deaths from malignant neoplasms

Keywords

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

annotation scientific article on clinical medicine, the author of the scientific work - Askarov R.A., Karelin A.O., Askarova Zagira Fatkhullovna, 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 the table. С51, "Distribution of the deceased by sex, age groups and causes of death ”of Bashkortostanstat. To calculate statistical indicators, parametric, nonparametric methods and the method of time series analysis were used. The dynamics of indicators as a whole is comparable with the national ones, that is, there is a slight decrease in the mortality rate by 2014. The analysis shows that both the “rough” and standardized mortality rates on average in Russia per 100,000 population were higher throughout the analyzed period. than in the Republic of Bashkortostan. However, both men and women of the Republic of Bashkortostan are experiencing an increase in mortality from malignant neoplasms many localizations. According to forecast estimates, a decrease in 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 population of the Republic of Bashkortostan in 2002-2014. The results were calculated according 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 testifies that during all both the "raw" and standardized mortality indices per 100,000 in average were higher in Russia than in the Republic ofBashkortostan. However, in the Republic of Bashkortostan, both in males and females increasing of mortality of malignant neoplasms of many localizations is detected. According prognosis estimates, decreasing of mortality of neoplasms in population of the Republic of Bashkortostan is possible.

The text of the 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.

1 GBOU VPO Russian State Geological University named after S. Ordzhonikidze ",

117997, Moscow;

2 State Budgetary Educational Institution of Higher Professional Education “First Saint 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 the 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 table. С51, "Distribution of deaths by sex, age groups and causes of death," Bashkortostanstat. To calculate statistical indicators, parametric, nonparametric methods and the method of time series analysis were used. The dynamics of indicators as a whole is comparable with the national ones, that is, there is a slight decrease in the mortality rate by 2014. The analysis shows that both the “rough” and standardized mortality rates on average in Russia per 100,000 population were higher throughout the analyzed period. than in the Republic of Bashkortostan. However, both men and women of the Republic of Bashkortostan show an increase in mortality from malignant neoplasms of many localizations. According to forecast estimates, a decrease in the mortality rate of the population of the Republic of Bashkortostan from neoplasms is possible.

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 IP 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 population of the Republic of Bashkortostan in 2002-2014. The results were calculated according 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 decreasing dynamics of indices is comparable with national one ie insignificantasing of mortality is observed to 2014. The analysis testifies that during all analyzed both the "raw" and standardized mortality indices per 100,000 in average were higher in Russia than in the Rep ublic ofBashkortostan. However, in the Republic of Bashkortostan, both in males and females increasing of mortality of malignant neoplasms of many localizations is detected. According prognosis estimates, decreasing of mortality of neoplasms in 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, of 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 № 2 Bashkir State Medical University, 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, and respiratory organs, which make the greatest contribution to the structure of high male mortality in our country. In this regard, it is important to study the frequency, structure of mortality from neoplasms and trends in its change, taking into account the medical and demographic processes in different territories, which will provide the necessary information for planning preventive and therapeutic measures both at the state and regional levels, contributing to the improvement of cancer 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 regularities 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 to effectively initiate timely and 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 sex, age groups and causes of death", on the population of the Republic of Belarus for the period 2002-2014, Rosstat. The work used modern statistical research methods. The analysis of the causes of death was carried out in accordance with the International Classification of Diseases of the 10th revision. Extensive, intensive and standardized mortality rates of the population from malignant neoplasms were calculated on the basis of generally accepted methods using the direct method of standardization using the European standard of the age structure of the population. To assess the dynamics of mortality, the average annual growth rate of intensive indicators was calculated, as well as the trend (regression coefficient).

results

Most of the medical and demographic indicators in recent years in the Republic of Belarus, as well as in Russia, have unfavorable trends in all major age groups of the population. Analysis of population dynamics in terms of growth / decline 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 the 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 a significant gender disparity. The number of men as of 01.01.14 was 1,908,668, women - 2,163,319 (there were 1133 women per 1000 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) PO! http://dx.doi.org/10.18821/0044-197X-2016-60-6-303-307

Health Organization

which corresponds to the average degree of urbanization. In the republic, since 2009, a natural population growth has been recorded, which in 2014 amounted to 1.7 per 1000 population. The population of the Republic of Belarus with the share of people aged 65 and over 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 (against 36.4 years in 2002) (in the Russian Federation - 39.4 years), men, respectively, 35.9 years (34.2 years in 2002) (in the RF - 36.6 years), women - 40.4 years (38.4 years in 2004) (in the RF - 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 rate, extrapolation, regression) showed a clear tendency 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 by 2025 will decrease to 4032.4014 thousand people (by 0.9%, or 37.3 thousand people) (Fig. 1).

Among all causes of mortality among the population of the Republic of Belarus, malignant neoplasms rank third (11.0%) after diseases of the circulatory system (52.9%), injuries, poisoning and some other consequences of external causes (12.3%) on average for 2002-2014 biennium In the structure of mortality from malignant neoplasms in 2002-2014. the largest proportion are neoplasms of the digestive system (39.8%), while the proportion 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 interval 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 and older, 35.3% of deaths occur in men and 41.7% in women.

Cancers of the trachea, bronchi, lung (27.8%) (in women, the share of these tumors is 4.6 times lower - 6%), stomach (13.2%), rectum (6 , 3%), prostate (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%), urinary bladder (2.9%), larynx (2.8%). Leukemia is 2.5%, tumors of the central nervous system (CNS) - 2.3% (on average for 2002-2014). In 2014, cancer of the lung (27.8%), stomach (11.8%), and prostate (7.2%) prevailed in the structure of mortality in men (Fig. 2).

Leading 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%), uterus (4.2%), liver, bile ducts (3.0%). Leukemia was 3.0%, esophageal cancer - 2.7%, CNS tumors - 2.5%, kidney - 2.3%. Malignant neoplasms of the

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

Health care organization

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. Dynamics of the population of the Republic of Bashkortostan and the linear regression equation (2000-2014).

Bladder

Lymphatic tissue 3% Kidney 3%

Esophagus

Lips, mouth and throat

Rectum

Pancreas 6%

Other 17%

Lung 28%

Stomach 12%

Prostate 7%

Colon

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

Ghans of the reproductive system make up 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 (8.3%). In contrast to the indicators in Russia, further in the structure of mortality among the female population is followed by cancer of the pancreas (6.9%), rectum (6.5%) (in the RF - cancer of the lung and pancreas) (Fig. 3).

In 2014, 6189 people died from malignant neoplasms in the Republic of Belarus (women - 44.6%, men - 55.4%), including from lung cancer 1126, stomach cancer 663, cancer of the colon and rectum 815, breast cancer 489 people. The average age of deaths 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 decline was 0.23%. According to forecast estimates, by 2025 the number of deaths may decrease to 5808.8 people per year (by 6.1%). With the estimated population of the Republic of Belarus 4,032,401 people, the mortality rate should be 144.1 per 100 thousand.

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

formations amounted to 243,867, the average annual rate of decline - 0.50%. According to forecast estimates, by 2025 the number of deaths of 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 forecast estimates, by 2025, the number of women who died may decrease to 2,663.9 people per year.

The long-term dynamics of mortality rates in RB from malignant neoplasms is generally comparable to the all-Russian one: there is a downward trend. So, in 2014, the mortality rate from neoplasms of the entire population of the Republic of Belarus was 152.0 per 100,000, men - 179.7, which is lower than the 2002 level by 2.3 and 4.8%, respectively. During the same period, there was a slight increase in the mortality rate among 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 was within 144.8 (2010) - 156.5% (2009), the standardized rate 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 in Russia (p = 0.000) and in the Volga Federal District (p = 0.010) (Kruskal-Wallis test).

As our studies show, an increase in mortality from neoplasms in women is noted 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 RF from 285.8 to 244.2%) and in women (from 109.7 to 100.2%; in the RF from 136.0 to 125.1%) decreased.

Analysis of the dynamics of mortality from tumors of the main localizations in men of RB indicates a significant increase in mortality from melanoma of the skin (by 54.4%), malignant neoplasms of soft tissues (by 47.8%), prostate gland (40.6%),

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

Health Organization

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 the 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 among women was held by bladder cancer (2.2 times). There was an increase in the mortality rate of the female population from non-Hodgkin's lymphomas (by 58.9%), cancer of the pancreas (by 40.8%), female genital organs (by 27.1%), uterus (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 overall mortality of the child population (0-14 years old), malignant neoplasms make up an average of 4.3%. During the analyzed period, 431 (0.54%) children died from neoplasms in Belarus. In the structure of child mortality, 30.4% accounted for leukemia; 30.3% - for CNS tumors; 7.3% - for 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% in 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% are men and 23.9% are women.

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

2002-2014 in men of working age, the increase in mortality from pancreatic cancer was 93.6%, lips, 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%, rectum - 21.8%, skin melanomas - 16.8%, stomach cancer - 5.1%. In 2014, compared with 2002, there was also an increase in mortality

Other 25%

Lymphatic tissue

Body of the uterus 5%

Cervix - 5% Ovary 6%

Breast 18%

Stomach 9%

Colon 9%

Pancreas 7%

Rectum

7% Light

Rice. 3. The 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%), urinary bladder (from 1.0 to 2.2%).

In dynamics, the proportion of breast cancer among 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 is 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%), body of the uterus (from 1.1 to 2.3%); lung (100.3%); there is an increase in the mortality rate from malignant neoplasms of the connective and other soft tissues (by 62.4%), the esophagus (by 51.6%), the pancreas (by 46.5%), the kidneys (by 23.7%), and the colon (by 20.3%), ovary (by 15.3%), cervix (by 13.2%), non-Hodgkin's lymphomas (by 8.3%). For the rest of the localizations, both men and women of working age showed a slight decrease in the mortality rate.

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

Discussion

The study of mortality of the population of the Republic of Belarus from neoplasms, according to the Bashkortostanstat (table C51) "Distribution of deaths by sex, 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 (5.9 %), colon and esophagus (5.3%). A significant proportion of cancer of the 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 is 2.5%, CNS tumors - 2.3% in 2002-2014. In 2014, cancer of the lung (27.8%), stomach (11.8%), and prostate (7.2%) prevailed in the structure of mortality in men (see Fig. 2). 2002-2014 leading localizations in the structure of mortality in 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 breast cancer (18.1%), stomach (11.3%), colon and rectum (15.2%), ovary (6.3%), trachea, bronchi, lung (6.0%) ... A significant proportion of cancer of the pancreas (5.4%), the cervix (4.9%), the body of the uterus (4.2%), liver, bile ducts (3.0%). Leukemia is 3.0%, esophageal cancer - 2.7%, CNS tumors - 2.5%, kidney cancer - 2.3%. Malignant neoplasms of the organs 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 (8.3%). Then there were cancer of the pancreas (6.9%) and rectum (6.5%), according to the RF, lung and pancreatic cancer (see Fig. 3). Moreover, 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 the age intervals of 70 years and older. Persons of working age were on average 34.9% of men and 23.9% of women who died from neoplasms.

The mortality rate of the population of the Republic of Belarus from malignant neoplasms has lower rates than in the Russian Federation and the Volga Federal District. However, it was possible to identify some unfavorable tendencies 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, which is especially alarming, in 20-24 years by 5.3%. Although the overall 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 melanoma of the skin, 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 structure of mortality among the female population is somewhat different,

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

The identified features of mortality from malignant neoplasms must be taken into account in the long-term planning of treatment and prophylactic measures and the improvement of oncological care for this category of patients.

Financing. The study was not sponsored.

LITERATURE

1. Demographic Yearbook of Russia. Moscow: 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 them. P.A. Herzen - branch of the Federal State Budgetary Institution "NMIRC" 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; vol. 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

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

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 organs 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 steady upward trend in cancer incidence both throughout the world and in the Russian Federation (hereinafter referred to as the RF) determines the increased attention to this medical and social problem. For a real improvement in the health status of the population, it is necessary to increase the efficiency of existing federal programs and introduce new ones, including regional ones, aimed at the prevention and timely early diagnosis of precancerous diseases and malignant neoplasms (hereinafter - cancer).

As a result of the implementation of the Europe Against Cancer program in the EU countries, the main components of which were measures aimed at combating smoking, rationalizing nutrition by increasing the consumption of plant foods 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 for 10 years decreased by 15%.

At the same time, according to medical statistics in the Russian Federation, there is a steady increase in the incidence of cancer. So, in 2015, the incidence rate was 241.35 per 100,000 population, which is 10.8% higher than the 2006 level (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 (20.7%) came out on top in the structure of the incidence of malignant neoplasms.

In the Moscow region (hereinafter referred to as MO) in 2015, 6449 cases of oncological diseases of the organs of the female reproductive system were registered (hereinafter referred to as YR). More than half of the cases - 3526 breast cancer (54.7%). Uterine body cancer - 1369 cases (21.2%), cervical cancer - 875 cases (13.6%). Ovarian cancer was diagnosed in 679 cases (10.5%) (Fig. 1).

Figure 1. The structure of the incidence of malignant neoplasm of iron ore in the MC

For the period 2011 - 2015 for the indicated nosologies in the MO, there is an increase in morbidity rates. The highest growth rate occurs with ovarian cancer of 13.8%, which significantly exceeds the same indicator 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 over the indicated period increased by 7.4% (RF - 9.6%, Central Federal District - 7.2%). Breast and uterine cancer - 5.8% (RF - 10%, CFD - 7.8%) and 4.7%, respectively (RF - 9.8%, CFD - 10.8%).

In the structure of mortality among the population of Russia, cancer takes the 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 malignant neoplasms, 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, cancer of the breast (16.7%), colon (9.8%), stomach (9.3%), diseases of the trachea, bronchi, and lung (6.8%) have the largest specific weight. In the Russian Federation, the share of mortality from malignant neoplasm of iron ore in the overall structure of female mortality is 32.0%

Among the causes of mortality among the population, the Ministry of Education and Science of ZNO ranks second (17%) after diseases of the circulatory system (61%). In 2015, 7,841 women died from cancer. Among all the causes of deaths from cancer, the share of cancer in the organs of iron ore was 31.5% (2473 cases).

In the structure of mortality from malignant neoplasms of the iron ore organs in the municipality, the largest specific weight belongs to malignant neoplasms of the mammary gland - 51.5% (1268 cases). Cancer of the body of the uterus and cancer of the cervix make up 18.7% and 18.1% (464 and 450 cases), respectively. Ovarian cancer accounts for 11.7% (291 cases) (Fig. 2).

Figure 2. The structure of cancer mortality in iron ore bodies in MC

In general, mortality rates for breast, cervical and ovarian cancers are on a downward trend. The standardized mortality rates in 2015 from the indicated nosologies were:

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

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

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

One of the main reasons for the high mortality rate in oncopathology is late diagnosis due to the insufficient prevalence of screening programs for the early detection of cancer, including of female reproductive organs, despite the fact that by now effective methods of preclinical diagnosis have been developed and tested in practice, requiring widespread introduction into 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 the coverage of the population with screening, improving the quality and availability of diagnostics and treatment, and promoting a healthy lifestyle. Implementation of the Concept's activities will allow achieving a reduction in mortality, including from cancer, and an increase in the life expectancy of the population.

Bibliography:

Healthcare in Russia, 2015: Stat. collection / 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., Federal State Budgetary Institution “MNIOI im. P.A. Herzen "of the 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 them. P.A. Herzen - a branch of the Federal State Budgetary Institution "FMITs im. P.A. Herzen, "the Ministry of Health of Russia, 2017. - 250 p.
Public health and health care [Electronic resource]: textbook / Lisitsyn Yu.P., Ulumbekova G.E. - 3rd ed., Rev. and add. - M.: GEOTAR-Media, 2013.

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

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
Blokhin Cancer Research Center, Russian Academy of Medical Sciences, 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 newly diagnosed malignant neoplasms increased over 1991-1996. 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 diseases is expected to increase to 480 thousand.
In 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 - breast cancer (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 tendency towards a decrease or stabilization of lung cancer and, in most regions, cancer of the lip and esophagus. The proportion of non-melanoma neoplasms of the skin, prostate cancer, kidney cancer (except for the North-West) and the thyroid gland (except for the North and Ural) increased. In women, there is a decrease or a downward trend in the proportion of cancer of the esophagus, stomach, lung, cervix (the latter, with the exception of the North-West and East Siberian regions). There was an increase in the proportion of breast cancer (except for the North-West 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 Caucasian region) to 289.6 - 290.5 (North-West region and Kaliningrad region); the highest incidence of lip cancer (8.5) - in the Volga region, esophageal cancer (13.1) and stomach (42.8) - in the North, liver (8.6) - in the West Siberian, non-melanoma skin tumors (30 , 0) - in the North Caucasian. Men are 1.2 - 2.3 times more likely than women to develop cancer of the stomach, colon and rectum, pancreas, 6.1 - 7.3 times - cancer of the lip, esophagus and bladder, 9.2 - lung cancer and 21.9 - cancer of the larynx. In women, the incidence of gallbladder cancer and skin melanoma is 1.2 - 1.3 times higher than in men, and the incidence of thyroid cancer is 4.1 times higher.
Fluctuations in morbidity rates in women ranged from 158.3 - 158.5 (East Siberian and Volgo-Vyatka) to 194.2 - 195.5 (West Siberian and North-West regions).
Compared to other regions, the incidence of cancer of the lip (1.7) and lung (12.6) in the West Siberian region is significantly higher; stomach (19.2), colon (14.6) and mammary gland (43.2) - in the North-West; liver (4.1) - in the Far East, the body of the uterus (13.7) - in the Central, thyroid gland (7.7) - in the West Siberian, ovary (11.2) and hemoblastoses (14.0) - in the Kaliningrad area.
In some 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 took place in the republics of Tuva (23.1 and 22.3, respectively, for men and women) and Yakutia (33.1 and 7.7); stomach - in Tuva (53.9 and 24.3) and the Novgorod region (51.8 - in men); rectum - in the Magadan region (17.0 and 15.2), Karelia (21.1 - for men) and the Kaliningrad region (19.2 - for women); lung - in men in Saratov (98.3) and Tambov (95.8) regions, in women - in Yakutia (23.1) and Kemerovo region (20.7); the mammary gland - in North Ossetia (49.5), the cervix - in Tuva (24.1), the 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 morbidity 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 in skin melanoma (35 and 15.4%), prostate cancer (31.4%) and breast (18.5%), hemoblastosis (4.8 and 11.9%), colon (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%), liver (by 3.3 and 7 , 1%), in men - cancer of the larynx (5.1%) and lung (5.0%).
In 1991 - 1996 the increase in the number of newly diagnosed malignant neoplasms in Russia was 4.1% for men and 10% for women. It was most pronounced due to an increase in the risk of developing kidney cancer (by 43.6% in men and 40.2% in women), thyroid cancer (16.7 and 51.8%), 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 (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 persons 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 (35.9%), bones and articular cartilage (by 10.2 %).
The probability of contracting a malignant neoplasm during the coming life for a newborn in Russia in 1996 is 17.4% for a boy and 18.5% for a girl. Boys have the highest risk of developing cancer of the lung (4.7%), stomach (2.6%), skin (1.6%), girls - breast cancer (3.5%), stomach (2.1%) ), colon (1.3%), skin (2.6%), cervix (1.1%).
The probability of getting sick at working age for people who have lived up to 20 years old is 6.7% for men and 5.4% for women in Russia. The proportion of the likelihood of getting sick at this age in the overall likelihood of contracting this form of tumor throughout the coming life is highest in Russia in men with malignant neoplasms of the larynx (49.2%), lung (38.3%), bones and soft tissues (47.8 %), hematological malignancies (44.6%), in women - with cancer of the cervix (46.4%), breast (42.9%), bones and soft tissues and hematological malignancies (33.3% each).
The probability for a newborn in Russia in 1996 to die from a malignant neoplasm during the next 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 colon and rectal cancer, as well as malignant neoplasms of the skin. 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 (0.94 %).
At a young age, the probability 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 times, and at 70 - 74 years old they are reduced to 2.5 - 4. In old age, the probability of dying from other causes is higher for patients with malignant neoplasms of the skin, breast (at 70 - 74 years ) 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 hemoblastosis.
To the greatest extent, the average life expectancy is reduced in people with cancer of the esophagus, stomach and lungs. In colon cancer, the average life expectancy of 40-year-old patients is higher than in rectal cancer; in cervical cancer, it is higher than in breast cancer. The life expectancy of patients with malignant neoplasms of the skin at the age of 40 and older is approaching a similar indicator for the general population.
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-West 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 Northwestern 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 some 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, the 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 Magadan Region ( 23.4); from 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 Vladimirskaya oblasts (18.6) - among women; for 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 the Altai Territory (83.9) - among men, in the Republics of Sakha (19.1), Tuva (17.7) - among women. Significantly higher than the average for Russia (16.4), mortality from breast cancer in the Magadan region (25.0), St. Petersburg and Moscow (22.4 each), 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 national average (7.5) in the Chukotka Autonomous Okrug (20.2), 1.6 times- in the Irkutsk, Tomsk, Astrakhan and Jewish Autonomous Regions.
1991 - 1996 In Russia, there was an increase in the rate of increase in the 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 and 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 the causes of death of the population would increase the average life expectancy of newborns by 2.0 years. Mortality from lung cancer (by 0.56 years) and stomach (by 0.29), hemoblastoses (by 0.13 years) has the maximum effect on reducing the average life expectancy of men; 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 died from a malignant neoplasm loses more years of her life than a man (16.9 versus 14.5 years). The greatest losses are incurred 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 population of Russia in 1996 lost 4.5 million person-years of life. The greatest damage to society is caused by lung cancer (808.2 thousand person-years), stomach (642.9 thousand), breast (367.0 thousand) and hemoblastosis (287.5 thousand).
Conditional economic losses due to deaths from malignant neoplasms in 1996 amounted to 3.9 billion rubles. (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 hemoblastosis.
Analysis and assessment of trends in morbidity, mortality, and their derivatives should be carried out systematically, facilitating the implementation of the link between planning and management, on the one hand, and the 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 ONTs AMS of Russia. - 1992. - No. 4. - P.3-14.
2. Trapeznikov N.N., Axel E.M. Morbidity and mortality from malignant neoplasms of the population of the CIS countries in 1996 - M., 1997. - P. 302.
3. Dvoyrin V.V., Axel E.M. Component analysis of the dynamics of the incidence of malignant neoplasms: Method. recommendations. - M., 1987.
4. Dvoyrin V.V., Axel E.M. Calculation of the likelihood of contracting malignant neoplasms throughout the coming life: Method. recommendations. - M., 1988.

Malignant neoplasms are one of the main causes of mortality in the population, reflecting on the demographic situation in Russia. Despite the continuing growth in mortality in Russia as a whole, its structure has not changed significantly (2004-2010).

In the first place is mortality from diseases of the circulatory system (42.2%), in the second - mortality from accidents, poisoning and injuries (25.2%), in third place is stable cancer (12.4%).

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

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

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

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

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

In the male population, trauma and poisoning (16.5%) shifted malignant neoplasms to third place (Figure 3.16.)

Rice. 3.16. The proportion 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 a worsening of mortality rates from malignant neoplasms: the mortality rate per 100 thousand of the population increased from 192 (in 2004) to 204.9 (in 2009) in men - from 220 to 237.1, in 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 cancer of the colon and rectum, 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 was 15.0%, and stomach cancer was 13.0%.

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

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

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

The increase in the number of patients with malignant neoplasm of the liver, the difficulties of diagnosis, morphological verification of the diagnosis, the incidence of viral hepatitis, the chronicity of the process brought this pathology to the main positions in the ranked order of morbidity and, accordingly, mortality.

The number of deaths from cancer in Moscow in 2004 reached 23,033 people. Among men, in the structure of mortality, the first place was taken by lung cancer (22.3%), the second - stomach cancer (14.5%), the third - colon cancer (8.3%); in women - breast cancer (18.4%), stomach (11.3%) and colon (11.2%), respectively. 63 deaths from malignant neoplasms were registered in Moscow every day. The maximum average age of the deceased was observed in cancer of the stomach, prostate, bladder, colon and rectum (68-74 years).

The standardized mortality rate from cancer of the male population of Moscow in 2004. amounted to 167.1 per 100 thousand of the population, female - 107.5 per 100 thousand (7th and 8th places among the regions of Russia, respectively). High mortality from breast cancer (21.4 per 100 thousand), colon (10.4 per 100 thousand). Men had 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 average in Russia. Significantly higher than the average Russian mortality rates of the female population of Moscow from colon cancer (10.5 per 100 thousand in Moscow and 7.3 per 100 thousand in Russia), breast (21.4 per 100 thousand and 6.0 per 100 thousand, respectively), ovarian cancer (7.8 per 100 thousand and 5.8 100 thousand, respectively).

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

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

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

The dynamics of mortality from cancer of the population in the service area of OD # 2 in Moscow indicates a decrease in the indicator from 124.1 per 100 thousand population in 2004. up to 117.6 per 100 thousand population in 2010. (tab. 3.6.). A high mortality rate was noted in breast cancer (women), cancer of the bronchopulmonary system (mainly men), stomach and colon cancer. (tab. 3.7, 3.8.)

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

The absolute number of sick deaths in the reporting year by location and by year of registration.

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
Bone and soft tissue	17	33	28	25	19	22	25
Melanoma	41	57	61	73	57	61	71
Others are new. 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	16	27	20	17	15	18	21
Total	2285	2418	2466	2341	2260	2242	2226

The relative number of sick deaths in the reporting year by location 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, rexigmoid comp. anus
Trachea, bronchi, lung	20.2	18.7	18.7	17.7	16.7	18.7	18.7
Bone and soft tissue	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
Others are new. 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	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 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 District and the North-Western Administrative District of Moscow indicates that the mortality rate per 100,000 people. in Moscow is lower than in the Russian Federation, and in CAO and CZAO it is lower than in Moscow, which can be attributed to the rather efficient operation of the Oncological Dispensary No. 2 in Moscow.

Biryukov A.P., Ivanova I.N., Gorskiy A.I., Petrov A.V., Matyash V.A.
Medical Radiological Research Center, Russian Academy of Medical Sciences, Obninsk.
Department of Healthcare and Pharmaceutical Provision of the Government of the Kaluga Region, Kaluga

annotation

This paper analyzes information on morbidity and mortality from malignant neoplasms of the digestive system of participants in the liquidation of the consequences of the Chernobyl accident (liquidators), accumulated in the Russian State Medical and Dosimetric Register (RGMDR) in the period from 1986 to the beginning of 1998. data on male liquidators registered in six regional centers of the RGMDR, annually supplying the most verified medical and dosimetric data: North-West, Volgo-Vyatka, Central Chernozem, Povolzhsky, North Caucasian 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 RGMDR. The average dose in the studied cohort of liquidators is 108 mGy, the average age at the time of entry into the work area is 34.3 years, the total accumulated number of person-years is 1,011,727. calculating the standardized ratio of morbidity (SIR) and mortality (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 entering the work zone - 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 of the 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 entering the work area - 1.15 (1.00; 1.33) and 1.02 (0.86; 1.19), respectively. The 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 exposure dose to the liquidators.

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

List of cited literature

1. Akleev A.V., Kosenko M.M., Silkina L.A., Degteva M.O. Clinical and epidemiological substantiation of the principles of formation of groups of increased oncological risk among the exposed population // Radiation and risk. 1995. Issue. 5.S. 163-175.

2. Biological effects of small doses of radiation / Ed. Yu.I. Moskaleva. M., 1983.

3. Buldakov L.A. // Chernobyl yesterday, today, tomorrow ... / Ed. S.P. Yarmonenko. Moscow: Izdat, 1994.S. 61-93.

4. Doses of irradiation of liquidators // Radiation and risk. 1995. Special Issue No. 2.

5. Malignant neoplasms in Russia in 1980-1995 / Ed. V.I. Chissov, V.V. Starinsky, L.V. Remennik. M., 1998.61 p.

6. Matveenko E.G. Study of iodine metabolism in normal and pathological conditions by the method of dynamic radiometry of the whole body and individual organs: Author's abstract. dis ... doct. honey. sciences. M., 1972.

7. Moskalev Yu.I. Radiobiology of incorporated radionuclides. M .: Energoatomizdat, 1989.

8. Moskalev Yu.I., Streltsova V.N. Radiation carcinogenesis in the problem of radiation protection. M .: Energoatomizdat, 1982.

9. UNSCEAR. Radiation carcinogenesis in humans. New York, 1977.

10. Pathological diagnostics of human tumors. A guide for doctors / Ed. N.A. Kraevsky, A.V. Smolyannikova, D.S. Sarkisova. M .: Medicine, 1993.Vol. 2.P. 11.

11. Order of the Ministry of Health of Russia No. 281 of 11/26/93 “On the procedure for maintaining the Russian State Medical and Dosimetric Register of Persons Exposed to Radiation as a result of the Chernobyl disaster”.

12. Order of the Ministry of Health of Russia No. 248 of 08.19.97 "On amendments to the order of the Ministry of Healthcare of Russia of 08.16.96 No. 311".

13. Order of the Ministry of Health of Russia No. 236 of 08/11/95 “On Amendments to the Order of the Ministry of Healthcare of Russia of 11/16/93 No. 281”.

14. Radiation protection. Publication No. 27 ICRP / Per. from English M .: Energoatomizdat, 1981.

15. Streltsova VN, Moskalev Yu.I. Blastomogenic effect of ionizing radiation. Moscow: Medicine, 1964.

16. Akiyama M. Late effects of radiation on the human immune system: an overview of immune response among the atomic-bomb survivors // Int. J. Radiat. Biol. 1995. V. 68, No. 5. P. 497-508.

17. Gentner N.E., Morrison D.P., Myers D.K. Impact on radiogenic cancer risk of persons exhibiting abnormal sensitivity to ionizing radiation // Health Phys. 1988. V. 55, No. 2. P. 415-425.

18. This email address is being protected from spambots. You need JavaScript enabled to view it. ... Last modified: February 10, 1999.

19. Ito C., Kato M., Yamamoto T. et al. Study of stomach cancer in atomic bomb survivors. Report 1. Histological findings and prognosis // J. Radiat. Res. 1989. V. 30, No. 2. P. 164-175.

20. Ivanov V.K., Tsyb A.F., Maksyutov M.A. et al. Cancer morbidity and mortality among Chernobyl accident emergency workers residing in the Russian Federation // Curr. Oncol. 1995. V. 2, No. 3. P. 102-110.

21. Pierce D.A., Shimizu Y., Preston D.L. et al. Studies of the mortality of atomic bomb survivors. Report 12, part 1. Cancer: 1950-1990 / RERF report N 11-95 // J. Radiat. Res. 1996. V. 146. P. 9-17.

22. Report on a workshop to examine methods to arrive at risk estimates for radiation-induced cancer in the human based on laboratory data. Jointly sponsored by the Office of Health and Energy Research, Department of Energy and Columbia University // Radiat. Res. 1993. V. 135, No. 3. P. 434-437.

23. Ritz B., Morgenstern H., Moncau J. Age at exposure modifies the effects of low-level ionizing radiation on cancer mortality in an occupational cohort // Epidemiology. 1999. V. 10, No. 2b. P. 135-140.

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

Related Topics scientific works on clinical medicine, the author of the scientific work - Askarov R.A., Karelin A.O., Askarova Zagira Fatkhullovna, Sharipova I.A.

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

The text of the 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)"