Organization of the regional cancer service to improve the detection of malignant new formations during the COVID-19 pandemic

In 2020, the activities of the oncological service of the Russian Federation were complicated by the development of the SARS-CoV‑2 respiratory syndrome, which had a pronounced effect on the health of patients with malignant neoplasms (MN) and contributed to the reorientation of employees of oncological services to ensure a special regime. The vertical line of continuity in the diagnosis and treatment of patients with malignant neoplasms was violated, the timing of treatment was violated. Aspects of the organization of the oncological service of the Magadan region (MagO) in the context of the SARS-CoV‑2 pandemic have been studied.

Purpose of the study. To assess the features cancer detection among the citizens of the Magistral District in 2019-2020.

Materials and methods. The available sources of information (documents of the Ministry of Health of the MagO), databases of the oncological dispensary (IODE), based on information from the state reporting forms – ff. 7 and 30, as well as from Internet resources. Results. MagO region, leading in the rate of morbidity and mortality from malignant neoplasms in the Far Eastern Federal District: incidence of malignant neoplasms for 2009-2019 increased by 23 %. In 2020, the indicator of malignant neoplasm (from 35 % to 25.4 %) decreased in the MAO, and the proportion of patients with malignant neoplasms in localized (III) stages was 50 %. In August 2020, the CAPC began to work, for 5 months. Cancer was detected in 35 people (7.6 %), including in the early (I-II) stages in 18 people, which did not significantly affect the rate of early detection of cancer. Physical examinations revealed 107 cases of malignant neoplasm (a decrease of 27.4 % compared to 2019). In 2019-2020 In the MAO, cancer screening was carried out for a number of nosoologies: as a result, the proportion of patients with lung cancer (MagO – 36 %, RF – 29.4 %) and cervix (MagO – 82 %, RF – 66 %) exceeded the national average.

Conclusion. To increase the detection of malignant neoplasms, it’s necessary to provide examination rooms in the districts of the MagO; drawing up a "map of contamination of the territory"; assessment of the conditions of human production activity and population density; introduction of the standard of examination of patients with cancer; increasing the alertness and qualifications of primary outpatient medical personnel.

1. Guan W-J, Ni Z-Y, Hu Y, Liang W-H, Ou C-Q, He J-X, et al. Clinical Characteristics of Coronavirus Disease 2019 in China. N Engl J Med. 2020 Apr 30;382(18):1708–1720. https://doi.org/10.1056/NEJMoa2002032

2. Sohrabi C, Alsafi Z, O’Neill N, Khan M, Kerwan A, Al-Jabir A, et al. World Health Organization declares global emergency: A review of the 2019 novel coronavirus (COVID-19). Int J Surg. 2020 Apr;76:71–76. https://doi.org/10.1016/j.ijsu.2020.02.034

3. World Health Organization. Coronavirus disease 2019 (COVID-19) Situation Report – 51, 11 Mar. 2020. Available at: https://www.who.int/docs/default-source/coronaviruse/situation-reports/20200311-sitrep-51-covid-19.pdf?sfvrsn=1ba62e57_10. Accessed: 22.03.2021. (In Russian).

4. Heldwein FL, Loeb S, Wroclawski ML, Sridhar AN, Carneiro A, Lima FS, et al. A Systematic Review on Guidelines and Recommendations for Urology Standard of Care During the COVID-19 Pandemic. Eur Urol Focus. 2020 Sep 15;6(5):1070–1085. https://doi.org/10.1016/j.euf.2020.05.02

5. Decree of the President of the Russian Federation No. 204 of 07.05.2018 "On National Goals and strategic Objectives of the development of the Russian Federation for the period up to 2024" Available at: https://base.garant.ru/71937200/. Accessed: 23.03.2021. (In Russian).

6. Federal project "Fight against cancer". Available at: https://minzdrav.gov.ru/poleznye-resursy/ natsproektzdravoohranenie/onko. Accessed: 23.03.2021. (In Russian).

7. Resolution of the Government of the Magadan Region of 27.06.2019 No. 456-pp "On approval of the Program for the fight against cancer in the Magadan Region for the period 2019- 2024". Available at: https://docs.cntd.ru/document/553375572. Accessed: 21.03.2021. (In Russian).

8. The state of oncological care for the population of Russia in 2019. Ed. by A.D.Kaprin, V.V.Starinsky, A.O.Shakhzadova. Moscow: P.A.Hertsen Moscow Oncology Research Institute – Branch of the National Medical Research Radiological Centre, 2020, 239 p. (In Russian).