On April 2, 2014, a round table was held in St. Petersburg, dedicated to the problem of oncological diseases of the female reproductive system. His organizers have become the Association of Oncologists SPO and FGBU «Nii oncology them. N.N. Petrov» Ministry of Health of Russia.
Content
Participants discussed the results of a pilot project of screening oncological diseases of the reproductive system in women and adopted a resolution on further improving cancer diagnosis.
The North-West region of Russia is sufficiently disadvantaged in terms of the incidence of malignant tumors of the female reproductive sphere. Thus, in 2012, a standardized incidence rate of cervical cancer (RSM) in the SPO amounted to 14.79 per 100,000 people of the population, and mortality — 4.95 per 100,000 people in the population. In the region with a population of about 14 million. Man was registered 608 deaths from this disease. Often the disease is detected on the III-IV stage, when radically changed the forecast is no longer possible.
At the same time, RSM is one of the nosological forms in which mass screening makes it possible to identify the disease at the initial stages and successfully combat him, which was confirmed during the pilot screening project. The study showed that the predisposition to the cancer has every 50th St. Petersburg. Of the 1000 women examined, RSM at the earliest stage was revealed in 2 cases; 17 people have precancerous states. Other deviations from the norm requiring medical control were discovered in 71 surveyed.
To change the current situation, it is necessary to fundamentally change the approach to the diagnosis: the disease or predisposition to it should be diagnosed not randomly, but to carry a targeted systematic population. Unfortunately, so far in most laboratories there are no modern research quality control systems. Each year in Russia, about 7 million cytological smears of the cervical cervix take about 7 million, but the detectability of RSMs in the early stages and the prejudice states are quite low and is at about 40-60%. The main disadvantages of the standard cytological study are the impossibility of standardizing the method, the influence of the human factor at each stage, the absence of modern laboratory equipment. You can avoid similar shortcomings with the help of modern computerized technology of liquid cytological research of cervical. This technique with standardized material for taking material, transportation and preparation recommended as world «Gold standard» Diagnostics of the pathology of the cervix, allows minimizing the risk of medical error, as well as maintaining material for 6 months: This makes it possible to re-molecular, immunocythic or genetic research without an additional visit to the doctor.
Following the work of the round table resolution was adopted. The leading oncologists of the region decided to create an expert working group under the SOFO JSC to develop recommendations in the field of oncohysecology with the inclusion of representatives of all leading medical institutions of the NWFO. This document presents a model for conducting mass screening of the PSSO population on the subject of early detection of oncological diseases of the reproductive sphere in women and is scheduled to be a complex necessary for its implementation of events.
The participants of the round table stressed that the introduction of screening programs and prevention in the region should be adjustable and centralized. Before the start of the implementation of screening programs and the prevention of oncological diseases, a quantitative assessment of the ability of a medical network is necessary to ensure adequate conditions for the diagnosis and treatment of early forms of cancer. For the introduction of mass screening it is important to ensure the creation of a single referractive center of Screening RSM in the region based on FGBU «NII oncologists. N.N. Petrov» Ministry of Health of Russia. Accounting for all participants in the program will be carried out on the basis of central and regional cancer registers, and quality control of the conducted programs — Central and regional abstract centers. Round table participants recommended to use vaccination against HPV and liquid technology as the most modern method of diagnostics in terms and age groups according to the recommendations adopted by the expert group.
Executive Director of the Cancer Prevention Foundation Ilya Fominsev, summing up the work of the round table, said: «Adoption of a resolution on the need for mass screening in the SFSO — This is a very important step to reduce the disability and mortality of women from cancer in reproductive sphere. As the experience of developed countries shows, screening can significantly reduce these indicators. For example, in Finland, it was possible to achieve a decrease in the incidence of RSM to 4 per 100,000 population, and mortality — Up to 1. What does it say on the scale of the country? Screening makes it possible to preserve hundreds of thousands of lives, and after the treatment, many women retain fertility, give birth to healthy children. In addition, the implementation of such programs allows you to provide significant budget savings in the field of health care, because the cost of treating cancer on initial and running stages is different».
