Culture of prevention and early disease detection of cancer in Russia
Introduction
Cancer is the second leading cause of death globally. In 2018, an estimated one in six deaths worldwide, or 9.6 million people, died from cancer (World Health Organization (WHO), 2019). One strategy that has led to higher success rates in cancer treatment and a lower number of cancer-related deaths is the identification of cancer in its relatively early stages (Byers, 2010; Gong et al., 2012; Goss et al., 2014; Gupta et al., 2018; Hanrahan et al., 2007; Haynes et al., 2008; Richardson et al., 2010; WHO, 2019).
Low-income and middle-income countries have the largest share of cancer cases. In 1970, 15% of newly reported cancers worldwide were in developing countries, compared with 56% in 2008 (Boyle, 2008). By 2030, the proportion is expected to grow to 70% (World Cancer Report, 2020). Russia is one of the middle-income countries with a high mortality rate attributed to cancer (The World Bank, 2019). Cancer is the second leading cause of death in Russia (Goss et al., 2014; Kaprin et al., 2017). According to Goss et al. (2014), Russia has “rapidly rising cancer incidence and … cancer mortality rates that are nearly twice as high as in the UK or the US” (p.489). The mortality burden from cancer is 0.60 for Russia compared with 0.40 in the UK and 0.33 in the USA. The financial burden per patient with cancer in Russia is $3784 compared with $37.836 in the UK and $86,758 in the USA (Goss et al., 2014).
In 2011, to address the issues of rising cancer rates, the government in Russia introduced a National Strategy for Oncology Treatment and Prevention. The National Strategy dedicated funds for purchasing specialized cancer diagnostic and treatment equipment, for outreach efforts to encourage screening through prevention visits, and for the training of specialized medical personnel (Sosnovskaya, 2018). In 2015, researchers from the Russian National Comprehensive Center and Russian Oncology Association also initiated a National Anti-Cancer Strategy. This strategy emphasized prevention, screening, and early cancer diagnostics followed by treatment, rehabilitation, and palliative care (Petrovsky et al., 2019). The goal of these efforts was to decrease cancer-related mortality rates from 202 to 185 death per 100,000 population by the year 2024.
Using cancer-related data presented by the bi-annual reports of the Russian Federation Department of Statistic (Goscomstat, 2007–2017), this study aims to answer two questions: (1) Is there a relationship between the number of patients diagnosed with I-II stage of cancer and the number of preventive visits, which include screening tests? (2) Is there a relationship between the number of patients diagnosed with I-II stage of cancer and the availability of access to specialists who could provide more specialized diagnoses?
The paper proceeds as follows: the first section provides a theoretical framework, history of healthcare system of the Russian Federation and analysis of the cancer prevention strategies in Russia. The next section focuses on the data and methodological approach, followed by a discussion of key research findings. The final section concludes the study, includes limitation and suggestions for future research and implications for policy and practice.
The paper proceeds as follows: the first section provides a theoretical framework, history of the Russian Federation's healthcare system, and analysis of the cancer prevention strategies in Russia. The next section focuses on the data and methodological approach, followed by a discussion of key research findings. The final section includes limitations and recommendations for improvements in healthcare management policies and practices.
Section snippets
Cancer prevention strategies
Each year, more than 14 million people worldwide are diagnosed with cancer, and 9.6 million people die from cancer, representing one in six deaths globally. The probability of deaths related to cancer increases significantly if the cancer is diagnosed in its advanced stages. In contrast, the early detection of cancer enables healthcare professionals to improve health outcomes and also supports more effective utilization of resources (Ferlay et al., 2012). The World Health Organization (WHO, 2019
Methodology
This study analyzes the impact of access to preventive and specialty services in Russia on early detection of cancer. Access to preventive and specialty services represent the main characteristics of health care delivery in the Russian Federation. This study used cancer detection data from 2005 to 2016 that were obtained from the State Committee for Statistical Analysis (Goscomstat) of the Russian Federation.
Discussion
In the time of the Soviet Union, mandatory annual clinical examinations were part of all USSR citizens' lives. These annual examinations were aimed at the early detection of non-communicable diseases and the prevention of chronic conditions. They included screening and examination by primary care physicians (PCP) followed up by specialist examinations by order of tests, and lab work. The examinations took place at the outpatient facilities closest to patients' homes; since all Soviet citizens
Declaration of competing interest
The authors declare that they have no conflict of interest.
References (32)
Challenges to effective cancer control in China, India, and Russia
Lancet Oncol.
(2014)- et al.
Use of preventive health services among cancer survivors in the U.S
Am. J. Prev. Med.
(2018) - et al.
Cancer survival in New Zealand: ethnic, social and geographical inequalities
Soc. Sci. Med.
(2008) Time to Attack
(2019, March 4)- et al.
No myth: benefits of breast screening
Nature
(2006) - et al.
World Cancer Report 2008
(2008) - et al.
Delays and barriers to cancer care in low-and middle income countries: a systematic review
Oncol.
(2019) Two decades of declining cancer mortality: progress with disparity
Annu. Rev. Publ. Health
(2010)- et al.
Cancer Statistics in Russia in 2011
(2013)(2019) - et al.
Cancer Incidence and Mortality Worldwide: IARC CancerBase #11, Lyon, France
(2012)