Culture of prevention and early disease detection of cancer in Russia

Highlights

• Relatively high rate of early cancer detection in Russia, despite low financing.

• Easier access to specialists and labs improves early-stage cancer detection in Russia.

• Day off for preventive visits can result in higher detection of early-stage cancer.

• Increase in outpatient cancer-screening facilities improves early cancer detection.

• Shift from healthcare access to efficiency decreases early-stage cancer detection.

Abstract

This study analyzed the early cancer detection in Russia. Using data from the Russian Ministry of Health from 2005 to 2016, this study aims to evaluate relationships between the number of patients diagnosed with I-II stage of cancer with the number of preventive visits, screening tests, and expedited access to specialists. The results of de-trending time-series model indicate that the number of specialists in outpatient facilities and the number of patients' preventive visits positively affect the number of patients diagnosed with cancer for the first time and the number of patients diagnosed with I-II degree cancer. The Russian Federation's experience suggests that early detection of cancer can be achieved by increasing the number of early cancer screening facilities, providing free screening, and moderating geographical and time constraints that prevent people of different geographic and socio-economic backgrounds from being screened. Another strategy includes dispelling myths associated with cancer screening, fostering outreach and patient education, and assuring availability and timely referrals to specialists and laboratory work.

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.