The records of patients with postmortem diagnosis of cancer (population study at the federal district level)

Abstract

Purpose: to determine the real state of cancer care in Russia for the identifcation of patients with postmortem diagnosis of cancer using the population-based cancer registry. Material and Methods. Data from the offcial reports of the cancer service (f. No. 7) and the database of the population-based cancer registry of the Northwestern Federal District of the Russian Federation with a volume of more than 1,350,000 cases of cancer were presented. Standard methods of cancer statistics were used. Results. The problem of the quality of registration of primary patients with cancer includes three main components: active cancer detection, including screening programs and medical survey; providing citizens with optimal conditions for free access to medical institutions, including cancer centers; improving the pathoanatomical service to detect cancer in deceased patients. The proportion of patients registered postmortemly, according to offcial data, may be several times less than the real value. At the same time, it should be noted that for 2 periods (1997–1999 and 2017–2019), according to the database of the Northwestern Federal District of the Russian Federation, the proportion of postmortemly registered patients decreased from 15.72 to 8.16 %, and in St. Petersburg from 24.46 to 9.76 %. During the period from 2017 to 2019, 2973 patients with bronchial and lung cancer (C34) – 15.17 %, 1708 patients with colon cancer – 10.32 %, 1640 patients with stomach cancer – 12.17 %, about 20 % of patients with pancreatic cancer and 29.43 % of patients with liver cancer were unaccounted for in the Northwestern Federal District of the Russian Federation. Conclusion. Thus, for the frst time in Russia, our study made it possible to identify the real state of cancer care for patients with post-mortem diagnosis of cancer, to determine the magnitude of the discrepancy between state reporting data and database of population-based cancer registry, to note the improvement in one-year and fve-year observed survivals. In recent years, the one-year mortality rate, subject to posthumously registered patients, loses 5.6 years, fve-year – 4.4 years. It is important to note that since 2000, due to improved registration of patients with a frst-time diagnosis of malignant tumors, the one-year and fve-year survivals of patients with posthumously registered increased by 18.5 % and 20.7 %, respectively.