[Results of a prospective randomized investigation [Russia (St.Petersburg)/WHO] to evaluate the significance of self-examination for the early detection of breast cancer]. / Rezul'taty prospektivnogo randomizirovannogo isledovaniia [Rossiia (Sankt-Peterburg)/VOZ] znacheniia samoobsledovaniia v rannem vyiavlenii raka molochnoi zhelezy.

Indications for puncture or excision biopsy were significantly higher in the study group (7.5%) as compared with control (3.5%) (p < 0.01) in a randomized prospective controlled trial of a comprehensive breast cancer screening (123,748) carried out in the framework of a self-examination education program. In the self-examination group, detection rates were higher both for benign (1.1%) and malignant (0.85%) tumors than in control (0.5% and 0.69%, respectively) (p < 0.05). Early stage (T1NOMO, Tis) distribution difference in the study group and controls was insignificant--23 and 17.6%, respectively. Compliance with the program requirements including monthly or bimonthly self-examination was followed by higher 15-year survival rates (53.2%) in 70-75% as compared with controls(45.8%) (p = 0.05105): yet it did not affect mortality.

[Interim results of a prospective randomized study of self-examination for early detection of breast cancer (Russia/St.Petersburg/WHO)]. / Promezhutochnye rezul'taty prospektivnogo randomizirovannogo issledovaniia (Rossiia/Sankt-Peterburg/VOZ) znacheniia samoobsledovaniia v rannem vyiavlenii raka molochnoi zhelezy.

Training in breast self-examination (BSE) technique involved 57,712 women, aged 40-64, at 14 out of randomly selected out-patient hospitals in St. Petersburg (1985-1989). Another 64,759 women selected at another 14 out-patient hospitals were in control. All patients with detected tumor pathology of the breast were biopsied and treated at the Institute's Clinic. The study focused on breast cancer incidence, survival and mortality. More women in the BSE group sought medical advice for suspected pathology (4,300) than those in control (2,438; p < 0.05). There were 493 cases of breast cancer in the BSE group with 157 fatalities, 446 cases of breast cancer with 167 fatalities in the control group. There was no significant difference in tumor stage. Nine-year survival (after Kaplan-Meyer) from the time of tumor detection was 65% in the study group and 55% in control (log rank 0.774; p > 0.05). There has been no significant difference in death rates in both groups for the past ten years. The study is to continue until the year 2001.

[Preliminary results of the Russia (St.Petersburg)/WHO program for the evaluation of the effectiveness of breast self-examination]. / Promezhutochnye rezul'taty programmy Rocciia (Sankt-Peterburg)/VOZ po otsenke éffektivnosti samoobsledovaniia molochnykh zhelez.

Although an absolute difference of 10% (65,4 vs. 54,9%) in 5- and 9-year survival in breast cancer patients was recorded between the self-examination and control groups a large-scale randomized population-controlled study of 122,471 females has failed to provide significant differences (Log-rank - 0,774, p > 0.05). No significant decrease in mortality was observed in the self-examination group as compared with the untrained controls. As a result of providing more information to the population on risk factors. twice as many of the trained females consulted oncologists. Also, the number of early detection of breast tumor (T1-2NOMO) in both groups was 1,5-2,5 times that recorded elsewhere. Since 3,55 per 1,000 patients with breast tumors per year, aged 50-59, died of cardio-vascular disease, i.e. 3,1 times the expected 1,16 per 1,000, more attention should be focused on timely diagnosis and treatment of concomitant cardio-vascular pathology.

[Use of automated information systems Oncoregistry and Specialist-Oncologist in establishing cancer registry of the Leningrad region]. / Primenenie avtomatizirovannykh informatsionnykh sistem "Onkoregistr" i "Spetsialist-onkolog" dlia sozdaniia kantser-registra Leningradskoi oblasti.

The paper describes the basic features and structure of a cancer register (CR) of the Informational Analytical Service System which can perform a package of interrelated functions to record and analyze an oncological condition, the status of anticancer struggle and the achieved level of specialized care for those who have fallen ill. CR is a fully independent structure of medical application wherein informational provision occupies the dominant position. The basic function of CR is also given in the paper. In Saint Petersburg and in the Leningrad Region there are all necessary conditions for successful CR operation. The basic software support of CR represents the automatic informational systems (AIS): Oncoregister AIS and Specialist-Oncologist AIS. The block diagram of these AISs and their informational communication are presented in this paper.

[The risk factors for breast cancer (a prospective controlled study)]. / Faktory riska raka molochnoi zhelezy (prospektivnoe kontroliruemoe issledovanie).

Preliminary results of a prospective study of known risk factors for breast cancer are discussed in the paper. The study included 42,785 females aged 40-64 years who were followed for 2-5 years (mean--3.1 years). Within this period, 146 cases of breast cancer were registered. A significant (p < 0.05) increase in the relative risk (RR) of breast cancer was established for females aged over 50 (50-59 years--RR-1.4; 95% CI--1.0-2.0 and 60-64 years-RR--2.4; 95% CI 1.6-3.7), overweight patients (RR--1.5; 95% CI--1.1-2.1), subjects who developed menopause after the age of 50 (RR--1.6; 95% CI--1.1-2.2) and those with a ten-year or longer history of liver or bile ducts pathologies (RR--1.7; 95% CI--1.1-2.7). The role of certain factors differed significantly in different age groups. At the age of 40-49 years, the RR of breast cancer rose significantly for overweight subjects (RR--2.0; 95% CI--1.2-3.4) and those with liver pathologies (RR--2.5; 95% CI--1.3-4.6), at the age of 50-59-for subjects with late (after the age of 50) menopause (RR--2.0; 95% CI--1.2-3.4) and at the age of 60-64 years-for nulligravidae (RR--2.8; 95% CI--1.1-6.8).