[Increment of the incidence of glioblastoma following decrease in the incidence of brain tumors in 2000-2020: a population-based registry study]. / Rost zabolevaemosti glioblastomoi na fone umen'sheniya chastoty opukholei golovnogo mozga v 2000­2020 gg.: populyatsionnoe registrovoe issledovanie.

BACKGROUND: Prevalence and dynamics of certain morphological variants of neuroglial brain malignancies (ICD-10 C71) are unknown in the Russian Federation. OBJECTIVE: To assess the incidence of neuroglial brain malignancies in 2000-2020 considering individual records of morphologically verified cases in the cancer registry of the Arkhangelsk region. MATERIAL AND METHODS: We analyzed overall and age-adjusted incidence of neuroglial brain malignancies in 2000-2020 considering morphological subtypes of tumor. Incidence of morphologically verified glioblastoma was assessed in detail taking into account gender, age and place of residence. Segmented regression analysis was used to assess the dynamics and significance of linear trends. RESULTS: In total, there were 1699 brain malignancies for the period from 2000 to 2020. Morphological verification was obtained in 1289 (76%) patients including 467 (27%), 92 (5%) and 307 (18%) ones with glioblastoma, anaplastic G3 glioma and G2 glioma, respectively. Percentage of glioblastoma and anaplastic gliomas increased from 23.4% and 3.9% in 2000 to 55.3% and 9.2% in 2020, respectively. Age-adjusted incidence for the entire C71 group decreased from 5.2 to 3.2 cases per 100,000 after 2015 (annual decline 7.1%). However, incidence of glioblastoma monotonously increased from 1.0 to 2.1 per 100,000 (annual increment 6.2%). Incidence was similar in men and women. Age-adjusted incidence was 50-70% higher among rural population. CONCLUSION: Significant increase (>2 times) in the incidence of glioblastoma was found over the past twenty years. Probably, it is associated with improved diagnosis and registration of this disease. In-depth analysis of morbidity and survival of patients with rare neuroglial tumors is required.

[Age-related features of annual mortality and survival of patients with thyroid cancer (C73) in Saint Petersburg (population study).]

Every year in Russia, more than 13 thousand (13 250 - in 2018) new cases of thyroid cancer are registered, in St. Petersburg about 1 000 (975 - in 2018) (150 among men and 825 among women). In Russia, almost no studies are conducted to analyze the survival rate of patients with thyroid cancer at the population level. Such developments have been carried out by us since 1998. It was found that the level of 5-year observed and relative survival of patients with thyroid cancer in our city was significantly lower than the European average (Eurocare-4 program). It is planned to analyze the dynamics of objective indicators of the activity of the cancer service based on the database of the population cancer register of St. Petersburg. There was a significant improvement in the indicators of partial mortality, mortality of patients in the first year of follow-up, one-year survival from 2000 to 2018 from 74,7 to 97,5%, and five-year survival from 71,2 to 76,2%. The relative survival rate was 1-5% higher. The five-year survival rate of patients with thyroid cancer was significantly higher among patients under 60 years of age than among those aged 60 years and older (92,2 and 62,7%, respectively). Given the low mortality rate among patients with thyroid cancer, the median survival rate is calculated only for 2004. It was 14,8 years.

[Epidemiological characteristics of the age-related features of malignant neoplasms of the thyroid gland in Saint-Petersburg, index of accurancy, histological structure of the tumor.]

The problem of thyroid cancer in Russia became especially relevant after the accident at the Chernobyl nuclear power plant in 1986. We can trace the dynamics of morbidity in the population of Leningrad-Saint Petersburg from 1980 to 2018. for the periods before and after the accident, even before the inclusion of this localization of malignant neoplasms in the state reports. Thyroid cancer can be attributed to rare malignancies. In addition to morbidity and mortality, it is planned to consider such analytical indicators that are practically not used in Russia as the reliability of accounting, partial mortality and five-year survival of patients with thyroid cancer calculated according to the international standard. In many territories of Russia and abroad, an increase in the incidence of thyroid cancer has been detected, which to some extent may be associated with its overdiagnosis, against the background of a decrease in the population's mortality from this cause. Favorable patterns were found in relation to the reliability of accounting in Russia and especially in Saint Petersburg. Some structural changes were detected in the histological structure of thyroid cancer.

[Age-related features of the prevalence and survival of patients with malignant tumors of the eye and its adnexa (C69) with taking into account the localization and histological structure: Population study.]

Malignant tumors of the eye and its adnexa (C69) are rare malignancies. To date state statistics in Russia (Form No. 7) have data only for estimating the incidence of the population. These data, at our proposal, were included in Form No. 7 only since 2011. In 2018 for the first time we were able to have data on the incidence of the population by age separately for men and women but only in Russia as a whole. The estimation of rates of a 1- and 5-year patient survival for this pathology is carried out only by us in the North-West Federal Region of Russia, where, in February 2019, we have formed the first Population-based Cancer Registry (PCR) in Russia at the Federal Region's level with a total database of more than 1 million cases. Previously similar work was conducted on the materials of the Population-based Cancer Registry of Saint-Petersburg. For the first time this work presents the features of data on changes in the structure of oncological pathology of the eye and its adnexa (C69) and estimations of a 5-year survival by age. Unfortunately the Office of the Federal State Statistics Service classifies the pathology of the eye (C69) as a group of «other malignant tumors¼ and does not publish mortality data. At the same time, using the PCR database, it must be borne in mind that index accuracy (the ratio of a number of deaths to a number of sick for the first time in life) according to malignant tumors of the eye (C69) is about 0,50% and is constantly decreasing.

[The first results of the analysis of the activity of the cancer service of the North-Western Federal district of the Russian Federation, conducted on the basis of the created population cancer register of the Federal district.]

The completely formed database of the Population Cancer Registry (PCR database) of the North-Western Federal district of the Russian Federation in February 2019 has significantly expanded the ability to objectively assess the activities of the cancer service on a more reliable basis of analytical materials. In Russia, for the first time, it was possible to conduct epidemiological studies of malignant tumors for rare tumor locations, any age groups, and calculations of patient survival rates. The PCR database has more than 1 million observations and includes all the headings and subheadings of ICD-10 for class II - codes C00-96. The article will present the dynamics of morbidity and mortality of the population of the northwestern Federal district of the Russian Federation in comparison with the national average, the reliability of accounting and survival of patients with malignant tumors. For 8 years, the growth of cancer incidence in the Northwestern Federal district of the Russian Federation by 10,4% in standardized indicators and a decrease in population mortality in the Northwestern Federal district of the Russian Federation by 11,4% in the same indicators. The dynamics of the 5-year observed survival rate of patients with Northwestern Federal district of the Russian Federation, taking into account age groups, is calculated. The reliability of the PCR database of the Northwestern Federal district of the Russian Federation is confirmed by the fact that the materials of 3 administrative territories are included in the IARC monograph «Cancer incidence in five continents. Vol. XI¼ (Saint-Petersburg, Arkhangelsk region and the Republic of Karelia).

[Morbidity, mortality and reliability of accounting of patients of different age groups with liver cancer in Russia.]

Liver cancer is a severe oncopathology. Mortality exceeds the number of primary-accounted patients in Russia on average. Every year in Russia more than eight thousand (8 810 in 2018) cases of liver cancer and more than 10 000 (10 018 in 2018) deaths from this cause are registered. Used Standard methods of medical statistics, all registered primary cases of liver cancer in Russia. In-depth development of the material was carried out on the basis of the database of the Population cancer register of the North-Western Federal district of the Russian Federation. The analysis of the data of the whole complex of available information in Russia as a whole is carried out. In-depth data development was carried out on the basis of the database of the Population cancer register of the North-Western Federal district of the Russian Federation. The increase in the incidence of liver cancer in Russia over 18 years in «rough¼ indicators and absolute numbers by 20% and in standardized by 1,22% was established. In women, there was a decrease in reported cases of liver cancer by 4,55%. The mortality rate of the Russian population in standardized indicators has decreased by almost 3% over 18 years. The excess of the number of deaths over those from liver cancer increases significantly in older age groups. The index of reliability of accounting is the ratio of absolute numbers or «rough¼ indicators of mortality to morbidity. For all malignant tumors, its value on average in Russia was 0,47, almost coinciding with the average European. The index of reliability of accounting for men is 0,55, higher than the calculated indicators for women - 0,40, which is primarily due to a more favorable structure of the incidence of malignant tumors in women. The median survival of primary liver cancer patients is a little more than three months. The five-year survival rate of patients with liver cancer even in the early stages is in the first among persons younger than 60 years - 25,3%, over 60 years - only 17,2%, in the second, respectively, 17,9 and 11%.

[Index of accuracy and survival of patients with malignant melanoma of the skin (C43), taking into account by the histological structure and stage of the disease.]

The present study examines the characteristics of registration accuracy and efficiency of treatment of patients at the population level using reliable analytical indicators of survival of patients, calculated according to international standards, taking into account the histological structure of tumors and the stage of the disease. For any research development, we must first ensure the reliability of the material selected for research. Among the six main most reliable criteria for evaluating the activities of the cancer service, such as morbidity, mortality, and the level of morphological verification of tumors, such indicators as the index of reliability of accounting, primary mortality, and survival of patients with malignant neoplasms are of the most important importance. The aim of the work is to determine the level of reliability of accounting for patients with skin melanoma (C43) and its dynamics from 1995 to 2018. for Russia as a whole and for a number of administrative territories. Calculate the five-year survival rate in the North-Western Federal District, taking into account the histological structure of tumors and the stage of the disease. The material for the study is statistical collections, including author's ones, the database of the cancer register of the North-Western Federal District of the Russian Federation. Standard methods of statistical analysis were used. It is important to note that for all administrative territories whose population cancer registry databases were used to calculate the five-year observed and relative survival rates, the survival rate of patients with malignant skin melanoma is significantly lower than the European average (Eurocare-4). Thus, the study revealed a significant improvement in the treatment of patients with malignant melanoma of the skin. At the same time, the estimated five-year observed and relative survival rates of patients with malignant melanoma of the skin remain relatively low.

[Age-related features of the dynamics of morbidity and mortality, localization and histological structures of rectal cancer (population study).]

Rectal cancer is a malignant tumor of the distal colon of epithelial origin. Every year, more than 30,000 (30 969 - 2018) new cases of Rectal cancer and 16,000 deaths (16 151) are registered in Russia. The index of reliability of accounting (the ratio of the number of dead to sick) is 0,52%. Rectal cancer refers to localities with an average mortality rate. In the North-Western Federal district, more than 3 thousand primary cases of Rectal cancer were registered (3285 - 2018). The state statistics of the Rectal cancer provides data on morbidity and mortality in three categories of ICD-10 together (C19-21). Detailed development of data not only separately for each category of ICD-10, but also for the fourth sign is possible only from the data bases of cancer registers. As of 01.01.2019, the Population cancer register of the North-Western Federal district created by us totaled more than 1 million cases of malignant tumors (1 067 661), including Rectal cancer - 50 745 cases, or 4,8%. The share of the Rectal cancer is close to the national average - 4,9%. The article presents a detailed structure of cancer pathology in Rectal cancer. The leading role of the 3 specified categories belongs to the rectal malignant tumors (C20) - 75,4%, 19,8% falls on the malignant tumors of the rectosigmoid department (C19) and only 4,7% on the C21 - malignant tumors of the anus and anal canal. For all these categories, the dynamics of the structure is presented, which proved to be quite stable.

[Regularities of the dynamics of age-specific cancer mortality indicators in Russian population.]

Every year more than 600 000 (617 177 in 2017 year) of new cases of malignant neoplasms (cancer) and more than 290 000 (290 622 in 2017 year) of death are registered in Russia. Cancer is on the second place among all causes of death (15,9% - 2017 year) followed cardiovascular morbidity (48,8% - 2017 year), while in a number of economically developed countries the cancer treatment has reached a new level. About 20-25% of the population of Russia suffer from this disease. Malignant neoplasms are common noncommunicable diseases strongly associated with the age structure of the population. More than 70% (72,5%) of the diseased and about 80% (79,07%) of those who died in Russia were registered at pensionable age. Census data for the period since 1960 until now has shown, that the proportion of persons of retirement age has doubled, what certainly influenced the morbidity rate and number of deaths from malignant neoplasms. The population-based cancer registries, established in 1990s of XX century, contributed to improving the reliability of summarized data from the country's oncological service. It had become possible to conduct in-depth epidemiological studies of the malignant tumors prevalence. The dynamics of age-specific rates of mortality in Russia from cancer is overlooked in this paper, taking into account sex, age and leading localization of tumors. The specificity of the dynamics of the structure of oncopathology for men and women of different age groups is presented as well. The established patterns of the reduce mortality in Russia in standardized indices over a long period demonstrate the real success of the anti-cancer means.

[Age-related risks of cancer (analytical indicators of registration and early diagnosis).]

Malignant tumors have a particular specificity of the frequency of tumors in different age groups. The risk of cancer among people under 35 years of age is extremely low - 10-15 cases per 100 000 population of each age group. After 35 years of age with each age-related year the likelihood of cancer increases by 10% and for a five-year period by 50-70% reaching values of 2-5 thousand cases per 100 000 population in older groups. Knowing these patterns and details of localization structure for the each age it is possible to plan the implementation of a complex of anti-cancer measures correctly. There are certain difficulties in the formation of state statistics of malignant tumors. Not all administrative territories of Russia since 2011 had and have an access to database of deceased, which leads to the accumulation of «dead souls¼ in patient contingents. Also there are distorted other analytical indicators. There is a difficulty in staffing specialists of territorial cancer registries as well. Despite a significant improvement in relative 5-year survival rates of cancer patients this process is much more modest in older age groups.

[Epidemiology and survival of men diagnosed with breast cancer].

Malignant tumors of male breast are a rare phenomenon not only in Russia but also in other countries. Possibility to evaluate the incidence of these tumors among men appeared in Russia only since 2011. In Leningrad such data are published since 1980 and then they became a part of data on primary male patients with breast cancer in the IARC monographs "Cancer in 5 continents" from VI up to X volumes. This paper presents an analysis of the prevalence of breast cancer in men through the world and Russia. Detailed characteristics of data on patients according to digit 4 of ICD-10, the level of morphological verification along different age groups and the feature of histological structure of tumors has been conducted on database of the Population-based Cancer Registry of St. Petersburg. For the first time there are estimated relative survival rates in men diagnosed with breast cancer on the population level.

Dynamics of morbidity, histological structure, contingents and survival of patients with malignant tumors of the lip (population-based study).

Introduction: Malignant tumors of the lip (C00) are rare tumor, and mainly affect men. Annually in Russia there are nearly 3000 new cases of malignant tumors of the lip (2011 - 2013). In 2000 there were registered more than 5000 cases. The positive dynamics of morbidity and mortality from this location was marked. Separately to analyze the dynamics of mortality from malignant tumors of the lip cannot be performed because the State Statistics Committee provides only aggregated data for all three-digit rubrics - malignant tumors of the lip, oral cavity and pharynx (S00-14). From 2000 to 2013 the number of deaths in this group according to both sexes increased from 8980 to 9445 or by 5.2%. According to the International Agency for Research on Cancer (IARC) the incidence rate of the population in various countries is also small (except Australia). Aims and objectives: To conduct a study of prevalence of malignant tumors of the lip at the population-based level and to estimate survival rates. Methods: For the first time in Russia there were estimated the rates of morbidity and survival of patients with malignant tumors of the lip by international standards. Paying attention to limited parameters that characterize malignant tumors of the lip in the state report, the main focus was aimed at database of Russia's first Population-based Cancer Registry of St. Petersburg working according to international standards. For the first time in Russia there is presented dynamics of a 5-year observed and relative survival of patients with malignant tumors of the lip. Results: For the first time in Russia there is provided the structure of morbidity of malignant tumors of the lip according to the 4th digits of ICD-10. There is underlined its stable distribution with decreasing of С00.9 rubrics (undefined parts of lips), showed a significant reduction in morbidity and average relative 5-year survival closed to the European rates.

Dynamics of morbidity of patients with malignant tumors of the tongue with regard to the stage of disease and histological structure of tumors (population-based study).

Introduction: Malignant tumors of the tongue (C-01. 02) are relatively rare visual tumor sites. Incidence rate in men is usually 4-5 times higher than in women. To estimate a complex of analytical rates with respect to malignant tumors of the tongue (morphological level of verification, the distribution of patients by the stage of disease, to evaluate one-year and relative survival, etc. ) in accordance with the state report (F. №35) is impossible since malignant tumors of the tongue are not considered separately. Such research can be performed only on the basis of data of the population-based cancer registry. Purpose of the study: To study the prevalence, the detailed structure of morbidity, to estimate a number of analytical rates characterizing malignant tumors of the tongue. Materials and methods: On the basis of materials of the International Agency for Research on Cancer (IARC), Statistical Handbooks of the P. A. Herzen Moscow Research Oncological Institute and database of the Population-based Cancer Registry of St. Petersburg there were studied all the aspects put in the purpose of the study, using a range of instructional techniques recommended by the International Association of Cancer Registries, which member we are at number 221. Results: This study showed that from 1970 to 2005 in various countries of the world the incidence rate (standardized rate the world standard) of malignant tumors of the tongue increased a little or maintained its level. In Russia it is possible to carry out such assessment only from 1989 to 2013. During this period the incidence rate of malignant tumors of the tongue has increased from 2,20/0000 till 2,30/0000 in men, and from 0,40/0000 and 0 ,50/0000 in women. In St. Petersburg-Leningrad since 1980 standardized rate of malignant tumors of the tongue has increased from 2,1 till 3,5 0/0000 in men or by 66. 6% and from 0,5 till 1,50/0000 in women three times more. Positive dynamics of survival rates of patients with malignant tumors of the tongue but a significant backlog from the European average retains.

[Intelligent distributed system of population cancer screening].

This review summarizes data dedicated to improving the efficiency of screening of malignant tumors through the use of modern information and telecommunication technologies. It is showed that currently available software solutions in the field of medical imaging is not enough adapted for population screening. So far there is no single standard that defines checking algorithms of data processing at certain controlled conditions. The most expected result will be the organization of information centralized storage, sharing diagnostic data, providing broad access to them, automated analysis and selection of diagnostically significant results through the software. The basic requirements for the development of self-learning systems for intelligent processing array of heterogeneous data through the use of technologies of semantic networks are provided.

[Automated identification, interpretation and classification of focal changes in the lungs on the images obtained at computed tomography for lung cancer screening].

This review article analyzes data of literature devoted to the description, interpretation and classification of focal (nodal) changes in the lungs detected by computed tomography of the chest cavity. There are discussed possible criteria for determining the most likely of their character--primary and metastatic tumor processes, inflammation, scarring, and autoimmune changes, tuberculosis and others. Identification of the most characteristic, reliable and statistically significant evidences of a variety of pathological processes in the lungs including the use of modern computer-aided detection and diagnosis of sites will optimize the diagnostic measures and ensure processing of a large volume of medical data in a short time.

[Prevalence of gynecological cancer and survival of patients].

The article presents an analysis of the situation with cancer in the world, Russia and more detailed (database of the Population-based Cancer Registry) in St. Petersburg. It is presented medium-term morbidity of the population of St. Petersburg per cervical cancer, endometrial cancer and ovarian neoplasms. The use of geoinformation systems allowed presenting incidence (standardized indicators) by districts of the town.

[Survival of patients with malignant brain tumors in St. Petersburg and Arkhangelsk region].

The results of studies are presented of the dynamics on survival of patients with malignant tumors of the brain and other parts of central nervous system (C70-72) over a long period at the population level (St. Petersburg and Arkhangelsk region) by sex, age, histological structure and other parameters.

[Epidemiology of malignant tumors of the brain and other parts of the CNS in the North-West Federal District of Russia].

For the first time in Russia the dynamics of morbidity and mortality from malignant tumors of the brain and other parts of the CNS in the North-West Federal District of Russia is presented. A precise elaboration of data on cases is performed according to the database of the Population-based Cancer Registries of St. Petersburg and Arkhangelsk region.

[Anticancer propaganda: myth or reality?].

The authors raise a very important problem of anticancer propaganda aimed at the early detection of cancer to be solved nowadays by means of screening and constructive interaction between oncologists and the public. To increase the level of knowledge of the population in this area it is necessary to expand the range of its adequate awareness of tumor diseases. Only joint efforts can limit the destructive effect of cancer on people's minds, so that every person would be responsible for his own health, clearly understanding the advantages of early visit to a doctor. This once again highlights the need of educational work with the public, motivational nature of which allows strengthening the value of screening in the whole complex of measures to fight cancer.