№68. Possible ways to reduce cancer mortality
- D.G. ZaridzeDOI 10.31917/1704213
Research in causation of cancer is an important part of cancer research in general and is an essential prerequisite for cancer prevention. The effective primary prevention is not visible without evidence based knowledge in the causation of cancer in humans.
There is sufficient evidence that certain life style and environment factors cause cancer in humans. These factors include: smoking and other types of tobacco consumption, overweight and obesity, lack of physical activity, diet rich in processed meat and poor in vegetables and fruits, certain types of viral and bacterial infection, ultraviolet radiation, ionizing radiation, ambient air pollution, carcinogens at workplace, exogenous hormones.
Cancer mortality is decreasing in majority of developed countries, including Russia. This mortality trend is mostly due to decrease in incidence and death rates of lung and other smoking related cancers and is caused by decline in smoking prevalence and change in tar content of cigarette smoke.
In Russia trend in mortality from all cancers is as well determined by decrease in incidence and mortality from gastric cancer, which is due to decline in prevalence of Helicobacter pylori infection and improvement of diet, increase in consumption of fruits and vegetables.
Thus the decline in cancer mortality is mostly the result of primary prevention which seems to be the most effective avenue of cancer control.
Keywords: cancer prevention, epidemiology, risk factors, etiology, incidence, mortality
- A.A. Barchuk, A.M. Belyaev, A.V. Filochkina, A.I. Arseniev, Anssi AuvinenDOI 10.31917/1704228
Cancer screening detects asymptomatic tumors and targets disease burden with its unfavorable consequences. Evidence of screening effects on mortality is essential for planning organized cancer control activity. In order to evaluate these effects, common terminology and clear definitions of interventions and outcomes studied in the screening research are required. Theoretical knowledge of disease natural history, evidence from screening trials, including their strengths, limitations and hidden biases is also essential for proper interpretation and comparing benefits and harms. There is sufficient and interpretable evidence with regards to cervical cancer, breast cancer and colorectal cancer screening. Additional research would facilitate putting the results of lung cancer and prostate cancer trials into practice. There is insufficient or limited evidence of screening with regards to other cancer types.
Keywords: cancer screening, mortality, study design, randomized trial, bias, breast cancer, mammography, lung cancer, computed tomography, cervical cancer, cytology, human papillomavirus, prostate cancer, prostate-specific antigen
The value of adjuvant and palliative antitumor drug treatment in reduction mortality from malignant neoplasmsE.V. KarabinaDOI 10.31917/1704247
Despite the significant number of scientific discoveries in the field of cancer research, the reduction of mortality rate from malignant neoplasms according to various sources amounts to only 10–20%. A very limited number of diseases boast the terminal payoff in using adjuvant chemotherapy and this effect is even less in palliative antitumor drug treatment. The contribution of these treatments in reducing mortality from all malignant neoplasms is lost and has no precise digital expression. The main problem of the lack of precise data is the inability to automatically extrapolate the statistical end points in clinical research studies on the general population and equate some of them to epidemiologic mortality rate. From the perspective of evidence-based medicine the significance of adjuvant and palliative drug treatment to reduce mortality from breast cancer and colorectal cancer looks most compelling. The decrease in mortality from malignant neoplasms is the result of cumulative contributions of the economic resources of health systems, availability of screening and programs aimed at addressing risk factors in the development of malignant tumors, as well as certain infrastructure and facilities for the proper conduct of all types of cancer treatment (including rehabilitation measures), level of education of oncologists and their adherence to current guidelines.
Keywords: mortality from malignant neoplasms, adjuvant treatment, palliative antitumor drug treatment, mortality rate reduction
Influence of some psychological and social factors on the course and results of treatment of oncological patientsG.M. Zharinov, N.Ju. Neklasova, O.A. Bogomolov, V.N. AnisimovDOI 10.31917/1704256
A brief history of psycho-oncology and area of psycho-oncology among other treatment options throughout the whole period of «natural history» of cancer are presented. Significant negative effect of cancer on the personality characteristics are well known, but the characteristics of the disease in patients based on their individual features practically have not been studied. In recent years was announced the hypothesis about the existence of psychogenic cancer, which occurs in conditions of chronic psycho-emotional stress. Particular interest is attracted to the study of the characteristics of the rate of tumor progression and long-term results of cancer patients treatment depending on the level of education. The education level represents a convenient and universal indicator for the characteristics of all factors of socio-economic sphere, affecting the patient, and also largely characterizes his emotional and mental state. In Russia, in terms of national health care, have not been conducted any large studies. Understanding mechanisms of tumor progression is a reserve for improvement of treatment results and opens new directions in the search of means and methods of struggle with cancer.
Keywords: psycho-oncology, education level, treatment results
- E.N. ImyanitovDOI 10.31917/1704272
The article provides information about the currently known hereditary tumor syndromes represent a variety of the most frequent medical and genetic pathology. The contribution of hereditary cancer syndromes in total cancer incidence and mortality was analyzed. The influence of the programs of early diagnosis of tumors in carriers of pathogenic mutations on decrease of mortality from hereditary malignant tumors was discussed.The role of prophylactic operations to reduce the incidence of various hereditary tumors was studied. The conclusion is that there is now a significant progress in the provision of care for patients with hereditary tumor syndromes. Although the diagnosis of hereditary cancers, there is no more than a quarter century, it can be assumed that progress in the field of health has allowed to save tens of thousands of lives.
Keywords: hereditary cancers, hereditary cancer genes, BRCA1, BRCA2, CHEK2, PALB2, NBS1, BLM, preventive surgery in oncology