PRIORITY TASKS OF IMPROVING CANCER REGISTRY IN RUSSIA

Abstract

Cancer incidence is significantly influenced by environmental factors. An adequate account for this is required to make prognoses and cross-country comparisons. Both environmental and medical statistics must be accurate enough for this. The present paper analyses the latter aspect. The topicality of this analysis follows in particular from the fact that procedures for cancer data collection and treatment are drastically different in Russia and abroad. First, the established terms of annual accounting are different. According to recommendations suggested by International Association of Cancer Registries (IACR), summed data should be presented in one year since the end of the accountable calendar year after careful monitoring of all parameters of primary records, elimination of duplicates, and accounting for all possible causes of death of registered patients. In Russia, this must be done during 20 days (of which 10 are vacations). The summary of all reports related to the past year must be submitted on January 20, when a significant number of medical certificates of death have not yet been submitted to registrar committees. Since 2011, it is prohibited by law in Russia for doctors to extract information from "Medical certificates of death", although they have personal data about the respective cases. In many but not all territories, admission to these documents is still possible. Those who have gained this possibility after 2011 still could not over years make notes of the dates of death of their patients. As a result, a huge layer of «dead souls» has accumulated in oncological contingents. The number of contingents of cancer patients has increased to 3.5 million, which is inconsistent with the real situation. Reported cancer-related death rate is almost two times lower than in the reality. Administrative pressure has led to a significant distortion of the proportion of early stages. After the establishment in 1993 of the first Russian Population-based Cancer Registry (PCR) and, later on, after analysis of 12 PRC databases using software tools developed by the present author in collaboration with Novel Ltd., it became clear that it is necessary to reorganize cancer registry in Russia and harmonize it internationally recognized standards.