Covid-19 worsenes situation with cancer incidence in Tatarstan

Temporary suspension of dispensary and preventive work last year, when doctors focused on the fight against the pandemic, has had an impact

Covid-19 worsenes situation with cancer incidence in Tatarstan
Photo: Maria Gorozhaninova

In Tatarstan, for the first time since 2018, the share of neglected malignant diseases has increased from 21,45% to 25,57% in the first half of 2021. In some municipal districts of the republic, this indicator doubled over the past year. What damage the coronavirus pandemic has caused to the health care system and what it threatens the seriously ill people of Tatarstan, how not to get into the risk group — read in the material of Realnoe Vremya.

Cancer neglect indicator has increased in Tatarstan

In Tatarstan, in the first half of 2021, the neglect of malignant diseases increased sharply — to 25,57% against 21,45% (for 6 months of 2020). At the same time, the increase occurred for the first time in 3 years, and quite sharply. From 2018, the indicator was only decreasing.

Of course, the current level of neglect of cancer diseases has not reached the record level of nine years ago — 30,49%. Nevertheless, the dynamics are depressing, because the lives of Tatarstan citizens are at stake.

“Boomerang returns”

Speaking about the increase in the share of advanced stages of malignant neoplasms in Tatarstan, the chief visiting oncologist of the Ministry of Healthcare of the Republic of Tatarstan, Eduard Nagumanov, called the main reason for the problem the temporary suspension of dispensary and preventive work in the conditions of the pandemic:

“In 2020, when the main blow came with Covid-19 infection, the number of detected cases of malignant neoplasms fell (compared to 2019) by 12%. This is the suspension of dispensary and preventive work, that is, malignant neoplasms were not detected in a timely manner, which is now boomeranging back in the form of an increase in the proportion of advanced stages. The patients who came to us in many ways came with the presence of certain symptoms of the disease. And the presence of any symptom indicates that the disease is already, as a rule, not at an early stage.”

According to the chief oncologist of the republic, the dispensary and preventive work was eventually resumed and is now yielding results — the detection of cancer is growing:

“In the first half of 2021, compared to the same period in 2020, 102 more cases of malignant neoplasms were detected — this is +1,5%. The situation has stabilised and started to grow.

If we study the statistics from 2012, according to Eduard Nagumanov, we still have significant progress in reducing advanced cases, and it is very intensive, from 30,49% for the 1st half of 2012 to 25,57% for the same period in 2021:

“This is due to that all these years the healthcare system has been working in the direction of medical examination of certain groups of adult population, early diagnosis programmes. These are the programmes that include screening technologies for the detection of breast cancer, prostate cancer, colorectal cancer, skin cancer, and cervical cancer. In general, this group of diseases in the structure of oncological diseases is about 50%. Due to this resource, we have increased the share of early stages from year to year and reduced the share of extensive cases. The extensive ones include not only the fourth stage, but also the third B stage of visual localisations.”

According to the doctor, “people need to be motivated to participate in the early cancer diagnosis programme!”. This makes it possible to detect cancer at an early stage at an asymptomatic stage of the development of the disease, which can eventually save lives, said Eduard Nagumanov.

How to avoid trouble?

There are screening technologies for a number of oncological diseases: breast cancer — it is mammographic examination, cervical cancer — cytological examination of a smear, prostate cancer — blood test to detect prostate-specific antigen, colorectal cancer detection — fecal examination for hidden blood, skin malignancies (including melanoma) — visual examination of the skin.

For other diseases, the possibilities of screening technologies are limited and require development. But even in these areas — at least to exclude them, it would be good, the doctor is convinced.

Eduard Nagumanov also recalled that each type of study has its own age periods of examination:

“These periods are determined taking into account the risk of a particular cancer in a particular age group. For each cancer, the time period in which the risks begin to increase is selected. Starting from this age, people could be diagnosed with cancer at an early stage and referred for specialised treatment.”

Medical examination programmes for certain groups of adult population and preventive examinations for mammographic screening are carried out in the primary health care network or polyclinics at the place of residence. According to the chief oncologist, the oncological dispensary closely cooperates with them in this area, provides organisational and methodological support and performs a number of diagnostic tests centrally and in accordance with a certain standard. A number of other major medical organisations of Tatarstan are also involved in this process:

“The information is accumulated by us, and based on the results of the analysis, we send back to the primary network the data on which patients have deviations from the norm and who needs to be further examined.

“The cancer service is taking a hit”

According to Eduard Nagumanov, the trend of falling detected cases of cancer in 2020 is identical with all regions of Russia, it is global:

“Despite all these difficult moments, the oncological service of the republic manages to maintain strict indicators, including mortality. For example, according to operational data, for the first six months of 2021, the mortality rate from neoplasms in Tatarstan amounted to 175,7 per 100,000 people of the population. This is significantly lower than in 2020. The cancer service is taking a hit. Not only oncological, but also of the entire healthcare system of the republic. This is a systematic, complex, multi-level work to ensure that our residents do not find themselves without medical care with such a terrible disease.”

The programme “Fight against oncological diseases” is being implemented in Tatarstan, designed for 2019-2024. It includes a lot of material and technical equipment and re-equipment of hospitals, as well as the use of new medical technologies, chemotherapy and radiotherapy regimens:

“Over the past year, radiotherapy buildings were opened on the basis of branches in Almetyevsk and Naberezhnye Chelny, that is, the south-western and north-western regions were able to complete a cycle of treatment of patients for a number of malignant neoplasms (including radiotherapy) at the local level. Cancer care in Tatarstan is developing. New technologies, new types of operations, new opportunities in terms of drug therapy are appearing," the medic noted.

Yevgeny Khramov. Photo: realnoevremya.ru
Tatarstan