Epidemiological characteristics of breast cancer in the Republic of North Ossetia-Alania in 2017-2021 and during the period of coronavirus infection COVID-19.

Abstract

The purpose of the study: to identify the features of the incidence and main diagnostic indicators of breast cancer in the Republic of North Ossetia-Alania and assess their change during the spread of coronavirus infection COVID‑19. Materials and methods. The data of the annual reports of the Republican Oncological Dispensary of the Republic of North Ossetia-Alania and the data of the state medical statistics (form No. 7 «Information on malignant neoplasms») for 2012–2021 were studied. The most important diagnostic indicators for breast cancer have been analyzed. A comparative assessment of the indicators in the republic, the Russian Federation and the North Caucasus Federal District is given. Results. The urgency of the problem of oncological morbidity in the Republic of North Ossetia-Alania is due to the increasing prevalence of malignant neoplasms, according to which it occupies the first place in the North Caucasus Federal District. The leading oncological pathology in the female population is breast cancer 26,6% (RF – 21,7%). The epidemiological situation associated with the spread of COVID‑19 coronavirus infection has had a significant impact on cancer incidence in recent years. The rate of newly diagnosed breast cancer incidence in 2021 (44,0 per 100,000 population) was lower than in 2019. The characteristic trends of deterioration of the main diagnostic indicators are revealed. Similar to the indicator for the Russian Federation (25,6%), the rate of active detection of breast cancer decreased (42,6%). Despite the positive dynamics of the detection of the tumor process at stage I, early detection of breast cancer suffers due to a decrease in the detection rate at stage II to 50,2%. A stable growth trend over a five-year period, more than 2 times, of the indicator of the neglect of the tumor process (stage IV), amounting to 16,3% by 2022, was revealed. The detection rate at stages III and IV by 2022 was 32,9% in North Ossetia, 34,5% in the North Caucasus Federal District, and 27.1% in the Russian Federation. In 2021, the mortality rate from breast cancer in the first year after diagnosis in North Ossetia (3,6%) is lower than in the Russian Federation (4,8%) and the North Caucasus Federal District (5,2%). There is a maximum decrease in the five-year survival rate in 2020 to 54,2%, correlating with similar trends in the Russian Federation (56,6%). The morphological verification index, indicating the quality of specialized oncological care, is consistently higher than the national average (99,7%). Conclusion. The improvement of oncological situation in the republic will be facilitated by the implementation of priority areas of the regional program for the fight against oncological diseases, the main task of which is the active detection of malignant neoplasms at early stages and their effective treatment. In order to eliminate the current situation, it is necessary to concentrate efforts to improve the effectiveness of providing oncological care to the population, primarily at the level of outpatient polyclinic health care, and increase the oncological alertness of medical workers. The indicators of the oncological service of the republic related to postcovid complications in oncolo need additional analysis. The indicators of the oncological service of the republic related to postcovoid complications in oncological patients need additional analysis.