Annals of the Russian academy of medical sciencesAnnals of the Russian academy of medical sciences0869-60472414-3545"Paediatrician" Publishers LLC132210.15690/vramn1322Research ArticleOrganizational aspects of improving primary diagnosticsmalignant neoplasms of visual localizations in the rural municipal areaVazheninAndrey V.<p>MD, PhD, Professor, Academician of the RAS</p>onco74@chelonco.ruhttps://orcid.org/0000-0002-7807-8479VoroshinaNatalya V.Natalyavoroshina67@gmail.comhttps://orcid.org/0000-0003-0793-6867DomozhirovaAlla S.<p>MD</p>2356563@mail.ruhttps://orcid.org/0000-0003-0806-3164State Budgetary Institution of Health of the Chelyabinsk Regional Center of Oncology and Nuclear MedicineRussian Scientific Center of Roentgenoradiology (RSCRR) of the Ministry of Healthcare of the Russian Federation (Russian Scientific Center of Roentgenoradiology)310820207532342392303202002062020Copyright © 2020, "Paediatrician" Publishers LLC2020<p><strong>Background.</strong> The proportion of malignant neoplasms detected at the IIIIV stages of the disease in Chelyabinsk region is large and 43.9%. Breast cancer in 2018 was detected at stages IIIIV at 24% and cervical cancer at 51.14%. Despite the fact that malignant neoplasms of vulva and vagina are diagnosed annually in isolated cases, the level of neglect reaches 66.7 and 100% respectively, which makes it necessary to develop organizational measures.</p>
<p><strong>Aims </strong> to increase the level of detection of visual localities OF female reproductive system organs in the early stages with the involvement of oncologists of regional clinics in the primary diagnosis.</p>
<p><strong>Materials and methods.</strong> Patients with malignant neoplasms of the reproductive system of visual localizations, first identified in the examining cabinet of the polyclinic of the central district hospital, geographically located and functionally subordinate oncologist of the rural municipal district. Comparative assessment of early detection of tumors in an area with high breast cancer and cervical cancer and results following the introduction of a new organizational structure.</p>
<p><strong>Results.</strong> Patients with malignant neoplasms of the reproductive system of visual localizations, first identified in the examining cabinet of the polyclinic of the central district hospital, geographically located and functionally subordinate oncologist of the rural municipal district. Comparative assessment of early detection of tumors in an area with high breast cancer and cervical cancer and results following the introduction of a new organizational structure.</p>
<p><strong>Conclusions. </strong>The involvement of oncologist of territorial polyclinics to participate in preventive examinations, which were previously within the competence of the medical assistant of the Examining Cabinet, during the first year of work increased detection and reduced the incidence of breast and cervical cancer by 8.3 and 3.7% respectively. The creation of the Breast Pathology Center in the regional oncology center, at the third level of specialized medical care on the profile of oncology, allowed to reduce the frequency of malignancy of benign and pre-cancer breast diseases.</p>cervical cancerbreast cancerexamining cabinetрак шейки маткирак молочной железызапущенные стадиисмотровой кабинет[Важенин А.В., Доможирова А.С., Пшиченко С.В. Эпидемиологические особенности онкологической ситуации Челябинской области и показатели состояния онкологической помощи населению в Челябинской области в 2015 году. — Челябинск, 2015. — 69 с. [Vazhenin AV, Domozhirova AS, Pshichenko SV. Epidemiologicheskie osobennosti onkologicheskoj situacii Chelyabinskoj oblasti i pokazateli sostoyaniya onkologicheskoj pomoshchi naseleniyu v Chelyabinskoj oblasti v 2015 godu. Chelyabinsk; 2015:69. (In Russ).]][Важенин А.В., Доможирова А.С., Аксенова И.А. Эпидемиологические особенности онкологической ситуации и показатели состояния онкологической помощи населению в Челябинской области в 2017 году. — Челябинск, 2018. — 88 с. [Vazhenin AV, Domozhirova AS, Aksenova IA. Epidemiologicheskie osobennosti onkologicheskoj situacii i pokazateli sostoyaniya onkologicheskoj pomoshchi naseleniyu v Chelyabinskoj oblasti v 2017 godu. Chelyabinsk; 2018:88. (In Russ).]][Важенин А.В., Доможирова А.С., Аксенова И.А., Ратнер Е.В. Эпидемиологические особенности онкологической ситуации и показатели состояния онкологической помощи населению в Челябинской области в 2018 году. — Челябинск, 2019. — 84 с. [Vazhenin AV, Domozhirova AS, Aksenova IA, Ratner EV. Epidemiologicheskie osobennosti onkologicheskoj situacii i pokazateli sostoyaniya onkologicheskoj pomoshchi naseleniyuv Chelyabinskoj oblasti v 2018 godu. Chelyabinsk; 2019:84. (In Russ).]][Huh WK, Ault KA, Chelmow D. Use of primary high-risk human papilloma virus testing for cervical cancer screening: Interim clinical guidance. Gynecol Oncol. 2015;136(2):178–182. doi: 10.1097/AOG.0000000000000669.][Кривонос О.В., Чиссов В.И., Старинский В.В. Роль и задачи смотрового кабинета поликлиники как этапа в организации профилактических мероприятий, направленных на совершенствование онкологической помощи населению. — М., 2010. — 34 с. [Krivonos OV, Chissov VI, Starinskij VV. Rol’ i zadachi smotrovogo kabineta polikliniki kak etapa v organizacii profilakticheskih meropriyatij, napravlennyh na sovershenstvovanie onkologicheskoj pomoshchi naseleniyu. Moskva; 2010, 34 s. (In Russ).]][Черенков В.Г., Петров А.Б., Александрова И.В. Рак вульвы: современные методы диагностики и хирургического лечения // Вопросы онкологии. — 2016. — № 62 (4). — С. 508–511. [Cherenkov VG, Petrov AB, Aleksandrova IV. Cancer of the vulva: modern methods of diagnostics and surgical treatment. Problems in oncology, 2016;62(4):508–511. (In Russ).]][Хмелевский Е.В. Лучевая терапия при раке молочной железы // Каприн А.Д., Рожкова Н.И. (ред.). Маммология: национальное руководство. — М., 2016. — С. 375–390. [Hmelevskij EV. Radiation therapy for breast cancer. Ed. by Kaprin AD, Rozhkova NI. Mammology: national guide. Moscow; 2016:375–390. (In Russ).]][Ворошина Н.В., Важенин А.В., Тюков Ю.А. Эффективность системы выявления злокачественных новообразований молочных желез и шейки матки по оценке женщин фертильного возраста // Уральский медицинский журнал. — 2019. — № 4 (172). — С. 91–95. [Voroshina NV, Vazhenin AV, Tyukov YuA. The opinion of patients about the timeliness and efficiency of diagnosis of malignant tumors of visual localization in the female reproductive system. Ural medical journal. 2019;4(172):91–95. (In Russ).]][Тюков Ю.А, Маркина А.Ю., Матвеева Е.С., Ворошина Н.В. Особенности выявляемости злокачественных новообразований репродуктивной системы у женщин фертильного возраста // Дневник Казанской медицинской школы. — 2017. — IV (XVIII). — С. 114–115. [Tyukov YuA, Markina AYu, Matveeva ES, Voroshina NV. Features detection of malignant tumors of the reproductive system in women of childbearing age. Diary of the Kazan medical school. 2017;IV(XVIII):114–115. (In Russ).]][Важенин А.В., Доможирова А.С., Аксенова И.А., Новикова Т.С. Эпидемиологические особенности онкологической ситуации и показатели состояния онкологической помощи населению в Челябинской области в 2016 году. — Челябинск, 2017. — 83 с. [Vazhenin AV, Domozhirova AS, Aksenova IA, Novikova TS. Epidemiologicheskie osobennosti onkologicheskoj situacii i pokazateli sostoyaniya onkologicheskoj pomoshchi naseleniyu v Chelyabinskoj oblasti v 2016 godu. Chelyabinsk, 2017:83. (In Russ).]]