1Ptoukha Institute for Demography and Social Studies of the National Academy of Sciences of Ukraine, Department of Demographic Modeling and Forecasting, Kyiv; Ukraine.
2Bogomolets National Medical University, Kyiv; 3Educational and Scientific Center "Institute of Biology and Medicine", Taras Shevchenko National University of Kyiv, Ukraine.
Georgian Med News. 2021 Dec(321):62-69.
The purpose of the study is to identify the features of the mortality regime from neoplasms in Ukraine, to make comparisons with selected countries in the WHO European Region, to identify challenges to public health and cancer services in connection with the COVID-19 pandemic and to hypothesize possible changes in mortality.The materials for the analysis were the data of official national statistics on mortality (State Statistics Service of Ukraine), data of the National Cancer Registry of Ukraine, and the European Health Information Gateway in the position "Neoplasms" ICD-10 codes: C00-D48. The method of standardization and comparative analysis was used.Comparative analysis in dynamics with individual countries (including with the states of the former socialist camp and the EU countries) revealed differences in mortality as a result of neoplasms in Ukraine, both in terms of the value of indices and their share in the structure, and in the direction of their changes since Ukraine gained independence. The most significant differentiation is observed in the average working age and in older age groups. In Ukraine the age-standardized death rate aged 30-44 is by 1.8 times higher, and at the age of over 75 years - is more than twice (by 2.3 times) lower than in the EU members before May 2004. Moreover, the indices in the group of 30-44 years have increased since 1991, in contrast to the decrease at the age of over 75 years.A feature of Ukraine is a small share in the structure of mortality among older people (12.3% of deaths at the age of 75-79 and 2.45% at the age of 85+, while diseases of the circulatory system account for more than 80% of deaths). Ukraine is also characterized by high mortality rates, which can be prevented: avoidable mortality. Thus, the mortality rate of Ukrainian women from cervical cancer increased before reaching 65 years of age (while in the EU-15 it decreased by more than a third), and the difference in indices in 2017 increased and reached more than four times.The deterioration of the epidemiological situation caused by the COVID-19 pandemic was manifested by a decrease in the detection rate of new cases of the disease; a decrease in the proportion of neoplasms detected at an early stage; changes in the incidence/mortality ratio, etc.). A probable increase in the mortality rate as a result of neoplasms and their share in the structure of mortality in the coming years, while ignoring the existing risks, is predicted.Awareness of the deterministic challenges of the COVID-19 pandemic for public health in general and the oncological service in particular is necessary to organize adequate measures to improve the fight against cancer (minimize interruptions in the provision of cancer care, establish work in new conditions, state control over the provision of medicines and equipment, increase the awareness and skills of health care providers in the early diagnosis of cancer; and the health literacy of the population).
本研究旨在确定乌克兰肿瘤死亡率的特征，与世界卫生组织欧洲区域的选定国家进行比较，确定与 COVID-19 大流行相关的公共卫生和癌症服务面临的挑战，并假设死亡率可能发生的变化。分析的材料是官方国家死亡率统计数据（乌克兰国家统计局）、乌克兰国家癌症登记处的数据以及欧洲卫生信息网关中“肿瘤”ICD-10 代码的位置：C00-D48。采用了标准化和比较分析方法。与个别国家（包括前社会主义阵营国家和欧盟国家）的动态比较分析表明，乌克兰的肿瘤死亡率存在差异，无论是在指数值及其在结构中的份额方面，还是在独立以来的变化方向方面。在平均工作年龄和老年人群体中观察到最显著的差异。在乌克兰，30-44 岁年龄组的标准化死亡率高 1.8 倍，75 岁以上年龄组的死亡率低 2 倍以上（低 2.3 倍）。此外，自 1991 年以来，30-44 岁年龄组的指数有所增加，而 75 岁以上年龄组的指数则有所下降。乌克兰的一个特点是老年人的死亡率在结构中所占比例较小（75-79 岁年龄组的死亡率为 12.3%，85 岁以上年龄组的死亡率为 2.45%，而循环系统疾病的死亡率超过 80%）。乌克兰还具有高死亡率的特点，这些死亡率是可以预防的：可避免的死亡率。因此，乌克兰妇女宫颈癌的死亡率在达到 65 岁之前上升（而欧盟-15 的死亡率下降了三分之一以上），2017 年的指数差异增加，并达到四倍以上。由 COVID-19 大流行引起的流行病学状况恶化表现为新病例检出率下降；早期发现的肿瘤比例下降；发病率/死亡率比等变化）。预计未来几年，由于肿瘤及其在死亡率结构中的比例增加，死亡率可能会上升，如果忽视现有风险，预计死亡率将上升。认识到 COVID-19 大流行对公共卫生、特别是肿瘤服务的确定性挑战，对于制定适当措施改善癌症防治工作（最大限度地减少癌症护理服务的中断，在新条件下开展工作，国家对药品和设备供应的控制，提高卫生保健提供者对癌症早期诊断的认识和技能；以及提高人口健康素养）是必要的。
