Background. The incidence of female reproductive system cancer, including breast, cervical, ovarian and uterine cancers, is steadily increasing, and therefore it is advisable to conduct an epidemiological analysis and assess the quality of medical care. The purpose of the study was to analyze the epidemiological characteristics of reproductive system cancer in females of the Tyva Republic. Material and Methods. The reporting forms № 7 “Cancer incidence in the Tyva Republic” for 2013–2022 were used. Age-standardized incidence rates were calculated using the “Oncostat” program, and cancer care quality was assessed using “Cancer Care Indicators” program. Results. Reproductive system cancer in the Tyva Republic accounted for 46.3 % of all malignant neoplasms in females during 2013–2022. In 2022, breast cancer was the most common cancer (16.2 %) followed by cervical cancer (13.7 %), ovarian cancer (6.7 %), and uterine cancer (4.0 %). During the study period, none of these cancers showed a statistically significant increase in agestandardized incidence rates (AS R). In 2022, age-standardized incidence rates in the Tyva Republic were higher than those in the Siberian Federal District for cervical cancer (27.5 ± 3.7 vs 16.3 ± 0.4 0/0000) and for ovarian cancer (14.1 ± 2.8 vs 12.7 ± 0.3 0/0000), but lower for breast cancer (32.4 ± 4.1 vs 58.7 ± 0.6 0/0000) and uterine cancer (8.6 ± 2.2 vs 19.7 ± 0.4 0/0000). Overall, cancer care quality indicators for reproductive system cancers had improved. Active detection increased from 22.0 to 29.8 %, p=0.039 (in the Siberian Federal District: from 27.6 to 37.2 %, p=0.001). The detection rate at I–II stages increased from 53.7 to 75.2 %, p=0.004 (in the Siberian Federal District: from 63.0 to 71.3 %, p=0.001). The percentage of advanced stages decreased from 37.4 % to 15.5 %, p=0.001 (from 27.4 % to 23.1 % in the Siberian Federal District, p=0.013). The oneyear mortality rates also decreased from 19.0 to 5.4 %, p=0.013 (in the Siberian Federal District: from 11.8 to 8.5 %, р<0.001). The high incidence of cervical cancer, the absence of noticeable optimal changes in the early detection and the high prevalence of HPV infection among the female population of the Tyva Republic indicate the relevance of mass HPV testing as a part of secondary cancer prevention. Conclusion. The high incidence of female reproductive system cancer and the current status of reproductive cancer care in the Republic of Tyva dictate the need to strengthen primary, secondary and tertiary cancer prevention.

Background. The non-declining cervical cancer incidence in the Siberian Federal District 16.30/0000 (in Russia - 13.80 /0000) necessitate preventive vaccination against the human papillomavirus (HPV).Aim. To evaluate the cost-effectiveness of HPV vaccination in girls aged 9-14 years in the Siberian Federal District as a whole and in the context of subjects with a 60, 80, 90 percent target cohort.Materials and methods. We studied the size of the female population aged 9-14 years in the constituent entities of the Siberian Federal District for 2022, the average total cost of the vaccine, information on the gross regional product per capita, form C51 “Distribution of deaths by gender, age groups and causes of death” of Tomsk region, 2022. Age-standardized rate per 100,000 population of morbidity and detection (in percentages) of pre-invasive cervix cancer (carcinoma in situ) in the Siberian Federal District were calculated per 100 newly diagnosed malignant cervix neoplasms in 2022.Results. In the Irkutsk, Tomsk regions, Altai and Krasnoyarsk territories age-standardized rate (16.6; 17.8; 16.3; 18.90 /0000, respectively), the detection rate of pre-invasive cancer was 48.0-82.4 %, which indicates on the effectiveness of measures for early cervical cancer diagnosis. In the Republics of Tyva, Altai, Khakassia, age-standardized rate (26.4; 20.1; 19.30 /0000, respectively), cancer in situ was diagnosed in 8.2-23.6 % of cases, which indicates an insufficient level and defects in the organization preventive examinations in medical institutions. In the first year of vaccination against HPV with 60 % coverage of a girls cohort 9-14 years old (n = 404,943), 9.3 billion rubles will be required, with 80 % coverage (539,924 girls) - more than 12.4 billion rubles, with 90 % coverage (607,415 girls) - more than 13.9 billion rubles for primary vaccination against HPV. In subsequent years, more than 2.5-2.8 billion rubles will be required annually. Over 5 years, with 90 % coverage of the population, the financial costs of vaccination will be (817.8 million rubles), and the subsequent 4 annual investments (163.6 million rubles per year). The economic damage caused by mortality from cervical cancer in the Tomsk region over five years (2018-2022) amounted to 3,166.4 million rubles.Conclusion. Using the example of the Tomsk region, it was noted that when comparing financial resources, the costs of vaccinating girls against HPV are 2.2 times less than the economic damage from cervical cancer mortality. Regional budget funding for girls vaccination in administrative territories is relevant before its integration into the national calendar of preventive vaccinations.

Surgery is the standard of care for non-small cell lung cancer (NSCLC). The overall survival rates especially in patients with locally advanced lung cancer are low. The resistance of cancer cells to chemotherapeutic drugs reduces the efficacy of treatment. Special attention is paid to the feasibility of assessing the tumor sensitivity to certain chemotherapy drugs. Currently, the most studied predictors are monoresistance and multidrug resistance genes, such as ABCC5, RRM1, ERCC1, BRCA1, TOP1, TOP2a, TUBB3 and TYMS.The aim of the study was to analyze the outcomes of combined modality treatment using radical surgery and personalized adjuvant chemotherapy for stage II–III NSCLC.Material and Methods. The study included 120 patients with stage II–III NSCLC, who underwent radical lung resection with mediastinal ipsilateral lymph node dissection. The patients were then divided into two groups. The main group consisted of 60 patients who received personalized platinum-based adjuvant chemotherapy based on the expression levels of the genes, such as ABCC5, RRM1, ERCC1, BRCA1, TOP1, TOP2a, TUBB3 and TYMS. The control group consisted of 60 patients who received postoperative chemotherapy empirically.Results. In the main group, disease progression occurred in 14 out of 60 patients, three-year disease-free survival (DFS) was 76.7 % (the median was not reached). In the control group, DFS was 53.3 % (28 out of 60 patients), the median was 31.0 (4–36 months); the differences were statistically significant: Logrank test χ2 =4.382 p=0.036. The overall three–year survival rate was 90.0 % in the main group (6/60 patients died) and 61.7 % in the control group (23/60 patients died), the differences were statistically signifcant: Logrank test χ2 =6.915, p=0.009.Conclusion. The personalized adjuvant chemotherapy resulted in the improved three-year relapse-free and overall survival rates in NSCLC patients.

BACKGROUND:Incidence and recording of neuro-oncological tumors comprise an important problem in the world and In Russia including the Siberian federal district. OBJECTIVE:To analyze the incidence of malignant tumors of the central nervous system (CNS) (C70-72) in the Siberian federal district and appropriate constituent territories. MATERIAL AND METHODS:Analysis of standardized indicators was based on form No. 7 "Information on malignant neoplasms" for the period 2013-2022, population and male-to-female ratio in the Siberian federal district. RESULTS:The number of patients with CNS tumors increases in the Siberian federal district while relative rates of CNS cancer incidence are stable (men 5.2±0.2%, women 3.8±0.2%). The peak incidence has shifted from the age of 65-69 years to older category (75-79 years). Mean age of patients increased by 4.6 years (53.8±1.9 years in 2022) for men and 5.5 years (58.3±1.7 years in 2022) for women (p<0.001). We developed the algorithm for therapeutic and diagnostic care in patients with CNS tumors to solve permanent organizational problems in the Tomsk region. A specialized neuro-oncological registry based on territorial cancer registry was used. CONCLUSION:Development and implementation of neuro-oncological registry programs for all tumors of the central nervous system will be valuable to assess oncological epidemiological situation. Moreover, we can expect earlier diagnosis and timely specialized treatment of such patients.

Background. Lung cancer has long been the most common type of cancer in the male population (16.4%). The incidence of lung cancer among women is increasing worldwide. In Russia, as of 2022 (compared to 2013), lung cancer shifted to the second place in the structure of cancer incidence among males, following prostate cancer. However, the anticipated rise in new cases of this pathology requires an analysis for evaluating and adjusting the current anti-cancer programs. Objective. To analyze the incidence rates and quality of oncological care provided for malignant neoplasms of the lung in the Siberian Federal District within 2013–2022. Methods. A retrospective observational study was conducted utilizing depersonalized data on the prevalence and structure of malignant neoplasms derived from the reports of the Siberian Federal District subjects, the Russian Federation (form No. 7 “Information on Malignant Neoplasms” and form No. 35 “Information on Patients with Malignant Neoplasms”), as well as from the Russian Federal State Statistics Service. The primary indicators of the study included the proportion of lung cancer within the structure of cancer incidence in men and women (C33.0, 34.0–C34.9 according to the ICD-10 classification), standardized incidence rates of lung cancer in men and women, age-specific incidence rates of lung cancer in men and women, by-stage distribution of the lung cancer tumor process, morphological verification, active case finding, one-year mortality, and the proportion of patients with malignant lung neoplasms who were registered for five years or more, uptake ratio of lung cancer population, ratio of one-year mortality to stage IV cases of the previous year. The calculations of standardized and age-specific incidence rates were performed using ONCOSTAT, while the quality indicators of oncological care were assessed using the Cancer Care Indicators software. Standardized incidence rates were calculated according to SEGI age standardization. Statistical analysis of qualitative indicators of medical care provided to patients with malignant neoplasms of the lung over time was conducted using linear regression analysis methods; statistical significance was evaluated at p ≤ 0.05. Results. A decrease in lung cancer incidence among men was observed in the Siberian Federal District, whereas the level of this indicator among women remained unchanged. The comparison of oncological care indicators for lung cancer patients in 2013 and in 2022 revealed several notable changes. The proportion of morphologically verified malignant neoplasms increased from 72.9% to 87.9%. The percentage of cases diagnosed at stages I-II grew from 24.2% to 29.1%, while the proportion of patients registered for five years or more increased from 37.3% to 43.4%. The uptake ratio of lung cancer population extended from 2.2 to 2.7. Conversely, the one-year mortality rate decreased from 55.2% to 47.8%, and ratio of one-year mortality to stage IV cases of the previous year diminished from 1.3 to 1.0. However, a number of advanced cases grew from 39.4% to 40.6%. Conclusion. The conducted epidemiological analysis revealed a decrease in the incidence of lung malignancies among men (from 63.9 to 57.5 cases per 100,000 population) and stagnation of the incidence rate among women (approximately 10.1 cases per 100,000 population) in the Siberian Federal District during the study period. The proportion of lung cancer within the structure of cancer incidence in men reduced from 21.5% to 17.6%. Key indicators of the quality of medical care provided to patients with lung malignancies demonstrate a positive trend; however, the proportion of cases diagnosed at stage IV appears pessimistic (40.6%). The obtained data necessitates the development and implementation of preventive measures for early diagnosis, including screening programs, as well as educational activities aimed at healthcare professionals and the general population, to promote healthy lifestyles and enhance oncological awareness.

The purpose of the study was to analyze cancer incidence in Siberia and the Russian Far East in 2010–2021. Materials and methods. We used data from population-based cancer registries in 21 administrative territories of Siberia and the Russian Far East for 2010–2021. The calculations were carried out using the direct standardization method. Results. In 2021, the most common cancer sites in males were: lung (18.7%), prostate (14.1%) and colorectum (11.1%); in females: breast (21.0%), skin (12.6%) and colorectum (11.3%). From 2010 to 2019, the overall cancer incidence rate increased by 26.7%. Age-standardized incidence rates in males increased from 301.2 to 332.10/0000. For females, age-standardized incidence rates increased from 220.8 to 256.10/0000. In 2020, cancer incidence rates decreased, the overall decline was 12.9%. Age-standardized cancer incidence rates in males and females were 288.5 and 223.2 per 100 000 population, respectively. In 2021, the corresponding rates for males and females were 288.2 and 235.80/0000, respectively. Limitations. To assess the prevalence of oncological diseases in the territories of Siberia and the Russian Far East 1 233 759 new cases of malignant neoplasms were analyzed over 12 years, which is a sufficient reference sample. Conclusion. In Siberia and the Russian Far East, cancer incidence rates in 2020 were lower than in 2019 due to the COVID-19 pandemic, which led to the reduction in the number of cases diagnosed and referred for the first-line treatment. In 2021, an increase in the age-standardized cancer incidence rate was observed, with the age at diagnosis tended to be younger. In 2010, 80–84 years men and 75–79 years women exhibited the highest incidence rates (2536.5 and 1246.80/0000, respectively). In 2021, the highest cancer incidence rates for males and females were observed in the 70 to 74 years group (2717.1 and 1402.60/0000, respectively).

Background. Disability-adjusted life year (DALY) is one of the well-known methods of comprehensive health assessment in the world. The method was developed by the World Bank and the World Health Organization. The DALY units and gross domestic product per capita are used for the assessment of the indirect economic damage from premature death of cancer. Aim. To estimate the number of years of life lost (DALY method) and economic losses due to death from cervical, uterine and ovarian cancers in the population of the Tomsk region. Materials and methods. The data of the Tomsk Region Federal State Statistics Service on the mortality of the population of the reporting form C51 Distribution of the dead by sex, age groups and causes of death, data on the sex and age distribution of the population, life expectancy, gross regional product per capita for 2018 of the Tomsk region were used. Results. In 2018, due to the death from gynecological cancer of the population of the Tomsk Region, 1616 DALY units were lost in absolute numbers. Of these, cervical cancer accounts for 44.3% (717 DALY units), uterine corpus cancer accounts for 24.8% (401 DALY units), ovarian cancer accounts for 30.8% (498 DALY units). At working age (1654 years), the absolute losses amounted to 694 DALYs. The economic damage to the Tomsk Region due to the mortality of the population from cancer of the cervix, uterine body and ovaries in 2018 amounted to 918.2 million rubles. Economic losses as a result of mortality from cancer of the cervix amounted to 407.4 million rubles, from cancer of the ovaries 283.0 million rubles, from cancer of the body of the uterus 227.8 million rubles. The economic damage from gynecological cancers in working age amounted to 394.3 million (42.9% of the total economic damage). Conclusion. Determining the socio-economic losses associated with mortality from malignant neoplasms of the female genital organs is necessary for the effective use of health care resources, which can be used to justify the need of the population for oncological care.

Регион Сибири и Дальнего Востока (СДВ) — территория с высокой долей городского населения (73,7%). В СДВ входит 21 субъект. Административными центрами являются города Барнаул, Красноярск, Абакан, Горно-Алтайск, Кызыл, Иркутск, Кемерово, Новосибирск, Омск, Томск, Улан-Удэ, Чита, Якутск, Владивосток, Хабаровск, Благовещенск, Петропавловск-Камчатский, Магадан, Южно-Сахалинск, Анадырь, Биробиджан. ЦЕЛЬ ИССЛЕДОВАНИЯ Проанализировать заболеваемость злокачественными новообразованиями (ЗНО) населения городов — административных центров региона СДВ. МАТЕРИАЛ И МЕТОДЫ Анализ отчетных форм №7 «Сведения о заболеваниях злокачественными новообразованиями» по административным центрам за 2012—2021 гг. РЕЗУЛЬТАТЫ И ОБСУЖДЕНИЕ В городах в 2021 г. зарегистрировано 42 694 случая ЗНО (45,5% от случаев ЗНО региона), темп прироста за 10 лет составил 13,7% (СДВ — 8,9%). В структуре заболеваемости ЗНО сохраняется снижение доли новообразований легкого (9,4%, СДВ — 9,1%) и желудка (5,1%, СДВ — 7,1%), наблюдается рост доли опухолей поджелудочной железы (3,4%, СДВ — 3,5%) и печени (1,9%, СДВ — 2,2%). Стандартизованный показатель в 2017—2021 гг. составил 268,90/0000 (СДВ — 249,60/0000), в женской популяции 253,1 (СДВ — 231,3), в мужской 312,2 (СДВ — 291,2) (p<0,05). Наибольшая заболеваемость регистрировалась в городах Иркутске (322,4), Барнауле (317,3), Чите (301,2), Красноярске (295,7), Южно-Сахалинске (292,7), наименьшая — в Кызыле (136,2), Горно-Алтайске (214,8), Кемерово (221,2), Якутске (229,9). Кумулятивный риск развития ЗНО высок и составил 35,1% (СДВ — 32,3%), для мужчин — 42,8% (СДВ — 39,7%), для женщин — 31,6% (СДВ — 28,5%). Риск очень высок в Барнауле (51,9%), Иркутске (51,6%), Южно-Сахалинске (49,7%), Красноярске (49,1%), Абакане (47,6%), Томске (45,1%), Хабаровске (43,8%), Чите (43,5%), Омске (43,5%) и Биробиджане (43,5%). Ниже риск в городах Кызыл (29,5%), Новосибирск (32,5%), Магадан (36,6%). ЗАКЛЮЧЕНИЕ Высокая заболеваемость злокачественными новообразованиями и кумулятивный риск ее развития в городах определяют необходимость обоснованного планирования первичной, вторичной, третичной профилактики.

Background. The age-standardized cervical cancer incidence rate in the Tomsk region in 2021 was consistently higher than the average for the Russian Federation (21.2 / 100,000 versus 13.6 / 100,000 women). Primary prevention of cervical cancer is best achieved by human papillomavirus (HPV) vaccination of girls. Aim. To evaluate HPV vaccine efficacy for the prevention of cervical cancer in the Tomsk region within the framework of implementation of two regional programs: “Prevention of gynecological cancer and rehabilitation of women diagnosed with gynecological cancer in 2008–2010” and “Urgent measures to improve cancer care for the population of the Tomsk region in 2011–2013”. Material and methods. We studied the tolerability and efficacy of HPV vaccination for the prevention of HPV-associated cervical cancer in 439 vaccinated girls aged 9–26 years during a follow-up time of 14-years. Results. The assessment of a 14-year follow-up study of the impact of HPV vaccination on HPV-associated cervical lesions has shown that HPV vaccine is safe and 100 % effective. Conclusion. Further prospects for primary prevention of cervical cancer before the introduction of vaccines against HPV infection in the national immunization schedule indicates the feasibility and real clinical effectiveness of the introduction of regional and regional programs with the development of a mathematical model for optimizing financial costs for primary prevention of cervical cancer, taking into account demographic parameters and socio-economic damage from cervical cancer in the study area.

The purpose of the study : to analyze the breast cancer incidence and breast cancer risk factors for the population of the Republic of Sakha (Yakutia) in 2011-2020. Material and Methods . The incidence of breast cancer in the population of Yakutia was analyzed using the data collected from population-based cancer registries of the Russian cancer statistics covering the period 2011-2020. The analysis of breast cancer risk factors was carried out using the data from systematic reviews published over the past 5 years (2018-2022). Results . The age-standardized incidence rates of breast cancer among the indigenous population of the Republic of Sakha (Yakutia) were lower than those in other Siberian ethnic groups and the Slavic population, amounting to 12.7 per 100,000 population. The rise in the breast cancer incidence rates in the region for 2011-2020 was associated with the aging of the population, since the trend in the population growth was not observed in the analysis of age-standardized rates. Conclusion . The breast cancer incidence rates among the indigenous population of the Republic of Sakha (Yakutia) are significantly lower compared to those observed in other ethnic groups living in Siberia. The rise in the breast cancer incidence rates in Yakutia is related to the aging of the population. The low age-standardized breast cancer incidence rates may be explained by a low consumption of hormonal agents and natural reproductive behavior. The search for ethno-specific mutations associated with breast cancer in the Yakut population as endogenous risk factors is of great importance. Further studies are required to elucidate the role of North-adaptive genetic mutations in the development of breast cancer. The assessment of the role of natural polyphenolic compounds, the content of which is high in wild berries (historically, a significant proportion of the food consumed by indigenous people), as a protective factor, is promising.

The purposeof the study was to assess the diagnostic value of endoscopic autofluorescence imaging (AFI) in patients with premalignant lesions and primary laryngeal/hypopharyngeal cancer.Material and Methods. The diagnostic value of AFI was assessed in 53 patients with chronic hyperplastic laryngeal/hypopharyngeal lesions and 48 patients with laryngeal/hypopharyngeal cancer.Results. The inclusion of video laryngoscopy with AFI in the algorithm for examining patients with chronic diseases of the upper respiratory tract made it possible to significantly improve the diagnostic efficacy of endoscopic examination in patients with premalignant lesions (high grade dysplasia) of the laryngeal mucosa. Video laryngoscopy with AFI was found to achieve higher sensitivity, specificity and accuracy rates than white light video laryngoscopy (87.5, 96.9 and 92.5 vs 50.0, 96.0 and 71.7 %, respectively, p<0.05). The video laryngoscopy with AFI allowed identification of not only pathological changes in the laryngeal and hypopharyngeal mucosa but also their malignant potential, as well as identification of areas for targeted biopsy. In 9 (18.8 %) laryngeal cancer patients, the standard white light video laryngoscopy demonstrated difficulties in the differential diagnosis of laryngeal cancer (n=4) and in assessing the extent of laryngeal cancer (n=5). In 3 out of 4 diagnostically difficult cases, video laryngoscopy with AFI made it possible to confirm the diagnosis of laryngeal cancer and in 5 cases to accurately determine the extent of hypopharyngeal cancer.Conclusion.The addition of standard videolaryngoscopy with a hightech technique of autofluorescence endoscopy makes it possible to accurately diagnose premalignant and malignant lesions of the larynx and hypopharynx.

Background. The increasing incidence of cervical cancer in Irkutsk region causes a growing workload for healthcare institutions of all levels. Therefore, we considered it necessary to analyze the quality of cancer care in Irkutsk region and its administrative center (Irkutsk city).Objective: to analyze the epidemiological situation of cervical cancer in Irkutsk region and Irkutsk city with the consideration of COVID-19 impact.Materials and methods. We used annual forms of federal statistical surveillance No. 7 “Information on malignant tumors” and No. 35 “Information on patients with malignant tumors” for Irkutsk region and Irkutsk city, as well as the information from the Federal State Statistics Service of the Russian Federation on the age-sex structure of population for 2010–2020. All calculations were performed in accordance with the methodological recommendations of P.A. Herzen Moscow Oncology Research Institute. Results. A total of 4,190 women were diagnosed with cervical cancer in Irkutsk region in 2010–2020; of them, 780 were from Irkutsk. We observed a 3.5 % and a 25 % decrease in the absolute number of new cases in Irkutsk region and Irkutsk city, respectively. Such a difference between the region and the city can be explained by a stricter adherence to the measures aimed at prevention of new coronavirus infection with suspended screening of certain groups of the adult population, as well as infection of healthcare professionals and their mobilization to COVID-19 hospitals, which had a negative impact on cancer care and, first of all, primary diagnostics of cervical cancer. There was an increase in the incidence of cervical cancer before the pandemic in both Irkutsk region and Irkutsk city up to 2019. The effectiveness of early diagnosis (active and early detection) increased significantly from 2010 to 2019; however, it became lower in 2020, due to transformation of many inpatient settings into COVID-19 hospitals and restrictive measures for preventive medical examination. Our findings suggest underdiagnosis of diseases during screening: we observed an increasing proportion of patients with late diagnosis (from 47.1 % in 2019 to 53.8 % in 2020), and, as a result, an increase in one-year mortality (from 16.9 to 17.9 %).Conclusion. Preventive measures for COVID-19 had a negative impact on the epidemiological situation of cancer in Irkutsk region in 2020 and worsened the quality of cancer care.

Background. Prostate cancer incidence rates continue to increase every year, therefore, the study of the quality indicators for cancer care, especially during a pandemic, is of great importance. Aim. To analyze prostate cancer incidence rates and quality indicators of cancer care in the Siberian Federal District. Materials and methods . For the calculation of cancer incidence rates, population-bases cancer registry data were used. Quality indicators were calculated according to the methodological recommendations of P.A. Hertzen Moscow Oncology Research Institute – branch of the National Medical Research Radiological Center. Results. The implementation of restrictive measures and the suspension of cancer screening programs in 2020 negatively affected the cancer care. The prostate cancer incidence rate decreased from 52.8 per 100 000 population in 2019 to 43.1 per 100 000 population in 2020, especially in the territories of the Republic of Tyva and the Omsk Region. Morphological verification in 2020 decreased compared to 2019 (97.0 % versus 97.8 %), with the exception of the Krasnoyarsk Territory and the Republic of Altai. Early prostate cancer detection increased from 62.9 to 64.0 %, and cancer detection at late stages decreased from 36.3 to 35.0 %. One-year mortality in the region decreased from 8.0 % (2019) to 7,3 % (2020), however, it increased significantly in the Republic of Tyva (from 3.2 to 40.0 %) and the Altai Republic (from 3.7 to 10.7 %). The number of patients who have been followed-up for 5 years or more increased from 40.7 to 42.3 %, except for Republic of Altai (from 32.8 to 25.0 %). Conclusion. Delay in the diagnosis of prostate cancer is associated with advanced stage, poor survival and high cost treatment.

Background . Cancer of unknown primary (CUP) is a metastatic lesion with diffcult identifcation of the primary tumor site using standard diagnostic approaches. Although the incidence of CUP is not high, this type of cancer often shows a high aggressiveness and therapy resistance and results in poor patient survival. The mechanisms of CUP origin are not clear, and further studies are needed. This study aims to analyze the mutational landscape of CUP and identify specifc genetic alterations. Material and Methods . Whole exome sequencing was used to analyze the mutational landscape of CUP. Results. CUP had single nucleotide variants (SNVs) in the EPHA8 (ephrin receptor) gene. CUP also harbored copy number variations (CNAs) in the ID2, FOXD4, ZMYND11, ZNF596, KIDINS220, LRRN1, GEMIN4, CEP72, TPPP , and MXRA5 genes. According to functional enrichment analysis, these genes are involved in the regulation of transcription, biogenesis of microRNA, cellular cytoskeleton, adhesion, extracellular matrix remodeling, proliferation, apoptosis, and epithelial-mesenchymal transition. Conclusion . Cancer of unknown primary harbors mutations in the genes that regulate different biological processes particularly cell motility.

Introduction. Malignant brain and other central nervous system tumors show a statistically significant increased incidence worldwide (GLOBOCAN, 2018).The study objective – to estimate the incidence of malignant brain and other central nervous system tumors in Siberia and the Russian Far East.Materials and methods. Using data from the population-based cancer registry in Siberia and the Russian Far East, we calculated the cancer incidence rates, the age-standardized incidence rates (ASIR), the index accuracy (the ratio of the number of cancer-related deaths to the number of new cases) of malignant brain and other central nervous system tumors during the period 2010 to 2019.Results. During the period 2010 to 2019, brain and other central nervous system malignances in males were the 14th most common cancers in Siberian and the Russian Far Eastern region, with the incidence of 1.6 % in 2010 and 1.5 % in 2019. In females, brain and other central nervous system malignances were the 16th most common cancers, with the equal incidence of 1.3 % in 2010 and 2020. Overall, the incidence rate of malignant brain and other central nervous system tumors in Siberian and the Russian Far Eastern regions increased from 5.1 to 5.6 per 100 000 with rate of increase of 9.8 %, including the territories of the Republic of Kamchatka (238.5 %), Amur (147.8 %), Khakassia (89.1 %), Irkutsk (65,1 %), Krasnoyarsk (37.8 %), and Primorsky (33.3 %) regions. The incidence rate decreased in the Kemerovo region (34.4 %) and the Trans-Baikal Territory (44.4 %). In women of Siberian and the Russian Far Eastern regions, the incidence rate was slightly increased from 3.7 to 4.0 per 100 000, the overall rate of increase being 8.1 %. The highest incidence rate was registered in the Altai Territory (47.8 %), Novosibirsk region (33.3 %), the Republic of Khakassia (25.0 %), Amur region (246.2 %), but the lowest incidence rate was observed in the Kemerovo region (7.0 %) and the Trans-Baikal Territory (61.1 %).The index accuracy indicated problems with the quality of territorial cancer registries. In males, the reduced the index accuracy was observed in Siberian and the Russian Far Eastern regions as a whole and amounted to 0.81. The index accuracy was also observed in the Krasnoyarsk, Primorsky, Kamchatka, Novosibirsk and Amur regions, as well as in the Republic of Khakassia, whereas the increased index accuracy was observed in the Kemerovo Region, Altai Republic, Khabarovsk and Trans-Baikal Territories. In females, the increased index accuracy was observed Siberian and the Russian Far Eastern regions as a whole, being 0.78 in 2019, and in the Krasnoyarsk, Kamchatka, Tomsk regions, as well as in the Republic of Khakassia. The reduced index accuracy was noted in the Altai, Primorsky Territories and the Amur Region.Conclusion. The problems of registration and monitoring of malignant brain and other central nervous system tumors in Russia does not make it possible to present the true incidence rate of these tumors. The development and implementation of a Neuro-Oncology Registry in accordance with the international standards will allow full analysis of the epidemiological situation of malignant brain and other central nervous system tumors.

Уровень заболеваемости злокачественными новообразованиями (ЗНО) продолжает увеличиваться, что определяет актуальность анализа качества специализированной помощи в городах — административных центрах.ЦЕЛЬ ИССЛЕДОВАНИЯОценка динамики основных показателей онкологической помощи населению административных центров Сибирского федерального округа (СФО).МАТЕРИАЛ И МЕТОДЫИспользованы отчеты о заболеваемости ЗНО по городам — административным центрам СФО (Горно-Алтайск, Улан-Удэ, Абакан, Барнаул, Чита, Красноярск, Иркутск, Кемерово, Новосибирск, Омск и Томск) за 2004—2018 гг.РЕЗУЛЬТАТЫПродолжается рост распространенности ЗНО в крупных городах (p=0,0000), причем этот показатель выше, чем в РФ и СФО в целом. В 2018 г. показатель составил 2867,9 на 100 тыс. населения, варьировал от 1460,1 в Горно-Алтайске до 3723,1 в Барнауле. Наиболее часто встречаются (без учета опухолей кожи без меланомы и органов половой системы) колоректальный рак, опухоли щитовидной железы, легких и желудка. За исследуемый период повысилась морфологическая верификация диагноза, увеличился удельный вес случаев выявления I—II стадии заболевания и активной выявляемости; уменьшились запущенность, одногодичная летальность и летальность контингента. Улучшились показатели, характеризующие состояние специализированной помощи в целом: абсолютное число пациентов, состоящих на учете более 5 лет, и индекс накопления контингентов.ВЫВОДЫЖители административных центров получают более качественную медицинскую помощь по сравнению с населением СФО в целом. Наблюдается положительная динамика основных показателей. Особенно ситуация улучшилась в Красноярске, Омске и Иркутске. Нестабильна она в Кемерове, Абакане. Выявление ЗНО пищевода, поджелудочной железы, печени, желудка, легкого на терминальных стадиях обусловливает высокую летальность больных.

Background. One of the main directions in the field of ensuring radiation safety of “nuclear legacy” facilities is the assessment of radiation effects and most significant radiogenic risks in employees of nuclear enterprises and their descendants.Objective. Analysis of the cancer incidence among employees of the Siberian Group of Chemical Enterprises (SGCE) exposed to ionizing radiation in the course of their professional activities.Material and Methods. The actual values and standardized estimated risks of developing cancer among the SGCE workers occupationally exposed to ionizing radiation were calculated using generally accepted methods based on the information of the regional medical dosimetry registry of Seversk Biophysical Research Center of FMBA, containing updated data on all SGCE employees diagnosed with cancer (period from 01.01.1950 to 31.12.2015 inclusive). The control group consisted of workers who were not occupationally exposed to ionizing radiation.Results. Among the male personnel of the SGCE, the highest incidence of cancer of the digestive, respiratory, and skin organs (including melanoma) was observed in patients aged 50–59 and 70–79 years. Among the female workers, the highest cancer incidence was in the age group 40–49 years; cancer of the gastrointestinal tract, genital tract and breast was the most common. The cancer incidence rate in the SGCE workers who occupationally exposed to ionizing radiation was not higher that that observed in the control group. The median age of male cancer patients occupationally exposed to ionizing radiation was significantly lower than the median age of male cancer patients of the control group. In female cancer patients, a significant difference in the median age of cancer diagnosis was found only in relation to skin cancer. Both male and female SGCE personnel occupationally exposed to ionizing radiation was at high risk of certain cancers: among male patients – cancer of the mesothelium and soft tissues, genital organs, eyes and brain, as well as multiple primary tumors; among female patients – cancer of lips, oral cavity, pharynx, digestive system, respiratory system, skin (including melanoma), mesothelium, soft tissues, breast, urinary tract, lymphatic and hematopoietic tissues, as well as multiple primary tumors.Conclusion. The data obtained will allow determination of the main directions for assessing the health risks of personnel of radiation hazardous facilities and the formation of a set of measures aimed at improving the system of protection and improving the health of workers at radiation hazardous enterprises and the extension of their working longevity.