Cancer alertness and early diagnosis of oncological diseases (tests, analyzes, laboratory and other studies) are important for obtaining a positive prognosis. Cancer detected at an early stage is effectively treatable and controlled, the survival rate among patients is high, and the prognosis is positive. Comprehensive screening is carried out at the request of the patient or at the direction of an oncologist at the Centers for Early Diagnosis of Oncological Diseases (in Stavropol, Moscow, Rostov-on-Don, Kazan and other cities of Russia). The early diagnosis program aims to detect cancer at the initial stages, when treatment is most effective.
Oncological diseases: statistics
Currently, cancer is the second leading cause of death inthe world. Oncological diseases are about 200 diagnoses, and each type of cancer has its own signs, methods of diagnosis and therapy. Every year, the incidence increases by 3%, and WHO believes that in the next twenty years this figure will increase by almost 70%. Today, 14.1 million cases of the disease are registered annually in the world, and 8.2 million people die from various types of cancer and complications.
British oncologists believe that the list of the most common types of cancer has changed little over the past half century. The most common are lung, breast, colon, prostate, and stomach cancers. Not far behind are cancers of the liver, cervix, esophagus, bladder, and non-Hodgkin's lymphomas (malignant neoplasms of the lymphatic system). Nearly half (42%) of cases worldwide are lung, breast, intestinal and prostate cancers. The most common among men is lung cancer, among women - breast cancer.
At 169.3 million years, scientists estimate the loss of years of life due to cancer. There are more than 32.6 million cancer patients worldwide, the number of people diagnosed with cancer in the five years to the end of 2012. A third of all cases are associated with four leading risk factors: smoking, alcohol consumption, poor diet and overweight, and insufficient physical activity. Smoking is responsible for about 20% of lung cancer deaths. In 18% of casesinfections are the cause. In poor regions, this figure is much higher.
In Asia, 48% of new cases are registered, in Europe - 24.4%, America - 20.5%, Africa - 6%, Oceania - 1.1%. Thus, more than 60% of new cases are diagnosed in Africa, Asia, South and Central America. About 70% of deaths are in these regions. Europe and North America have relatively low mortality compared to the total number of new patients.
Denmark has the highest case rate. There were recorded 338 diseases per 100 thousand people. In France, this figure is slightly lower - 325 people, in Australia - 323 people, in Belgium - 321, in Norway - 318. As for the states in the Middle East, the worst indicators are in Israel.
In developing countries, 99% of deaths are due to untreated cancer. At the same time, 90% of strong analgesics are used in Australia and New Zealand, Canada, the USA and some European countries. It turns out that less than 10% of painkillers are used by 80% of the population. The statistics are truly appalling. These data are given to popularize information and combat prejudice associated with a terrible disease. It is important to remember that the massive early diagnosis of cancer would significantly reduce the statistics.
Major risk factors for cancer
WHO identifies factors that increase the risk of getting a serious illness. Among those risk factors for cancer that are scientificallyproven, the following are of particular importance. The occurrence of oncology can be associated both with certain characteristics of the organism and the state of he alth of a particular patient, and with environmental conditions.
Some infectious diseases cause structural changes that lead to the formation of malignant neoplasms. Of particular importance are: hepatitis C and B virus, immunodeficiency virus (HIV), Helicobacter pylori bacterium, human papillomavirus (HPV). Timely use of antiviral, antiparasitic and antibacterial drugs helps to avoid severe complications.
HIV often leads to the development of acute forms of cancer of the lymph nodes and blood. The reason for this is the restructuring of the genetic material. HPV causes cervical cancer and precancerous conditions in 70% of cases. There are more than 100 types of HPV, of which 13 lead to the development of malignant neoplasms. The bacterium Helicobacter provokes stomach cancer, viral hepatitis B and C - liver damage.
Benign neoplasms are prone to malignant transformation. These are, for example, intestinal polyps, cervical erosion, changes in the esophagus. Early diagnosis of oncology will help to eliminate the influence of this risk factor.
Genetic mutations that are inherited are associated with the occurrence of malignant tumors. For example, these include a mutation that increases the risk of developing breast and ovarian cancer. With certain types of intestinal polyposis orIn Lynch syndrome, the probability of developing a malignant tumor during life approaches 100%. Effective preventive measures can be taken by early diagnosis of oncological diseases and oncological alertness. In some cases, even preventive operations are carried out.
To a significant increase in the incidence of cancer of the lungs, bladder and breast, blood and skin leads to environmental pollution and the harmful effects of chemical carcinogens. Strict adherence to recommendations regarding the use of detergents and other household chemicals will help reduce the number of cases. A harmful factor is exposure to ultraviolet and ionizing radiation. Strict compliance with building codes (construction materials may contain excessive concentration of radon), dosed exposure to the sun and the use of sunscreens will help reduce the harmful effects.
A balanced diet will help prevent the development of many diseases. In the daily diet should be a sufficient amount of antioxidants, which are found in fruits and vegetables. The lack of these substances can provoke the development of cancer. Fats are carcinogenic, especially those that have undergone repeated heat treatment, some dyes and preservatives.
The connection between obesity and the development of cancer of the intestines, uterus, esophagus, and breast has been proven. Systemic and local influence is exerted by the systematic use of alcohol, smoking. A direct relationship between smoking and the incidence of oncology of the esophagus, stomach, lips, larynx, pharynx, urinarybladder, cervix and pancreas.
The most effective methods for early diagnosis
Most cancers have a relatively good prognosis if detected early. Modern diagnostics allows us to limit ourselves to minor procedures in order to preserve the affected organ and prevent the negative effects of therapy. For early diagnosis of oncological diseases, screening is widely used today - several laboratory tests and instrumental methods that allow detecting a tumor in the absence of a clinical picture. Screening tests are widely used not only for individuals who are exposed to risk factors, but also for relatively he althy people of different ages.
The main methods for the early diagnosis of cancer are as follows: tumor marker test, genetic studies, occult blood test, Pap test, mammography, breast MRI, ultrasound, CT, endoscopy, virtual colonoscopy, mole scanning and skin examination.
A blood test for tumor markers allows doctors to suspect the presence of precancerous changes in patients who do not present any complaints. Some studies are recommended to be carried out en masse after reaching a certain age. This is, for example, a test that diagnoses prostate cancer (recommended once every two years after 40-50 years). Genetic tests are ordered if you suspect the presence of genetic mutations that increase the risk of developing cancer. A special study is shown in the family circle of patients who suffer from cancer of the uterus or ovaries, as well as the breast.
Analysis of feces for occult blood allows you to determine even a slight gastric bleeding, the cause of which is often oncology. Periodic examination is recommended for all persons over fifty years of age, as well as for anemia of unknown nature in patients of various ages.
Pap and HPV tests are recommended for women aged 21 to 65. These methods make it possible to detect not only a cancerous tumor, but also timely diagnose precancerous changes that can be effectively treated.
Mammography and regular follow-up with a mammologist are the most effective methods for diagnosing oncology in the early stages. Mammography significantly reduces the risk of detecting malignant neoplasms at inoperable stages in patients aged 40 to 74 years. Often, such a study is combined with ultrasound, which allows you to get a comprehensive picture of the condition of the breast.
MRI is performed to diagnose the slightest structural changes in tissue according to the recommendations of specialists. Indicated for patients with diagnosed mutations of the BRCA2 and 1 types. The same groups, as well as women with Lynch syndrome, are indicated for ultrasound with a transvaginal sensor for the timely diagnosis of transformations in the ovaries and uterus.
CT is performed with a low dose of radiation. This method is recommended for patients who are exposed to risk factors for developing lung cancer, as well as for all smokers after fifty-five years.
Endoscopic methods can detect cancer and precancerous changes in the digestive tract. Some time ago, gastroscopy was massively carried out as part of the early diagnosis of oncological diseases in Japan, since gastric cancer occupied a leading place among all oncological diseases there.
Colonoscopy is recommended for people over 50 who are at risk. Also, the study is carried out in the presence of hereditary risk factors in patients of any age. Medicine today allows you to undergo a non-invasive examination of the intestine - a virtual colonoscopy. The method is indispensable for patients with contraindications to invasive technique.
Timely detection of melanoma allows observation by a dermatologist and the use of optical diagnostic methods. An examination by a dermatologist is recommended for all patients with pigmentary changes (moles and age spots). It is also necessary to monitor the growth dynamics of moles with periodic scans.
Early detection of breast cancer
Breast cancer is extremely common among women (compared to other types of cancer). The main methods of early diagnosis of oncological diseases in women are manual examination (including self-examination), mammography, ultrasound, determination of the presence of hereditary mutations, and biopsy. Often the first method is quite informative - the usual manual examination. Palpation allows you to detect the presence of seals, assess their nature, seedermatological symptoms (redness, discharge from the nipple), condition of the lymph nodes.
But still the most reliable methods are instrumental, when it comes to the early diagnosis of cancer. And the oncological alertness of the patient herself, by the way, is of no small importance here. A woman can self-diagnose from time to time. Reasons to see a doctor are pain in one of the glands, a change in the shape and shape of the breast, a dense formation, bloody or any atypical discharge from the nipples, swelling on the nipple, retraction or wrinkling of the skin of the breast, enlargement of the lymph nodes on the corresponding side.
Mammography is an informative and safe method by which a tumor can be detected even before it is determined by palpation. Breast imaging is recommended every year after age 40. The question of additional diagnostic methods is decided by the doctor based on the results of MMG. Ultrasound is informative for patients under 40 years of age. The method is absolutely safe and can be used for dynamic monitoring of the patient. A biopsy is indicated when a tumor is detected. If the formation is less than 1 cm, then the manipulation resembles a conventional injection. The procedure is performed on an outpatient basis, without preparation, usually does not require anesthesia. Material for histological examination is processed within seven to ten days.
Methods for early detection of skin cancer
If a patient has many moles, then within the framework of oncological alertness and early diagnosis of oncologicaldisease test is performed to determine the nature of skin formations. Often, harmless moles hide diseases bordering on skin cancer, as well as malignant neoplasms. It can be, for example, melanoma, basalioma, carcinoma, and so on. Benign neoplasms, which, due to their localization, are constantly injured, it is desirable to remove. It is more often recommended for people with the first type of skin: red or blond hair, blue eyes and fair skin. Before excision of the mole, it is recommended to perform dermatoscopy. Be sure to determine whether a malignant neoplasm or benign. After that, the specialist will determine the best method of therapy: cryodestruction or excision.
Additional study: test for tumor markers
The test for tumor markers is carried out as an additional study in the framework of the prevention and early diagnosis of cancer. Tumor markers are specific substances that appear during tumor development. This analysis can be carried out without a referral from an oncologist, but not for free. As part of the program for the early diagnosis of oncological diseases, the test is carried out under the MHI policy if there are certain indications. The analysis determines the markers of the oncological process in the rectum, large intestine, liver, stomach, lungs, prostate, bladder, mammary gland, pancreas, ovaries, gallbladder. Tumor markers can be present in small amounts in the body of a he althy person. Under certain conditions, theythe number is increasing, so the discrepancy between the results and the norm does not always indicate the presence of oncology.
Reasons for extraordinary diagnostics
Any symptoms that did not bother you before are a reason for an extraordinary screening. Should alert: subcutaneous node of any localization, education on the skin, persistent cough, bleeding or changes in bowel function (diarrhea, constipation). Women are advised to see a doctor if they have enlarged axillary lymph nodes, feel a lump in the breast, changes in the skin of the breast, or discharge from the nipple.
In addition, many types of cancer are preceded by underlying diseases. This is, for example, chronic gastritis or peptic ulcer for stomach cancer. For cervical cancer, erosions and polyps are precancerous lesions. With such diagnoses, screening should be done annually. The same is recommended in the presence of several risk factors. If you have questions related to diagnostics, you should contact the insurance representative of the company that issued the CHI policy - this is an important regulatory document. Early diagnosis of oncology (that is, an affordable range of medical services) is determined by the policy.
Need for diagnosis in case of familial risk
If there is a family risk, that is, cases of a certain type of cancer among family members, oncologists recommend starting the diagnosis of this type of oncology five years earlier than the disease was detected in a relative. In this case, the patient himself should pay considerable attention to his he alth and regularlyundergo examinations.
Where to get a diagnostic screening
In Russia, many procedures for early cancer diagnosis are available to the public free of charge under a medical policy. For example, a Pap test, which allows you to detect precancerous changes in the uterus, is carried out as part of a medical examination once every three years among women from 21 to 69 years. If necessary (the patient has oncogenic types of HPV), the smear should be taken more often. The frequency will be determined by the gynecologist. The study will also be free under the policy.
Professional development of doctors
Continuing Medical Education (CME) oncological alertness and early diagnosis of oncological diseases highlights the main task that will help reduce the incidence in Russia. An early diagnosis program is essential to control morbidity and effectively treat patients. General practitioners and narrow specialists in polyclinics pay attention to symptoms that may accompany cancer and refer the patient for additional examinations. Therefore, the first stage of diagnosis can be completed at the clinic at the place of residence or registration. If necessary, the doctor will refer the patient to highly specialized medical centers.
Today, an electronic course for distance professional development has been developed for general practitioners. This is necessary for the formation of competencies for the detection of oncology at an early stage. The development of an individual cycle for certification in the speci alty is a prerequisite for mastering the module "Cancer Alertness and Earlydiagnosis of oncological diseases". The cycle is also needed for the accreditation of a doctor in the speci alty.
Early diagnosis is the key to successful treatment
Diagnosis of cancer in the early stages can significantly increase the percentage of survival, and also increases the likelihood of a full recovery. Survival within five years from the time of diagnosis of the tumor, as a rule, indicates a complete recovery of the patient or effective medical control of tumor growth. In lung cancer, the prognosis depends not only on the stage, but also on the histological form of the disease. With breast cancer, qualified treatment in the early stages can achieve up to 90% survival within five years. Gastric cancer is rarely diagnosed in the first stage, and the five-year survival rate is almost 80%. Thus, most types of cancer are treatable in 95% of cases if they are diagnosed in the early stages.
