Malignant neoplasms as a medical and social problem. Prevention

The second most pressing problem of modern medicine is malignant neoplasms. Experts call malignant neoplasms “killer No. 2,” noting that in many countries of the world malignant neoplasms occupy second place (after diseases of the circulatory system) among the causes of death. First of all, this, and also high losses due to premature mortality and disability, the social and hygienic significance of such diseases is explained. In addition, malignant neoplasms are characterized by fatal doom for patients in many localizations. If at the beginning of the twentieth century, among all causes of death in economically developed countries, malignant diseases accounted for 3-7%, then currently they account for 14-20%.

This is largely due to more complete detection of diseases due to improved medical diagnosis and an increase in the proportion of elderly people in the population, predominantly affected by malignant neoplasms.

The number of patients registered at the dispensary is increasing to a much greater extent than the number of newly identified patients annually. When using materials on the incidence and morbidity of malignant neoplasms, as well as mortality from them, attention is drawn to the increase in both the absolute number of newly ill, chronically ill and deceased, and relative values. The increase in the number of patients with newly diagnosed malignant neoplasms is determined mainly by changes in age composition population, improved diagnosis of diseases and more complete accounting of sick people. This, as well as the expansion of the network of oncological institutions, earlier identification of patients and improvement in the quality of their treatment explains the increase in the number of patients with malignant neoplasms.

The primary incidence rate of malignant neoplasms in 2004 was 326.3 per 100 thousand population, which is 12.7% higher than the level of 1994, the prevalence rate compared to 1994 increased by 31.3% and amounted to 1617.1 per 100 thousand .population. In 2005, for the first time in life, 469,195 cases of malignant neoplasms were identified, the primary incidence rate was 328.8 per 100 thousand population. The maximum incidence rates were noted in the Ivanovo (411.7 per 100 thousand inhabitants), Novgorod (408.2) and Yaroslavl (394.6) regions, the city of St. Petersburg (392.9), the minimum - in the republics of Ingushetia (103, 2), Dagestan (131.0) and Tyva (158.0). The maximum values of the prevalence rate in 2004 were recorded in the Krasnodar Territory (2207.0), St. Petersburg (2097.4), Saratov region(2069.4), minimal - in the republics of Tyva (429.8) and Dagestan (484.8).

The total number of people registered at the dispensary in oncological institutions is more than 2 million people (about 1.5% of the total population of the country), the share of rural residents is about 20%.

Both the level and structure of mortality from malignant neoplasms are closely dependent on gender and age. In men, the first place in the mortality structure is occupied by respiratory cancer, second by stomach cancer and third by esophageal cancer. In women: the first place is stomach cancer, the second is breast cancer, the third is cervical cancer. The mortality rate from cancer is significantly higher in men than in women. The mortality rate from malignant neoplasms increases rapidly with increasing age, which reflects age characteristics morbidity.

The higher mortality rate of men both in general and in certain age groups (with the exception of 30-year-olds) is explained, first of all, by more high level incidence of cancer in men, and most importantly, that cancer occurs more often in men than in women internal organs: esophagus (2 times more often), stomach, trachea, lungs (7.2 times more often), i.e. such localizations where early diagnosis still pose serious difficulties. In women, a significant proportion are tumors of the breast and genital organs, i.e. localizations in which there is a high chance of timely detection.

Of great interest is the question of the dynamics of mortality from malignant neoplasms. According to WHO, mortality from such diseases is growing everywhere. However, most scientists involved in the epidemiology of malignant neoplasms believe that when analyzing the dynamics of mortality from such diseases, it is necessary to take into account certain circumstances: over the past decades, the quality of cancer diagnosis has improved throughout the world; appeared sufficient quantity Oncology specialists, qualitative changes have occurred in the histological and X-ray examination of tumors, the statistical recording of such diseases is being improved, and the age structure of the population has changed towards its aging.

The main link in the provision of specialized assistance is oncology clinics. Such dispensaries that provide all types of special assistance including inpatient care, organized in regional centers and large cities. At the Central District Hospital, in other cities and in city district clinics, oncological dispensary departments or offices.

Oncology dispensaries have the following tasks: organizing early identifying patients; highly qualified and specialized treatment;

organized and methodological guidance on oncology issues for all medical institutions in the territory of the dispensary;

implementation of the most effective methods diagnosis and treatment of cancer in the practice of medical institutions;

control over the treatment of patients in medical institutions; study and analysis of cases of late detection of patients; organization of preventive examinations of the population;

assisting health authorities in developing cancer control plans.

All groups of cancer patients subject to clinical examination are divided into the following groups accounting:

1a - patients with suspected cancer;

1b - precancer;

2 - patients subject to special treatment;

2a - patients subject to radical treatment;

3 - practically healthy;

4 - patients in advanced stages requiring intensive treatment.

Oncology dispensaries are leading, but not the only institutions in the treatment of cancer patients; great success is achieved where early detection of such patients takes place, and this is only possible with active participation all medical institutions and, above all, clinics. For early detection There are two prerequisites for malignant neoplasms: special oncological alertness of doctors of all specialties and the population, organization and conduct of targeted medical examinations of the population.

An obligatory section of work with cancer patients of any medical institution is the analysis of advanced cases of cancer detection. A study of the reasons for the late identification of such patients shows that in 40-50% of cases the patient seeks medical help late; in 35-40% - latent, asymptomatic course of the disease; up to 20% - incorrect diagnosis.

An important indicator working with cancer patients is the one-year mortality rate, i.e. deaths of cancer patients in the first year of diagnosis of the disease (per 100 patients). Over the past ten years, there has been a positive downward trend in this indicator (1994 - 38.1%, 2004 - 33.2%).

There are two basic principles prevention cancer:

1) study carcinogenic substances and eliminating human contact with them - elimination occupational hazards in production, measures against environmental pollution, strict sanitary and hygienic control of water and food.

2) early detection and radical treatment of precancerous diseases.

Trauma as a medical and social problem. Measures for the prevention and organization of trauma care

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STATE EDUCATIONAL INSTITUTION OF HIGHER PROFESSIONAL EDUCATION

"BASHKIR STATE MEDICAL UNIVERSITY OF THE FEDERAL AGENCY FOR HEALTH AND SOCIAL DEVELOPMENT"

DEPARTMENT OF PUBLIC HEALTH AND HEALTHCARE ORGANIZATION WITH A COURSE IN NURSING MANAGEMENT

Head department

Doctor of Medical Sciences, Professor

N.H. Sharafutdinova

teacher: Nazmieva L.R.

ABSTRACT ON THE TOPIC:

"MALIGNANT NEOPLASMS

AS A MEDICAL AND SOCIAL PROBLEM"

Completed by a student

5th year L - 502 b groups

Mingazova Albina Rafikovna

INTRODUCTION

As of January 1, 2008, according to the State Committee of the Republic of Belarus on Statistics, the permanent population of the Davlekanovsky district is 42,467 people, of which 24,242 people live in urban areas. (57.1%), in rural areas- 18225 people (42.9%). Men - 19,720 people, women - 22,747. The number of working-age population is 25,547 people. The number of children - from 0 to 17 years old - 9680 people, including children from 0 to 14 years old - 7401, children under one year old - 434.

Basic demographic data of Davlekanovsky district

Table No. 1 Demographic status and morbidity structure of the federal and territorial population

Indicators			In Davlekanovo
Fertility		10.1 people per 1000 people
Mortality		13.0 people per 1000 people
Natural increase
Morbidity
		Cardiovascular diseases	Cardiovascular diseases
			Oncological diseases
	Oncological diseases	Oncological diseases

Fig. No. 1 Dynamics of demographic indicators of the population of Davlekanovo

As a result of the analysis of the demographic indicators of the region for 2005 - 2007, the following were obtained: during 2005 - 2007. improvement in key population health indicators continues; an increase in the birth rate from 9.8‰ in 2005 to 12.6‰ in 2007, a moderate decrease in mortality from 15.5‰ to 13.5‰. The mortality rate in the region in 2006 was at the level of republican indicators.

Table No. 2. Population size. Age and sex structure of the Davlekanovsky district for 2005 - 2007.

				At working age Total MenWomen	Up to 14. Up to 1.

1. The population has increased due to migration of people.

2. Given the gender structure of working age, the proportion of the male population predominates.

3. The child population is falling slightly.

Medicinal - preventative care to the population of the region is carried out in accordance with the Program of State Guarantees for providing citizens of the Republic of Belarus with free medical care.

Inpatient medical care is provided to the population of the city and region with 290 beds, including 270 at the Central Regional Hospital, 20 at the Ivanovo SUB. There are 230 beds in the compulsory medical insurance system, and 60 in the budget.

Outpatient clinic with capacity: 700 visits per shift, day hospital at the clinic for 81 places and at home - 2.

Analyzing the main performance indicators of the state of health care in the region for 2005 - 2007. received the following: low supply of doctors 17.7 and paramedical staff 81.7.

The supply of beds is 68.7 due to reform and restructuring bed capacity in implementation of the “Concept of development and reform of the healthcare system and medical science in the Republic of Belarus for 2001 - 2006 and for the period until 2010."

Expected results:

Reducing the shortage of medical and nursing staff medical personnel, reducing staff turnover;

Increase in wages for local doctors, ambulance and emergency doctors medical care and another category of workers, in connection with which an influx is expected medical workers from commercial and departmental structures, return to the profession of medical workers who do not work in their specialty;

Transition to postgraduate training of doctors in internship and residency on a contractual basis with mandatory work of at least 1 year in a city healthcare facility;

Social support for young specialists, which will ensure the influx and retention of medical personnel in treatment and preventive healthcare institutions of the city;

Improving the quality of medical care through a system of advanced training for medical workers, certification and certification;

improving the quality of medical care;

increasing the availability of highly qualified, specialized medical care for the population of Davlekanovo, reducing the waiting list for specialists in clinics;

improvement of staffing in outpatient clinics, growth vocational training medical personnel;

Improving the examination of the quality of medical care in municipal medical institutions;

Improving the quality of drug provision for the population during inpatient and outpatient treatment;

Reducing the percentage of wear and tear on all buildings after repair work;

Improving the stay of patients and working conditions of medical workers;

Ensuring coverage of organized groups with preventive examinations of children and adolescents;

An increase in the number of planned surgical interventions for diseases of the abdominal organs;

Decrease in hospital mortality rate;

Improving the safety of surgical activities and the effectiveness of medical care during intensive care of emergency conditions;

Increasing the level of readiness of the surgical anesthesiology and resuscitation service to provide emergency medical care during mass admissions and emergencies;

Increasing the number of cases of early detection of cancer patients;

Increasing the level and scope of preliminary diagnosis of malignant neoplasms;

Reducing the number of advanced visual forms of malignant neoplasms;

Increasing the coverage of veterans and WWII participants with dispensary observation;

Increasing the level of early detection of deviations in the health status of schoolchildren;

Increasing the number of qualified doctors and nurses;

Increasing the efficiency of teams arriving to calls according to established time standards;

Increasing the number of medical personnel with qualification category and a specialist certificate;

Timely hospitalization of emergency patients;

No preventable deaths during transport;

reducing the mortality rate in working age;

stabilization of the financial and economic condition of the industry;

planning the expenditure of financial resources aimed at final result depending on the volume and quality of medical services and public health indicators;

rational and efficient use of industry resources and optimization of spending funds allocated for healthcare.

To improve the organization of the oncology service, it is necessary to provide for the following tasks:

1. implement measures aimed at the early detection of malignant neoplasms, while paying attention to the work of the examination room;

2. develop an action plan to improve the qualifications of doctors in medical institutions of the city on early detection issues oncological pathology and anti-cancer health education work;

3. increase the level and volume of clarifying diagnostics of malignant neoplasms;

4. carry out further improvement of registration and clinical examination of cancer patients;

5. introduce the study of observed and adjusted survival of cancer patients;

6. provide timely, extraordinary, free examination of patients with malignant neoplasms in the outpatient clinics of the city in the shortest possible time.

A COMMON PART

Table No. 3 Main performance indicators of a healthcare institution per 10 thousand population

	Indicators
	Availability of beds
	Clinic capacity incl. SUB
	Availability of doctors
	Availability of average health workers
	Bed work per year
	Average patient stay in bed
	Hospital mortality
	Hospitalization rate per 1000 inhabitants
	Number of visits per 1 resident
	Implementation of the periodic inspection plan
	General morbidity
	Primary incidence

Work with personnel.

The district's health care facilities employ 789 employees, of which 77 are doctors, 348 are paramedics, the number of doctors is 18.1, and the number of paramedics is 82.1. The staffing level is 76.3% with doctors, 79.2% with paramedics. 5 doctors and 16 paramedics arrived. 4 doctors and 13 paramedics left.

During the reporting year, 7 doctors and 44 paramedics underwent advanced training. 47 doctors are certified, which is 61.0%; 68 (88.3%) have certificates. 217 paramedical workers were certified, which is 62.3%. 286 - 82.1% have certificates.

Table No. 4 Number of doctors and paramedics by category

		Paramedics

There remains a need for therapists, neurologists, otolaryngologists, surgeons, and ophthalmologists. There are 2 Honored Doctors of the Republic of Belarus and 9 Doctors of Excellence in Health Care of the Republic of Belarus working in the region.

Table No. 5. Mortality structure of the working-age population

	Causes of mortality

	Diseases of the circulatory system
	Injuries, poisonings, accidents
	Neoplasms
	Respiratory diseases
	Tuberculosis

Structure of injuries

1st place - suicides - 21 cases (39.8%)

2nd place - injuries associated with DDP - 11 cases (7.6%)

3rd place - intentional murder and drowning - 7 cases (4.8%)

Morbidity rate of the population of the city and region.

General morbidity rate per 100 thousand population - 129126.1

Primary incidence - 74997.0 (for 2006 - 71923.7)

1. Respiratory diseases - 28739.9 (22.2%)

2. Diseases of the circulatory system - 13528.1 (10.4%)

3. Diseases of the digestive system - 10989.7 (8.5%)

4. Diseases of the nervous system - 10589.3(8.2%)

5. Diseases of the genitourinary system - 8974.0 (6.9%)

6. Injuries and poisonings - 4029 (3.1%)

Morbidity among adolescents

General morbidity rate per 100 thousand population - 196401.9

Primary incidence - 102150.0

The main causes of morbidity in the population are:

1. Respiratory diseases - 37648.0 (19.0%)

2. Diseases of the digestive system - 32075.4 (16.3%)

3. Diseases of the nervous system - 12110.5 (6.1%)

4. Diseases of the genitourinary system - 10530.9 (5.3%)

5. Diseases of the circulatory system - 12198.3 (6.2%)

6. Injuries and poisonings - 1974.5 (1.0%)

Morbidity in children

Overall morbidity rate per 100 thousand population - 201053.9

Primary incidence - 128090.7

The main causes of morbidity in the population are:

1. Respiratory diseases - 79800.0 (39.7%)

2. Diseases of the circulatory system - 21375.4 (10.6%)

3. Diseases of the nervous system - 16349.1 (8.1%)

4. Diseases of the digestive system - 19483.8 (9.6%)

5. Diseases of the eye and its adnexa - 7607.0 (3.7%)

6. Injuries and poisonings - 1553.8 (0.7%)

Table No. 6. Morbidity among socially significant diseases

According to the table, there is an increase in the incidence of drug addiction, and the upward trend in HIV-infected persons also continues.

Table No. 7. Main morbidity indicators with VUT

Morbidity structure according to VUT

1st place - respiratory diseases - 1388 (26.7%)

2nd place - diseases of the circulatory system - 672 (12.9%)

3rd place - diseases of the musculoskeletal system - 670 (12.8%)

4th place - injuries, poisoning and some other consequences of exposure to the external environment - 667 (12.8%)

Structure of primary disability by nosology

1 place - congenital anomalies- 8 cases (5.3%)

2nd place - mental disorders- 4 cases (2.6%)

Organizational and methodological work

Organizational and methodological work is organized according to a comprehensive plan. Conducted during 12 regional paramedic meetings, medical and nursing conferences - 14 (of which 12 were on schedule), medical councils - 17, pathological conferences - 4, meetings of the Council of Paramedics - 5.

Ivanovo district hospital

The capacity of the outpatient clinic is 150 visits per shift. The doctor's appointment was completed at 127.4%, the workload per hour was 5.0. Dental appointments are 33.3% complete, workload per hour is 1.0. Hospital with 20 beds, bed capacity - 329.0.

Table No. 8 Indicators by department for 2007

Gerontology

Narcology

Neurology

Infectious

Surgery

Gynecology

Ivanovskaya UB

TB dispensary

Psychiatric

Plan k/days

Number of patients

Employment

Wed. staying

Mortality

Obstetrics service.

In the district, the female population is 22,747, of which 11,335 are women of fertile age. Early registration of pregnant women up to 12 weeks is 92.6%. Examination by a therapist - 100%, ultrasound - 100%.

A total of 569 pregnant women were registered, 538 ended in childbirth, of which 95.3% were at term, 4.6% were premature. Percent normal birth increased to 59.6% (in 2006 - 49.3%)

Among pregnant women, 53.0% suffered from anemia, 15.3% from diseases of the genitourinary system, 9.0% from diseases of the cardiovascular system, 17.1% from gestosis (in 2006 - 16.9%), the number of cesarean sections was 18 ( 2006 - 13).

Gynecological operations in total - 36, abortions in total - 160 (in 2006 - 164), the number of mini-abortions - 66 (2006 - 57). The ratio of births to abortions is 2.2:1.

Abortions per 1 thousand women of fertile age with mini-abortions - 14.1 (RB - 31.5). Abortions from 15 to 19 years old - 8.1%.

43.1 women of fertile age are covered by contraception (in 2006 - 43.2%), of which 34.4% have an IUD, hormonal contraceptives - 8.6%.

There are no surgical sterilizations.

A family planning office has been organized in the district in the youth department, renovations have been carried out in the office and equipment has begun with solid equipment and medical equipment. Equipment and office equipment.

The work of the examination room is organized in two shifts. Patients were identified - 1957 (in 2006 - 2362), of which:

· Cervical erosions - 353

Leukoplakia - 19

· Uterine fibroids - 37

Ovarian cyst - 23

· Mastopathy - 42

Breast fibroadenoma - 14

Cytological examination of women - 98.2%

The implementation of the republican target program “Safe Motherhood” continues. All those discharged are given baby kits.

Pediatric service

The child population is 7401, up to 1 year old - 434.

Infant mortality - 11.2% (in 2006 - 7.1%).

Children aged 0 to 1 year died - 6 (in 2006 - 3).

There is a slight increase in incidence - 201053.9 (in 2006 - 197275.3).

The incidence of children in the first year of life in 2007 was 2066.8 (in 2006 - 1997.6).

Children are covered by medical examinations 100%. Disabled children - 149.

Sanatorium - spa treatment 389 - 90.5% covered. Improved health in suburban areas health camps- 4461 - 99.4% of children. There are 556 dispensary patients per doctor (515 in 2006).

Ambulance Service

The area is served by 4 paramedic teams around the clock. Service radius 50 km. During the year, 13,781 calls were served. According to the state guarantee, 13,431 calls were identified based on the population. The indicator per 1 thousand population is 324.5.

Unresulting calls - 0.9%. Children served - 2167 - 15.7%. In the first 4 minutes, 89.6% of patients are served. The load on 1 brigade is 9.4. Acute pathology- 86%. 22.0% were admitted to the hospital; of these, 58.2% were hospitalized. The discrepancy between diagnoses is 8.2%.

Orthopedic service

In total, 454 prostheses were manufactured, the average visit for prostheses was 4.0%, there were no persons who received free prostheses.

Narcological service

In 2007, 91 patients were identified, of which 15 were women. 16 were included in the risk group, 2 of them were women. Of those identified: through the Municipal Department of Internal Affairs - 5, health care facilities - 12, applied independently - 51.

Table No. 9 Indicators

Psychiatric service

In total, 935 patients were registered in the district, 469 were registered at the dispensary, 67 were primary patients. The overall morbidity rate was 2213.8. Primary incidence - 157.7; incl. from 0 to 17 years - 229.6. Primary disability - 8, incl. children - 3. During the reporting year, re-hospitalization of patients in the Republican Hospital decreased. Fluoroexamination covered 53% of patients; 212 patients were examined through the examination room. Mentally ill of fertile age - 91, covered with IUD - 74%.

Anti-tuberculosis service

During the year, 26 patients were identified. The primary morbidity rate is 61.2 (for 2006 - 66.2). Detection rate during medical examinations - 17 people - 70.8%. 91 patients were healed in tubal health centers (2006 - 31)

BCG vaccination was completed by 93.2% (2006 - 97.4%).

Fluorographic examination of the district population in 2007 - 40%.

The Mantoux test was performed - 470, which is 47.1%. According to the results, 32 children were registered as Mantoux. There is an increase in mortality rates from tuberculosis (2006 - 4.7; 2007 - 9.4 per 100 thousand population).

Outpatient and polyclinic service

Clinic for 550 visits per shift. Admission is carried out in 23 specialties. The examination room operates on 1 shift. The number of dispensary patients per 1 doctor is 612.0 (2006 - 755.8).

The number of visits to doctors per 1 resident is 6.4 (2006 - 7.9).

Medical examinations of the decreed population were completed by 96.7%. Agricultural workers - 82.7%, workers industrial enterprises- 88.9%. Fluoroexamination of the population 52.5%. There are 2 in-home clinics. 37 patients were involved or 583 bed days were completed.

Table No. 10 Activities of support services in the district

Oncological service

During the year, 143 patients were identified (2006 - 98). The primary incidence rate is 336.7. Of those newly identified in stage 4 - 31 (21.6%), in stage 3 - 41 (28.6%), in stage 2 - 69 (48.2%). During medical examinations, 14 patients were identified - 9.8%.

According to the morbidity structure: 1st place - stomach cancer - 19

2nd place - breast cancer - 18

3rd place - skin cancer - 17

Dermatovenerological service

During the reporting year, 14 patients with syphilis were registered, which amounted to 33.1%. There is a decline venereal diseases. Wassermanization of somatic patients is 98.5% complete. Gonorrhea: identified - 8 people, incidence - 18.9%.

Infectious diseases service

The infectious disease service in the city and region has been operating with stable indicators for many years. Absent nosocomial infection. No infectious mortality has been observed within 10 years.

During 2007, there was a decrease in the level of infectious morbidity of acute respiratory diseases - 256.6 (2006 - 320.2). The incidence of HFRS in 2007 was 4.7 (2006 - 9.4). HIV infection in 2007 - 32. Hepatitis disease has decreased: A - 1, B - no, the number of asymptomatic carriers of hepatitis C virus is decreasing - 16 (2006 - 21).

Dental service

Dental care is provided to the population at the Central District Hospital and at the Ivanovo district hospital.

The supply of dental doctors is 0.7. Inspected in order for the current year planned rehabilitation- 70.4% of children. Of the identified patients, 69.5% were sanitized. Among pregnant women, the percentage of sanitation is 95.6% of those identified.

Surgical service

The total number of operations in the hospital is 827, including 100 in children.

Planned 339 (40.9%), emergency - 488 (59%).

The number of operations per 1 surgeon is 169.6.

Overall mortality - 0.2.

Surgical activity - 37.1.

Postoperative mortality - 0.2%.

Quantity outpatient surgeries - 501.

Postoperative complications - 1.1%.

After emergency - 1.1%.

As a result of the advisory, diagnostic, treatment and preventive measures carried out in 2007, the sustainable functioning of health care facilities in the city and region was ensured.

From social - significant diseases It is necessary to note the stabilization of incidence rates of syphilis and tuberculosis. Unfortunately, HIV infection among the population is steadily increasing.

Conducted big job to improve the quality of medical care to the rural population: 33 have undergone improvement, have certificates and 16 heads of FAPs have a category, and routine repairs were carried out in 5 FAPs during the year.

The main performance indicators of health care facilities: the number of visits per 1000 residents, per 1 resident and the number of emergency calls per 1000 residents comply with the standards for the provision of free medical care to the population.

In connection with the reform of the bed network, the work of the beds slightly exceeds the state guarantee of free medical care to the population.

There is a shortage of medical personnel: therapists, neurologists, ENT doctors, ophthalmologists.

The medical building, the clinic of the Central District Hospital, the building of the Ivanovo SUB require ongoing general construction and repair work and major repairs.

LITERATURE REVIEW

Malignant neoplasms occupy second place in the structure of causes of overall mortality (since the 40-50s of the 20th century). In our country they account for approximately 17% of all causes of death. Over the past 10 years, the number of deaths has increased by 30%. The mortality rate in Russia in 1994 was 207 per 100,000 population. Every day in Russia 814 deaths from malignant neoplasms are registered. In St. Petersburg, the mortality rate is higher than in Russia - 273 per 100,000 population. The increase in mortality from malignant neoplasms occurs both due to improved diagnosis of diseases and due to an increase in life expectancy. Although the increase in mortality and morbidity is not only due to people in older age groups, it is observed in all age groups, including in young people.

Mortality rates vary significantly by age group for men and women. At the age of 25-34 years, mortality is higher in men, from 35 years in women. From 55 to 64 years of age it significantly prevails in men. In general, the mortality rate among men exceeds that among women. Along with the increase in mortality from malignant neoplasms, the incidence of these diseases is growing. The incidence of these diseases in Russia in 1994 was 280 per 100,000 population. In St. Petersburg - 350 per 100,000 population. Men are more likely to suffer from malignant neoplasms than women.

Morbidity structure in men:

lung cancer- 29% of all cases

stomach cancer 16%

skin cancer 8%

hemoblastosis 5%

Structure of morbidity in women :

breast cancer 17%

stomach cancer 12%

skin cancer 12%

colon cancer 6%

In general, the incidence of malignant neoplasms increases with age, but it does not increase evenly. There are two peaks of incidence: at the age of 0 to 4 years and at the age of 70-74 years.

Mortality from malignant neoplasms is decreasing average duration life expectancy for men in Russia is 3 years, and for women 2.5 years. main reason Mortality rates in men include lung cancer, stomach cancer and hematological malignancies. In women - breast cancer, stomach cancer, colon cancer. The Russian population loses approximately 5 million lives annually. The probability of developing malignant neoplasms during the next life for a boy born in 1993 is higher and is approximately 20%, and for a girl this probability is 16%. The chance of dying is 16.5% for boys and 10% for girls.

Principles of prevention of malignant neoplasms :

early detection and treatment of precancerous diseases

detection of carcinogenic substances, their detailed description and development effective measures to prevent human contact with these substances.

Detection of diseases at early stages, which causes effective treatment and prevention of metastases and relapses

mandatory long-term observation of patients after treatment for the purpose of prevention or early treatment relapses and metastases

identification of risk factors, study of lifestyle

Our country has a system for providing care to cancer patients (dispensaries, research institutes, X-ray and radiological institutes).

WHAT IS CANCER?

The human body consists of millions of cells, each of which has specific functions. For example, erythrocytes (red blood cells) in the blood carry oxygen to all cells of the body, and skin cells provide protection to the body.

Normal cells grow, divide and die in a certain pattern. Normally, cell division occurs in appropriate quantities instead of dead cells and within certain organs and tissues. This process is strictly controlled by the body. The rate of cell division varies in various organs and fabrics.

In cases where the structure of cells changes under the influence of various factors, they begin to divide uncontrollably and lose the ability to recognize their cells and structures and become cancer cells, they form a tumor and can penetrate other organs and tissues, disrupting their functions. Almost all tumors develop in normal tissues of the body and more often in those tissues and organs in which the rate of cell division is higher (for example, skin, intestines, lymphatic system, bone marrow, bones). Tumor cells differ from normal cells in that instead of dying, they continue to grow and divide, forming new pathological cells.

Tumor cells usually produce toxic substances, which lead to deterioration of a person’s condition, weakness, loss of appetite and weight loss.

According to IARC (International Agency for Research on Cancer), in 2000, about 10 million people worldwide fell ill, and 8 million died from malignant tumors. More than 2 million people are registered with cancer in Russia. Every 5th Russian has a risk of developing cancer during his future life.

There are many known causes and factors that lead to the development of malignant tumors. Approximately 80% of these causes and factors can be eliminated, which means that theoretically 80% of cancers can be prevented.

Cancer is a long, multi-stage process. It is known that before reaching lung tumor, stomach or mammary gland measuring 1-1.5 cm in diameter takes 5-10 years. Thus, most tumors begin at the age of 25-40, and in some cases in childhood. This is when cancer prevention should begin.

Modern oncological science has developed and offers some recommendations for the prevention of cancer in general and specific localizations in particular.

CANCER STATISTICS

“Statistics are to a politician what a street lamp is to a drunken drunk: more a support than a light.”
Andrew Lang

The population explosion, which is considered the characteristic problem of our time, actually began in the 19th century. Past epidemics of plague, famine and war had a regulating effect on the population, which increasingly became balanced due to changes in organizational character and evolution Agriculture. The general improvement in sanitation and nutrition observed in developing countries has had a significant impact on public health, resulting in a decrease in infant mortality and more and more people began to live to see reproductive age. In addition, diseases that were previously fatal, such as tuberculosis, were now able to be treated, causing their incidence to decline and eventually become curable. Thanks to the discovery of antibiotics, common infections no longer threaten people's lives. As a result, life expectancy has risen from about 40 years in the 19th century to more than 70 years today.

An inevitable consequence of population growth and aging is the spread of diseases, the incidence of which increases with age; Disabling diseases, heart disease, strokes and cancer are becoming increasingly challenging for modern medicine. In European and other Western countries Approximately 1% of the population dies each year. Cancer, heart disease and strokes account for about 75% of deaths from these causes, while most others are caused by respiratory diseases, accidents and congenital disorders. As might be expected, the incidence of death increases with age, but cancer is the second leading cause of death in children after accidents.

Half a century ago, every tenth person died from cancer. Now this ratio is approaching 1:5. However, this increase is not actual, but is mainly due to the use of antibiotics, which has reduced the importance of infectious diseases as one of the main causes of death, accounting for about 1% of all deaths.

In developing countries, where malnutrition, health problems and lack of resources in medical field, deaths from infections and malnutrition are much more common, and cancer is much less important as a public health problem, accounting for one in 20 deaths. This difference is, of course, artificial, since life expectancy in these countries is also lower, and as resources increase everywhere, we can expect a significant increase in the relative number of cancer patients.

There are a few things you should know below: definitions :

Morbidity (incidence) is the number of cases of a disease that occur in a given population during its lifetime. For example, malignant melanoma occurs in one in 100,000 people in the UK.

Affection - the number of people with cancer at a given time in a specific geographic area or population group. People move around the country, some die, others are born, so the number of sick people per 100,000 people in any area will differ significantly from the incidence.

Mortality - frequency of deaths. In any given population it will eventually be 100%. It is more appropriate to express it as the number of deaths in given year in general, with distribution by cause or some other parameters, for example by diagnosis, age, gender or a combination of different parameters.

Morbidity - characterizes the consequences of the disease as the degree of “illness”. Colds are characterized by mild morbidity, but pneumonia can be very severe or even result in death.

Epidemiology is the study of the distribution of disease cases in different groups population. The task of epidemiology is to identify the causes of diseases and high-risk groups.

In long-term studies, changes in morbidity and mortality can provide insight into the etiology of diseases. However, it may be decades before any health effects associated with, for example, the Chernobyl accident can be identified.

One in three people will develop cancer at some point in their lives. Cardiovascular disease and accidents are also certainly important causes of morbidity (“ill health”), but cancer-related morbidity is largely reversible.

The impact of modern cancer care on cancer mortality can be judged by the difference between incidence rates of 1:3 and mortality rates of 1:5. The opposite is true for heart disease, as heart disease is cured only in rare cases.

The table (below) shows the number of deaths of males and females in the UK and USA from various types of cancer.

Table No. 11. Cancer deaths in the UK and US by tumor site as a percentage of total number cases of death from cancer.

Localization (type of cancer)	1992 Great Britain	1993 USA

Oral cavity (pharynx)



Colon/rectum
Pancreas


Melanoma (skin)
Breast
Cervix

Body of the uterus

Prostate
Urinary system
Leukemia (blood)

In an area of 300,000 people, there are approximately 1,500 new cases of cancer and approximately 900 deaths from this cause each year. If we take into account the number of referrals for hospitalization, the given figures will be far from real. In fact, anyone family doctor very rarely encounters certain types of cancer.

The question often arises: “Can I get cancer?” This probability can be approximately calculated, but for each specific person it will not have any significant significance. To determine whether I am exposed greater risk more likely to get cancer than my friend or neighbor requires information that epidemiologists gather as they study risk factors for cancer in different populations. To one degree or another, these are numerous and varied factors. These include, for example, age, gender, occupation, environment, diet, ethnicity, smoking habit and, in the case of breast cancer, family history (mother or sister's disease).

A widely accepted causative factor is tobacco smoking. Back in the 18th century. It has been discovered that snuff can cause nasal cancer, and at the end of the last century a link was identified between lip cancer and pipe smoking. In the 20th century There was a significant increase in the prevalence of lung cancer in Western countries, but it was not until the 1940s that its connection with increased consumption of tobacco products was clearly established.

Cancer of the larynx, pancreas, kidney and Bladder are also associated with cigarette smoking, and cancers of these localizations account for up to 35% of all cancer deaths. In addition, men who smoke are at risk of having a fatal or non-fatal attack. coronary disease heart rate is 60-70% higher than in non-smokers: smoking is also associated with about 70% of cases of chronic obstructive respiratory diseases (for example, chronic bronchitis). Smoking during pregnancy increases the risk of early fetal or neonatal death. It is now recognized that the risk of developing these diseases extends to non-smokers who are in the same room as smokers (so-called “passive smoking”).

Chemicals that can cause cancer were mentioned earlier. The most well studied of them was found in cigarette smoke. There is also evidence that certain dietary and other environmental factors (eg, exposure to dust, certain minerals, chemicals, radiation, and certain viruses) may contribute to increased cancer incidence. Some epidemiological surveys have found a high incidence of certain types cancer in certain geographic areas. This phenomenon serves as a basis for searching for a causative factor. The most recent example is a slight increase in the incidence of leukemia among children living near the Sellafield nuclear power plant. The question arises whether the apparent increase in the number of cases of leukemia could be a consequence of nuclear radiation. This cannot be stated unconditionally, but since the existence of the specified enterprise is fundamental external difference of a given area from others, one can hypothesize about such a connection. According to another theory, the formation of an isolated community could have contributed to this. As it were, this example indicates only the difficulties in establishing a cause-and-effect relationship.

It has long been known that radiation is associated with increased risk cancer development. Among those who dealt with x-rays In the early days of work in this field, there was an increase in the incidence of skin cancer. Those who have come into contact with radioactive materials, such as when extracting radium from uranium ore or more late time When phosphorescent paint containing radium or thorium was applied to watch dials, other types of cancer developed, including leukemia and bone cancer.

The most detrimental mass exposure to radiation occurred after the atomic bomb explosions in Hiroshima and Nagasaki. Not counting the deaths directly as a result of explosions, over the next 20 or more years from leukemia and some types of solid tumors More people died than predicted.

It is now known that the degree of health risk from radiation exposure varies depending on the type of radiation and the degree of exposure. As a result of the release of massive doses of radiation from an atomic explosion, people immediately receive a huge dose in a single exposure (dubbed fractions). With chronic exposure, health risk levels can vary greatly. When, for example, X-rays are used in a controlled manner for treatment and people receive relatively low doses in repeated exposures (fractions), the likelihood of a new malignant disease practically absent.

Following the release of nuclear energy as a result of the accident at the Chernobyl nuclear power plant, attention to the dangers of radiation to environment. Thousands of reindeer were slaughtered in Finland because the levels of radioactivity in their bodies were much higher than acceptable standards. Unfortunately, prevailing winds carried rain clouds into northern Europe, resulting in some radioactive fallout in Scotland and northern Wales, where animals also had to be slaughtered and their carcasses disposed of. Some radioactive material also penetrates into the plant canopy and thus has limited recirculation, meaning that exposure lasts for more than one season. As forecasts show, the accident may result in a slight increase in the incidence of cancer, but in general its consequences are hardly comparable to the damage and number of victims at the disaster site.

It is known that some rocks used in construction, in particular granite, are characterized low level release of radioactivity. If we assume that this is a cause of cancer, then in areas where granite is often used as one of the main building materials, one would expect a concentration of cases of diseases, such as leukemia, due to increased radioactivity. Cornwall is a typical example in this regard, but there is no high incidence of cancer here. This is encouraging. However, since to quantify long-term consequences radiation is impossible, any known fact of radiation exposure will from time to time cause public concern.

There are also reports of high incidence of certain types of cancer in other situations. Thus, the detection of nasal cancer among forest industry workers led to a change in industrial practice. After workers at a dye production plant were found to have frequent cases bladder cancer, recognized the carcinogenicity of some aromatic dyes. Reports have been made, although without sufficient evidence, that in areas near gas developments on the side opposite to the direction of the prevailing winds, the incidence of lung cancer is higher: other studies report that among local population Hodgkin's disease appears to be more common than in other areas. Most of these observations are probably due to pure chance, but thanks to modern information systems, each such situation can be re-examined over time.

Frequency cancer diseases has a different character when the latter are concentrated not in space (i.e., not geographically), but in time. Many years ago, it was noticed that people suffering from Hodgkin's disease, who were in no way connected spatially, were for some time in fairly close contact with each other: for example, they studied at the same school. The significance of this association is still questioned because the causative factor for Hodgkin's disease has not been established. But since it can develop in both identical twins and in more than one family member, a complex relationship between heritable and environmental factors has been hypothesized. It is possible that such associations occur very rarely, since few people suffering from Hodgkin's disease are blood relatives.

In very rare cases (so rare that whenever they occur, interested parties tend to document them in great detail) there is a high incidence of cancer in individual families. Such “cancer” families are very different from families where one or two people have cancer. It is now known that there are genetic connections. Screening family members can identify those at higher than normal risk of developing cancer. This will help identify families who would benefit from some preventive measures or screening. For such families it is advisable to carry out genetic counseling, especially in terms of identifying risk to offspring. Since the frequency oncological diseases in the general population is 1:3, many families may have one or more members affected by cancer, so this feature alone is not sufficient to identify a family affected by cancer. “Oncology” families are very rare. Some have associated congenital conditions, such as multiple colon polyps.

Many inevitably ask the question: is cancer contagious?. We have absolutely no information about its infectious nature - quite the contrary, the overwhelming majority of data indicate its non-contagiousness (non-infectiousness). However, it is known that infectious hepatitis Hepatitis B, which is rare in the UK but very common in the Far East, can cause liver damage and is associated with an increased risk of liver cancer - hepatoma - in some people. It is one of the most common types of cancer in China and neighboring countries.

Now that the detection of most types of cancer is associated with increased life expectancy, the improvement in the health of the nation and the resulting increase in the elderly population will inevitably lead to the fact that cancer will remain an important public health problem for the foreseeable future.

Government Decree

Russian Federation

From 01.12.04 No. 715

On approval of the list of socially significant diseases and the list of diseases that pose a danger to others.

In accordance with Article 41 of the Fundamentals of Legislation of the Russian Federation on the protection of the health of citizens, the Government of the Russian Federation decides:

Approve the attached:

list of socially significant diseases;

list of diseases that pose a danger to others.

Chairman of the Government

Russian Federation M. FRADKOV

SCROLL

socially significant diseases

Disease code According to ICD-10 *	Name of the disease
	Tuberculosis
	Infections transmitted primarily through sexual contact
3. B16; V18.0; V18.1	Hepatitis B
4. B17.1; V18.2	Hepatitis C
	Disease caused by human immunodeficiency virus. (HIV)
	Malignant neoplasms
	Diabetes
	Mental disorders
	Diseases characterized by high blood pressure

Malignant neoplasms are a numerically increasing type of pathology. The most common lesions of epithelial tissues are the skin, oral cavity and larynx, digestive tract, sexual and endocrine glands, respiratory systems and urinary system(cancer itself); then tumors of connective tissue, nervous system, melanoma and embryonal malignancies.

Currently, about 150 types of cancer have been identified. Stomach cancer is the most common. If we talk about the role of gender, then in men the first place is lung cancer, in women - breast cancer.

Currently, there are no significant discoveries in oncology that would offer new approaches to diagnosis and treatment. Surgery in oncology has apparently already reached its “ceiling of effectiveness.” In this regard, the main emphasis should be on prevention and, above all, on improving the environment, since it has already been convincingly proven that the effects of radioactivity, environmental pollution from industrial waste, exhaust gases Vehicle is largely responsible for the increase in morbidity.

Coordination of the reproduction of body cells is carried out by the nervous, humoral and tissue regulatory systems. Their influence is realized through gene regulation of cell division - the synthesis of nucleic acids, proteins, etc.

The most common types of tissue growth disorders are changes in either central mechanisms regulation, or intracellular complex.

CLASSIFICATION OF TISSUE GROWTH DISORDERS(according to Ado A.D.).

HYPERBIOTIC PROCESSES: hypertrophy, hyperplasia, regeneration and tumor.

HYPOBIOTIC PROCESSES: atrophy, dystrophy, degeneration.

If a change in the mass of an organ is associated with the multiplication of its cells, and due to a change in the mass of each cell, but without changing their number, then an increase in the mass of an organ of this type is called HYPERTROPHY, and a decrease is called ATROPHY. HYPERPLASIA is more characteristic of mitotic tissues that, under physiological conditions, experience constant loss - bone marrow, epithelium, as well as tissues that have retained the ability to reproduce - connective tissue.

True hypertrophy and hyperplasia is expressed by a proportional increase in the parenchyma and other tissues of the organ. Wherein functional activity increases. False hypertrophy (hyperplasia) is associated with the predominant proliferation of stromal elements, while the number of parenchymal cells may decrease with a decrease in function. Hypertrophy is also divided into physiological (working and replacement or vicarious) and pathological.

REGENERATIVE HYPERTROPHY (hyperplasia) develops when the cells of the remaining part of the organ increase after damage.

Correlation hypertrophy (hyperplasia) is noted in the system of organs associated regulatory relationships(for example, hyperplasia and hypertrophy of the adrenal cortex due to excess production of ACTH).

All of the listed types of hypertrophy and hyperplasia have an adaptive, compensatory value, however, with possible outcome in some cases to decompensation (myocardial hypertrophy).

Sometimes there is a hyperbiotic growth of tissues without any visible functional need (gigantism, acromegaly due to hyperproduction of growth hormone), and some types of congenital hypertrophies associated with disorders have no compensatory value. embryonic development(ichthyosis).

VACATE HYPERTROPHY (hyperplasia) develops with a decrease in mechanical pressure on the tissue (joint tissue when releasing excess synovial fluid).

Regeneration (rebirth) - restoration of lost tissues and organs can be physiological and pathological. If physiological is the process of constant restoration of the epithelium and other cells of the body, then pathological regeneration is associated with the restoration of tissues after their damage. Connective and connective tissue regenerate better epithelial tissue, weaker muscle. In nervous tissue, neuroglia have a high regenerative capacity.

In regenerating tissue, substances are formed that stimulate cell reproduction - damage products, proteases, polypeptides. The stimulating effect of leukocyte breakdown products (trephons) has also been revealed. Also shown to be important in regeneration nervous trophism, physiological ratio of hormones along with the influence of the temperature factor, adequate provision of amino acids and vitamins.

ATROPHY - the process of reducing cell volume, according to the development mechanism, is divided into atrophy from inactivity, due to denervation (neurogenic) and atrophy due to prolonged compression organ or tissue.

TUMOR GROWTH - local, autonomous, unregulated tissue growth. Unlike the physiological one, it is not limited by anything, is not regulated by the corresponding mechanisms of the affected organism, and is of a procedural nature, i.e. develops over time. Malignantly degenerated cells retain their properties and pass them on to subsequent generations.

A TUMOR is a pathological process characterized by the uncontrolled proliferation of cellular elements without the phenomena of their maturation.

TUMOR - a typical pathological process representing an unregulated, unlimited proliferation of tissue, not associated with general structure of the affected organ and its functions.

A set of characteristics that distinguish tumor tissue from normal and components biological features tumor growth is called atypia. Malignant tumors are characterized by both CELLULAR and TISSUE ATYPISM.

The following manifestations are noted:

1) the presence of interconnection between the membranes of various organelles;

2) “monotonicity” of the lipid structure of membranes;

3) reducing the effect of contact inhibition;

4) increasing membrane permeability.

Metabolic atypia. expressed by predominance in tumor cells anaerobic breakdown of carbohydrates.

Immunological atypia. - the appearance in tumors of proteins that have antigenic significance for the host organism.

Malignant neoplasms as a medical and social problem

0,5

In an area of 300,000 people, there are approximately 1,500 new cases of cancer and approximately 900 deaths from this cause each year. If we take into account the number of referrals for hospitalization, the given figures will be far from real. In fact, it is very rare for any family physician to encounter certain types of cancer.

The question often comes up: “Can I get cancer?” This probability can be approximately calculated, but for each specific person it will not have any significant significance. Determining whether I'm at greater risk of cancer than my friend or neighbor requires information that epidemiologists gather by studying cancer risk factors in different populations. To one degree or another, these are numerous and varied factors. These include, for example, age, gender, occupation, environment, diet, ethnicity, smoking habit and, in the case of breast cancer, family history (mother or sister's disease).

Cancers of the larynx, pancreas, kidney and bladder are also associated with cigarette smoking, with cancers in these locations accounting for up to 35% of all cancer deaths. In addition, men who smoke have a 60-70% higher risk of fatal or non-fatal coronary heart disease than non-smokers: smoking is also associated with about 70% of cases of chronic obstructive airway diseases (for example, chronic bronchitis). Smoking during pregnancy increases the risk of early fetal or neonatal death. It is now recognized that the risk of developing these diseases extends to non-smokers who are in the same room as smokers (so-called “passive smoking”).

Chemicals that can cause cancer were mentioned earlier. The most well-studied of these is found in cigarette smoke. There is also evidence that certain dietary and other environmental factors (eg, exposure to dust, certain minerals, chemicals, radiation, and certain viruses) may contribute to increased cancer incidence. Some epidemiological surveys have found high incidence of certain types of cancer in certain geographic areas. This phenomenon serves as a basis for searching for a causative factor. The most recent example is a slight increase in the incidence of leukemia among children living near the Sellafield nuclear power plant. The question arises whether the apparent increase in the number of cases of leukemia could be a consequence of nuclear radiation. This cannot be stated unconditionally, but since the existence of this enterprise is the main external difference between this area and others, we can put forward a hypothesis about such a connection. According to another theory, the formation of an isolated community could have contributed to this. Be that as it may, this example only demonstrates the difficulties in establishing a cause-and-effect relationship.

It has long been known that radiation is associated with an increased risk of cancer. Among those exposed to X-rays in the early days of the field, there was an increase in the incidence of skin cancer. Those exposed to radioactive materials, such as when radium was extracted from uranium ore or, more recently, when watch dials were coated with phosphorescent paint containing radium or thorium, developed other types of cancer, including leukemia and bone cancer.

The most detrimental mass exposure to radiation occurred after the atomic bomb explosions in Hiroshima and Nagasaki. Not counting the deaths directly resulting from the explosions, over the next 20 years or more more people died from leukemia and some types of solid tumors than predicted.

It is now known that the degree of health risk from radiation exposure varies depending on the type of radiation and the degree of exposure. As a result of the release of massive doses of radiation from an atomic explosion, people immediately receive a huge dose in a single exposure (dubbed fractions). With chronic exposure, health risk levels can vary greatly. When, for example, X-rays are used in a controlled manner for treatment and people receive relatively low doses in repeated exposures (fractions), there is virtually no chance of developing a new malignant disease.

Following the release of nuclear energy as a result of the Chernobyl nuclear power plant accident, attention to the dangers of radiation to the environment has increased. Thousands of reindeer were slaughtered in Finland because levels of radioactivity in their bodies far exceeded acceptable limits. Unfortunately, prevailing winds carried rain clouds into northern Europe, resulting in some radioactive fallout in Scotland and northern Wales, where animals also had to be slaughtered and their carcasses disposed of. Some radioactive material also penetrates into the plant canopy and thus has limited recirculation, meaning that exposure lasts for more than one season. As forecasts show, the accident may result in a slight increase in the incidence of cancer, but in general its consequences are hardly comparable to the damage and number of victims at the disaster site.

It is known that some rocks used in construction, in particular granite, are characterized by a low level of radioactivity. If we assume that this is a cause of cancer, then in areas where granite is often used as one of the main building materials, one would expect a concentration of cases of diseases, such as leukemia, due to increased radioactivity. Cornwall is a typical example in this regard, but there is no high incidence of cancer here. This is encouraging. However, since it is impossible to quantify the long-term effects of radiation, any known fact of radiation exposure will from time to time cause public concern.

There are also reports of high incidence of certain types of cancer in other situations. Thus, the detection of nasal cancer in forest industry workers led to changes in production practices. After frequent cases of bladder cancer were discovered among workers at a dye production plant, some aromatic dyes were recognized as carcinogenic. Reports have been made, although without sufficient evidence, that in areas near gas developments on the side opposite the direction of the prevailing winds, the incidence of lung cancer is higher: other studies report that Hodgkin's disease appears to be more common among the local population than in other areas. Most of these observations are probably due to pure chance, but thanks to modern information systems, each such situation can be re-examined over time.

The incidence of cancer is different when the latter are concentrated not in space (i.e., not geographically), but in time. Many years ago, it was noticed that people suffering from Hodgkin's disease, who were in no way connected spatially, were for some time in fairly close contact with each other: for example, they studied at the same school. The significance of this association is still questioned because the causative factor for Hodgkin's disease has not been established. But since it can develop in both identical twins and in more than one family member, a complex relationship between heritable and environmental factors has been hypothesized. It is possible that such associations occur very rarely, since few people suffering from Hodgkin's disease are blood relatives.

In very rare cases (so rare that whenever they occur, interested parties tend to document them in great detail) there is a high incidence of cancer in individual families. Such “cancer” families are very different from families where one or two people have cancer. It is now known that there are genetic connections. Screening family members can identify those at higher than normal risk of developing cancer. This will help identify families who would benefit from some preventive measures or screening. For such families, it is advisable to conduct genetic counseling, especially in terms of identifying risks for offspring. Since the incidence of cancer in the general population is 1:3, many families may have one or more members affected by cancer, so this feature alone is not sufficient to identify a family affected by cancer. “Oncology” families are very rare. Some have associated congenital conditions, such as multiple colon polyps.

Many people inevitably wonder whether cancer is contagious. We have absolutely no information about its infectious nature - quite the contrary, the overwhelming majority of data indicate its non-contagiousness (non-infectiousness). However, it is known that infectious hepatitis - hepatitis B, which is rare in the UK but very common in the Far East, can cause liver damage, which is associated with an increased risk of liver cancer - hepatoma - in some people. It is one of the most common types of cancer in China and neighboring countries.

Government Decree

Russian Federation

From 01.12.04 No. 715

On approval of the list of socially significant diseases and the list of diseases that pose a danger to others.

In accordance with Article 41 of the Fundamentals of Legislation of the Russian Federation on the protection of the health of citizens, the Government of the Russian Federation decides:

Approve the attached:

list of socially significant diseases;

list of diseases that pose a danger to others.

Chairman of the Government

Russian Federation M. FRADKOV

SCROLL

socially significant diseases

Malignant neoplasms are a numerically increasing type of pathology. The most common lesions are epithelial tissues - skin, oral cavity and larynx, digestive tract, reproductive and endocrine glands, respiratory system and urinary system (cancer itself); then tumors of connective tissue, nervous system, melanoma and embryonal malignancies.

Currently, there are no significant discoveries in oncology that would offer new approaches to diagnosis and treatment. Surgery in oncology has apparently already reached its “ceiling of effectiveness.” In this regard, the main emphasis should be on prevention and, above all, on improving the environment, since it has already been convincingly proven that exposure to radioactivity, environmental pollution from industrial waste, and vehicle exhaust gases are to a large extent responsible for the increase in morbidity.

The most common variants of tissue growth disorders are changes in either central regulatory mechanisms or the intracellular complex.

CLASSIFICATION OF TISSUE GROWTH DISORDERS (according to Ado A.D.).

HYPERBIOTIC PROCESSES: hypertrophy, hyperplasia, regeneration and tumor.

HYPOBIOTIC PROCESSES: atrophy, dystrophy, degeneration.

True hypertrophy and hyperplasia is expressed by a proportional increase in the parenchyma and other tissues of the organ. At the same time, functional activity increases. False hypertrophy (hyperplasia) is associated with the predominant proliferation of stromal elements, while the number of parenchymal cells may decrease with a decrease in function. Hypertrophy is also divided into physiological (working and replacement or vicarious) and pathological.

REGENERATIVE HYPERTROPHY (hyperplasia) develops when the cells of the remaining part of the organ increase after damage.

Correlative hypertrophy (hyperplasia) is observed in a system of organs connected by regulatory relationships (for example, hyperplasia and hypertrophy of the adrenal cortex with excess production of ACTH).

All of the listed types of hypertrophy and hyperplasia have an adaptive, compensatory value, however, with a possible outcome in some cases to decompensation (myocardial hypertrophy).

Sometimes there is hyprobiotic growth of tissues without any visible functional need (gigantism, acromegaly due to hyperproduction of growth hormone), and some types of congenital hypertrophies associated with disorders of embryonic development (ichthyosis) do not have a compensatory value.

VACATE HYPERTROPHY (hyperplasia) develops with a decrease in mechanical pressure on the tissue (joint tissue when releasing excess synovial fluid).

Regeneration (rebirth) - restoration of lost tissues and organs can be physiological and pathological. If physiological is the process of constant restoration of the epithelium and other cells of the body, then pathological regeneration is associated with the restoration of tissues after their damage. Connective and epithelial tissues regenerate better, muscle tissues are weaker. In nervous tissue, neuroglia have a high regenerative capacity.

In regenerating tissue, substances are formed that stimulate cell reproduction - damage products, proteases, polypeptides. The stimulating effect of leukocyte breakdown products (trephons) has also been revealed. The importance of the physiological ratio of hormones, along with the influence of the temperature factor, and adequate provision of amino acids and vitamins in the regeneration of nervous trophism has also been shown.

ATROPHY is the process of reducing cell volume; according to the development mechanism, it is divided into atrophy from inactivity, due to denervation (neurogenic) and atrophy due to prolonged compression of an organ or tissue.

A TUMOR is a pathological process characterized by the uncontrolled proliferation of cellular elements without the phenomena of their maturation.

TUMOR is a typical pathological process that is an unregulated, unlimited proliferation of tissue, not related to the general structure of the affected organ and its functions.

The set of characteristics that distinguish tumor tissue from normal tissue and constitute the biological characteristics of tumor growth is called atypia. Malignant tumors are characterized by both CELLULAR and TISSUE ATYPISM.

The following manifestations are noted:

1) the presence of interconnection between the membranes of various organelles;

2) “monotonicity” of the lipid structure of membranes;

3) reducing the effect of contact inhibition;

4) increasing membrane permeability.

Metabolic atypia. is expressed by the predominance of anaerobic breakdown of carbohydrates in tumor cells.

Immunological atypia. - the appearance in tumors of proteins that have antigenic significance for the host organism.

Malignant neoplasms as a medical and social problem. Prevention

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Malignant neoplasms as a medical and social problem

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