N.O. Saidakova, V.M. Grygorenko, L.V. Pereta

The importance of territorial features of problems of kidney cancer to improve the efficiency of providing specialized care therefore

The research presents the state of the kidney cancer (KC) problem in Ukraine in terms of comparison with the Central region, where one fifth of the total number of registered patients is concentrated. It was evaluated according to the data of epidemiology and the main indicators of the effectiveness of specialized care. The study period 2014-2018, the primary material was the official statistical reporting forms. When analyzing the obtained results, both the similarity and the difference of the data for Ukraine and the Central region, in particular, are traced. Thus, the annual increase in patients with KC was 4.0 ± 0.4% and 4.2 ± 0.8%, respectively, for 5 years their growth was 17.3 and 19.5%. In 2018, there were 38,898 patients in Ukraine. The prevalence rate (per 100,000 inhabitants) increased in Ukraine by 19.1% to 92.1 and by 21.4% to 103.2 ± 1.5 in the region. At the same time, there are more patients with a new diagnosis (by 5.2% to 4695 and 6.5%, respectively), with more men (by 5.3% to 2691) in the country and women in the region (by 8.4%). The incidence rate (per 100,000 people) is everywhere higher among men, in the region the rates of both sexes are higher than the average Ukrainian. Over 5 years, the level increased in Ukraine as a whole by 6.7% to 11.1 among men by 6.5% to 13.8, women by 6.0% to 8.8, while in the region - by 6.5 %, 3.9%, 11.7% to 13.0 ± 0.7; 16.0 ± 1.1 and 10.5 ± 0.4. The negative tendency of KC stages among patients with the first established diagnosis is revealed. If in Ukraine the percentage of IV cases stabilized (21.8%) with a slight increase in I-II (by 2.6% to 56.5%), in the region the first increased by 32.3% (to 24.3 ± 3,6%), and the second decreased by 2.6% (to 56.8 ± 1.1%). At the same time, at professional examinations in Ukraine, patients are stable at just over 20.0%, and in the region only 16.2 ± 3.0% with a decrease of 11.1% over 5 years. Almost one in five in Ukraine and, in particular, in the region, dies within a year of diagnosis. The fact of an increase of 9.6% in Ukraine and 12.1% in the region of patients registered for і5 years (up to 61.7%) is positive. This is due to an increase in patients receiving special treatment (by 5.6% and 3.8%, respectively). The difference was manifested in the growth of surgical care in Ukraine in its structure (by 7.2%), including nephrectomies (by 1.6%), while in the region the indicators became lower by 4.3% and 13.8%, respectively. Mortality in Ukraine from KC, which is twice as high among men everywhere, has stabilized at 5,390 per 100,000 people, with a decrease in men (by 1.5%) and an increase in women (by 2.6%); features by place of residence - in the growth among rural residents is 4 times more intense than among women and the decrease in urban areas is more intense among men. In the region, a significant increase (by 6.1% to 6.24 ± 0.3) of the indicator occurred only at the expense of men (by 13.6% to 9.66 ± 0.4), among the rest of the population there was a decrease with varying intensity.