N.O. Saidakova, V.M. Grygorenko, A.P. Onyschuk, G.E. Kononova, V.I. Grodzinsky, V.M. Shylo

Kidney cancer: features of distribution and main indicators of specialized care effectiveness

The paper presents an analysis of official statistics on the incidence and prevalence of kidney cancer (KC) among the adult population of Ukraine and the Western region, as an example to identify certain territorial features and where about 22.4% of patients are concentrated. The main indicators of the results of providing specialized care to such patients were also studied. The main period was 2014-2018, the received data were compared with the previous five years. It was proved that both the incidence and the prevalence of pathology continue to grow in Ukraine and the Western region as a whole, with a similar rate against the background of slightly lower rates in the latter. The incidence rate is generally higher among males and significantly, as well as among females, did not differ in size. The prevalence rate is ahead of the incidence rate, which positively indicates the results of specialized care. Thus, the proportion of patients with newly diagnosed in stages I-II is gradually increasing, but it still remains quite high in stage IV - in every fourth in the country and the third in the region. This is partly due to the low percentage detected during professional examinations (up to 20%), the fluctuations of which have a negative trend. The consequence of the situation is the fact of practical stability of the dead up to a year from the time of diagnosis: in Ukraine in the range of 17-21.7%, in the region 18.3-23.7%. According to the positive trend, there is an increase in patients registered for і5 years; in 2018 to 61.7% and 61.4± 0.9% in Ukraine and the region, respectively. Up to 70% of patients with a first diagnosis receive special treatment. In its structure, the leading one is surgical (63.6±0.9% and 59.7±2.1 in the country and region); the percentage of complex or combined, which ranks second, accounts for 7.9% and 9.7%, respectively, it decreases across the country and increases in the region. Against the background of the general decrease in nephrectomies in Ukraine, their growth was observed in the case of KC everywhere. Every third and fourth operation, respectively, was performed in oblast-oncologic dispensaries. Over the years, postoperative mortality has decreased (by 21% to 1.23 in the whole country), in the region, in the absence of most oblasts, Lviv (by 2.4%) stood out in terms of size.

There has been proved the need to focus on the issues of early diagnosis of the disease, which is in the plane of searching new opportunities with the involvement of biomarkers, and organizational measures of various directions.