ANALYSIS OF THE MEDICAL ASSISTANCE ORGANIZATION FOR PATIENTS WITH ONCOLOGICAL AND PRECANCEROUS DISEASES OF THE STOMACH

Анотація

Cancer prevention is a rather difficult task for the oncology service and the state. Preventionin oncology is a complex system of measures aimed at preventing the occurrence of malignanttumors and their progression. But at the same time, the experience of economicallydeveloped countries, in particular Japan, where the incidence rate is one of the highest inthe world, shows that modern medical technologies make it possible to diagnose malignantneoplasms of the stomach (MNS) in the early stages, using screening programs.The purpose of the study – to identify shortcomings in the organization of prevention andmedical care, in particular regarding early detection and prevention of malignancy ofprecancerous diseases in gastric cancer (PCDG).Materials and methods. Analytical retrospective epidemiological medico- sociologicalstudy of a representative number of patients with malignant neoplasms of the stomach –130 patients of the main group and 50 people with precancerous diseases of the stomachof the comparison group was conducted with the aim of in-depth study of the organizationof medical care for patients.Results. It was found that the complete coverage of patients with gastric cancer by dispensaryobservation in 2016-2020 increased both in Ukraine (up to 84.0%) and in the Chernivtsi region(92.1%), but the specific weight of those who was registered for more than five years, althoughit also increased somewhat, remained significantly lower (59.5% and 69.8%, respectively).It has been proven that the absence of dispensary monitoring for precancerous diseasesof the stomach significantly increases the chances of their malignancy (OR=29.18;95%CI=11.60-73.40), but only 18.2% of such patients were registered. Respondents withprecancerous diseases of the stomach also showed insufficient adherence to the medicaltreatment, mainly due to financial motives (21.00; 2.51-175.70) and the prescribed diet,non-compliance of which also contributes to malignancy (4.73; 2.15-10,40).Conclusions. The main risk factors for the transformation of precancerous diseases of thestomach directly into cancer are failure to consult doctors, primarily PMD, both aboutthe disease and screenings, and especially – about dynamic monitoring, as well as lowadherence to recommendations for drug treatment and diet.

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