PECULIARITIES OF MORTALITY DUE TO NEOPLASMS IN UKRAINE: WHAT ARE THE THREATS OF COVID- 19 PANDEMIC?

Анотація

The purpose of the study is to identify the features of the mortality regime from neoplasms in Ukraine, to make comparisons with selected countries in the WHO European Region, to identify challenges to public health and cancer services in connection with the COVID-19 pandemic and to hypothesize possible changes in mortality.The materials for the analysis were the data of official national statistics on mortality (State Statistics Service of Ukraine), data of the National Cancer Registry of Ukraine, and the European Health Information Gateway in the position "Neoplasms" ICD-10 codes: C00-D48. The method of standardization and comparative analysis was used.Comparative analysis in dynamics with individual countries (including with the states of the former socialist camp and the EU countries) revealed differences in mortality as a result of neoplasms in Ukraine, both in terms of the value of indices and their share in the structure, and in the direction of their changes since Ukraine gained independence. The most significant differentiation is observed in the average working age and in older age groups. In Ukraine the age-standardized death rate aged 30-44 is by 1.8 times higher, and at the age of over 75 years - is more than twice (by 2.3 times) lower than in the EU members before May 2004. Moreover, the indices in the group of 30-44 years have increased since 1991, in contrast to the decrease at the age of over 75 years.A feature of Ukraine is a small share in the structure of mortality among older people (12.3% of deaths at the age of 75-79 and 2.45% at the age of 85+, while diseases of the circulatory system account for more than 80% of deaths). Ukraine is also characterized by high mortality rates, which can be prevented: avoidable mortality. Thus, the mortality rate of Ukrainian women from cervical cancer increased before reaching 65 years of age (while in the EU-15 it decreased by more than a third), and the difference in indices in 2017 increased and reached more than four times.The deterioration of the epidemiological situation caused by the COVID-19 pandemic was manifested by a decrease in the detection rate of new cases of the disease; a decrease in the proportion of neoplasms detected at an early stage; changes in the incidence/mortality ratio, etc.). A probable increase in the mortality rate as a result of neoplasms and their share in the structure of mortality in the coming years, while ignoring the existing risks, is predicted.Awareness of the deterministic challenges of the COVID-19 pandemic for public health in general and the oncological service in particular is necessary to organize adequate measures to improve the fight against cancer (minimize interruptions in the provision of cancer care, establish work in new conditions, state control over the provision of medicines and equipment, increase the awareness and skills of health care providers in the early diagnosis of cancer; and the health literacy of the population).

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