Risk factors for late detection of cancer in the female reproductive system

Abstract

BACKGROUND: The pressing issue of the primary diagnosis of oncopathology in later stages of cancer hinders effective implementation of treatment and rehabilitation measures and leads to the disability of the patient. In this aspect, the crucial factor lies in the population’s engagement to medical organizations for examinations according to the road map for the prevention of socially significant diseases.

OBJECTIVE: The study aimed to investigate the risk factors for late detection of cancer of the female reproductive system based on the results of a survey on contingents of women with diagnosed cancer of three localizations (cancer of the ovaries, body, and cervix) in the Chechen Republic.

MATERIALS AND METHODS: Sample: Female patients diagnosed with cancer of the reproductive system (299 women). Observation units: patients diagnosed with ovarian cancer, uterine body cancer, and cervical cancer. Research base: Republican Oncological Dispensary, Grozny. Research design: face-to-face individual questionnaire survey (2020–2022). Research methods: Initially, survey, statistical, and graphical analysis of the data was conducted. Finally, ranking of risk factors for detection of the disease at late stage and the construction of a decision tree.

RESULTS: The key factors with an increase in the risk of late diagnosis of cancer of the female reproductive system to 100.0% were the diagnosis of ovarian cancer, the absence of vaginal discharge outside of menstruation/in menopause, an increase in the size of the abdomen, and late treatment (100.0% absolute risk). In the contingent diagnosed with ovarian cancer, all cases were detected late, while in 22.7% of cases aggregate of patients presented two other nosologies. Among patients who did not notice an increase in the abdomen, late diagnosis of cancer was noted in 26% of patients. Conversely, among those who noted this change, all cases were diagnosed at an advanced stage (p <0.05). Regarding the target indicator “The disease was detected at a late stage” seven risk classes were identified (risk from 7.5% to 100.0%). The high-risk class was characterized by a combination of factors: “Noted pain in the lower abdomen during intercourse (No),” “Blood relatives revealed tumor diseases (No),” and “I noticed an increase in the size of the abdomen (Yes)” (100.0% risk).

CONCLUSION: The relevance of the problem of oncogynecology is associated with the need for extensive educational work among the female population with an emphasis on the need for active participation in preventive examinations. Justifying the use of the strategy of “coercion to health” is essential in identifying risk factors and cancerous lesions of the organs of the female reproductive system in the early stages. This will prevent the progression of the malignant tumors and will contribute to effective medical and social prevention of disability.

Keywords

cancer / ovaries / body of uterus / cervix / survey / questionnaire / disability / late appeal / risk / decision tree

References

[1] Gordienko VP, Leont’eva SN, Korobkova TN. Cancer of the reproductive organs in women of the Far Eastern Federal District. Siberian journal of oncology. 2020;19(3):23–37. (In Russ). doi: 10.21294/1814-4861-2020-19-2-23-37

[2] Гордиенко В.П., Леонтьева С.Н., Коробкова Т.Н. Рак репродуктивных органов у женщин Дальневосточного федерального округа // Сибирский онкологический журнал. 2020. Т. 19, № 3. С. 23–37. doi: 10.21294/1814-4861-2020-19-2-23-37

[3] Armstrong DK, Alvarez RD, Bakkum-Gamez JN, et al. Ovarian cancer. NCCN Clinical Practice Guidelines in Oncology, version 2. 2020. Natl Compr Canc Netw. 2021;19(2):191–226. doi: 10.6004/jnccn.2021.0007

[4] Armstrong D.K., Alvarez R.D., Bakkum-Gamez J.N., et al. Ovarian cancer. NCCN Clinical Practice Guidelines in Oncology, version 2. 2020 // J Natl Compr Canc Netw. 2021. Vol. 19, № 2. P. 91–226. doi: 10.6004/jnccn.2021.0007

[5] Emons G, Steiner E, Vordermark D, et al. Interdisciplinary diagnosis, therapy and follow-up of patients with endometrial cancer. Guideline (S3-Level, AWMF Registry Number 032/034-OL, April 2018) ― Part 2 with Recommendations on the therapy and follow-up of endometrial cancer, palliative care, psycho-oncological/psychosocial care/rehabilitation/patient information and healthcare facilities. Geburtshilfe Frauenheilkd. 2018;78(11):1089–1109. doi: 10.1055/a-0715-2964

[6] Emons G., Steiner E., Vordermark D., et al. Interdisciplinary diagnosis, therapy and follow-up of patients with endometrial cancer. Guideline (S3-Level, AWMF Registry Number 032/034-OL, April 2018) — Part 2 with Recommendations on the therapy and follow-up of endometrial cancer, palliative care, psycho-oncological/psychosocial care/rehabilitation/patient information and healthcare facilities // Geburtshilfe Frauenheilkd. 2018. Vol. 78, № 11. P. 1089–109. doi: 10.1055/a-0715-2964

[7] Shabad LM. About the WHO expert meeting on the morphological definition of precancerous. Problems in oncology. 1973;19(4):117–8. (In Russ).

[8] Шабад Л.М. О совещании экспертов ВОЗ по морфологическому определению предрака // Вопросы онкологии. 1973. Т. 19, № 4. С. 117–8.

[9] Sukhikh GT, Ashrafyan LA, Kuznetsov IN. Early Diagnosis of the Most Common Female Reproductive Cancers: Challenges and Prospects. Doctor.Ru. 2018;146(2):6–9. (In Russ).

[10] Сухих Г.Т., Ашрафян Л.А., Кузнецов И.Н. Ранняя диагностика основных локализаций рака органов репродуктивной системы у женщин: проблемы и перспективы // Доктор.Ру. 2018. № 2 (146). С. 6–9.

[11] Sobivchak MS, Protasova AE, Raskin GA, et al. Malignant transformation of endometrial hyperplastic processes: immunohistochemical features. Tumors of female reproductive system. 2022;18(3):89–99. (In Russ). doi: 10.17650/1994-4098-2022-18-3-89-99

[12] Собивчак М.С., Протасова А.Э., Раскин Г.А., и др. Злокачественная трансформация гиперпластических процессов эндометрия: иммуногистохимические особенности // Опухоли женской репродуктивной системы. 2022. Т. 18, № 3. С. 89–99. doi: 10.17650/1994-4098-2022-18-3-89-99

[13] Chien J, Poole EM. Ovarian Cancer Prevention, Screening, and Early Detection: Report From the 11th Biennial Ovarian Cancer Research Symposium. Int J Gynecol Cancer. 2017;27(9S Suppl 5):S20–S22. doi: 10.1097/IGC.0000000000001118

[14] Chien J., Poole E.M. Ovarian Cancer Prevention, Screening, and Early Detection: Report From the 11th Biennial Ovarian Cancer Research Symposium // Int J Gynecol Cancer. 2017. Vol. 27, № 9S Suppl 5. Р. S20–S22. doi: 10.1097/IGC.0000000000001118

[15] Fan Z, Li H, Hu R, et al. Fertility-preserving treatment in young women with grade 1 presumed stage IA endometrial adenocarcinoma: a meta-analysis. Int J Gynecol Cancer. 2018;28(2):385–93. doi: 10.1097/IGC.0000000000001164

[16] Fan Z., Li H., Hu R., et al. Fertility-preserving treatment in young women with grade 1 presumed stage IA endometrial adenocarcinoma: a meta-analysis // Int J Gynecol Cancer. 2018. Vol. 28, № 2. Р. 385–93. doi: 10.1097/IGC.0000000000001164

[17] Kaprin AD, Starinsky VV, Shakhzadova AO, editors. Malignant neoplasms in Russia in 2020 (morbidity and mortality). Moscow: Hertsen MORI; 2021. 252 p. (In Russ).

[18] Злокачественные новообразования в России в 2020 году (заболеваемость и смертность) / под ред. А.Д. Каприна, В.В. Старинского, А.О. Шахзадовой. Москва: МНИОИ им. П.А. Герцена, 2021. 252 с.

[19] Idrisova LS, Suleymanov EA, Puzin SN, Shurgaya MA, Memetov SS. Ovarian cancer in the regional aspect of cancer care in Russia. Bulletin of the All-Russian Society of Specialists in Medical and Social Expertise, rehabilitation and rehabilitation Industry. 2022;(1):60–8. (In Russ).

[20] Идрисова Л.С., Сулейманов Э.А., Пузин С.Н., Шургая М.А., Меметов С.С. Рак яичников в региональном аспекте оказания онкологической помощи в России // Вестник Всероссийского общества специалистов по медико-социальной экспертизе, реабилитации и реабилитационной индустрии. 2022. № 1. С. 60–8.

[21] Shurgaya MA. Malignant neoplasms: age-related features of the epidemiology of primary disability in the Russian Federation. Russian Journal of Oncology. 2016;21(6):319–324. (In Russ). doi: 10.18821/1028-9984-2016-21-6-319-324

[22] Шургая М.А. Злокачественные новообразования: возрастные особенности эпидемиологии первичной инвалидности в Российской Федерации // Российский онкологический журнал. 2016. Т. 21, № 6. С. 319–324.

[23] National project “Health care”: federal project “Fight against oncological diseases”. Approved December 24, 2018 (implementation period 2019–2024). Available from: http://government.ru/. Accessed: 28.01.2022. (In Russ).

[24] Национальный проект «Здравоохранение»: федеральный проект «Борьба с онкологическими заболеваниями». Утверждён 24 декабря 2018 г. (срок реализации 2019–2024 гг.). Режим доступа: http://government.ru/. Дата обращения: 28.01.2021.

[25] Nechushkina VM, Dengina NV, Kolomiets LA, et al. Practical recommendations for the treatment of uterine body cancer and uterine sarcomas. Malignant Tumors: Practical recommendations of RUSSCO #3s2. 2018;8(3S2):190–203. (In Russ). doi: 10.18027/2224-5057-2017-7-3s2-168-180

[26] Нечушкина В. М., Деньгина Н. В., Коломиец Л. А., Кравец О. А., Морхов К. Ю., Новикова Е. Г., и др. Практические рекомендации по лечению рака тела матки и сарком матки // Злокачественные опухоли: Практические рекомендации RUSSCO #3s2. 2018. Т. 8. С. 190–203. doi: 10.18027/2224–5057–2017–7–3s2–168–180

[27] Singh S, Resnick KE. Lynch Syndrome and Endometrial Cancer. South Med J. 2017;110(4):265–269. doi: 10.14423/SMJ.0000000000000633

[28] Singh S., Resnick K.E. Lynch Syndrome and Endometrial Cancer // South Med J. 2017. Vol. 110, № 4. P. 265–269. doi: 10.14423/SMJ.0000000000000633

[29] Serov VN. Hormonal and Metabolic Changes in Proliferative Processes and Precancerous Lesions of the Female Reproductive Organs. Doctor.Ru. 2018;146(2):11–14. (In Russ).

[30] Серов В.Н. Гормонально-метаболические изменения при пролиферативных процессах и предраке женских половых органов // Доктор.Ру. 2018. Т. 146, № 2. С. 11–14.

[31] Ashrafyan LA, Novikova EG, Tyulandina AS, Urmancheeva AF, et al. Cervical cancer. Clinical recommendations, 2020. Moscow: All-Russian National Union “Association of Oncologists of Russia”, Scientific Council of the Ministry of Health of the Russian Federation; 2019. 56 p. (In Russ).

[32] Ашрафян Л.А., Новикова Е.Г., Тюляндина А.С., Урманче-ева А.Ф., и др. Рак шейки матки. Клинические рекомендации, 2020. Москва: Общероссийский национальный союз «Ассоциация онкологов России», Научный совет Министерства здраво-охранения Российской Федерации, 2019. 56 с.

RIGHTS & PERMISSIONS

Eco-Vector