Survival of patients with colon cancer before and after implementation of the National project “Health” in the Arkhangelsk Region, Northwest Russia: a registry-based study

Valkov, Mikhail

Survival of patients with colon cancer before and after implementation of the National project “Health” in the Arkhangelsk Region, Northwest Russia: a registry-based study

Tuesday, 19 August 2014

Exhibit hall (Dena'ina Center)

Lyudmila Lebedeva , Northern State Medical University, Arkhangelsk, Russia

Sergey Asakhin , Northern State Medical University, Arkhangelsk, Russia

Mikhail Levit, PhD , Northern State Medical University, Arkhangelsk, Russia

Z Manambaeva, PhD , Semey State Medical University, Semey, Kazakhstan

As Masadykov , Semey State Medical University, Semey, Kazakhstan

MT Kuderbaev , Semey State Medical University, Semey, Kazakhstan

Dinara Ospanova , Institute of Postgradual Edication of Physicians (AGIUV), Almaty, Kazakhstan

Andrej M Grjibovski, PhD , Northern State Medical University, Arkhangelsk, Russia

Mikhail Valkov, PhD , Northern State Medical University, Arkhangelsk, Russia

INTRODUCTION: Colon cancer (CC) is one of the most common cancers worldwide. The incidence of CC in the North of Russia is above the national level and is increasing. The national project “Health” was initiated in 2007 to improve primary health care and could therefore increase the proportion of detection of CC at early stages in Russia and thus decrease mortality. The aim of the study is to assess whether survival of CC patients improved in Russia after initiation of the National project “Health”.

METHODS: Data on all cases of CC (ICD 10 code: C18) were obtained from the Arkhangelsk Regional Cancer Registry for the period 2000-2011. One- and five-year observed survival was calculated using life-tables. The difference in survival before and after initiation of the National project “Health” was studied using Cox regression with adjustment for stage at diagnosis, patient’s age, gender and place of residence.

RESULTS: Altogether, there were 3049 cases of and 1944 deaths from CC in 2000-2011. One- and five-year survival increased from 51.3% and 28.1% in 2000-2006 to 52.5% and 30.6% in 2007-2011, respectively. Unadjusted analysis showed a significant increase in the overall survival after initiation of the project (Crude HR=0.89, 95%CI: 0.81-0.97). After adjustment for sex, age, and stage the estimates changed only marginally (Adjusted HR=0.88, 95% CI: 0.80-0.96). In the multivariable Cox model, time period remained the only parameter associated with survival.

CONCLUSIONS: Better survival of patients with CC after the start of the National project “Health” in the Arkhangelsk region was observed. This improvement is however unlikely to be attributed to detection of CC at earlier stages.