National Childhood Cancer Plan Prepared by the National Center of Pediatric Hematology, Oncology and Immunology and the National Society of Pediatric Hematologists and Oncologists as a New Successful Strategy

Abstract

Background and context: More than 4000 cases of pediatric cancer registered in Russia annually. Overall survival for pediatric cancer is about 80% and improved from 10% during last 25 years. Dmitry Rogachev National Medical Research Center of Pediatric Hematology, Oncology and Immunology (Center) and the National Society of Pediatric Hematologists and Oncologists (NSPHO) played a major role in this movement. Aim: Build new childhood cancer control plan based on close collaboration of 86 centers and departments of pediatric oncology. Strategy/Tactics: Plan is based on close collaboration between leading Center and NSPHO (representative of all centers) and supported by the government and the Ministry of Health. Plan developed as the result of analysis of strengths, weaknesses, threats and possible opportunities. Strengths: unique standards (guidelines and protocols) for pediatric cancer for all country with the financial governmental support, strong society (NSPHO), availability of modern technologies and rapid improvement of rehabilitation for children with cancer. Weaknesses: absence of national pediatric cancer registry, lack of high quality oncology nursing, comparable low publication activity. Opportunities: building of the national pediatric cancer registry, increasing of number of multicenter studies, implementation of the new technologies (cellular and gene therapy) and active educational activities based on international collaboration. Program/Policy process: Dmitry Rogachev Center in charge of pediatric hematology, oncology and immunology for Russia and NSPHO is key society. Strategy: scientific analysis and continuous improving of standards (guidelines and protocols) based on multicenter studies; building the morphologically-based national pediatric hematology/oncology registry; continuous development of professional standards for education and quality control; capacity building; scientific and educational activities (national meetings, schools for healthcare professionals, regional educational programs, Russian CME accreditation, outreach programs). Outcomes: Sixty guidelines were prepared, this work is continuing. Morphologic study for more than 13,000 children was made in Dmitry Rogachev Center (all suspicious cases controlled). New standards prepared and discussed. National telemedicine network formed (consulting, case registration, database updates, etc.). More than 5000 cases were consulted through this system in 2017. CME educational seminars (on/off-line) organized. About 12 regions of Russia visited annually with preparation of the report with proposals for improvement of regional service for children with cancer. What was learned: Success is based on close collaboration between Center, Society and Government (all aspects of pediatric cancer control from diagnostics to education covered). This experience could be implemented in the countries with post-Soviet model of healthcare.