Level Of Federal Districts Research Articles

Analysis on the dynamics and structure of scientific and innovation-information development indicators of the Russian federal districts

The factor of scientific and innovation-information development of the country has a significant impact on the level of its economic security. The article presents an analysis of science, innovation and information systems development in Russia, as they are one of the most important factors of the economic security of the state. An assessment of the leading and lagging regions in terms of innovation activity of organisations and volume of research and development was made. Also, directions for development were identified which require additional detailed study of science, innovation and information systems development at the level of federal districts with respect to their specific features and implementation of national projects. The obtained data are the basis for further assessment of the Russian economic security level within the framework of the National Security Strategy.

Analysis of factors stimulating the development of competition at the level of federal districts of the Russian Federation

Analysis of factors stimulating the development of competition at the level of federal districts of the Russian Federation

The state of oncology care in Russia: children (0–14 years old), morbidity, mortality, year-by-year lethality (populated study at the federal district level). Part I

Relevance. Malignant tumors among the children’s population is a relatively rare phenomenon. In the USSR, the form of state reporting for the analysis of morbidity provided for the collection of data in the first age group totaling from 0 to 29 years. Indeed, in this age group, malignant tumors are rare 10–15 cases per 100,000 children. Then, after the 35-year-old group, the risk of cancer increases by 10 % every year, and a five-year period gives an increase in the incidence rate by 50–70 %. The probability of malignant tumors in younger age groups differs hundreds of times from those who have reached the age of 70. In accordance with World Health Organization – IARC recommendations, the data in IARC monographs are summarized for 5-year-old age groups 0–4, 5–9, 10–14, 15–19, etc. The last open interval is 85+.Prepared by the staff of the Laboratory of Oncological Statistics and the Children’s Department of the N.N. Petrov National Medical Research Center of Oncology together with Novel LLC, the completed topic of scientific development of the population children’s cancer registry at the federal district level, transmitted and accepted by the Ministry of Health of the Russian Federation, turned out to be unclaimed.In February 2019, we formed a unified database of the Northwestern Federal District with a volume of more than 1 million 350 thousand observations, which made it possible to carry out a more detailed development of data on rare localizations: cancer of the heart, eye, thymus, including rare tumors that occur among children population (0–14 years old) and adolescents (15–17 years old). The purpose of the study is to study the patterns of dynamics of morbidity, mortality, the reliability of accounting for sick children (0–14 years old) at the population level, to calculate the survival rates of patients with all tumor localizations, taking into account gender, age, stage of the disease, histological forms and other parameters included in the registration form card (in accordance with the international standard of the Eurocare program). Results. From 2000 to 2018, 4970 children (0–14 years old) with malignant tumors were registered in the Northwestern Federal District of the Russian Federation, of which 3011 are subject to the staging of the tumor process. It is important to note that among all children of patients with malignant tumors, the five-year survival rate of stageable and non-stageable patients was close to 80 %. There is a high level of staging of patients of this group. Thus, patients with stage I of the disease had a five-year survival rate (2010–2014) – 96.3 %, with II – 91.0 % and only with stage IV – 50.9 %.Conclusions. The creation of a children’s population cancer registry at the federal district level could significantly raise the level of primary registration of malignant tumors, eliminate losses and be able to calculate analytical indicators for rare childhood localization of malignant tumors.

НОВЫЕ ЗАДАЧИ ПОДГОТОВКИ КАДРОВ ДЛЯ ЛЕСНОГО ХОЗЯЙСТВА

The article deals with the issues of training personnel for forestry. The predicted need for forest personnel has been established. The annual need for highly qualified specialists is comparable to the volume of state-funded places taught by forestry universities, technical schools and colleges within the admission target. The complex nature of forestry work, their high labor intensity, combined with the impact of natural and climatic risks on the process of labor activity, reduce the attractiveness of forestry professions for graduates. The greatest shortage of personnel is formed in institutions that protect forests from fires. An increase in the number of forest firefighters is possible when the profession "Forest Firefighter" is included in the List of occupations of workers, positions of employees for which vocational training is carried out in educational organizations. For the accelerated training of forest firefighters and volunteer firefighters, it is necessary to organize innovation and educational centers at the level of federal districts.

Morbidity, mortality, reliability of accounting, survival of patients with malignant neoplasms (ZNO) in Russia. The impact of the SARS-CoV-2-betacoronavirus coronavirus epidemic (population study at the federal district level)

Since the second half of the twentieth century, active events have been held in our country and around the world to study the prevalence of cancer, form specialized medical institutions to provide necessary help to cancer patients. Over the following decades, a steady increase in the number of primary patients was observed, and a gradual decrease in mortality was observed, associated with the successes of anti-cancer measures. The outbreak of pneumonia in December 2019, caused by the seventh newly discovered SARS-CoV-2-beta coronavirus, quickly spread to all continents. At the first stage of the pandemic, panic was observed, outpatient and even specialized hospitals were closed. This had a significant impact on the organization of oncological services, in particular on the incidence, mortality of the population and the survival of cancer patients.
 The aim of the study was to determine the impact of the newly emerged virus on the organizational problems of the oncological service, primarily on the incidence, mortality of the population and the survival of cancer patients.
 Materials and methods data of state reporting, data of the Federal State Statistics Service on the deceased, database of cancer registries of St. Petersburg and the South-West Federal District of the Russian Federation.
 The results of the study showed the need for a thorough study of the problems of the development of cancer registries, determined the negative impact of the pandemic on the incidence of cancer, identified the maximum damage by localization, age groups and administrative territories of Russia. It was found that in general, the country had an undercount of about 100,000 cancer patients, and the quality of primary registration decreased by 13%. The greatest damage to the primary patients was caused to the elderly and elderly, especially in localities with a low mortality rate. A stable increase in one-year and five-year survival of cancer patients was revealed, as well as a negative (by 6%) decrease in one-year survival from 2019 to 2020. More complex conditions for maintaining databases for rural populations were identified.

The state of cancer care in Russia: one-year survival rate of patients with malignant neoplasms and first-year mortality rate for cancer of any site. (Population study at the federal district level)

Наиболее объективным критерием оценки деятельности онкологической службы является показатель выживаемости, исчисленный по международным стандартам на базе данных тщательно выверенного Популяционного ракового регистра. Уровень стандартизованных показателей заболеваемости населения злокачественными новообразованиями (ЗНО) в России и Северо-Западном федеральном округе Российской Федерации (СЗФО РФ) различаются на 4,26% (в пределах статистической погрешности, что позволяет нам перевести итоги нашего исследования на всю Россию. Население СЗФО РФ в 2022 году составило 13,9 млн. человек, что соответствует населению Белоруссии, Латвии и Литвы вместе взятых. Впервые в России на материале базы данных популяционного регистра (БД ПРР) СЗФО РФ исчислены показатели однолетней и пятилетней выживаемости по всем трехзначным рубрикам МКБ-10 плюс 13 сгруппированным рубрикам, как это принято в отчетах (форма №7) для анализа динамики заболеваемости и смертности населения от ЗНО. Цель исследования: на обширном выверенном материале БД ПРР СЗФО РФ представить анализ деятельности онкологической службы региона на основе расчета динамики показателей наблюдаемой выживаемости больных 71 локализации опухолей. Материалы и методы. Материалом явилась БД ПРР СЗФО РФ объемом более 1 млн. 150 тыс. наблюдений, использована методология расчета показателей выживаемости по программе Eurocare. Полученные результаты. Проведенное сравнение уровней показателей однолетней выживаемости больных ЗНО за два периода наблюдения (1995-1999 и 2015-2019) выявило рост однолетней наблюдаемой выживаемости с 63,8 до 71,0, т.е. на 11,29%, соответственно снижение одногодичной летальности по региону составило с 36,2 до 29,0%. Наибольшие успехи достигнуты (прирост однолетней выживаемости более 25%) для ЗНО печени (С22), тонкого кишечника (С17), желчного пузыря (С23, 24), рото- и гортаноглотки (С10, 12, 13). Более 10% прирост однолетней выживаемости пришелся на ЗНО языка (С01, 02), пищевода (С15), предстательной железы (С61), плаценты (С58) и ободочной кишки (С18). При среднем показателе (С00-96) – 11,29%. По многим локализациям ЗНО, выявлены более скромные успехи. По ведущим локализациям опухолей прирост этого показателя составил для рака желудка +5,5; рака легкого +2,7; рака прямой кишки +4,7; меланомы кожи +3,8; рака шейки матки +2,5. Однолетняя выживаемость больных раком тела матки и раком поджелудочной железы остались без изменений, по ряду локализаций (С51, С81-96, С60, С07-08, С00 и С70-72) отмечено снижение показателя от -2 до -9%. Пятилетняя наблюдаемая выживаемость возросла с 42,9% в 1995-1999г. до 47,1% в 2010-2014 году или на 9,8%. Относительная однолетняя выживаемость была на 1-2% выше, пятилетняя кумулятивная относительная выживаемость на 5-7% выше. Прирост показателя пятилетней выживаемости больных ЗНО произошел по многим локализациям опухолей и системным новообразованиям лимфатической и кроветворной ткани, но в существенно меньших объемах по сравнению с однолетней выживаемостью. По 20 локализациям пятилетняя выживаемость больных ЗНО уменьшилась, в первую очередь по опухолям головного мозга, поджелудочной железы, пищевода, желудка, легких и некоторых других. Заключение и выводы. Проведенное популяционное исследование показало улучшение проводимых мероприятий противораковой борьбы, существенный рост показателя однолетней выживаемости и рост показателя пятилетней выживаемости. К проценту прироста-убыли показателя надо относиться критически с учетом её реальной величины на исходном уровне. По ряду локализаций уже ранее были достигнуты высокие уровни выживаемости больных, в связи с чем величина прироста показателя может быть скромной. Это в первую очередь относится к новообразованиям щитовидной железы, мочевого пузыря, яичка, меланомы кожи, глаза, тела матки, губы, системных новообразований лимфатической кроветворной ткани.

STARTUP: META-ANALYSIS, VIABILITY ASSESSMENT, FORMATION OF CONDITIONS FOR THE DEVELOPMENT OF IDEAS IN THE EDUCATIONAL SPHERE

The purpose of the article is the theoretical systematization of scientific approaches to the development of startup projects as a possibility of obtaining a commercialized effect based on combined implementation tools. The article presents a meta-analysis of evolutionary ideas about the development of startup projects in the global space from the standpoint of marketing, team-building, venture and innovative approaches. The directions of research on the formation of the startup environment are summarized: the construction of innovative business models, conditions for the creation of startup teams, the mechanism of venture investment of a startup, the implementation of startup solutions in the post-pandemic period of COVID-19. The author’s scheme for the implementation of projects in the startup format with the possibility of entering the stage of commercialization has been developed. The analysis of the forms of organization of startups in the form of small innovative enterprises in the educational environment is carried out, the dynamics of the development of startup ideas at the level of federal districts is presented. The key directions of support and development of startups in the educational environment are proposed – infrastructural, innovative, investment, partnership, economic, social. The results of the study can be used in updating strategic plans for the development of educational institutions as an additional source of investment profits and effective capital investments, as well as by executive authorities as an addition to the regional development strategy of the subject of the Russian Federation.

Spatial Organization of Inter-Municipal Cooperation in Russia

Unlike the world experience, in Russia during the years of local government reform, inter-municipal cooperation has not become a landmark element of the regional planning system. Using methods of economic and statistical analysis we have analyzed the prerequisites for the introduction and forms of inter-municipal cooperation and examined its mechanism. In recent decades, inter-municipal cooperation in Russia has been developing within the framework of non-commercial associative and contractual forms focusing mainly on socio-economic problems, joint protection, and defense of general municipal interests before public authorities. Organizational and economic forms of cooperation did not receive proper incentives for development. A comparative analysis of indicators of the state of commercial forms of inter-municipal cooperation at the all-Russian and federal district levels allowed identifying three models of participation of municipalities at the federal district level in inter-municipal commercial organizations. The municipalities of the Northwestern, Southern, and Far Eastern Federal Districts are most actively involved in the activities of inter-municipal commercial organizations where the share of municipalities participating in inter-municipal commercial organizations is higher than the average Russian parameters. The study found that there is no obvious correlation between the level of economic development of the subject of the Federation and the degree of participation of its municipalities in inter-municipal commercial organizations. The study identified the directions of improving the inter-municipal cooperation, the possibility of using foreign experience, and the directions of improving the statistical accounting of cases of inter-municipal cooperation.

The state of cancer care in Russia: cancer of the small intestine (C17). Survival of patients, median survival, survival of patients according to tumor localization, histological pattern and stage of the disease (Population study at the federal district level). Part II

Background. Small intestine cancer is extremely rare cancer worldwide with an incidence of less than 1.0 per 100,000 population. In 2020, 1,711 cases of small intestine cancer were recorded in Russia, including 781 cases among the male population, and 930 among the female population. It should be noted that in Russia, despite the decrease in the total number of new cancer cases associated with the coronavirus epidemic, the number of patients with small intestine cancer increased by 4.14 % from 2019 to 2020. In the Northwestern Federal district of the Russian Federation, 216 patients with newly diagnosed small intestine cancer were registered in 2020, (29 more patients than in the previous year). The purpose of the study was to analyze the efficiency of small intestine cancer care provision based on of the database of the population cancer Registry (db pcr) of the Northwestern Federal district of the Russian Federation, with an assessment of one- and five-year survival rates. Material and methods. To calculate the survival rates for patients with small intestine cancer, we selected 1922 patients from the database of the pcr of the Northwestern Federal district of the Russian Federation, for the period from 2000 to 2018. Standard methods for calculating survival rates according to the eurocare program were used. Results. The one-year survival rate of small intestine cancer patients increased from 50.0 % to 61.1 % from 2000 to 2018, and the five-year survival rate remained almost unchanged. The relative one-year survival rate of patients was 2.0 % higher. The five-year survival rate for five-year cohorts indicates defects in staging of small intestine cancer rather than an improvement in patient care; although this rate increased from 31.5 to 32.9 %. The histological detail of small intestine cancer according to the icd-10 was investigated. Conclusion. The study confirmed the high mortality rates and modest survival benefits in survival rates in patients with small intestine cancer. Defects in the distribution of patients by disease stages were revealed. The most common histological types of small intestine cancer with calculations of patient survival were identified.

The state of cancer care in Russia: cancer of the small intestine (C17). morbidity, mortality, index of accuracy, annual mortality (population study at the federal district level). Part I

Relevance. Small intestine cancer is extremely rare cancer among the Russian population with the incidence of less than 1 per 100,000 populations. in 2019, 1,643 cases of small intestine cancer were recorded in Russia, including 750 cases among the male population, and 893 among the female population. only since 2011 state statistics provides for the inclusion of primary cases of small intestine in a separate line in the state report form № 7. in 2019, none of the small intestine cancer cases was registered in four administrative territories of Russia, and only one case was registered in 13territories among the female population. in the North-Western Federal district (NWFD) of the Russian Federation, 187 primary cases of small intestine cancer were diagnosed in 2019; the standardized incidence rates were 0.91 and 0.57 0/0000 for men and women, respectively. more than 1,200 people die from small intestine cancer annually in Russia, and approximately 130 people die from this cancer in the Northwestern Federal district of the Russian Federation. the standardized mortality rates among the population of Russia and the Northwestern Federal district of the Russian Federation for men and women are 54 and 0.58 per 100,000 and 0.33 and 0.37 per 100,000, respectively. The purpose of the study was to analyze small intestine cancer incidence and mortality rates in the population of Russia. Material and methods. The population-based cancer registries of IARC, P.A. Herzen institute of oncology, N.N. Petrov Research institute of oncology as well as the population-based cancer registries of the Northwestern Federal District of the Russian Federation were used. Standard methods of oncology statistics were used. Results. the study, for the first time in Russia, made it possible to estimate the prevalence of small intestine cancer, which is much less common in Russia than in the USA and in other economically developed countries. Conclusion. In females, a significant decrease in standardized mortality rates of small intestine cancer was revealed. in males, this rate remained almost unchanged. a positive dynamics of annual mortality rates, especially within the first year of follow-up, was found.

Situation with cancer care in Russia. Kidney cancer (median survival, cumulative survival, and survival of patients depending on their disease stage). Population-based study at the federal district level. Part 2

Background. In the first part of our study, we described the dynamics of kidney cancer (С64) incidence and mortality, as well as reliability of kidney cancer surveillance in Russia. This study analyzed the effectiveness of cancer control measures in Russia by assessing patient survival using the data form the newly developed Population-based cancer registry of the North-Western Federal District.Materials and methods. We used the data from the Population-based cancer registry of the North-Western Federal District of Russia that has more than 1,350,000 records, including 35,629 kidney cancer patients. Standard methods of the European Network of Cancer Registries (EUROCARE program) were used for data processing and analysis.Results. Our findings confirmed that kidney cancer is characterized by a low death rate. Over the last 18 years, median survival of kidney cancer patients in the North-Western Federal District of Russia increased form 4 years to 6.5 years. The 1-year survival rate increased from 68 % to 78.5 % (by 16.5 %); 5-year cumulative observed survival increased from 47.3 % to 54.1 %; 5-year cumulative relative survival increased from 56.8 % to 61.8 %. Female kidney cancer patients demonstrated higher 5-year cumulative survival rates than male patients (65.8 % vs 43.9 %).Conclusion. We observed a positive dynamic of the main analytical indicators of cancer control, including an increase in the median survival and 5-year cumulative survival of kidney cancer patients.

Cluster formations as instruments of interregional integration at the Federal District level

The role and place of clustering processes in ensuring interregional integration are considered. At the same time, it is noted that the increasing importance in deciding on the formation of interregional clusters belongs not to the interaction of counterparties within a single technological chain, but to the common goals of regional development. The expediency of the formation of interregional poly-clusters is substantiated.

The state of cancer care in Russia: breast cancer among the female population. Year-by-year lethality, median survival, survival of patients with cancer. (Population study at the federal district level)

To get the real state of cancer care, it is necessary to use only reliable data that are available in all administrative territories in Russia – these are databases (DB) of population cancer registers (PСR). The PRR system created in Russia almost completely complies to international requirements, the development of the database gives a real idea of the effectiveness of the anti-cancer measures carried out.

The state of cancer care in Russia: breast cancer among the female population. Morbidity, mortality, index of accuracy, detailed localization and histological structure. (Population study at the federal district level)

Breast cancer is the leading pathology of malignant tumors among the female population of most countries of the world. In Russia, breast cancer have first rank in the structure of the incidence of malignant neoplasms of the female population (21.2%), as well as in the structure of mortality (15.91%). The maximum levels of standardized indicators of breast cancer were recorded in Belgium (> 100 0/0000), Germany and Denmark - the minimum, in India (32, 70/0000).

The state of cancer care in Russia: breast cancer among the male population. Prevalence and survival of patients (Population study at the federal district level)

Breast cancer among the male population is extremely rare. The risk of this pathology among the male population is 129 times less than among the female population. The incidence in "rough" indicators correlates as 0.48 to 93.98 0/0000, a difference of 112 times, in standardized indicators 0.56 to 53.54 0/0000 or 97 times. Out of 21,871 cases of deaths from breast cancer in Russia, only 151 cases occur in the male population. The ratio of "crude" mortality rates among the male and female population is 0.22 and 27.61 0/0000, respectively, standardized - 0.14 and 13.59 0/0000, the difference between these indicators is also 97 times. Calculations of the probable risk of breast cancer should be calculated on the basis of standardized indicators that eliminate the difference in the age composition of the compared population groups. The fact that the probability of the occurrence of breast cancer among the male population is a rare phenomenon is proved by the materials of the handbook prepared by the staff of the P.A. Herzen Moscow Research Oncology Institute. In 2019, no cases of breast cancer among the male population were registered in 35 administrative territories of Russia, and only 1 case was registered in 20 more territories. The Population Cancer Registry created in the North-Western Federal District allows us to approach the assessment of the prevalence of breast cancer among the male population and assess the effectiveness of therapeutic and diagnostic measures carried out, as well as for other rarely occurring diseases, for example, such as heart, eye, thymus and other cancers.

The records of patients with postmortem diagnosis of cancer (population study at the federal district level)

Purpose: to determine the real state of cancer care in Russia for the identifcation of patients with postmortem diagnosis of cancer using the population-based cancer registry. Material and Methods. Data from the offcial reports of the cancer service (f. No. 7) and the database of the population-based cancer registry of the Northwestern Federal District of the Russian Federation with a volume of more than 1,350,000 cases of cancer were presented. Standard methods of cancer statistics were used. Results. The problem of the quality of registration of primary patients with cancer includes three main components: active cancer detection, including screening programs and medical survey; providing citizens with optimal conditions for free access to medical institutions, including cancer centers; improving the pathoanatomical service to detect cancer in deceased patients. The proportion of patients registered postmortemly, according to offcial data, may be several times less than the real value. At the same time, it should be noted that for 2 periods (1997–1999 and 2017–2019), according to the database of the Northwestern Federal District of the Russian Federation, the proportion of postmortemly registered patients decreased from 15.72 to 8.16 %, and in St. Petersburg from 24.46 to 9.76 %. During the period from 2017 to 2019, 2973 patients with bronchial and lung cancer (C34) – 15.17 %, 1708 patients with colon cancer – 10.32 %, 1640 patients with stomach cancer – 12.17 %, about 20 % of patients with pancreatic cancer and 29.43 % of patients with liver cancer were unaccounted for in the Northwestern Federal District of the Russian Federation. Conclusion. Thus, for the frst time in Russia, our study made it possible to identify the real state of cancer care for patients with post-mortem diagnosis of cancer, to determine the magnitude of the discrepancy between state reporting data and database of population-based cancer registry, to note the improvement in one-year and fve-year observed survivals. In recent years, the one-year mortality rate, subject to posthumously registered patients, loses 5.6 years, fve-year – 4.4 years. It is important to note that since 2000, due to improved registration of patients with a frst-time diagnosis of malignant tumors, the one-year and fve-year survivals of patients with posthumously registered increased by 18.5 % and 20.7 %, respectively.

Prevalence and survival of patients with malignant tumors of the thymus gland (C37). (Population study at the federal district level).

The thymus gland has a scientific name thymus. The gland is located in the upper part of the chest immediately behind the sternum. During puberty, it reaches its maximum size, then its atrophy occurs, which reduces immunity in subsequent age groups. The maximum decrease in immune indicators occurs in old age.
 Until now, neither in Russia nor abroad, nothing was known about the patterns of the prevalence of malignant neoplasms of the thymus due to the extremely rare occurrence of such cases.
 We have attempted to establish the patterns of occurrence of malignant neoplasms of the thymus gland (C37) and get some idea of the effectiveness of its treatment at the population level. This opportunity was presented to us in connection with the creation of a cancer registry database at the level of the North-Western Federal District, numbering more than 1 million 350 thousand patients with a population of more than 13 million people.
 The International Agency for Research on Cancer (IARC) publishes a monograph "Cancer incidence in Five Continents" every 5 years. In the latest edition of 2021, vol. XI, the prevalence of the thymus gland (C37) is presented together with the heart disease (C38).
 Purpose. Based on the database of the newly created population cancer registry of the North-Western Federal District, to determine the prevalence, primary mortality and survival of patients with malignant neoplasms of the thymus gland (C34), taking into account gender, age characteristics and survival of patients. At the international level, try to divide the combined heading С37, 38. Select separately С37.
 Methods. The material for the study was the database of the population cancer registry with a volume of more than 1 million 350 thousand observations. Standard research methods recommended by the International Association of Cancer Registries were used.
 Results. The conducted research has shown the possibility to assess the prevalence and effectiveness of anticancer measures for rare malignant neoplasms. The specific weight of malignant neoplasms of the thymus gland (C37) among all tumors in the Northwestern Federal District is 0.02%, 5 times less than the occurrence of malignant neoplasms of the heart (C38). Attention is drawn to the fact that in recent years the accounting of this group of tumors has significantly improved in the North-Western Federal District. There were no sharp differences in the structure of the male and female population in the values of registered cases of the disease among people younger and older than 60 years.
 It is important to note that positive dynamics of mortality rates of patients with malignant neoplasms of the thymus gland (C37) has been established for each year of follow-up. The parameters of age-specific indicators of morbidity have been determined, where the highest level is set for patients in the age group of 60-69 years. Grouped into four temporary cohorts, patients with the ventricular gland (C37) showed positive dynamics of one-year and five-year survival. A 25% decrease in the proportion of patients with an unspecified stage of the disease was revealed.
 A high level (90-100%) of survival in patients with localized tumor process was noted. The five-year survival rate increased from 42.5 to 45%.

State of the Russian Oncology Service: lip cancer. Population-based study at the federal district level. Part II. Survival of patients, median of survival, survival of patients taking into account the localization, histological 
 structure and disease stage

Malignant neoplasms of the lip are a rare type of tumor. State reporting provides only a set of data for calculating incidence rates. The Population-Based Cancer Registry (PCR) database developed by us at the level of the Northwestern Federal District of the Russian Federation allowed, for the first time in Russia, to calculate a set of analytical indicators, such as the median survival, one-year and five-year cumulative survival rates of lip cancer patients, taking into account the detailed localization and histological structure.
 The aim of the study was to investigate the level and trends in survival of lip cancer patients in the Northwestern Federal District of the Russian Federation considering the localization and histological structures and the stage of the disease.
 The material of the study was the Population-based Cancer Registry of the Northwestern Federal District of the Russian Federation. Data processing was carried out using the methodology recommended by the International Association of Cancer Registries under the EUROCARE program.
 Unfavorable trends in the lip cancer incidence rate have been established in Russia and the Northwestern Federal District of the Russian Federation. The median survival remained within 68 years. Survival rates of patients have indicated a high level of treatment of patients with malignant lip neoplasms at the level of the Northwestern Federal District. Survival of patients in the first year of observation was: observed 89.3%, relative 93.8%. The five-year observed survival did not reach 50%, the relative exceeded 60%.
 Detailed localization development of the PCR data has revealed that patients with malignant neoplasms of the outer surface of the lower lip (C00.1) account for 60%. Histological characteristics of the registered patients have been significantly improved.

The state of cancer care in Russia. Analytical indicators: one-year mortality (population study at the federal district level)

In February 2019, Russia's first Population-based Cancer Registry (PCR) was created at the federal district level with a database of more than 1 million 350 thousand observations. It is important to note that the levels of standardized morbidity and mortality indicators in the North-Western Federal District (NWFD) and on average in Russia do not have significant differences: morbidity – 261.3 and 249.5 0/0000 (both sexes), men - 293.2 and 286.8 0/0000, women - 252.7 and 234.5 0/0000, respectively; mortality is both sexes (117.6 and 106.8 0/0000, men - 164.7 and 152.4 0/0000, women - 91.3 and 79.5 0/0000, respectively, which allows us to consider the data obtained from the database of the population cancer registry of the Northwestern Federal District to be close to the national average. After we created the first population cancer registry in Russia in St. Petersburg in 1993, operating according to international standards, the Ministry of Health of the Russian Federation issued Order No. 420 dated December 23, 1996 "On the creation of the State Cancer Registry", which included our recommendations on the nature of work, staffing and technical support. Cancer registries have been established in all administrative territories of the country, many doctors have been trained in St. Petersburg. In this paper, we will focus our attention on the main important criteria of one-year lethality, its true magnitude and the patterns of its changes. Methods. The research material was the database of the population cancer registry of the North-Western Federal District. Statistical methods recommended by the International Association of Cancer Registries were used to assess the patterns of death of patients. Purpose. To reveal the true state of the oncological service of Russia by the leading parameter - the level of one-year mortality. The main criteria for evaluating the effectiveness of anti-cancer measures is the level of the proportion of patients who died during the first year after registration in a territorial oncological institution. Results. According to official data, the one-year mortality rate of patients with malignant neoplasms in Russia and the Northwestern Federal District of the Russian Federation is currently (for both sexes) 20.6 and 20.9% (F. No. 7 of state reporting). The planned indicator is to reduce this level to 16-17% in the coming years. The real values of this indicator, calculated on the basis of the population cancer registry database, are at least 30-40%, as in other countries. All this is what we have to figure out. Such a low value of the indicator is explained by the fact that when preparing state reports by superimposing tables from the district level to the reverse, those who died in the last months of the calendar year are not taken into account. They have not yet been received by oncologists from the State Statistics Committee, and the report for the past year must be submitted from the district level on January 20. The main misconception of all management structures is that they do not know on what basis the state reporting is formed and that the database of the population cancer registry has nothing to do with it. This is what our attention has been directed to in recent years - to compile a state report based on the database of the population cancer registry. Conclusions. Taking into account the presence of existing territorial cancer registries in all administrative territories of Russia, which have accumulated extensive statistical material, switch to calculating one-year mortality rates only on the basis of the population cancer registry database after the data for the reporting year is fully completed. Present these data not only together for both sexes, but separately for men and women. To bring the database of the population cancer registry in full compliance with International standards of its management, to calculate not only the mortality rate in the first year of observation, but also the one-year and five-year observed and relative survival. The assessment of the activity of the oncological service should be carried out according to the dynamic series of survival only on the basis of the database of the population cancer registry.

State of the Russian Oncology Service: lip cancer. Population-based study at the federal district level. Part I. Incidence rate, annual mortality rate, localization and histological structure

Malignant neoplasms of the lip (C00) are rare types of malignancies. It is ranked 30 in terms of the structure of oncopathology in Russia and the Northwestern Federal District of the Russian Federation. There is a positive trend in the incidence rate as the proportion in the database of the Population-based Cancer Registry (PCR) of the Northwestern Federal Region of the Russian Federation takes modestly 0,4% (both sexes).
 It should be noted that according to the official reporting (Form No. 7) it is impossible to obtain any other criteria for assessing the effectiveness of combating this tumor in addition to the trends of morbidity. We have presented the estimation on the state of the effectiveness of anticancer measures regarding malignant tumors of the lip (C00) on the basis of the PCR database of Saint Petersburg.
 As of January 1, 2020 the Northwestern Federal Region of the Russian Federation (NWFD RF) includes 11 subjects with the population of 1 397 727. In February 2019 we created a unified database of malignant neoplasms of the Federal Region. In fact there has been organized the first in Russia Population-based Cancer Registry at the Federal Region level. Total number of registered lip cancer cases includes more than 1 million 350 thousand cases. To develop analytical criteria, only reliable materials with a number of 952791 cases including 2663 cases of malignant tumors of the lip were selected.
 Aim of the study: to determine the prevalence of malignant neoplasms of the lip, annual mortality, features of localization and histological structure.
 Materials and methods. The study was based on the reference books on the prevalence of malignant tumors (IARC publication Cancer on Five Continents volume XI, P.A. Herzen Institute of Medical Research, N.N. Petrov National Research Center of Oncology, the Population Cancer Registry database of the Northwestern Federal District of the Russian Federation). Standard research methods recommended by the International Association of Cancer Registries were used.
 Results of the study. The study has revealed a high level of lip cancer morbidity of the population in Russia and the North-Western Federal District against the background of indicators for economically developed countries, but the incidence rate is gradually decreasing.
 The highest standardized incidence rate of malignant tumors of the lip in the Northwestern Federal District of the Russian Federation remains among the male population of the Vologda, Pskov regions and the Komi Republic.
 We have established a special procedure for the death of patients with malignant neoplasms of the lip in the Northwestern Federal District of the Russian Federation. A surge in mortality from lip cancer has been revealed in women in the second, fourth, seventh, ninth and tenth years of follow-up, in men in the fourth, seventh and tenth, which requires fundamental research in search of the causes of the surge in mortality. Unfavorable annual mortality trends in patients with lip cancer in the Northwestern Federal District of the Russian Federation have been revealed. The features of localization and histological structure of malignant tumors of the lip have been established.