Russian oncologists launched a system that detects predisposition to cancer

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On April 13, a press conference dedicated to the launch of the All-Russian educational project "Year of Cancer Prevention" was held in Moscow.

The Cancer Prevention Foundation together with the N.N. Petrov announced a new development - the SCREEN system. With its help, any Internet user will be able to assess their risks of developing the most common types of cancer - lung, breast, skin, prostate, colon and rectum.

Leading Experts Russian oncologists and onco-epidemiologists - noted that although cancer mortality in Russia is gradually decreasing, there are still many difficulties, primarily in the field of diagnosis. One of the main problems is the lack of training and awareness of doctors. According to the Cancer Prevention Foundation, 67% of doctors cannot correctly determine the method of examination that should be used in a particular case. At the same time, 93.8% of Russians believe that they need preventive cancer screening.

93.8% of Russians believe they need preventive cancer screening

The second problem is the lack of awareness of people about the rules and methods of diagnosing cancer. “The first thing we face is confusion and resistance to the knowledge and norms of screening. For example, many are surprised that it is not necessary to get screened for cervical cancer more often than once every three years, says Executive Director Cancer Prevention Foundation, oncologist Ilya Fomintsev. How and when should you be examined? What to do with the results? There is no single answer. We decided to create an educational program that would give everyone the opportunity to learn about their own risks.”

How does the SCREEN system work?

The user completes an anonymous test, which includes questions about their age, weight, diet, lifestyle, and illnesses (including those that run in the family). The computer evaluates the answers in accordance with the instructions from the database and makes recommendations that are stored in personal account. And then - the user has a choice. He can immediately sign up for a doctor's consultation at the nearest clinic (of those participating in the action) or set a reminder to do it later.

Test responses are evaluated based on current WHO recommendations, as well as major cancer research centers and institutes, including the US National Cancer Institute, Cancer Research UK and others. “In fact, the questionnaire is a kind of convenient navigator through the summary table of risks and recommendations,” explains Ilya Fomintsev. – However, this navigator was compiled by specialists who understand evidence-based medicine and credibility of information sources.

Passing the test and registering in the system is free. In the future, a system feedback– expert oncologists will answer user questions directly on the site online. Among other plans, there is even the option to pay for a “hanging screening” (similar to “hanging coffee” 1), which can then be used by another person. According to the authors' calculations, 30 million people should pass the test in two years.

For more information and to take the test, visit the Cancer Prevention Foundation website.

1 Hanging coffee is a tradition that comes from Italy. A visitor in a cafe buys one coffee and pays for two. The second portion of the drink is considered "suspended". Any next visitor can already get it for free.

There are not many studies that can catch some types of cancer on early stage. Some tests can indicate cancer with a low false positive rate. But at the same time there will be false negatives. Then they lead to additional research(eg biopsy) and even unnecessary chemotherapy. For some types of cancer early detection does not affect life expectancy. Medical associations look at all of the above and conclude: how many people will benefit from the massive introduction of screening, and how many will get meaningless heavy treatment. As a result, the recommendations for everyone look rather meager, but there are plenty of things that you should not do.

What to do

Pap test (screening for cervical cancer)

From 21 to 29 years old every 3 years. In the UK, screening is carried out from the age of 25, and studies show that this is justified. From 30 to 65 years old, you can replace it with a Pap test along with an analysis for oncogenic human papillomavirus once every 5 years.

If these studies are carried out more often, then with more likely you will find conditions like dysplasia that could go away on their own, but now they will be subjected to aggressive treatment With . Cervical cancer grows rather slowly, therefore, with the recommended regimen, it is possible to detect precancerous changes in time and stop the pathological process.

Low dose computed tomography (lung cancer screening)

From age 55 every year to age 80 if the person smokes now or quit less than 15 years ago and if the smoking history is more than 30 pack years (number of packs smoked per day multiplied by the number of years the person smokes).

This study is much better than the others (and) helps to detect lung cancer at the stage when it is still possible to influence the prognosis.

Mammography (screening for breast cancer)

From the age of 40, every two years, if the woman herself wants this after talking with the doctor and evaluating everyone. From 50 years old to 75 years old every two years.

Associated with mammography great amount disputes, and now everything means that the age at which it is recommended to be carried out is increasing. A woman's breast becomes less dense over time, and mammography can therefore give a better result.

Examination of feces for occult blood every year

Sigmoidoscopy (examination of the inner lining of the sigmoid colon and rectum) every five years and fecal examination for occult blood every three years. Colonoscopy (examination of the inner lining of the large intestine) every ten years. These studies are conducted at the age of 50 to 75 years.

It's all screening on colorectal cancer(cancer of the colon and rectum). It is worth consulting with your doctor about what is best for you to do. However, the executive director of the Cancer Prevention Foundation, oncologist Ilya Fomintsev, that these recommendations do not suit us: “We do not the right amount qualified colonoscopists. And this research should be done only in those places where they really know how, and only to those people who are shown. Therefore, I am in favor of two-stage colorectal cancer screening in intermediate-risk groups. This is selection through the quantitative analysis of stool for occult blood.”

What not to do

Colposcopy

Colposcopy (examination of the cervix with a colposcope) is performed if the Pap test shows something wrong. If a Pap smear is taken at the same time as a colposcopy, then these studies, in fact, duplicate each other.

Examination of the cervix

At the other extreme, do no research other than visual inspection. So you can precancerous or cancerous changes in the cervix. The fact is that the color of the cervix says little about her health: she can be perfectly pink and still have.

Fluorography and radiography of the lungs

Both of these tests may be needed for some diseases (such as tuberculosis), but as a screening lung cancer they are absolutely useless. Fluorography and radiography give a much lower quality image than low-dose CT scan Therefore, cancer can usually be detected with their help only in the later stages.

Ultrasound of anything

The domestic list of examinations for clinical examination is full of a variety of ultrasounds that can allegedly be used to screen for certain types of cancer. In fact, ultrasound is not used anywhere in the world for such purposes. This study does not reduce mortality from, uterine cancer (), etc.
However, in some cases, for example, if a person is in a group increased risk or basic investigations show something suspicious, an ultrasound may come in handy.

Breast self-examination and breast examination by a doctor

If a woman regularly probes her breasts and looks for tumors, this, according to studies, does not lead to a decrease in mortality from breast cancer. Quite the contrary: when a woman conducts a self-examination and finds a seal, she begins to worry and goes to the doctor, which leads to unnecessary research. However, in the vast majority of cases, the seal is quite harmless. Regular examination mammary glands by a doctor is also no good. This in no way cancels the item about mammography from the "What to do" section.

Blood test for tumor markers

Tumor markers are proteins that can be elevated in cancer. However, this also happens when various inflammations, injuries, etc. And none of the tumor markers is useful for cancer screening: too many false positives and false negatives. The last to give up was prostate-specific antigen (PSA). Now in the USA, an analysis for it is recommended or carried out only if the man himself is so, having assessed all the risks. The remaining tumor markers are used when a person has already been diagnosed with an oncological disease and it is necessary to see in dynamics what changes are taking place.

Testicular self-examination

It would seem free and you can detect testicular cancer - why not? In principle, if you want, you can do whatever you want, but medical organizations cannot recommend studies that show evidence of a decrease in mortality.

General urine analysis

Blood in urine could be a sign of cancer Bladder or kidney cancer. It may not be. Infections, kidney stones also lead to this result. On the this moment there is no good screening for these cancers that does not lead to a large number unnecessary intervention.

What you need to explore for yourself will be prompted by the launcher today. Read an interview with the Executive Director of the Cancer Prevention Foundation Ilya Fomintsev.

Now each person can assess the risk of oncology and get professional advice. Just go to the site nenaprasno.ru and pass the SCREEN test. This is a joint project of the Cancer Prevention Foundation and the Research Institute of Oncology. Petrov.

“Polling the population to determine risk factors or risk of developing cancer is not a new tool. Hundreds of doctoral dissertations have been written on this topic, - says the director of the Research Institute of Oncology named after V.I. Petrov Alexey Belyaev. – The authors of SCREEN put everything into the program modern achievements from what is in oncological statistics.

It turns out that, knowing a person's age, his eating habits and what kind of lifestyle he leads, it is possible to determine the risks of cancer. SCREEN tests for the most common types of cancer: breast, cervix, colon and rectum, stomach, lung, prostate and melanoma.

– The test consists of 30–50 simple questions, - explains Ilya Fomintsev, Executive Director of the Cancer Prevention Foundation. – After completing the questionnaire, the program evaluates the information and determines the need for medical intervention.

Based on the results obtained, SCREEN classifies a person as a low, medium or high risk group and gives him recommendations. For example, go to a consultation, get tested or quit smoking.

“According to our experience, if a person is not allowed to quickly implement these tips, then he will simply forget about them,” Ilya added. – Therefore, we have introduced such functions as “remind me later about the examination” and “sign up immediately”. For the second, we connected clinics. By pressing a button, a person can request a call back and immediately make an appointment with a doctor.

Quality control in these clinics is carried out by the Research Institute of Oncology. Petrov.

“The Institute monitors everything that each clinic connected to the system does,” assured the Deputy Director of the Russian Oncological scientific center them. Blokhin David Zaridze. “They train doctors—these are people who specialize in cancer screening.

Refrigerator against cancer

Ilya Fomintsev, Executive Director of the Cancer Prevention Foundation, told Metro why early diagnosis of oncology is important and who does not need to be examined

What influences the incidence of cancer?

We have a drop in mortality from lung cancer, this is due to the fight against smoking. Stomach cancer is now becoming less common all over the world, one of the reasons is the appearance of refrigerators, the Helicobacter pylori bacterium simply does not survive in the cold.

Why is it important to identify malignant tumor at an early stage?

This reduces the risk of mortality and increases the likelihood that the person will survive. And the second. Early diagnosis makes it possible to identify a precancerous condition, something from which oncology will eventually develop. For example, a colon polyp - if it is removed, there will be no cancer.

What misconceptions in the initial diagnosis are most often encountered?

Tumor markers. They don't work at all early detection cancer. Nevertheless, more than 70% of the population is sure that it is they who detect oncology at the initial stage.

So maybe everyone should just go through a full examination just in case?

Young people without additional factors risk (hereditary or other) medical intervention will bring more harm than good. We need a balance.

Your foundation seeks to change the entire system of combating cancer. This is a multi-component work, complex, huge. How did you decide on this?

I graduated from the medical faculty in Mordovia and came to St. Petersburg for residency. I wanted to become a surgical oncologist and became one. He specialized in tumors of the head, neck, and breast. I worked in the Leningrad Regional Dispensary, and, in general, everything worked out for me, there were ups and downs, but by the age of 28 I realized that I could no longer.

My mother died of breast cancer, she was operated on in the same dispensary, and I was, in fact, her doctor. It was very hard.

At the same time, I realized that I could poke around until I was 60, and then they would give me a cast-iron horse, as in “ office romance', and retire. Unhealthy, drunk and uninteresting to women. And everything will be the same.

I realized that I no longer want to participate in this, because my work does not change anything. But I can do something big and important.

And so the Cancer Prevention Foundation was born. Our fund works in several directions. And first of all, we strive to educate the population. Because cancer morbidity and mortality remains one of the highest serious problems in Russia. And for a long time she wasn't getting enough attention.

- What idea, information is important to convey to people?

Cancer is a controlled disease. This means that we can largely influence our own destiny. But any educational article still raises the same question in people: “OK, but what exactly should I do?”

It is impossible to answer this question without tools to assess the risk of cancer in each person. We cannot give everyone the same advice, because it will suit someone, and it will be harmful to someone. But we can give everyone a link to our screening test. We have developed it ourselves, bringing together a huge amount of information from serious international studies. This test is needed to divide the population into risk groups. This will determine the appropriateness of cancer screening for each individual.

- The test has been running for several months - have many people already passed it?

We tested over 90,000 people in a month. It's a lot. But when more than a million people pass the test, it will be big data. This is going to be a big and cool study. Now, for example, we are negotiating with one very large region of Russia to assess the risks of all - I emphasize: all - residents of this region using SCREEN algorithms. And then the regional health authorities will track their fate.

morbidity and mortality from cancer remains one of the most serious problems in Russia

So we get a giant Scientific research which will allow to substantiate the Russian recommendations on cancer screening.

Later we will do Full description of how our test is arranged and works, and we will put it on the Internet for doctors. We also hope that this test will be used in the future in most medical institutions - public and private.

- Does the situation in Russia differ from the world one?

The incidence statistics in Russia and the developed world are quite comparable. Even our incidence will be less. But as for mortality, there are features. For some types of cancer, the figures in Russia are much higher than in the world. Mortality from breast cancer, cervical cancer, colorectal cancer is much higher in our country. And these numbers are rising while falling around the world. In countries where there is a screening program for these types of cancer, the mortality rate for these types of cancer is low and continues to fall.

- In what, for example?

Finland, UK, France. In the United States, screening is opportunistic, like ours, that is, it is not systemic with a single control center, but it is very good quality. This means that there is no centralized system, but doctors regularly screen the population according to well-calculated screening indications and make recommendations. If screening works at the state level in Russia, mortality could decrease by 30-40%. And for some types of cancer even more.

What is "screening" anyway? What does it include?

People constantly confuse screening and diagnosis. The difference is simple. If something hurts somewhere or a seal appears, this is a mandatory reason for diagnosis. And if there are no symptoms and complaints - this is not a diagnosis, this is just a screening examination. Screening is a system, a process, aimed at identifying asymptomatic cancer in risk groups.

- And what are the indications for examination, if there are no complaints?

The risk that the test allows you to determine is the indication. Based on the results of the Screen test, a recommendation is given - to undergo one or another examination. Right on our website, you can already sign up for two clinics with which we cooperate (there are many applications from clinics, but we are slowly connecting them to our system, they must pass our control). In Russia, there is a paternalistic relationship between doctors and patients - "the doctor said, but I do it." But each person must know and understand a lot about himself. And the Screen test is a good starting tool for that.

- Can all types of cancer be prevented by screening?

No, but cervical cancer, skin cancer, colorectal cancer can be detected at the "precancerous" stage. The processes of appearance of these tumors are very clear. In the vast majority of cases, colorectal cancer develops through a polyp. If the polyp is noticed in time, it can be removed. And cervical cancer - through dysplasia. And at the precancerous stage to prevent cancer.