[Evaluation of the effectiveness of prophylactic oncological screenings at large industrial enterprises].
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Biomedical subjects
Publications and source records attributed to S Iu Kozhevnikov.
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Early diagnosis of the most frequently--occurring cancers cannot be improved unless integrated approach to the problem is used. This should include application on a wider scale of regular medical check-ups in population older than 40 years with more extensive but justified use of modern laboratory and instrumental methods and computer--based follow-up programs.
The paper is concerned with a comparative evaluation of the costs of radical operative treatment of lung cancer in a specialized clinic versus the extent of surgery. The mean cost of surgical treatment of a lung cancer patient proved to be 495.58 roubles: pneumonectomy--563.71, partial resection of the lung--466.59 roubles.
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The paper discusses automated screening procedures for detection of precancerous and tumor lesions in gastrointestinal organs in factory and office workers. These procedures include application of computers and a classifying matrix (a table of syndromes) in the processing of data obtained by means of questionnaires. Automated screening method provides a rationale for selection of subjects who should undergo further instrumental examination. Its application makes the work of medical staff at the initial stage of mass screening unnecessary. It also provides for standardization of procedures of screening for those who should be further examined for precancerous and tumor lesions in the esophagus, stomach, colon and rectum.
The authors analyze results of the treatment of 1261 patients with carcinoma of the skin and recurrent basiliomas arising after other methods of treatment. The patients were observed within the period of from 1 to 11 years. Recurrences were detected in 1.9% of the patients subjected to laser therapy. Great curative and economic efficiency of laser therapy is shown as compared with X-ray therapy and surgical treatment.
5,320 workers of various professions in Leningrad were involved in a computerized primary screening for further detailed oncological and stomatological examination. On the basis of computer data, 55% of those involved in the questionnaire survey became candidates for such examination. Curettage was performed in cases of pathological changes in the mucosa of lip and oral cavity. Various diseases of the lip, oral cavity and throat (precancerous lesions--3.7, cancer--0.17%) were detected in 22.6%. No precancerous lesions or cancer were identified in the control group of 2,321 subjects. The results point to the effectiveness of computer and cytological examination application in mass oncostomatological screenings.
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The authors describe the method of conducting mass prophylactic oncological examinations by means of questionnaires at the first stage, which was developed at the N. N. Petrov Research Institute of Oncology of the USSR Ministry of Health. Questionnaires were aimed at the recognition of somatic pretumor and tumor lesions of the main localizations and the increase of oncological vigilance of general practitioners. The method has been tested on 11386 inhabitants of rural district of Leningrad and Novgorod Provinces. As a result of mass prophylactic oncological examinations 738 different pathologies were revealed (in 6.6% of all questionnaires), pretumor lesions making 2.05% malignant neoplasms--0.06%. The use of the questionnaire method in conducting prophylactic examinations made it possible: to enhance their medical efficacy, to reduce the number of individuals subject to medical control, to employ instrumental-laboratory tests on more proper grounds, and on the basis of a questionnaire to make a registry of the primary account of persons undergoing prophylactic examinations.
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