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Main arrow Archive of previous Issues arrow №5 2013 (33) arrow Age-specific characteristics of avoidable mortality in Russia
Age-specific characteristics of avoidable mortality in Russia Print
Monday, 11 November 2013

T.P. Sabgayda
Federal Research Institute for Health Organization and Informatics of Ministry of Health of the Russian Federation

Summary. Mortality of the Russian population has been declining in recent years, posing a question of whether avoidable mortality in different age groups equally responds to changes in public health. Answers to this question are relevant for planning measures to further reduce mortality.

The aim of the study was to analyze avoidable mortality in different age groups, compare death dynamics at different stages of social and economic changes in Russia (increased mortality in 1989-1994 and 1998-2003; reduced mortality in 2005-2011).

Methods. The standardized death rates in six age groups of men and women (5-14, 15-19, 20-29, 30-39, 40-49 and 50-64 years) were analyzed on the basis of official statistics. Avoidable mortality was evaluated in line with the European approach: preventable mortality is mortality of people aged 5-64 from 38 preventable death causes and classes divided into three groups according to the three levels of prevention.

Results. After 2005, the avoidable mortality has been falling at a faster rate than the unavoidable one. From 2005 to 2011, the highest decrease in avoidable mortality was reported in children, the smallest - among average working ages. Mortality from preventable causes of the first and third groups (depending on primary prevention and quality of care) significantly reduced; however, mortality from the second group of causes (depending on timely disease detection) did not.

Conclusions. Active implementation of measures to reduce mortality in Russia led to unequal changes in avoidable mortality in different age groups. The results demonstrate that resuming practice of disease control implemented directly by large industry businesses or associations is feasible. It is possible that administration of organizations be responsible for regular medical checkups of their employees.

The feasibility of regular population checkups is questionable due to lack of improvements in timeliness of detection of malignant neoplasms in Russia.

Keywords: avoidable mortality; age-specific mortality; preventable death causes; prevention effectiveness; assessment of health system performance; mortality risk factors.

References

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Comments (1)
1. 04-12-2013 07:54
Очень полезное исследование, но есть одно замечание по поводу 
"Ускорение снижения смертности женщин старших возрастных групп, по-видимому, отражает эффект проведения дополнительной диспансеризации трудоспособного населения с применением онкомаркеров при обследовании".  
Это серьезное заблуждение 
В настоящее время имеются ясные показания к применению онкомаркеров в клинической онкологии, поддерживаемые как национальными онкологическими организациями индустриально развитых стран, так и международными медицинскими сообществами. 
Онкомаркеры, за исключением PSA, не должны применяться для скрининга, т.е. для массового выявления скрытого протекающих злокачественных заболеваний из-за низкой чувствительности и недостаточной специфичности этих тестов.  
Как правило они должны применяться для контроля за течением заболевания, оценки эффективности лечения, выявления рецидивов при уже выявленных онкологических заболеваниях.  
Вот всего несколько ссылок 
- Fleisher M, Dnistrian AM, Sturgeon CM, Lamerz R, and Wittliff JL, Practice Guidelines and Recommendations for Use of Tumor Markers in the Clinic, AACC Press, Washington, DC, 2002, 542 pages. 
- 2000 Update of Recommendations for the Use of Tumor Markers in Breast and Colorectal Cancer: Clinical Practice Guidelines of the American Society of Clinical Oncology; Journal of Clinical Oncology, Vol 19, No 6 (March 15), 2001: pp 1865-1878 
- Smith RA, Cokkinides V, von Eschenbach AC, Levin B, Cohen C, Runowicz CD, et al. American Cancer Society guidelines for early detection of cancer (2002). CA Cancer J Clin 2002;52:8–22. 
- Tumor markers in gynaecological cancers-EGTM recommendations. European Group on Tumor Markers. Anticancer Res. 1999 Jul-Aug;19(4A):2807-10. 
- Tumor markers in breast cancer-EGTM recommendations. European Group on Tumor Markers. Anticancer Res. 1999 Jul-Aug;19(4A):2803-5.
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