O.I. Apolikhin¹, M.I. Katibov¹, A.V. Sivkov¹, I.V. Chernishev¹, D.A. Roschin¹, I.A. Shaderkin¹, N.G. Moskaleva¹, G.D. Efremov¹, V.M. Kuraeva^2
1Research Institute of Urology of Ministry of Health of the Russian Federation;
²Federal Research Institute for Health Organization and Informatics of Ministry of Health of the Russian Federation

Abstract. The aim of the study was to predict problems of prostate cancer screening that could be induced by comprehensive medical examination of the Russian population. For that purpose current state of the art of the healthcare system was analyzed. The analysis identified the following issues of concern: lack of a universal standard of screening test performance – blood test for prostatic specific antigen, insufficient sensitivity and specificity of this test, sharp increase in demand for prostate biopsy, shortage of qualified staff, poor material and technical resources of health care facilities, overdiagnosis and over treatment. It is calculated that comprehensive medical examination can detect about 173589 new case of prostate cancer per year, which is six times higher when usually diagnosed without comprehensive medical examination – 28552 cases. Expenses for detection, staging and treatment of prostate cancer as a result of comprehensive medical examination can add up to 15.7 billion rubles per year. Therefore, to reduce implications of the comprehensive medical examination it is crucial to proactively conduct personnel training and improve material and technical resources of health care facilities, to apply the principle of “risk groups selection” during implementation of comprehensive medical examination and employ step-wise approach for care delivery on the basis of clinical and financial feasibility of each step.

To exemplify application of those principles to improve efficiency of screening programs the authors refer to the subprogram “Urology” developed by the Research Institute of Urology under the “Healthcare development in Voronezh region in 2011-2015” program.

Key words: screening; population survey; prostate cancer; prostate specific antigen; prostate biopsy.

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