FEATURES OF THE ORGANIZATION OF ANTICANCER MEASURES IN TERRITORIES WITH LOW POPULATION DENSITY ON THE EXAMPLE OF THE TOMSK REGION

The poor performance of rural health in remote from the center territories of the Tomsk region, determined the need for the optimization of cancer control measures. In 2013-2015 in the oncology service of the Tomsk region there were occurred structural and qualitative changes: there was formed a three-level system of the provision of specialized health care. For workers of the first level of health care system - feldsher obstetric units (FOUs) there were approved methodical approaches to the organization and implementation of screening for external location cancer, the formation of cancer risk groups for further examination; routing and observation of cases with risk factors, precancerous and background processes; documenting of the execution of the examination for cancer; routing and tactics for the observation of cancer patients. There are introduced motivational measures for the improvement of the quality of the work of medical staff. There are actively practiced mobile forms of the activity, with taking into account seasonality, the state of the transport accessibility (the use of mobile mammographs based on KAMAZ chassis, the regional project «The floating clinic», curation of districts by oncologists). There was introduced the mechanism of «individual road map», including telemedical technologies for distance observation of patient documents (the number of unnecessary visits of rural residents decreased by 30%). There were founded primary oncological units (POU), their base is enhanced by the diagnostic equipment, which reduced the number of underexamined patients by 47.5%. There was created the network of primary cytological laboratories completed with microscopes with digital processing and transmission of images over the Internet, there were performed more than 20,000 telemedical consultations, resulting in 70 diagnosed cases of cervical cancer for 2 years. The execution of POU-based courses of drug antitumor therapy increased the number of patients received the treatment at site of residing by 2.2 times. There was organized beneficiary drug coverage, including drugs for the treatment of chronic pain. Thanks to the work of POUs in the new status there were increased both the coverage of the population by cancer preventive examinations and indices of detection rates of precancerous diseases and chronic external localization diseases as in men as well in women.

anticancer measures, Tomsk region, feldsher obstetric unit, rural population