Anti_cancer service organization in Ukraine

In Ukraine the state system of cancer registration has been functioning since 1932. At the present time, oncological patients are recorded and the cancer cases are registered through the system of specialised oncological dispensaries (in total - 46 establishments, including 25 oblast-level ones). Availability of a specialised oncological service, covering the whole population, is the major feature of Ukrainian public health system and the basis for creation of the national cancer registry. Most Western cancer registries, despite their solid experience and high material support, lack for this system of registration and movement of information, adopted at the state level.

The Ukrainian Ministry of Public Health Decision #10 of January 22, 1996, approved creation of the Ukrainian National Cancer Registry and transition to the automated technology of cancer registration.
Let us consider the technology existing in Ukraine for cancer registration. Once a new case of cancer is identified or even suspected, the corresponding general practitioner fills in a special signal form ("Notification of patient with cancer or other malignant neoplasm established for the first time ") and forwards it to the oblast oncological dispensary within the territory of the patient's residence.

In the dispensary the notifications are checked and duplicates are excluded. The identified patient can be invited for examination. If the malignant diagnosis is confirmed, the "Registration Card for a patient with malignant neoplasm" (Form š030/î) is filled in. Hereinafter this form is updated with the information on treatment and follow-up of the patient. In addition, the control card of follow-up can be entered on the basis of abstracts from the medical in-patient card (Form š027-1/î - "Abstract"), from the medical out-patient card, information from Death Certificates, etc. If the dispensary already entered Registration Card, its information is updated.

This scheme in its present form has been working for 40 years already. It provides, on the one hand, obtaining of aggregated information about all identified cases of disease in the entire country, and, on the other hand, further follow-up with updating and accumulation of information about individual cancer cases. You are welcome to see some schemes that illustrate cancer registration technology in Ukraine. Until recently this information has been collected on paper forms. In the late 1980s, the Ukrainian Research Institute of Oncology and Radiology started development and introduction of an automated information system for the Ukrainian cancer registry. Application of the automated system allows considerable improvement in the quality of collected data-- through multilevel procedures of data logic control, automated search for duplicates, and electronic data transfer. Many search and calculation operations, inconceivable with the paper technology, have also become possible.
It has already been several years since the new information system has being introduced in oblast, city and rayon dispensaries. Along with the system of the population-based cancer registry, the automated system of the hospital-based cancer registry has been developed and introduced, compatible with the population-based registry at the level of data transfer. The hospital cancer registry is seen as the main source of data for the population-based registry, since up to 90% of patients are examined and receive treatment in the oncological dispensary within the territory of the patient's residence, and the automated transfer of data considerably reduces the labour demands of the population-based registry.

The centralised automated database of the population-based registry contains currrently over 1 100 000 records about cancer cases in Ukraine. The automated hospital registry database of the Ukrainian Research Institute of Oncology and Radiology alone contains histories of disease of about 70 000 patients, having received treatment in this institute. All these data formed the basis for various scientific research studies, and have been the basis for a set of publications and dissertations. And the work on creation of the national cancer registry is still far from being finished !..

Thus, distinctive features of the National Cancer Registry of Ukraine are as follows:

Availability of a specialised oncological service, covering the whole population of Ukraine and having long-term experience of accumulation and processing of information about cancer;
Availability of the central unit, carrying out coordination of the oblast cancer registries, development and introduction of uniform software, centralised data collection and analysis, and conduct of research;
Introduction strategy for registry information technology, allowing phased introduction of the automated technology in parallel with functioning of the paper technology;
Availability of user-friendly software with advanced means of automated control, data linkage, search of duplicates, data transfer, reception and analysis of statistical parameters, etc.
Centralised engineering of hospital and population-based cancer registries, allowing data exchange between them and automated collaborative research;
Conformity to international standards (rules and recommendations of the WHO and IARC on cancer cases coding, TNM classification, International Classification of Diseases);
Application of cancer registry data for not just scientific, but also administrative purposes , assessment of the oncological service activities, and planning of public health;
Experience, skills and enthusiasm of the cancer registry personnel of all levels, including our modest efforts.

You can learn more details about the Ukrainian cancer registry from some of our publications and articles or directly from us.

The national cancer registry of Ukraine consists of oblast registries, which are based in oblast dispensaries. Some oblasts still support only paper technology of registration. Some are in the initial stages of introduction of automation. We have developed complex parameters for rating of cancer registries . Their purpose is to approximately reflect the readiness of oblast registries for thorough scientific research. These are not official ratings. They reflect the Kiev view on various aspects of activities of oblast registries.