Risk factors for late detection of cancer in the female reproductive system

BACKGROUND: The pressing issue of the primary diagnosis of oncopathology in later stages of cancer hinders effective implementation of treatment and rehabilitation measures and leads to the disability of the patient. In this aspect, the crucial factor lies in the population’s engagement to medical organizations for examinations according to the road map for the prevention of socially significant diseases.

OBJECTIVE: The study aimed to investigate the risk factors for late detection of cancer of the female reproductive system based on the results of a survey on contingents of women with diagnosed cancer of three localizations (cancer of the ovaries, body, and cervix) in the Chechen Republic.

MATERIALS AND METHODS: Sample: Female patients diagnosed with cancer of the reproductive system (299 women). Observation units: patients diagnosed with ovarian cancer, uterine body cancer, and cervical cancer. Research base: Republican Oncological Dispensary, Grozny. Research design: face-to-face individual questionnaire survey (2020–2022). Research methods: Initially, survey, statistical, and graphical analysis of the data was conducted. Finally, ranking of risk factors for detection of the disease at late stage and the construction of a decision tree.

RESULTS: The key factors with an increase in the risk of late diagnosis of cancer of the female reproductive system to 100.0% were the diagnosis of ovarian cancer, the absence of vaginal discharge outside of menstruation/in menopause, an increase in the size of the abdomen, and late treatment (100.0% absolute risk). In the contingent diagnosed with ovarian cancer, all cases were detected late, while in 22.7% of cases aggregate of patients presented two other nosologies. Among patients who did not notice an increase in the abdomen, late diagnosis of cancer was noted in 26% of patients. Conversely, among those who noted this change, all cases were diagnosed at an advanced stage (p <0.05). Regarding the target indicator “The disease was detected at a late stage” seven risk classes were identified (risk from 7.5% to 100.0%). The high-risk class was characterized by a combination of factors: “Noted pain in the lower abdomen during intercourse (No),” “Blood relatives revealed tumor diseases (No),” and “I noticed an increase in the size of the abdomen (Yes)” (100.0% risk).

CONCLUSION: The relevance of the problem of oncogynecology is associated with the need for extensive educational work among the female population with an emphasis on the need for active participation in preventive examinations. Justifying the use of the strategy of “coercion to health” is essential in identifying risk factors and cancerous lesions of the organs of the female reproductive system in the early stages. This will prevent the progression of the malignant tumors and will contribute to effective medical and social prevention of disability.