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Modern approaches for improving prevention, screening and early diagnosis of head and neck tumors of occupational genesis

Modern approaches for improving prevention, screening and early diagnosis of head and neck tumors of occupational genesis

ISSN 2223-6775 Ukrainian journal of occupational health Vol.16, No 3, 2020

Modern approaches for improving prevention, screening and early diagnosis of head and neck tumors of occupational genesis

Varyvonchyk D. V.1, Ejibiya O. M.1, Kopach K. D.2

 

https://doi.org/10.33573/ujoh2020.03.187

1) SI "Kundiiev Institute of Occupational Health of the NAMS of Ukraine"

2) P.L. Shupyk National Medical Academy of Postgraduate Education of the Ministry of Health of Ukraine (Kyiv, Ukraine)

 

Full article (PDF), UKR

Introduction. One of the little-studied groups of malignant neoplasms (MN) of occupational origin is tumors of the head and neck (THN). At present, THN includes primary MN of lips, oral cavity, salivary glands, pharynx, cervical esophagus; nasal cavity and paranasal sinuses, larynx, trachea. Taking into account the anatomical unity, common etiology and carcinogenic risk factors, it is important to develop and implement measures for prevention, screening and early diagnosis of THN among those working in carcinogenic conditions.

The purpose of the study is to develop modern measures for prevention, screening and early diagnosis of THN in individuals working in carcinogenic conditions.

Materials and methods. Using the IARC statistical database "CANCER TODAY" (2018) and data from the National Cancer Registry of Ukraine (1999, 2009, 2019), an epidemiological analysis of the incidence of THN was conducted. According to the “List of classifications by cancer sites with sufficient or limited evidence in humans” [IARC, 2020] and “Diet, nutrition, physical activity and cancer: a Global perspective” [AICR, 2018], risk factors for THN were identified.

On the basis of the research database "Occupational cancer in Ukraine" (1992 - 2019), clinical and epidemiological characteristics of THN of occupational origin were studied. Based on the data obtained in the study and the latest clinical recommendations based on evidence, measures for prevention, screening and early diagnosis of THN among individuals working in carcinogenic conditions were developed.

Results. In the general structure of cancer morbidity of the population of Ukraine THN takes the V place, in the countries of the European region and in the world – the IV place. THN ranks second in the structure of occupational cancer (OC) in Ukraine (10.6%). THN of occupational genesis is characterized by high incidence in males (96.9%); the average age of the first diagnostics of the disease is 57.2 ± 9.1 years, the average duration of industrial exposure to carcinogenic factors - 21.3 ± 9.7 years. Mostly, patients with THN of occupational genesis worked in the mining industry (54.7%), mainly - mining and processing of uranium ores (91.4%); and in the manufacturing industry (31.2%), mainly in mechanical engineering (50.0%). The main etiological factors of ТHN of occupational genesis in Ukraine are: gamma radiation (56.2%), radon-222 and daughter products of radon decay (DPRD) (46.9%), organ-specific chemical carcinogens (37.5%), including: chromium (VI) compounds and welding aerosols (54.2%), formaldehyde (20.8%), asbestos (12.5%), nickel (12.5%). For patients with THN of occupational genesis the detection of pathology at the late (III - IV) stages (61.2 - 87.1% of patients) is characteristic, which determines the high rates of 1-year mortality in these patients (26.9 - 64.4%). Currently, the only method of screening and early diagnosis (at I-II stages) of THN of occupational origin is systematic clinical examinations of individuals working in carcinogenic conditions by dentists and otorhinolaryngologists, during preliminary and periodic medical examinations (ME). For medical examinations, the tactics of increased "cancer alertness” is recommended, through an independent double and extended medical examination of individuals at high risk of THN. A clinical protocol for screening and early diagnosis of THN for ME has been developed. A set of measures to prevent the occurrence of THN among high-risk groups  is proposed.

Conclusions. The proposed measures will improve the prevention and early detection of THN of occupational origin, reduce primary morbidity and 1-year mortality among those working in carcinogenic conditions.

Key words: carcinogenic production, workers, occupational cancer, head and neck tumors, screening, diagnosis, prevention.

 

 

References

  1. Varyvonchyk D.V. (2020), " Occupational cancer in Ukraine: 1992-2019", Ukrainian Journal of Occupational Health, 2, 104-114.
    https://doi.org/10.33573/ujoh2020.02.104
  2. Varyvonchyk D.V. (2013), "Development of the national system of occupational cancer prevention in Ukraine", Ukrainian Journal of Occupational Health, 4, 35-46. https://doi.org/10.33573/ujoh2013.04.35
  3. Guidelines for the early diagnosis of cancer. (2018), WHO. URL: https://apps.who.int/iris/bitstream/handle/10665/272264/9789244511947-rus.pdf?ua=1 (Accessed 14.07.2020).
  4. ILO Convention No 139 "On combating the dangers of carcinogenic substances and agents in the industrial environment and prevention measures". (1974), URL: https://zakon.rada.gov.ua/laws/show/993_162#Text (Accessed 14.07.2020).
  5. Kundiev Y.I., Nahorna A.M., Varyvonchyk D.V. (2008) Profesiynyy rak: epidemiolohiya ta profilaktyka [Occupational cancer: epidemiology and prevention], Naukova Dumka, Kyiv, Ukraine.
  6. Nakaz MOZ Ukrayiny «Pro zatverdzhennya Poryadku provedennya medychnykh ohlyadiv pratsivnykiv pevnykh katehoriy» vid 11.05.2007 r. No(2007) [Order of the Ministry of Health of Ukraine "On approval of the Procedure for medical examinations of certain categories of workers", dated 11.05.2007 No 246], URL: https://zakon.rada.gov.ua/laws/show/z0846-07#Text (Accessed 14.07.2020).
  7. Onkologiya: Natsional'noye rukovodstvo. Kratkoye izdaniye (2017)[Oncology: National guidelines. Short edition],(eds.Chissov V.I. and Davydov M.I.), GEOTAR-Media, Moscow, Russia.
  8. Cancer prevention and control.(2005), Fifty-eighth World Health Assembly (WHA58.22).  URL: https://www.who.int/cancer/media/news/WHA58_22-ru.pdf?ua=1 (Accessed 14.07.2020).
  9. Rak v Ukraini, 1998 – 2020. Zakhvoryuvanistʹ, smertnistʹ, pokaznyky diyalʹnosti onkolohichnoyi sluzhby. (2001), [Cancer in Ukraine, 1998 - 2020. Morbidity, mortality, indicators of the oncology service], Byuletenʹ Natsionalʹnoho kantser-reyestru Ukrainy, Кyiv, Ukraine.
  10. Rak v Ukraini, 2009 – 2010. Zakhvoryuvanistʹ, smertnistʹ, pokaznyky diyalʹnosti onkolohichnoyi sluzhby. (2011), [Cancer in Ukraine, 2009 - 2010. Morbidity, mortality, indicators of the oncology service], Byuletenʹ Natsionalʹnoho kantser-reyestru Ukrainy, 12, Кyiv, Ukraine.
  11. Rak v Ukraini, 2018 – 2019. Zakhvoryuvanistʹ, smertnistʹ, pokaznyky diyalʹnosti onkolohichnoyi sluzhby. (2020), [Cancer in Ukraine, 2009 - 2010. Morbidity, mortality, indicators of the oncology service], Byuletenʹ Natsionalʹnoho kantser-reyestru Ukrainy, 21, Кyiv, Ukraine.
  12. Laryngeal cancer. (2018), Clinical guidelines, Association of Oncologists of Russia, Russian Society of Clinical Oncology, URL: http://www.oncology.ru/association/clinical-guidelines/2018/rak_gortani_pr2018.p.df (Accessed 14.07.2020).
  13. Laryngopharyngeal cancer. (2018),  Clinical guidelines, Association of Oncologists of Russia, Russian Society of Clinical Oncology,  Мoscow, URL: http://www.oncology.ru/association/clinical-guidelines/2018/rak_gortanoglotki_pr2018.pdf (Accessed 14.07.2020).
  14. Nasopharyngeal Cancer. (2018), Clinical Guidelines, Association of Oncologists of Russia, Russian Society of Clinical Oncology, Мoscow, URL: http://www.oncology.ru/association/clinical-guidelines/2018/rak_nosoglotki_pr2018.pdf (Accessed 14.07.2020).
  15. Cancer of the nasal cavity and paranasal sinuses. (2018), Clinical guidelinesm, Association of Oncologists of Russia, Russian Society of Clinical Oncology Мoscow, URL: http://www.oncology.ru/association/clinical-guidelines/2018/rak_polosti_nosa_i_pridatochnykh_pazukh_pr2018.pdf (Accessed 14.07.2020).
  16. Oropharyngeal Cancer. (2018), Clinical Guidelines, Association of Oncologists of Russia, Russian Society of Clinical Oncology, Мoscow,URL: http://www.oncology.ru/association/clinical-guidelines/2018/rak_rotoglotki_pr2018.pdf (Accessed 14.07.2020).
  17. Oral Mucosal Cancer.(2018), Clinical Guidelines, Association of Oncologists of Russia, Russian Society of Clinical Oncology, Мoscow, URL: http://www.oncology.ru/association/clinical-guidelines/2018/rak_polosti_rta_pr2018.pdf (Accessed 14.07.2020).
  18. Diet, nutrition, physical activity and cancers of the mouth, pharynx, larynx: a Global Perspective: 3rd Expert report.(2016), World Cancer Research Fund International, American Institute for Cancer Research, Revised 2018. URL: https://www.wcrf.org/sites/default/files/Mouth-Pharynx-Larynx-cancer-report.pdf (Accessed 14.07.2020).
  19. Diet, nutrition, physical activity and nasopharyngeal cancer: a Global Perspective: 3rd Expert report.(2013), World Cancer Research Fund International, American Institute for Cancer Research, Protocol vers. 2. URL: https://www.wcrf.org/sites/default/files/nasopharyngeal-cancer-protocol.pdf (Accessed 14.07.2020).
  20. Diet, nutrition, physical activity and oesophageal cancer: a Global Perspective: 3rd Expert report. (2016), World Cancer Research Fund International, American Institute for Cancer Research, Revised 2018. URL: https://www.wcrf.org/sites/default/files/Oesophageal-cancer-report.pdf (Accessed 14.07.2020).
  21. Early detection.  WHO Cancer control: guide for effective programmes. (2007), URL: https://apps.who.int/iris/bitstream/handle/10665/43743/9241547338_eng.pdf?sequence=1 (Accessed 14.07.2020).
  22. Head and neck cancer. (2020), URL: https://en.wikipedia.org/wiki/Head_and_neck_cancer (Accessed 14.07.2020).
  23. List of Classifications by cancer sites with sufficient or limited evidence in humans. (2020), IARC, 1 – 127, Last update: 26 June 2020, URL: https://monographs.iarc.fr/wp-content/uploads/2019/07/Classifications_by_cancer_site_127.pdf (Accessed 14.07.2020).
  24. CANCER TODAY (2018), Data visualization tools for exploring the global cancer burden in 2018, IARC, URL: https://gco.iarc.fr/today. (Accessed 14.07.2020).
  25. Prevention. WHO Cancer control, (2007),  guide for effective programmes, URL: https://apps.who.int/iris/bitstream/handle/10665/43575/9241547111_eng.pdf?sequence=1 (Accessed 14.07.2020).
  26. Cancer: Key facts. (2018), WHO, URL: https://www.who.int/news-room/fact-sheets/detail/cancer (Accessed 14.07.2020).