An evaluation of the prevalence of malignant neoplasms in Russia using an incidence-mortality model

This paper aims to estimate Russian cancer incidence and mortality derivatives given limited access to medical and demographic data. We use the population model of cancer proposed by J. Duchene, which is a special case of a well-known multiple-decrement life table that makes it possible to obtain otherwise inaccessible indicators, such as the prevalence of cancer in the population. Applying this model to the publicly available Russian cancer incidence and mortality data, we were able to estimate the following indicators: average age at disease onset, average duration of disease, prevalence of malignant cancer, and average age at death from malignant cancer in Russia. We aimed to determine whether the prevalence of cancer is on the rise in the Russian Federation and, if it is, whether this increase is occurring due to an expansion of morbidity. It was found that the average age at disease onset and the average age at death from it in Russia are increasing, with the primacy of the latter. These processes are in turn resulting in an increase of the average number of years lived with cancer, thus justifying the hypothesis of an expansion of morbidity. This phenomenon, along with the increase in the incidence of malignant cancer, is what is causing the increased cancer prevalence. Groups of cancer localizations with the highest and lowest prevalence were identified, as well as localizations with a visible tendency toward an expansion of morbidity. It was found that in Russia the general trend is towards the expansion of morbidity, expressed by an increase in the number of years lived in an imperfect health condition. Malignant neoplasms of the lip, oral cavity and oesophagus (C00-C15) in females is the only localization for which the expansion of morbidity does not occur. For this localization a compression of morbidity is observed that is an antipode to the expansion. The main  limitations and drawbacks of the study are discussed in a separate section.