Oncology in Russia: Problems and Opportunities They Open for Clinical Trials

According to research done by the International Agency for Research on Cancer (IARC, GLOBOCAN 2012), Russia was the fifth country in the world by the number of deaths (295,357) among oncology patients in 2012. In 2014 the number of deaths caused by cancer accounted over 15% out of the total number of deaths. 

Data in this article is taken from report published in the Lancet Oncology magazine in April 2015

The following facts outline the scope of clinical trial opportunities for CROs and pharmaceutical companies interested in clinical studies of cancer treatment in Russia.

In 2014, the accumulated risk of developing cancer by the age of 75 was 24.7% (29.4% were men and 22.3% – women).

By the end of 2014, registered in cancer care facilities were 3.29 million patients. In Russia, there are annually about 2 million cancer patients in need of palliative care that is inaccessible (for drug-related regulatory reasons) for a great number of patients.

In terms of five-year survival rate, in 2014 only 52.4% of cancer patients could overcome the five-year period after first being diagnosed, whereas in the U.S. the percentage of such patients reached 80%.

Mortality rate

According to the report published in Lancet Oncology magazine in April 2015, oncology mortality in Russia is much higher than in Europe and the U.S, with 26% of oncology patients in Russia dying during the first year after being diagnosed. This means that every fourth cancer patient in Russia dies during the first year after being diagnosed.

According to World Bank’s classification, Russia is a developing country with high population income. However, this fact has no effect on the population’s longevity, with oncology diseases causing 15% of all deaths in the country.

The total risk of dying from cancer in Russia is about 60%, which is higher than in the UK and the USA where this index is 40% and 33% correspondingly.

Diagnostics

Early detection is a crucial factor that could make cancer incidence rates in Russia even higher.  In remote areas, far from the country’s European part, cancer is hard to detect in patients while living, and even harder – after they die. The reason is that capacity of the existing medical facilities – well furnished with qualified specialists and quality equipment – is not enough to accommodate the great number of cancer patients.

The high mortality rate of cancer in Russia is explained by late detection of the disease. In a vast number of cases, it is diagnosed at a stage when its treatment is very difficult and often impossible.

Thus, in 2014, only 26.7% of cancers were diagnosed at the first stage, and all remaining – at second (25.3%), third (20.6%), fourth (21%), and some 6.4 % of cases were of an undetected stage.

Oncology stages structure in Russia, 2014 - Atlant Clinical US CRO

Accessibility of Cancer Care

Because of scarce financial support from the government, cancer care is inaccessible for a great part of cancer patients, especially for those who live far from big cities. Only about 50% of patients in Russia get access to radiotherapy. Accountable for this fact is the absence of resources, including specialized equipment and finance. In developed countries, 70% patients have access to radiotherapy (with short half-life isotopes and special equipment).

This largely miserable condition of medical cancer care in Russia opens wide opportunities for conducting clinical trials. This is the reason why Atlant Clinical CRO’s services of conducting clinical studies in this country are so much in demand by pharmaceutical companies from worldwide.

Most Common Types of Oncological Diseases

In Russia, there are about 44 million smokers – 60.2% of them being men, and 21.7% – women.

With smoking being extremely widespread in Russia, lung cancer is the leader among oncology diseases here, followed by other cancer types stemming from the same causes:

  • bladder cancer
  • head and neck cancer
  • kidney cancer
  • gastric cancer
  • pancreatic cancer
  • esophageal cancer
  • liver cancer
  • colon cancer.

The mentioned types of cancer are more common in Russia than in most European countries and the USA, featuringalmost 3 times higher rate of mortality.

The mortality and new incidences ratio for, say, head and neck cancer, is three times higher in Russia than in the U.S.

The high mortality cancer types among women in Russia are:

  • cervical cancer – with new incidents of the disease here being 15.9 per 100,000 of the population, which is higher than in European countries (9.6) or in the USA (6.6);
  • colon and rectal cancer – the type second in high mortality among women, and the third among men;
  • breast cancer.

Another crucial circumstance giving rise to a great number of cancer incidents is poor ecology. Some regions in the country have alarming pollution rates because of deforestation and nuclear wastes.

All these facts suggest that it is quite easy for pharmaceutical companies and CROs to find and recruit the required number of cancer patients for clinical trials in a vast number of cancer types and fields of research (diagnostics, therapy, palliative care and/or some other)in Russia.