Malignant neoplasms of the kidney in Ukraine: Epidemiological indicators in different regions during 2018-2024

Abstract

The increase in cancer incidence in recent decades is a major problem today, and the need for further improvement in the diagnosis and treatment of patients prompts us to study the dynamics of epidemiological indicators in recent years. 

The purpose of the study is to determine the dynamics of malignant neoplasms of the kidney (MNK) incidence and mortality, the number of all persons registered at the end of each year and newly diagnosed, including through medical examinations, with an analysis of the stages of pathology and the index of accumulation of contingents, in different regions of Ukraine in the period 2018-2024 years (ys).

Materials and Methods. The source of data was statistical collections for the analysis of absolute and relative epidemiological indicators of the prevalence and incidence of MNK, patient mortality and others in order to determine trends in the formation of pathology, forecasting and improving the development of onco-urological care. The data obtained was considered both for Ukraine as a whole, including the provinces, and for each of the five regions - Western (West.), Central (Centr.), North-Eastern (North-East.), South-Eastern (South-East.), Southern (South.) - and by their constituent regions, as well as in Kyiv. For statistical processing using the software package "SPSS for Windows. Version 11“ and ”MedStat" software, the chi-square test was used; the proportion of two groups was compared using Fisher's angular transformation (with Yates correction); a difference of p<0.05 was considered significant.

Results. The highest incidence of MNK in 2018–2021 was recorded in the South-East region, while the lowest rates were observed in the North-East and South. In 2022–2024, the West and Central regions had the highest incidence, whereas Kyiv and, during the last three years, the Southern region had the lowest rates. Despite a significant decrease in MNK incidence per 100,000 population from 2018 to 2019, the number of patients registered at the end of each year increased steadily from 2018 to 2024 (p<0.001), including those registered for more than 5 years. This increase was most pronounced in the Western and Central regions, particularly in Kyiv, Mykolaiv, Chernivtsi, and Odesa regions.

The accumulation index increased significantly in 2020 and remained high through 2024. The highest values were observed in the South-East and South regions and in Kyiv in 2022, when the national index also reached its maximum.

The proportion of newly diagnosed patients with stage I–II disease decreased significantly in all regions in 2020 and in Kyiv in 2021–2022, followed by recovery to 2018 levels in 2023–2024. This improvement coincided with an increase in cases detected during medical examinations to 14%, although this indicator had declined almost twofold between 2018 and 2022 (p<0.001). In Kyiv, it decreased from 60% to 52% (p=0.002).

The annual number of deaths from MNK, mortality per 100,000 population, and the proportion of patients who died within 1 year of diagnosis decreased gradually from 2018 to 2021, with a marked decline in 2022 (p<0.001), and remained stable thereafter.

Conclusions. The decline in MNK incidence and in the proportion of newly diagnosed stage I–II cases in 2020–2022 may reflect reduced opportunities for timely screening and preventive care during the COVID-19 pandemic and the beginning of hostilities. The significant decrease in the proportion of MNK cases detected during professional examinations in 2022 compared with 2018 represents an important negative socio-medical trend.

At the same time, the gradual decline in mortality, stabilization in 2023–2024, increasing numbers of patients remaining under follow-up, and the rise in the accumulation index since 2020 may indicate improved survival and continuity of care for patients with MNK in Ukraine.