Cancer mortality in Russia and Ukraine: validity, competing risks and cohort effects

Area of Science:

• Epidemiology
• Demography
• Health Services Research

Background:

• Mortality rates in Russia and Ukraine increased significantly in the late 1980s and 1990s.
• Cardiovascular disease, accidents, and violence were primary drivers of increased mortality.
• Cancer mortality showed a slight decline during the same period.

Purpose of the Study:

• Analyze trends and patterns in cancer mortality in Russia.
• Investigate four potential explanations for the observed decrease in cancer deaths.
• Provide insights into the complex factors influencing mortality changes.

Main Methods:

• Analysis of cancer mortality trends.
• Examination of data collection changes and coding practices.
• Assessment of cohort effects and competing mortality.
• Evaluation of potential impacts of healthcare improvements.

Main Results:

• Underrecording of cancer deaths, particularly among the elderly in rural areas, and changes in coding practices were identified.
• Reduced mortality from cardiovascular diseases and accidents partially explained decreased cancer deaths in middle-aged males.
• Birth cohort effects contributed to reduced cancer mortality in males and females across various age groups.
• Improvements in healthcare may have reduced childhood leukemia deaths, though this is harder to ascertain.

Conclusions:

• Observed changes in Russian mortality are multifaceted.
• A multidisciplinary approach involving demography, epidemiology, and health services research is crucial for comprehensive understanding.
• Further research is needed to fully elucidate the complex interplay of factors affecting mortality patterns.