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Vol. 24, Art. 83 (pp. 1207-1222)    |    2023       

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Problems of early diagnosis of laryngeal cancer, diagnosis and treatment of precancerous diseases of the larynx and ways to solve them

1Shlyaga I.D., 2Kaliadich Zh.V.,3 Sanukevich T.A., 2Mirylenka L.V, 2Bukov J.F.

1?Gomel State Medical University?, Gomel, 246000, Republic of Belarus
2?N. N. Alexandrov National Cancer Centre of Belarus?, Lesnoy, Minsk District, 223040 Republic of Belarus
3Ministry of Health of Republic of Belarus, Minsk, Myasnikova St. 39

Brief summary

The purpose of the study is to identify the problems of early diagnosis of laryngeal cancer, diagnosis and treatment of precancerous diseases of the larynx in the Republic of Belarus and determine ways to solve them. Material and research methods The study material was patients of the pilot region: with newly diagnosed malignant neoplasms (MN) of the larynx (n=47), patients registered with an otorhinolaryngologist for chronic hyperplastic laryngitis (CHL) (n=61), as well as 179,874 residents of the Gomel region. areas included in the target audience for screening for malignant and precancerous diseases of the larynx. The research methods included the collection of patient data, instrumental examination of the ENT organs, questionnaires, biopsy, statistical and scientific analysis of the information received. Results Of 47 patients with newly diagnosed laryngeal cancer (LC), 12 (25%) patients had the disease in stage I, 17 (35%) in stage II, 13 (28%) in stage III, and 5 (11%) in IV stage (LC). All patients went to the otorhinolaryngologist on their own with symptoms of the disease, the duration of which ranged from 1 to 30 months. (median 17.5 months), in 30 (64%) patients this period was 1 year or more. Therefore, during informal annual examinations, these individuals could have been diagnosed with the disease earlier. Before contacting an otolaryngologist, 30% (14 out of 47) of patients were observed by other specialists. As of October 1, 2021, in the pilot region, 61 patients were on dispensary registration (DR) with an otorhinolaryngologist with a diagnosis of CHL in the pilot region. Only 1 patient was referred to a doctor based on the results of a physical examination, 60 (98%) applied on their own. The duration of symptoms ranged from 10 days to several years, with a median of 2 years. The median time spent on DR was 5 years. On average, patients received 12 courses of outpatient treatment, which consisted mainly of antibiotic therapy. 34 (56%) patients received inpatient treatment, 71 courses in total. Biopsy was performed in 15 (25%). In a prospective study, all patients were referred for biopsy, 14 patients refused to perform a biopsy. Twenty-four (51%) patients had MN of the larynx or CHL with severe dysplasia. Based on the identified problems, ways to solve them were determined. Conclusion The problems of early diagnosis of laryngeal cancer, diagnosis and treatment of precancerous diseases of the larynx in the Republic of Belarus have been identified. The ways of their solution have been determined, which, in particular, include the development and implementation of measures to inform the population and medical workers about the symptoms, nature, treatment and consequences of malignant and precancerous diseases of the larynx, the development and implementation of the Program for the early diagnosis of precancerous diseases and malignant neoplasms of the larynx. The measures taken have shown their effectiveness already at the initial stage.


Key words

laryngeal cancer, chronic hyperplastic laryngitis, public awareness, target population, screening, early diagnosis program.

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