The relevance of the problems of diagnosis and treatment of skin cancer is currently determined not only by the high incidence rate, but by the existing difficulties in differential diagnosis and treatment with traditional methods. For localizations of basal cell skin cancer (BCSC) that are \"inconvenient\" for treatment, such as the external auditory canal, auricle, and wing of the nose, treatment is associated with certain difficulties and the possible appearance of a cosmetic defect, therefore, when choosing a treatment method, the anatomical features of these organs are taken into account. It has been determined that the effectiveness of treatment for primary BCSC of the nose and auricles is higher than recurrent one, and among the various treatment methods, the most effective and radical is the surgical method. The immediate results of treatment of BCSC in the form of PR by surgical method were 86.7%, which is statistically significant compared with other types of treatment (p < 0.05). Long-term treatment results with the surgical method are also higher (77%) compared to other methods, which is also statistically significant (p < 0.05).

OBJECTIVE: To examine changes in multiple myeloma incidence and mortality rates during 1982-2018, and to estimate its incidence, mortality, and prevalence for 2019-2043.
METHODS: Population-based statistical modelling study; analysis of and projections based on Australian Institute of Health and Welfare multiple myeloma incidence, mortality, and survival data.
METHODS: Australia, 1982-2018 (historical data) and projections to 2043.
METHODS: Changes in multiple myeloma incidence and mortality rates, 1982-2018, determined by joinpoint regression analysis (age-standardised to 2021 Australian population); projection of rates to 2043 based on age-period-cohort models; estimated 5- and 30-year prevalence of multiple myeloma (modified counting method).
RESULTS: The incidence of multiple myeloma increased during 1982-2018 (eg, annual percentage change [APC], 2006-2018, 1.9%; 95% confidence interval [CI], 1.7-2.2%), but the mortality rate declined during 1990-2018 (APC, -0.4%; 95% CI, -0.5% to -0.2%). The age-standardised incidence rate was projected to increase by 14.9% during 2018-2043, from 8.7 in 2018 to 10.0 (95% CI, 9.4-10.7) new cases per 100 000 population in 2043; the mortality rate was projected to decline by 27.5%, from 4.0 to 2.9 (95% CI, 2.6-3.3) deaths per 100 000 population. The annual number of people newly diagnosed with multiple myeloma was estimated to increase by 89.2%, from 2120 in 2018 to 4012 in 2043; the number of deaths from multiple myeloma was projected to increase by 31.7%, from 979 to 1289. The number of people living with multiple myeloma up to 30 years after initial diagnosis was projected to increase by 163%, from 10 288 in 2018 to 27 093 in 2043, including 13 019 people (48.1%) diagnosed during the preceding five years.
CONCLUSIONS: Although the decline in the mortality rate was projected to continue, the projected increases in the incidence and prevalence of multiple myeloma in Australia over the next 25 years indicate that investment in prevention and early detection research, and planning for prolonged treatment and care, are needed.

BACKGROUND: Lymphatic metastasis is the major challenge in the treatment of penile cancer. The prognosis of individuals with lymphatic metastasis is extremely poor. Therefore, early identification of disease progression and lymphatic metastasis is an urgent task for researchers in penile cancer worldwide.
METHODS: In this study, using single-cell RNA sequencing, an immune landscape was established for the cancer ecosystem based on 46,861 cells from six patients with penile cancer (four with lymphatic metastasis [stage IV] and two without lymphatic metastasis [stage I]). Using bulk RNA sequencing, the discrepancy between the cancers and their respective metastatic lymph nodes was depicted based on seven patients with penile cancer.
RESULTS: The interaction between epithelial cells, fibroblasts, and endothelial cells, and the functional cooperation among invasion, epithelial-mesenchymal transition, and angiogenesis were found to be important landscapes in the penile cancer ecosystem, playing important roles in progression of cancer and lymph node metastasis.
CONCLUSIONS: This study is the first to investigate the altered tumor microenvironment heterogeneity of penile cancer as it evolves from non-lymphatic to lymphatic metastasis and provides insights into the mechanisms underlying malignant progression, the premetastatic niche, and lymphatic metastasis in penile cancer.

BACKGROUND: Qualitative research on the perceptions of healthcare professionals involved in cancer care about their respective roles in the patient care pathway is limited. Therefore, the aim of this qualitative study was to document these perceptions.
METHODS: A multidisciplinary team that included patient researchers constructed a semi-structured interview guide on the perceptions of the colorectal cancer care pathway by professionals. Interviews were conducted with healthcare professionals from two French hospitals that manage patients with colorectal cancer. Then, the interviews were fully transcribed and analysed by the whole multidisciplinary team.
RESULTS: Thirteen healthcare professionals were interviewed (six nurses, four physicians, one psychologist, one social worker and one secretary). They described the colorectal care pathway using a great lexical diversity and listed a significant number of professionals as taking part in this pathway. Among the people mentioned were healthcare professionals working inside and outside the hospital, family members and non-conventional medicine practitioners. However, they did not spontaneously mention the patient. Their views on the role of the referring physician, the general practitioner and the patient were further explored. The interviews highlighted the coordination difficulties among the various professionals, particularly between general practitioners and hospital teams. These data provided interesting elements for developing a tool to help coordination among professionals.
CONCLUSIONS: This preliminary study, with its participatory design, brings interesting elements of reflection on the care pathway for patients with colorectal cancer. It will continue through the creation of a larger participatory project.
UNASSIGNED: Patient partners were included in all steps of this study. This transdisciplinary project was coordinated by a group composed of three patient partners, two healthcare professionals and two humanities and social sciences researchers. Their knowledge of the patient\'s perspective on the care pathway enriched discussions from the study design to results analysis.

One of modern methods of estimating health losses under malignant neoplasms in economic terms, characterizing number of deaths and age of death are lost years of potential life. The cumulative losses from premature cancer mortality made up to 29 217.5 man-years in 2013 and 39 710 man-years in 2021. The number of years lost over 9 years increased by 10 492.5 man-years despite decreasing of mortality across all ages. The rate of lost years of potential life during this period increased from 5.3 to 6.2 years. The maximal contribution to lost years of potential life was made by population groups 45-59 years old. Total losses from premature mortality from cervical cancer were 2682.5 man-years and 2411 man-years in 2013 in 2021. The number of years lost decreased by 271.5 man-years. The rate of lost years of potential life during this period increased from 0.5 to 3.7 years. The greatest contribution to lost years of potential life was made by population groups 60-64 and 40-49 years old. The calculation demonstrated that there are significant reserves for reducing population mortality from malignant neoplasms in most vulnerable age population groups that is important for organization of oncological care and planning of target prevention programs.

Until recently, in Kazakhstan, both health care services and medication support of population were financed from National budget and compulsory social health insurance foundation. But actual system meet needs of Kazakhstanis in medications not in full measure. The purpose of the study is to identify readiness of citizens to implementation of new medicinal insurance program with state co-financing. The study was carried out in 2022 in 17 regions of Kazakhstan. The readiness of Kazakhstanis to participate in medicinal insurance program with state co-financing was studied through sociological survey of 5 819 Kazakhstanis. The sociological survey revealed that respondents express average degree of readiness to implementation of new medicinal insurance program with state co-financing and to purchasing of insurance policy. The correlation between social demographic characteristics (objective indicators) and readiness indicator (subjective indicator) was revealed. The younger males with higher education, residing in urban areas, with average and high income and officially married are more inclined to purchase insurance policy. At that, according to results of sociological survey, one third of respondents have no relevant information about health insurance in general and medicinal insurance in particular. They found it difficult to express their personal position about this issues. It is supposed that Kazakhstanis in the result of educational measures will take part in medicinal insurance program with state co-financing. The education projects can be implemented through public organizations operating locally and communicating with population at the micro level. It is determined that it is especially important to apply educational measures to rural residents, middle-aged and elderly people, females and persons with low average income per family member.

The psycho-emotional status of women after radical surgery for breast cancer was assessed. The international questionnaire FACT-G and module FACT-B module were applied to investigate life quality of 186 women under dispensary monitoring concerning breast cancer of stage I-II. The respondents were aged 30-40, 41-50, 51-60, 61-70 and 71 years and older. In women who underwent radical surgery for breast cancer, psycho-emotional status is manifested most vividly as compared with other perceptions in the postoperative period and decreases quality of life. The overwhelming majority of women with breast removal experiences feeling of inferiority and depression, despair, fear of health deterioration and death that increase with age. The percentage of women satisfied with their coping with illness is 64.8% among 30-41 years old, 45.8% among 51-60 years old and 4.2% among 70 years and older. The impact of stress on disease is most felt in women of 51-60 years old (63,6%) and 61-70 years old (58,8%). No reliable differences in level of emotional condition of urban and rural respondents was established. The attitude of women to methods of postoperative correction through formation of breast lost depends on their age, place of residence, level of education. More than 60% of respondents under age of 50 years consider solution of aesthetic problem in endoprosthesis replacement with implants. Among respondents aged 51-60 years, 25.0% preferred simultaneous mastectomy and breast reconstruction and 10.1% - breast plastic surgery. The endoprosthesis replacement is more often resorted by women older 60 years and rural residents. The choice of mode of breast correction often depends on financial possibilities of patients. The study of quality of life of women with post-mastectomy syndrome is valuable component of integrated approach to dispensary monitoring that individualizes rehabilitation measures. The effectiveness of psychological rehabilitation of women requires involvement of clinical psychologists and medical social services.

The article considers results of assessment of dynamics of mortality from cardiovascular diseases and the most important nosologic forms - acute cerebrovascular disorders and coronary heart disease with acute coronary syndrome and development of accessibility of X-Ray endovascular care of patients in the Oblast. The results of analysis of changes in mortality after implementation of new model of care of patients with acute vascular diseases are presented. The relationship between accessibility of X-Ray endovascular interventions and decrease of mortality was analyzed. The reliable significantly strong connection was found for cerebrovascular diseases, and medium negative connection for coronary heart disease with acute coronary syndrome.

The article for the first time analyzes and compares data of STEPS-studies in 2016-2017 and 2019-2020 in Belarus. It demonstrates impact of organizational measures and management decisions at level of the Ministry of Health of the Republic of Belarus on monitoring indicators of main risk factors of development of non-communicable diseases based on results of the study. The prospects of impact of risk factors of development of diseases of circulatory system on levels of population morbidity is demonstrated. The STEPS-studies of 2016-2017 and 2019-2020 were carried out by the authors as coordinators for the Brest region. In Belarus, the study was part of set of the UN measures implemented by the WHO targeted to ensuring increase in standard of living and well-being of population of Belarus. In 2016-2020, Belarus implemented project \"Prevention of noncommunicable diseases, promotion of a healthy lifestyle and modernization of the healthcare system in the Republic of Belarus\" (BELMED), funded by the EU as international technical assistance project. Within this project with the support of the WHO, national study was organized on prevalence of main risk factors of development of non-communicable diseases (NCDs) in population of the Republic of Belarus aged 18-69 years. The article compares and demonstrates dynamics of indicators of main risk factors of development of diseases of circulatory system (BSC) according STEPS-studies of 2016-2017 and 2019-2020. It is demonstrated that organizational and managerial decisions made on the basis of large-scale studies can affect further prevalence of risk factors of NCDs in population. The problems of prospects for further increasing of incidence of BSC in the Republic of Belarus and their relationship with cardiovascular risks are also highlighted.

The treatment of women aged 35 years and older with infertility applies assisted reproductive technologies (ART) in every third case. The purpose of the study is to analyze impact of maternal health on health of children who were delivered by women aged 35 years and older after application of ART. The analytical, direct observation, sociological (questioning), and statistical methods were applied. To study health status of children born after application of ART methods in women aged 35-45 years, representative main group of 648 preschool children (4-6 years old) was selected. The second control group included 649 preschool children (4-6 years old), who were as identical as possible to children from the main group, selected according to following characteristics: mother\'s age at birth of child (35-45 years), age (from 4 to 6 years), all were observed in same medical organization, birth from a singleton, full-term (37 weeks or more) pregnancy. The main and control groups differed from each other only in presence or absence of ART methods. The children born preterm, from egg donor programs and multiple pregnancies were excluded from study. The children health was studied according to medical examinations, medical records, child development history, and mothers questionnaire data on children health. The course of pregnancy and childbirth, morbidity and lifestyle characteristics of mothers were studied according to their questionnaires and copies of data from their outpatient medical records. It was established that there is direct correlation between health of child and health of mother (r = 0.571; p < 0.01, t = 3). At that, it was revealed that differences in level of general morbidity of children after ART and children from spontaneous pregnancy are achieved within account of significant differences in subgroup of children of mothers aged 38-45 years (3353.7‰ and 2341.8‰ control group).