Planning the routing of oncological patients with head-neck tumors at the regional level

Introduction. The principles of diagnosis and treatment of malignant neoplasms in the Russian Federation is based on clinical recommendations validated by the state, as well as the normative principles of the management of oncological care. The planning of such care for relatively rare tumors in the territories with low population density is a special challenge.

Materials and methods. The authors analyzed the legislative requirements and proposed possible models of care manahement for patients with head-neck tumors on the example of one of the regions of the Russian Federation — Yamalo-Nenets Autonomous Okrug (YNAO), the features of which include a relatively low incidence of these neoplasms — 4.3 per 100 thousand population to the data of 2022.

Results. Taking into account the peculiarities of the medical infrastructure of the study region and the morbidity rate, the basic modeling of routing for head-neck tumors and oncological consultations by the multidisciplinary team (MDT) in a remote format, enshrined in the regulatory documents of the regional Department of Health Care, was performed. The influence of the proposed approaches on the quality of diagnostics at the level of outpatient cancer care center was studied, the modification of the basic model for patients with «head-neck» tumors was justified, and the ranking evaluation of the two presented models. The advantage of the modified scheme in nine studied parameters is shown. The differences in the evaluation are statistically significant (p = 0.005).

Research limitations. The present study is relevant for regions with an incidence rate of head-neck tumors below the national average.

Conclusion. The proposed solution can serve as a basis for managing approaches for regional medical institutions providing specialized oncological care for tumors rarely occurring in the region.

Compliance with ethical standards. The study does not require the submission of a medical ethics report or other documentation.

Contribution of the authors:
Parts S.A. — concept and design of the study, statistical analysis, writing text, illustrations, scientific editing;
Leskov S.V. — literature search and review, data analysis, structuring an article;
Kulikova E.N. — data analysis, structuring an article;
Reshetov I.V., Galkin V.N. — writing text, structuring an article;
Kuzmina E.S. — writing text, structuring an article, scientific editing.
All authors are responsible for the integrity of all parts of the manuscript and approval of the manuscript final version.

Funding. The study had no sponsorship.

Conflict of interest. The authors declare no conflict of interest.

Received: April 16, 2024 / Accepted: October 3, 2024 / Published: June 30, 2025

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