🇺🇦 Cancer in Ukraine

The registry's Bulletin No. 27 counts 60,397 cancers in men and 64,404 in women in 2024, 1,959 (1.6%) more than in 2023, and 44,545 cancer deaths, 25,094 men and 19,451 women. Most cancers were found at ages 45 to 74: about 75% of cases in men and almost 70% in women. In men prostate cancer was 16.4% of new cases (9,934, up 14.0% on 2023) and lung cancer 14.6% (7,882); the registry expects the long fall in lung cancer and rise in prostate cancer in men, visible since at least 2010, to continue. In women breast cancer was 21.5% of new cases (13,850). Thyroid cancer rose by 38.2% in men and 20.4% in women, and the registry says this may be a prolonged effect of the Chornobyl accident. Lung cancer caused the most cancer deaths in men aged 30 to 74, and breast cancer caused 20.1% of cancer deaths in women. The registry counted 579 cancers in children aged 0 to 17, three fewer than in 2023, which it describes as unchanged, but 35% fewer than in 2021, which it attributes partly to hospitals not reporting cases and possibly to wartime migration.

Bulletin No. 27 states that cases have been undercounted in Donetsk and Luhansk regions since 2014 because of occupation, migration and the relocation of the regional registries and cancer centres, and that since 2022 similar problems affect many regions, most of all Zaporizhzhia and Kherson, large parts of which are occupied. In 2024 Luhansk registered 277 cases and Donetsk 1,049. It describes a substantial undercount of deaths since 2015, growing since 2019 in more than half of the regions, because registries lost access to data from the State Statistics Service and the civil registry offices; in Kharkiv the ratio of cases to deaths reached 10.3. With no population data for 2024 and 2025, the bulletin gives only counts and proportions. Late reports matter: the confirmed figures for 2024 contain 13,555 (12.2%) more cases than the first count. The registry concludes that it can keep only the count of new cases at a reliable level, close to 95%, and only a year after the year ends, and calls for its registrars to be given access to the national e-health system's data on whether patients are alive. The national strategy records that 22.3% fewer cancers were registered in 2022 than in 2021, with falls of 89% in Luhansk and 82.1% in Kharkiv regions.

The registry's history, published in Bulletin No. 27 for its thirtieth anniversary, says its electronic system grew from work begun in 1989 at the Kyiv research institute of oncology, now the National Cancer Institute, and received state backing with the Ministry of Health's order No. 10 of 30 December 1996 on creating a national cancer registry. A population-based registry runs in every region, inside the regional cancer centre, and a hospital registry system is used in 26 of the largest cancer clinics, which pass electronic discharge summaries to the population registry; the whole country was covered by 2000. The registry says it covers the entire population, that its data appear in volumes X to XII of Cancer Incidence in Five Continents and in International Incidence of Childhood Cancer, and that it has been a member of the European Network of Cancer Registries since the end of the 1990s. Its linkage with the register of people affected by the Chornobyl disaster has been used in studies of the accident's consequences. The bulletin notes that a Ministry reorganisation of the registry on modern information technology is planned and will not be quick.

Cabinet resolution No. 1808 of 31 December 2025 sets the 2026 rules. The chemotherapy package is paid to each hospital as a monthly global rate built from an annual capitation of 36,807 hryvnias per patient, weighted 3.555 for children, 0.97 for adults treated in hospital and 0.7 for adults treated only as outpatients; it is open to providers that treated at least 100 patients with the listed diagnoses in the first half of 2025, and a provider that also holds a radiotherapy contract earns a higher weight of 1.1 for offering both. Radiotherapy is paid per course at 51,368 hryvnias, weighted 1.5 on a linear accelerator, gamma knife or brachytherapy and 0.753 on cobalt or X-ray units, which rewards modern equipment. Blood cancers have their own package at 74,429 hryvnias per patient per year. PET-CT is paid at 19,185 hryvnias a scan, with 4,000 scans planned for the year, and a mammogram at 248.64 hryvnias. Providers in territories with active fighting or under occupation are excluded from some packages and paid under separate rules.

The Ministry of Health announced on 22 October 2025 that the government had added palbociclib for hormone-receptor-positive, HER2-negative advanced breast cancer, inotuzumab ozogamicin for acute lymphoblastic leukaemia and gemtuzumab ozogamicin for acute myeloid leukaemia to the medicines bought under managed entry agreements, with a three-year contract signed by Medical Procurement of Ukraine. It described the agreements as confidential arrangements that in many cases cut the price several times, said earlier agreements covered the HPV vaccine and atezolizumab for lung cancer, and said 17 medicines were then bought this way. On 4 February 2026, as reported by Interfax-Ukraine, the agency said cancer medicines take more than 20% of its yearly budget for medical goods, that it bought 243 cancer medicines and devices worth 11.6 billion hryvnias in 2020 to 2025, and that in 2025 it bought pembrolizumab, atezolizumab, brentuximab vedotin, palbociclib, inotuzumab ozogamicin and gemtuzumab ozogamicin. The National Cancer Institute publishes its remaining stock of state-funded medicines on its website, updated weekly.

Section III of the 2026 Programme of Medical Guarantees, on reimbursement, lists the medicines the NHSU reimburses for outpatient treatment under the 2021 reimbursement procedure, by international non-proprietary name and form. Under the heading of cancer, for patients with hormone-dependent breast cancer and patients with other breast cancer prescribed hormone therapy under the national standards, it lists exemestane, letrozole and tamoxifen as solid oral forms. The other groups on the list are mostly heart, lung, diabetes and other chronic conditions; for some medicines the resolution sets a fixed 50% reimbursement. Cancer appears as a heading in the reimbursement section only for these three medicines, so tablets such as targeted therapies are not on the 2026 pharmacy reimbursement list.

The State Expert Centre's Department of Health Technology Assessment works under Cabinet resolution No. 1300 of 23 December 2020 and names its uses: adding or removing medicines from the National List of Essential Medicines, from the lists bought from the state budget, applying or extending managed entry agreements, and some regional purchases. The conclusion read for this page states that it is advisory. Its conclusion of 27 February 2026 on trastuzumab deruxtecan for HER2-positive metastatic breast cancer found the cost per quality-adjusted life year above five times GDP per head, 659,720 hryvnias on 2021 figures, and so not cost-effective on Ukraine's recommended scale, with a budget impact above the affordability threshold; after a meeting of the expert committee on 22 January 2026 it still recommended the medicine for central purchase, including through a managed entry agreement, and recommended updating the national breast cancer standard. The same conclusion records that 168,912 women with breast cancer were on the registry's books in 2024.

The Centre's list of applications and conclusions dates the trastuzumab deruxtecan application 1 August 2025 and the conclusion 27 February 2026; pembrolizumab for high-risk early triple-negative breast cancer, 30 June 2025 and 1 June 2026; and daratumumab with bortezomib and dexamethasone for myeloma after at least one earlier treatment, 19 June 2025 and 18 June 2026. Pembrolizumab for PD-L1-positive persistent, recurrent or metastatic cervical cancer was applied for on 9 April 2025, with a conclusion uploaded on 27 January 2026. An application for enfortumab vedotin in urothelial cancer dated 10 September 2025 was left without consideration under point 17 of the procedure, on a date the list does not give, and a new application is dated 20 October 2026. These are individual cases read from the list, not an official average, and the time from a conclusion to the medicine reaching patients is not published; it is named under gaps.

Article 9 of the Law "On Medicinal Products" of 4 April 1996, in its text of 5 February 2023, lets a medicine registered by the competent authority of the United States, Switzerland, Japan, Australia or Canada, or by the European Union through the centralised procedure, be registered on its dossier, quality control methods, labelling and instructions without an expert review of the dossier submitted to the regulator that approved it. The review of the materials may not exceed ten working days and the decision is due within seven working days; refusal is limited to missing or inconsistent documents or a mismatch with the original approval. A similar fast route applies to medicines bought through international procurement organisations. The State Expert Centre now publishes lists of medicines registered by the competent authorities of the United States, the United Kingdom, Switzerland, Japan, Australia, Canada and the European Union. The Centre describes itself as the Ministry's authorised expert organisation for clinical trials, registration and pharmacovigilance; registration itself is a Ministry decision.

Law No. 2469-IX "On Medicinal Products" enters into force on 1 January 2027, under its final provisions as amended in February 2025, with some articles from 2028, and repeals the 1996 law. It assigns regulation to a body of state control, defined as a central executive body with special status for the market entry, quality, safety and efficacy of medicines. Article 26 gives that body 210 calendar days to decide on registration, with the clock stopped while deficiencies are corrected. Article 27 requires a decision within 30 days for orphan, innovative and advanced therapy medicines and for medicines for HIV, haemophilia and cancer, and vaccines, that are registered by a stringent regulatory authority or the European Medicines Agency. The law defines stringent regulators as countries whose agencies were members or observers of the International Council for Harmonisation before 23 October 2015, or that have mutual recognition or conformity agreements with Ukraine or the European Union. For international phase II to III trials already approved in such countries, it sets a 25-calendar-day limit for the decision.

The Ministry of Health's order No. 1368 of 5 August 2024, registered with the Ministry of Justice and in force from 1 January 2025, approves three procedures and cites the National Security and Defence Council's decision of 22 December 2023 on cancer. Breast: population screening for women aged 50 to 69 and risk-group screening from 40, with examination and referral for mammography every two years. Cervix: population screening from age 30, a Pap or PCR test at least at 30 to 35 and then every ten years until 55, and every five years from 25 for women living with HIV. Bowel: a faecal occult blood test or faecal immunochemical test every two years for people aged 50 to 75, yearly for risk groups, with colonoscopy after a positive result. The order sets targets for family practices, such as at least 70% of people aged 50 to 75 tested every two years. The 2026 Programme of Medical Guarantees has the NHSU assess family practices each year on screening coverage for the three cancers. In 2024, 12.9% of new cancers were found at preventive examinations (16.6% in women, 8.8% in men).

Writing in Bulletin No. 27, V. O. Zub, member of parliament and head of the parliamentary health committee's subcommittee on cancer, reports that the updated vaccination calendar in force from 1 January 2026 provides one dose of HPV vaccine for girls aged 12 to 13, using a 9-valent vaccine. The Ministry of Health's announcement of 22 October 2025 says the vaccine was bought under a managed entry agreement, and Medical Procurement of Ukraine said in February 2026, as reported by Interfax-Ukraine, that it first bought HPV vaccine in 2025. The government's action plan for 2026 to 2028 sets the indicator as coverage of at least 30% of the target age groups nationally, under the vaccination calendar of the Ministry's order No. 595 of 16 September 2011, and asks regions to adopt programmes for groups the state budget does not cover. Coverage achieved in 2026 had not been published in a form that could be read; it is named under gaps.

The Ministry's screening order cites the Council's decision of 22 December 2023, "On prevention, early diagnosis and treatment of malignant neoplasms", enacted by presidential decree No. 842/2023; V. O. Zub writes in the registry's bulletin that the decision identified cancer as a factor of national risk. Cabinet order No. 730-r of 2 August 2024 approved the National Cancer Control Strategy to 2030 with seven strategic goals and indicators that include a 2% yearly fall in cancer mortality and a 1% yearly rise in the detection of cancers at an early stage. Its diagnosis records that early-stage cancers fell from 51.2% of new cases in 2018 to 45.7% in 2022, and late-stage cancers rose from 21.1% to 27.1%. Order No. 165-r of 18 February 2026 approved the action plan for 2026 to 2028, including an analysis of patient routes between hospitals by the end of 2026, reference centres for molecular genetic testing, workload standards for pathologists, monitoring of wartime carcinogenic exposures, and simpler rules for academic clinical trials.

In a thematic article in Bulletin No. 27, the registry compared average stage distributions for 32 cancer groups between the two five-year periods, testing differences at the 95% level. For solid cancers other than skin cancer, the share found late rose from 26.1% to 30.9% in men and from 14.6% to 16.8% in women, and the share found at stage I or II fell by 4.4 to 4.6 points. Late cervical cancer rose 1.5 times (by 11.1 points), breast cancer 1.2 times and uterine cancer 1.4 times; in men, laryngeal cancer rose 1.6 times. The only significant fall was in thyroid cancer in women. The registry saw sharp rises in late diagnosis in April and May 2020, during lockdown, and in March and April 2022, during occupation and mass displacement, and a partial fall in 2023 and 2024. For newly found cancers in 2025 the operational share diagnosed late was 20.1%, the same as the year before. Separately, 21.0% of people diagnosed in 2024 died within a year, a figure the registry says is distorted by the undercount of deaths.

A study in JCO Global Oncology analysed the Ministry of Health's MedEvac records for April 2022 to April 2023: of 639 applications, 339 had enough data, and 281 of those patients (82.9%) were evacuated to EU hospitals, mostly newly diagnosed and mostly for systemic therapy. Patients in good general condition were much more likely to go, and patients with head and neck cancer much less. Medical Procurement of Ukraine said in February 2026, as reported by Interfax-Ukraine, that it bought 21 linear accelerators in 2023 and 2024 and, in 2025, equipment for nuclear medicine centres at the National Cancer Institute in Kyiv and in Lviv, due in 2027. The National Cancer Institute announced on 28 July 2026 that a third linear accelerator, bought with support from the Ministry and the agency, had gone into use. The 2026 payment rules pay radiotherapy on a linear accelerator 1.5 times the base rate and on older units 0.753 times. A 2025 pilot in Zaporizhzhia region, close to the front line, showed that HPV self-testing for cervical screening could run during active war, with 572 of 593 women offered a kit returning a sample.

Counted from ClinicalTrials.gov participation data in OnCo's graph on 4 November 2026: 172 trials list Ukraine among their countries, 145 of them phase 3; the registry shows 88 active but not recruiting, 52 completed, 25 recruiting and 7 terminated. ClinicalTrials.gov names Merck Sharp & Dohme as lead sponsor of 36, Hoffmann-La Roche of 22 and AstraZeneca of 14, and non-small cell lung cancer is the first-listed cancer for 30. By the start dates in OnCo's records, 28 began in 2020, 20 in 2021, 3 in 2022, 4 in 2023, 4 in 2024 and 10 in 2025. A direct count on ClinicalTrials.gov the same day, of interventional studies with the condition cancer and a location in Ukraine, gives 36 starting in 2018, 43 in 2019, 43 in 2020, 45 in 2021, 8 in 2022, 6 in 2023, 8 in 2024 and 17 in 2025; 44 cancer studies listing Ukraine were recruiting. The trial in OnCo's records with Ukraine as its only country is a phase 1/2 study of KLS-1 sponsored by Vector Vitale LLC. OpenAlex counts between 202 and 262 oncology papers a year with an author in Ukraine from 2021 to 2025, 1,120 in all.

Bulletin No. 27 states that, without demographic data from the State Statistics Service for 2024 and 2025, rates relative to the population cannot be calculated, and that because the registry cannot establish whether patients are alive it cannot reliably report mortality, one-year fatality, survival or prevalence. Of the 403,090 people diagnosed in 2021 to 2025 and still on its books, between 42.2% and 49.6% of each year's patients diagnosed in 2021 to 2024 were last seen in the year of diagnosis. Survival estimates for Ukraine in international studies were not read for this page. The number of people living after a cancer diagnosis, 1,164,449 at the end of 2025 excluding four regions, is likely to be an overestimate by the registry's own account.

nszu.gov.ua refused scripted requests on 4 November 2026, and the Internet Archive limited requests, so the NHSU's package statistics and budgets were not read; the 2026 payment rates come from the Cabinet resolution itself, read through an Internet Archive copy of zakon.rada.gov.ua because the legislation portal did not answer directly. Medical Procurement of Ukraine's website answers only to a browser, so its figures are quoted from the Ministry's announcement and from Interfax-Ukraine's report of the agency's statement. The prices agreed in managed entry agreements are confidential. Health technology assessment times are individual cases read from the State Expert Centre's list, not an average, and the cost-effectiveness scale it applies was read only as cited in one conclusion.

No national figure for screening coverage or uptake under order No. 1368 was located, and the order's annexes were read as published in 2024, not checked for later amendments. HPV vaccination coverage for 2026 was not found. The State Expert Centre publishes clinical trial documents but no annual count of cancer trial authorisations was read. The current consolidated text of the 1996 medicines law was not readable, so its fast registration route is described from the February 2023 text and the Centre's current lists, which add the United Kingdom. Nothing about cancer care in the occupied territories could be sourced, and the registry does not count them.