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An audit of ten Russian regional cancer registries against international rules found four of the ten fit to compare with other countries, with morphological verification as low as 62 per cent in some regions and up to 23 per cent of Saint Petersburg cases known only from a death certificate.
Data from ten population-based cancer registries in the Northwestern Federal District, covering about 13 million people of whom about 5 million are in Saint Petersburg, were processed against IARC, IACR and European Network of Cancer Registries recommendations, focusing on cases diagnosed between 2008 and 2017.
Data collection followed international standards and the distribution of diagnosis dates was broadly uniform. The proportion of multiple primaries ranged from 6.7 per cent in Vologda oblast to 12.4 per cent in Saint Petersburg. Between 2013 and 2017 the proportion of morphologically verified cases ranged from 61.7 to 89 per cent across the regions, and death-certificate-only cases from 1 to 14 per cent, except Saint Petersburg where they reached 23 per cent. Cases with unknown primary site were 1 to 3 per cent. Validity was lowest for pancreatic, liver, haematological and central nervous system tumours and in older age groups.
Russian national cancer figures are assembled from regional registries of very uneven quality, so a national average conceals both real differences in disease and differences in how carefully cases are recorded. It is the reason to read the Herzen institute's annual volumes alongside an independent audit rather than on their own.