Contemporary data on different therapy schemes for colorectal cancer are presented from the point of view of “costeffectiveness” indicator. There is an information about Federal programs aimed at increasing annual healthcare financing connected with preventing and curing malignancies. The statistics of the annual growth in colon and rectum cancer rates is discussed. An actual problem of increasing number of resource-intensive medicines for oncology treatment is stated. This is the reason to analyze cost-effectiveness.

The aim of the study is to assess the clinical and economic effectiveness of the practical implementation results of programmed screening for colorectal cancer (CRC) in the Primorsky Territory using clinical and economic research methods.Materials and methods. In the study, the following kinds of data were used: the statistical data from the regional clinic’s cancer registry on the structure of the morbidity and average life expectancy of CRC patients in the Primorsky Territory; the data on the cost of screening studies and the stages of anticancer therapy in accordance with the “Territorial Tariff Agreement on Payment for Medical Care (Medical Services) in the System of Compulsory Health Insurance in the Territory of Primorsky Krai”, 2021. Two methods of clinical and economic analysis with the corresponding calculation formulas have been applied. The cost of medical interventions were estimated in accordance with the screening standards and clinical guidelines for the treatment of malignant neoplasms of the colon and rectum, approved by the Scientific and Practical Council of the Ministry of Health of the Russian Federation, 2020.Results. The evidence-based substantiation of screening clinical effects has been obtained: the structure redistribution of colorectal cancer incidence towards the prevalence of early forms by 16.81%; the average increase in the life expectancy of patients with the studied disease is 12.8 months. A natural consequence of these events is the predicted decrease in the mortality rate from CRC in the territory of the subject in the subsequent years. The economic justification of CRC screening software which guarantees a significant saving in health care resources amounting to 23% compared to an alternative strategy, has been demonstrated. It can influence the management decisions on the further strategy of the mass introduction of this medical technology.Conclusion. Currently, CRC screening is the most effective way to reduce morbidity and mortality from this disease. The predominance of the early diagnosis of the disease is extrapolated to significant savings in public health care. A promising direction for further research in the field of CRC screening is the study of its long-term effects, in particular, a detailed clinical and economic analysis of the diagnostics effectiveness and the elimination of premalignant neoplasms.

Nowadays, colorectal cancer (CRC) ranks 3rd in prevalence among men with oncological diseases and 2nd in women. Adding that, there is a tendency to increase the incidence of CRC among young patients. The most important factor in the CRC prevention is screening, the clinical value of which is reflected in the ability to prevent cancer morbidity and mortality, as well as in reducing treatment costs by detecting precancerous pathologies and early stages of cancer. The review aims at systematizing the study results devoted to the viral etiology of CRC. Up-to-date data on the association of CRC with human papillomavirus, cytomegalovirus and Epstein-Barr virus is presented. Research data on the role of viruses in the CRC pathogenesis are insufficient and contradictory. The structure of the analyzed studies, the sample size, as well as the methods used to detect viruses, differ markedly. Therefore, they do not allow obtaining reliable results, which dictates the need for further problem study. Understanding the mechanisms by which viruses maintain and stimulate virulence is an important step towards developing treatment tactics in cancer associated with oncoviruses. KEYWORDS: colorectal cancer, human papillomavirus, cytomegalovirus, Epstein-Barr virus, colon polyps, adenomatous polyps, adenocarcinoma, oncoviruses. FOR CITATION: Petukhova Yu.Yu., Petukhova A.G., Eliseeva E.V., Apanasevich V.I. Viral etiology of colorectal cancer. Russian Medical Inquiry. 2021;5(8):538–544 (in Russ.). DOI: 10.32364/2587-6821-2021-5-8-538-544.

Objective: to perform a pharmacoeconomic evaluation of the effectiveness of therapies for metastatic colorectal cancer (mCRC) based on real practical data on medical help for patients with this disease.Material and methods. The authors performed a comparative cost-effectiveness analysis and the calculation of resource consumption in the application of several options of chemotherapy for mCRC: FOLFOX, FOLFIRI, and FOLFOXIRI; targeted therapy: FOLFOX + bevacizumab, FOLFOX + panitumumab, FOLFIRI + cetuximab, FOLFIRI + aflibercept, regorafenib monotherapy.Results. The cost-effectiveness parameter, calculated as a ratio of the cost of therapy to the median survival without progression, for chemotherapeutic schemes varied from 108 to 167 thousand rubles and for the targeted therapy schemes – from 223 to 930 thousand rubles. The calculation of resource consumption showed that in the case of a limited budget, 100% of patients can be treated by FOLFOX scheme, or 26% of patients by FOLFOX + panitumumab, or 47% of patients by FOLFOX + bevacizumab; and 100% of patients by FOLFIRI scheme or 11.5% of patients by FOLFIRI + cetuximab (aflibercept). Besides, it was established that in the case of a similar budget, 100% of patients with mCRC can be treated by chemotherapy schemes or a limited number of patients with regorafenib.Conclusion. The cost of targeted therapy significantly exceeds the cost of chemotherapeutic schemes. Still, considering the gross domestic product per capita in the Russian Federation, they can be an economically feasible investment and the optimum option of therapy