Effectiveness of Imaging-Based Chest Screening: Outcomes of Stage One Adult Health Screening Effort in the Russian Federation

   Introduction: Malignant neoplasms and tuberculosis make a significant contribution to the global mortality, which makes mass health screening even more critical.

   Objective: To investigate and compare the scope, dynamics, and effectiveness of preventive chest fluorography/X-ray examinations in the context of the pandemic and to argue for enhanced preventive care efforts.

   Materials and methods: We conducted a comparative study of the scope and effectiveness of individual clinical efforts adopted within the first stage of adult health screening in the Russian Federation as a whole and its federal districts in 2019–2022 based on data of Report Form No.131/u (personal checkup records). We applied descriptive statistics methods and analyzed data using Medcalc 18.2.1 software (Medcalc Software Ltd).

   Results: The number of preventive fluorography/X-ray examinations in the country has increased by 10.4 %. Most federal districts demonstrated growing numbers of fluorography/X-ray examinations (except for the Central and Siberian Federal Districts), which positively affected the detection rate (with the exception of the Ural Federal District). The increase in detection of pathological conditions amounted to 36.2 %, with the Southern Federal District being the absolute leader: the detection rate went up by 97.9 %. Other federal districts demonstrated both positive and negative growth. On the
national level, the number of pulmonary tuberculosis cases decreased by 31.9 % (to 2,759 cases) while the number of tracheal, bronchial and pulmonary malignant tumors increased by 19.6 % (to 15,784 cases).

   Conclusion: Uneven changes in the scope and effectiveness of preventive measures were due to the continued stagnation of the screening endeavors. To achieve better quality of disease prevention, it is necessary to develop and adopt new workflows, which would incorporate artificial intelligence technologies to automate detection and reporting of findings of preventive imaging.

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