195632
Using verbal autopsy family interviews to evaluate the survival experience and health care received by women of reproductive age (15-49 years) who died from malignant neoplasms in the Republic of Georgia in 2006
Wednesday, November 11, 2009
Marina Shakhnazarova, MS
,
Head of Division of Data Analysis and Presentation, National Center for Disease Control, Tbilisi, Georgia
Konstantin Kazanjian, MD
,
Head of Division of Database Maintenance and Medical Classifications, National Center for Disease Control, Tbilisi, Georgia
Nino Lomia, MD, MPH
,
Monitoring and Evaluation Advisor of Healthy Women in Georgia Program, JSI R&T Inc., Tbilisi, Georgia
Khatuna Kuparadze, MD, MPH
,
Consultant to Healthy Women in Georgia Program, JSI R&T Inc., Tbilisi, Georgia
Official Georgian mortality statistics lack sufficient validity and reliability the Government needs to reform health policies. In 2007, a national RAMOS study was initiated to investigate all causes of death in women of reproductive age (15-49 years) who died in 2006. Purpose: To conduct intermediate evaluation of survival experience and health care received by women who died from cancer. Methods: Midway through interview phase, data from 515 (50% of expected number) family interviews were obtained. Respondents designated cancer as cause of death in 239 (46.4%) interviews. Analysis: SAS Lifetest and Freq procedures were used to calculate median survival times, 5-year survival rates, and frequency distributions of demographic and health care variables. Results: Of 239 women who died from cancer (breast-32.6%, genital-28.9%, other-38.5%), 68.6% were urban, 38.9% (28%) were 15-39 years at diagnosis (at death), 70.3% were diagnosed in late stages, 25.5% received surgery and chemotherapy (52.6% of 78 breast cancer patients received radical mastectomies), 69.5% received health care before death, and 87.5% died at home. They waited an average of 9 months after first symptoms to seek diagnosis. Median survival times in months were: 36-breast cancer, 12-genital cancers, 7.5-other cancers. 5-year survival rates were: 22.1%-breast cancer, 1.5%-genital cancers, 3.3%-other cancers. For comparison, 5-year survival rates in USA for white women for the following cancers are: 89.9%-breast, 72.5%-cervix, 84.7%-uterus, 45.3%-ovary. Implications: Offers evidence to policymakers that educating women to adopt pro-active attitudes to screening and early detection and providing routine access to diagnostic-treatment facilities are necessary to improve cancer survival rates.
Learning Objectives: 1. Assess the impact of cancer on women�s mortality in the Republic of Georgia.
2. Compare the 5-year survival rates for similar cancers in the USA to rates in a post-Soviet developing country, such as the Republic of Georgia.
3. Discuss how the lack of education might impact on a woman�s attitude to screening and early detection in a developing country, such as the Republic of Georgia.
4. Evaluate the differences in median survival times among cancer groupings in the Republic of Georgia.
5. Explain how diagnosis of cancer at earlier stages might improve the survival times.
Keywords: International Health, Cancer
Presenting author's disclosure statement:Qualified on the content I am responsible for because: I have been involved with this RAMOS study from the very beginning as co-principal investigator: identifying several sources of death data, creating a database application to hold all information gathered from these sources, developing the questionnaire to be used for the family interviews, supervising data managers, and preparing regular summary updates.
Any relevant financial relationships? No
I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines,
and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed
in my presentation.
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