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

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.