Early and late detection of cancer in Georgia: Evidence from a population-based cancer registry, 2018–2019
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- Title :Early and late detection of cancer in Georgia: Evidence from apopulation-based cancer registry, 2018–2019
- Author: Tornike Batavani a,*, Maia Kereselidze b, Nino Chikhladze a, Nato Pitskhelauri a
- Publication: Cancer Epidemiology
- Publisher: Elsevier Inc
- Year: 2022
- Language: English
- Pages: 7
- Format: PDF
- File size: 1,939KB
- DOI: 10.1016/j.canep.2022.102216
- CBID: CBR171
Abstract
Background
Georgia is an upper middle-income country, which has lower cancer survival rates than most of the countries in the World Health Organization European region, as well as compared to many other post-Soviet states and upper middle-income countries. The purpose of our study was to analyse the cancer stage distribution data of Georgia as a first step towards identifying the areas of early cancer detection in the country that might need improvement or require further research.
Methods
Descriptive analysis of the population-based cancer registry of Georgia was performed using the data for the period of 01.01.2018–31.12.2019.
Results
Around 57 % of cancers in males and 56 % of cancers in females were amenable to early detection. At least 35.7 % of these cancers in males and 44.2 % in females were detected early. 15.2 % (n = 964) of male and 35.3 % (n = 3179) of female cancer patients met the age criteria for the respective cancer screening programmes. Breast, colorectal, cervical and stomach cancers contributed to 58.7 % of all late-stage cancers in females. Lung, prostate, colorectal, laryngeal and stomach cancers made up 72.4 % of all late-stage cancer cases among males. At least 83.8 % (n = 1438) of thyroid cancers in females and 84.2 % (n = 246) of thyroid cancers in males were diagnosed at stage I. Moreover, stage I thyroid cancer cases made up 50.7 % of all stage I cancer cases detected in women and 25.6 % of all stage I cancers in men. At least 42.4 % of stage I thyroid cancers in females and 37.4 % of stage I thyroid cancers in males were papillary microcarcinomas.
Conclusion
The potential of early cancer detection is underutilised in Georgia and there is a need to strengthen screening and especially early diagnosis in the country. The possibility of thyroid cancer overdiagnosis requires further investigation.
Highlights
- • Early detection recommendations exist for more than 56 % of cancer cases in the study.
- • Nevertheless, a large proportion of these cancers were still detected late.
- • Cancer screening programmes have been underperforming in Georgia.
- • Early diagnosis of cancer needs to be improved in the country.
- • On the other hand, thyroid cancers might be overdiagnosed in Georgia.
1Introduction
Georgia is an upper middle-income country, which has a higher mortality-to-incidence ratio (MIR) and lower cancer survival rates than most of the countries in the World Health Organization (WHO) European region, as well as compared to many other post-Soviet and upper middle-income countries .
One of the main reasons for low cancer survival in low- and middle-income countries (LMICs) is detecting cancer at later stages. Early cancer detection requires effective functioning of its two components: early diagnosis and screening.
In Georgia, the following cancer screening and management programmes have been present since 2011: breast cancer screening (for females aged 40–70 years), cervical cancer screening (for females aged 25–60 years), colorectal cancer screening (for persons aged 50–70 years) and prostate cancer management (for males aged 50–70 years) . Since 2018, a thyroid cancer management programme has been available for women aged 25–70, who are registered in the capital city – Tbilisi, and meet certain criteria .
Treatment costs of oncological diseases are covered to varying degrees by the universal healthcare programme of Georgia, depending on the income group of the citizens.
In 2015, a population-based cancer registry (PBCR) was established in Georgia. Before the PBCR implementation, cancer cases were not accurately recorded and the cancer-related data of the country were mostly unreliable.
Based on the data from the PBCR, in 2019 the most common cancers among females in Georgia were cancers of the breast, thyroid, colorectum, corpus uteri and cervix uteri . Among males, the most common malignancies were cancers of the lung, prostate, bladder, colorectum and larynx .
Analysing the cancer stage distribution data is one of the ways to assess the performance of early cancer detection initiatives present in the country and to find out about the potential gaps that need to be addressed. However, to the best of our knowledge, the cancer stage distribution in Georgia has not been analysed in detail yet.
The aim of our study is to describe the cancer stage distribution data of Georgia, with the purpose of learning the characteristics of early and late detection of cancer in the country. This represents the first step towards identifying the areas of early cancer detection in Georgia that might need improvement or require further research.
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