OVARIAN CANCER BURDEN IN GEORGIA

Abstract

Goal 1. To determine the incidence and death rates and features of ovarian cancer in the female population of Georgia in 2015-2019 using standardized rates and to create epidemiological maps. 2. To study the risks of cancer progression, recurrence and metastasis in oncogynecologic patients in the posttreatment period. 3. Study of 3-year survival rates of ovarian cancer. 4. To determine the burden of gynecologic cancer in the female population . 5. To develop preventive recommendations for oncogynecology patient advocacy. METHODS The following gross and standardized rates were calculated: Crude Morbidity and Mortality Rate (CrudeRate); AgeSpecific Rate (Age-Specific Rate); Age-Standardized Rate (ASR); 95% confidence interval of Age-standardized Rate (95% CI ASR); Truncated Age Standardized Rate (TASR); 95% confidence interval of Truncated Age Standardized Rate (95% CI TASR); Age-Adjusted Rate (AAR); 95% confidence interval of age-adjusted rate (95% CI AAR); Standardized Rate Ratio (SRR); 95% confidence interval of standardized ratio ratios (95% CI SRR); Cumulative risk indicator (Cumulative Risk-CR , CR ,); 95% confidence interval of cumulative risk indicator (95% CI CR); Proportional Incidence 64 74 Ratio (PIR); 95% confidence interval of proportional incidence ratios (95% CI PIR); Standardized Incidence Ratio (SIR); 95% confidence interval of standardized incidence ratio (95% CI SIR). 3-year survival rates for ovarian cancer were studied using SPSS, Kaplan-Maier curves, and Cox multifactorial analysis were used. Disability-adjusted life years (DALYs) in patients with gynecologic cancer were studied. RESULTS 1. In the overall structure of cancer incidence in women, according to age standardized (ASR) rates per 100 000 women, in 2015-2019, the third most common site for gynecologic cancer in Georgia was cervical cancer (ASR = 13,4; 95% CI ASR = 12,8-14,1) , the fourth – uterine cancer (ASR = 11,3; 95% CI ASR = 10,8-11,9), and sixth - ovarian (ASR = 9,8; 95% CI ASR = 9,3-10.3) cancer. 2. In the overall structure of cancer incidence in women, by age-adjusted (AAR) rates per 100 000 women (Georgian Standard 2014), in 2015-2019, the fourth most common gynecologic cancer in Georgia was cervical cancer (AAR = 18,6; 95% CI AAR = 18,0-19,3), uterine cancer was the fifth (AAR = 18,5; 95% CI AAR = 18,0-19,1), and ovarian cancer the sixth (AAR = 15,1; 95% CI AAR = 14,6 -15 6). 3. In Georgia, the risks of recurrence and/or development of metastases and disease progression after the period of treatment and remission of cervical and uterine cancer are not statistically significantly different from each other (OR = 1,0, 95% CI OR = 0,7-1,4), while compared to the cervical and uterine cancer, the risk of ovarian cancer progression is 2,9 times higher (OR = 2,9, 95% CI OR = 2,1-3,9).The risk of recurrence and / or development of metastases and disease progression post-therapy and remission is 2,3 times higher for uterine cancer compared to cervical cancer in Tbilisi (OR = 2,3, 95% CI OR = 1,4-3,9). At the same time, compared to cervical and uterine cancers, the risk of ovarian cancer progression is 4,1 times and 1,8 times higher, respectively (OR = 4,1, 95% CI OR = 2,4-6,8; OR = 1 , 8, 95% CI OR = 1 2-2 7). 4. In Tbilisi (the capital city of Georgia), the 3-year survival rate of gynecologic cancer with Kaplan-Meyer curves averaged 70,5%. Better 3-year survival rates among gynecologic cancer localizations were observed in cases of uterine cancer (78,7%) and cervical cancer (75,2%). The 3-year survival rate for ovarian cancer was 55,2%. 5. According to the DALYs index of gynecologic cancer in Georgia and Tbilisi, 39 459,1 women/year were lost due to gynecologic cancer in Georgia in 2015-2019, each patient lost an average of 7,3 years, and in Tbilisi, respectively 11 521,3 women/year is lost, each patient lost an average of 5,8 years.