The availability of comprehensive care of gastric cancer in developing countries: Georgian experience.

Abstract

e13529 Background: The availability of comprehensive cancer care in different regions is the main problem in developing countries. In fact, the cancer centers are centralized and patients fail to receive the proper medical care in regions. The situation is critical for patients living in the zones of conflict. In Georgia we have cancer centers only in two cities Tbilisi and Kutaisi. The aim of the study was to investigate the rate of gastric cancer diagnoses in different regions of Georgia, that could be a model for developing countries. Methods: The spread of gastric cancer in Georgia was investigated retrospectively by analyzing the cases reported in different regions based on 5 years national cancer registry data from 2015 to 2021. The data included the number of cases, age, sex, and stage of gastric cancer. Data from all regions of Georgia were analyzed including occupied regions as Abkhazia and Tskhinvali. Other regions were – Tbilisi, Adjara, Guria, Imereti, Kakheti, Mstkheta, Racha, Samtskhe, Kvemo Kartli, Shida Kartli. Results: A total of 1825 patients with gastric cancer were evaluated during the period of 2015-2021 years. The highest number of diagnosed cases were reported in Tbilisi, with 258 cases in males and 200 cases in females, followed by Imereti (Kutaisi) with 125 cases in males and 80 cases in females and Adjara 132 cases in males and 56 cases in females. The other regions had lower numbers of diagnosed cases, with the lowest being Tskhinvali with only three cases in males and six cases in females. In Abkhazia were 44 cases in males and 19 cases in females. In terms of stage distribution there was no difference between the regions, the majority of patients were stage IV accounting 42 % of all cases, 28% was stage III, 10 % was stage II, 5% was stage I and 15% was of unknown stage. Age ranges were different according to the sex and regions – in Tbilisi 35-83 in males and 26-94 in females, in Adjara 29-88 in males and 28-84 in females, in Abkhazia 35-83 in males and 41-83 in females, in Guria 37-91 in males and 39-83 in females, in Imereti 37-88 in males and 34-84 in females, in Kakheti 34-85 in males and 37-89 in females, in Mtskheta 34-91 in males and 50-84 in females, in Racha 31-72 in males and 30-81 in females, in Samegrelo 33-96 in males and 21-90 in females, in Samtskhe 43-94 in males and 38-81 in females, in Kvemo Kartli 26-85 in males and 38-90 in females, in Shida Kartli 39-85 in males and 38-90 in females, in Tskhinvali 66-84 in males and 33-76 in females. Conclusions: The study found that availability of comprehensive care for gastric cancer including diagnosing is limited in the regions of Georgia, with the lowest rates in occupied regions. To improve the cancer care in developing countries such as Georgia international and national strategies are needed.