Medical Presentation // Epidemiology

1. EPIDEMIOLOGY OF
CERVICAL CANCER IN
GEORGIA,2000-2009
DONE BY:
NOEL CHRISTIAN
GROUP 6

2. INTRODUCTION
• Epidemiology is a discipline that has a crucial role in describing health status,
identifying risk factors, and analyzing relationships between health and different
hazardous agents.
• As epidemiology is one of the essential disciplines of public health, its major aim is
to contribute to fulfilment of the definition of public health as “a science and art to
promote health and prevent disease by organized effort of society”.

3. • Cervical cancer is a type of cancer that occurs in the cells of the cervix — the lower
part of the uterus that connects to the vagina.Various strains of the human
papillomavirus (HPV), a sexually transmitted infection, play a role in causing most
cervical cancer.
• Cancer is the second cause of death in Georgia.
• Cervical cancer comes in second after breast cancer.
• The cancer epidemic was made worse by the poor state of the country’s public
health system, which emphasized curative services rather than prevention.

4. MATERIAL & METHOD
• Cancer disparities & cervical cancer disparities in Georgia by calculating and
comparing incidence-to-prevalence ratios by health district and in relation to
geographical factors.
• Method:
* Incidence Rate =
𝑁𝑒𝑤 𝐶𝑎𝑠𝑒
𝑇𝑜𝑡𝑎𝑙 𝑃𝑜𝑝𝑢𝑙𝑎𝑡𝑖𝑜𝑛
x 100,000
* Prevalence Rate =
𝑇𝑜𝑡𝑎𝑙 𝑁𝑜.𝑜𝑓 𝐶𝑎𝑠𝑒𝑠
𝑇𝑜𝑡𝑎𝑙 𝑃𝑜𝑝𝑢𝑙𝑎𝑡𝑖𝑜𝑛
x100,000
* Mortality Rate =
𝑁𝑜. 𝑜𝑓 𝐷𝑒𝑎𝑑 𝑃𝑒𝑟𝑠𝑜𝑛𝑠
𝑇𝑜𝑡𝑎𝑙 𝑃𝑜𝑝𝑢𝑙𝑎𝑡𝑖𝑜𝑛
x 100,000
* Case-fatality ratio =
𝑁𝑜.𝑜𝑓 𝐷𝑒𝑎𝑑 𝑃𝑒𝑟𝑠𝑜𝑛𝑠
𝑁𝑜.𝑜𝑓 𝑝𝑒𝑟𝑠𝑜𝑛𝑠 𝑤𝑖𝑡ℎ 𝑑𝑖𝑠𝑎𝑠𝑒
x100%

5. CANCER IN GEORGIA
0
200
400
600
800
1000
1200
1400
1600
1800
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009
PREVALENCE INCIDENCE

6. CERVICAL CANCER IN GEORGIA
0
20
40
60
80
100
120
140
160
2002 2003 2004 2005 2006 2007 2008 2009
PREVALENCE INCIDENCE

7. CERVICAL CANCER IN GEORGIA
(CASE FATALITY & MORTALITY)
0
5
10
15
20
25
2002 2003 2004 2005 2006 2007 2008 2009
CASE FATALITY MORTALITY

8. COMPARISON OF INCIDENCE RATE OF
CANCER & CERVICAL CANCER IN GEORGIA
0
50
100
150
200
250
300
350
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009
CANCER CERVICAL CANCER

9. COMPARISON OF PREVALENCE RATE OF
CANCER & CERVICAL CANCER IN GEORGIA
0
200
400
600
800
1000
1200
1400
1600
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009
CANCER CERVICAL CANCER

10. CERVICAL CANCER STAGES ATTHE
DIAGNOSIS 2006 - 2009
2006
24%
2007
25%
2008
27%
2009
24%
I STAGE

11. 2006
29%
2007
25%
2008
27%
2009
19%
II STAGE

12. 2006
23%
2007
27%
2008
21%
2009
29%
III STAGE

13. 2006
24%
2007
23%
2008
24%
2009
29%
IV STAGE

14. 2006
17%
2007
19%
2008
34%
2009
30%
UNKNOWN

15. RESULT
2006 2007 2008 2009
STAGE I 24 % 25 % 27 % 24 %
STAGE II 29 % 25 % 27 % 19 %
STAGE III 23 % 27 % 21 % 29 %
STAGE IV 24 % 23 % 24 % 29 %
UNKNOWN 17 % 19 % 34 % 30 %

16. CERVICAL CANCER BY AGE GROUP
0
5
10
15
20
25
30
0-29 30-34 35-39 40-44 45-49 50-54 55-59 60-64 65-69 70-74 75-79 80-84
INCIDENCE
INCIDENCE

17. CERVICAL CANCER IN DIFFERENT
REGIONS OF GEORGIA,2009
0
10
20
30
40
50
60
70
80
90
100
AJARA
TBILISI
KAKHETI
IMERETI
SAMEGRELO
SHIDAKARTLI
KVEMOKARTLI
GURIS
SAMTSKHEJAVAKHETI
MTSKHETA-MTIANETI
RACHA-LECHKHUMIAND
KVEMOSVANETI
INCIDENCE
PREVALENCE

19. DISCUSSION
CANCER CASES IN GEORGIA
• Highest prevalence rate of cancer in Georgia is in 2009
• Lowest prevalence rate of cancer in Georgia is in 2000
• Highest incidence rate of cancer in Georgia is in 2009
• Lowest incidence rate of cancer in Georgia is in 2000

20. CERVICAL CANCER CASES IN GEORGIA
• Prevalence rate of cervical cancer in Georgia is highest in 2005
• Prevalence rate of cervical cancer in Georgia is lowest in 2003
• Incidence rate of cervical cancer in Georgia is highest in 2004
• Incidence rate of cervical cancer in Georgia is lowest in 2009

21. FROMTHE ABOVE WE CONCLUDE:
• The overall incidence rate of cervical cancer has seen a downward trend by the
year of 2009.This may be due to the detection of cervical cancer at its early stages
and prevention that is supported by promoting a healthy lifestyle among the
population and involving healthy populations in cancer-screening programs.
• The mortality and case-fatality ratio is seen to be the highest in the year of 2009
and the lowest in the year of 2006.This may be due to a systematic ,ongoing
surveillance system.

22. BY AGE GROUP DISTRIBUTION:
• The incidence rate for cervical cancer is seen to be the highest in the age groups of
60-64 and lowest in the ages of 30-34.
BY REGION DISTRIBUTION:
• The prevalence rate of cervical cancer in Georgia is seen to the highest in the
regions of Shida Kartili and lowest in the regon of Samegrelo.
• The incidence rate of cervical cancer in Georgia is seen to the highest in the
regions of Racha-Lechkhumi and Kvemo Svaneti and lowest in Kvemo Kartli.

23. RECOMMENDATION
• One of the most important measures is the awareness of the first tier of
healthcare providers, meaning rural / family doctors and nurses.
• One of their functions is to educate the population and provide information about
preventive and early detection activities, and they may be able to direct a healthy
population to participate in the state-sponsored cancer screening programs.

24. PREVENTIVE MEASURES OF CERVICAL
CANCER
• To prevent cervix cancer is to have testing (screening) to find pre-cancers.
• The citizens of Georgia can undertake a state-sponsored tumor diagnosis program
which is free of charge, namely: cervical tests for persons from 25 to 60 years old
(Pap test and if required - colposcopy).
• Use condoms
• Don’t smoke
• Get vaccinated (HPVVaccine - Routine HPV vaccination for girls and boys should
be started at age 11 or 12.The vaccination series can be started as early as age 9.)

25. REFERENCES
• 1. Kohler BA,Ward E, McCarthy BJ, Schymura MJ, Ries LAG, Eheman C, et al.
Report to the Nation on the status of cancer, 1975–2007, featuring tumors of the
brain and other nervous system. JNCI. 2011[PMC free article] [PubMed]
• 2.Ward E, Jemal A, Cokkinides V, Singh GK, Cardinez C, Ghafoor A, et al. Cancer
disparities by race/ethnicity and socioeconomic status. CA Cancer J
Clin. 2004;54(2):78–93. Available
fromhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&
dopt=Citation&list_uids=15061598. [PubMed]
• 3. [NCI] [Accessed July 19 2011];National Cancer Institute, Cancer health
disparities. http://www.cancer.gov/cancertopics/factsheet/disparities/cancer-
health-disparities.
• 4.Chen WQ, Zhang SW, Zou XN, Zhao P. Cancer incidence and mortality in China
2006. Chinese Journal of Cancer Research. 2006;23(1):3–9. [PMC free
article] [PubMed]

26. THANKYOU
GROUP 6
NOEL CHRISTIAN