Thyroid cancer incidence in the female population of Georgia by regions and municipalities

Abstract Background According to the NCDC (Tbilisi, Georgia), in 2015-2019, thyroid cancer ranked second in the cancer structure of cancer in Georgia. Additional studies are needed to identify the thyroid cancer incidence by regions and municipalities of Georgia. Methods E-dBase of cancer population registry for 2015-2019 (52,178 cancer cases), Tbilisi registry database for 2002-2004 (33,478 deaths from all causes), methodology recommended by IARC (Lyon) and UICC (Geneva), SEER program and 2014 Georgian census data were used in the study. Standardized cancer incidence and mortality rates (ASR, TASR, AAR, SRR, CR64, CR74, SIR, SMR, PIR, 95% CI) were calculated. Results Ranking and proportion of thyroid cancer in female population of Georgia in 2015-2019 according to the regions and municipalities, its age specifics and dynamics were determined. Incidence of thyroid cancer in women in Tbilisi (ASR=52.4%000; AAR=64.1%000), compared to Georgia (ASR=34.4%000; AAR=41.0%000), indicates that Tbilisi is the geographically highest prevalence zone for this site cancer and the highest levels were observed in the 25-69 age group (TASR25-69 - Georgia = 110.8%000, Tbilisi = 190.1%000). In dynamics, the incidence of thyroid cancer in the 27-year period (2015-2019 vs 1988-1992) according to the SIR, increased by 66.4%. According to the cumulative risk index (CR64, CR74), the municipalities, where the risk of developing thyroid cancer is almost 1.5 times higher than the total rate in Georgia, were identified. According to the PIR, the ratio of thyroid cancer to the share of thyroid cancer in the structure of cancer in the regions of Georgia (including Tbilisi) showed that the proportion of thyroid cancer in Tbilisi (PIR=117.7) is 17.7% higher compared to proportion of total thyroid cancer in Georgia. Conclusions It is recommended that the epidemiological map of thyroid cancer incidence be used in planning national, regional, and municipal preventive programs. Key messages • It is recommended to continue study in this direction: retrospective review of histological and histochemical features of each case of thyroid cancer. • It is recommended: to conduct molecular (oncogenes) studies in conjunction with histological and histochemical studies.


Background:
According to the NCDC (Tbilisi, Georgia), in 2015-2019, thyroid cancer ranked second in the cancer structure of cancer in Georgia. Additional studies are needed to identify the thyroid cancer incidence by regions and municipalities of Georgia.

Results:
Ranking and proportion of thyroid cancer in female population of Georgia in 2015-2019 according to the regions and municipalities, its age specifics and dynamics were determined. Incidence of thyroid cancer in women in Tbilisi (ASR = 52.4%000; AAR = 64.1%000), compared to Georgia (ASR = 34.4%000; AAR = 41.0%000), indicates that Tbilisi is the geographically highest prevalence zone for this site cancer and the highest levels were observed in the 25-69 age group (TASR25-69 -Georgia = 110.8%000, Tbilisi = 190.1%000). In dynamics, the incidence of thyroid cancer in the 27-year period (2015-2019 vs 1988-1992) according to the SIR, increased by 66.4%. According to the cumulative risk index (CR64, CR74), the municipalities, where the risk of developing thyroid cancer is almost 1.5 times higher than the total rate in Georgia, were identified. According to the PIR, the ratio of thyroid cancer to the share of thyroid cancer in the structure of cancer in the regions of Georgia (including Tbilisi) showed that the proportion of thyroid cancer in Tbilisi (PIR = 117.7) is 17.7% higher compared to proportion of total thyroid cancer in Georgia.

Conclusions:
It is recommended that the epidemiological map of thyroid cancer incidence be used in planning national, regional, and municipal preventive programs. Key messages: It is recommended to continue study in this direction: retrospective review of histological and histochemical features of each case of thyroid cancer. It is recommended: to conduct molecular (oncogenes) studies in conjunction with histological and histochemical studies.

Background:
Many low-and middle-income countries and international organizations have invested resources to strengthen primary health care services. Despite efforts from the Ministry of Health on primary health care, barriers to accessing health care services and health inequality in Myanmar still exist. This study aimed to identify the challenges and unmet needs in the current primary health care services by assessing the experiences and perceptions of healthcare workers and local leaders in three townships (Htantabin, Hmawbi, and Taikkyi) in Yangon, Myanmar.

Methods:
The study was conducted among healthcare professionals and community leaders in three townships. By adopting a mixedmethod approach, a cross-sectional health needs assessment survey was conducted for quantitative data (n = 66), and focus group discussions (15 group discussions) were conducted online for qualitative data.

Results:
As a result of the survey regarding six domains; hygiene, primary medical care, maternal and child health, infectious diseases, non-communicable diseases, and leadership, enhancing the management and leadership capacity had the lowest average score on the current achievement (2.81 out of 5), while strengthening infectious disease control service and accessibility was perceived as the highest mean on the priority of intervention (4.28 out of 5) and the impact of the intervention (4.7). The focus group discussions revealed that while specific infrastructures and equipment necessary for the category were addressed, the need for financial support has been the recurrent theme throughout the discussions.

Conclusions:
Utilizing the World Health Organization's six-building block framework, our findings suggest that a long-term targeted financial investment in the primary health care system is critical in Myanmar by increasing health care expenditure per capita. At the same time, related barriers and facilitators should be considered to optimize the effectiveness of prioritized interventions. Key messages: Health care providers and local leaders perceived the management and leadership capacity as the lowest current achievement.
15th European Public Health Conference 2022 iii419