The breast cancer incidence and screening organization in Georgia.

B154

Objective: To evaluate the breast cancer screening national program and its economical motivation. Materials and Methods: Information on 7830 cancer cases was collected. 507 breast cancer patients, managed at the outpatient clinic of National Cancer Center and Mammology Center in 2001-2002 were evaluated. 676 risk group females were tested with the evaluated high sensitive and cost-effective screening scheme. The Descriptive and Analytical Epidemiology study methods, recommended by International Agency on Research of Cancer (IARC, Lyon) and International Association of Cancer Registries (IACR, Lyon) were used for analyses of data base. Results: According to analyses of descriptive epidemiological data, it was found that breast cancer ranked first in Tbilisi females oncology disease structure (ASR=35,8) and in the general population for both genders among the 5 main localization cancers (ASR=21,0). The peak incidence was revealed in the Saburtalo region (ASR=56,9), which is 1.6 times more (SRR=1.6) compared to mean figures in Tbilisi (ASR=35.8) and 2.5 times more, compared to lowest figures in Tbilisi (ASR=23.0), registered in the Gldani region. According to cumulative risk indicators, the breast cancer cumulative risk among 0-74 aged females in Saburtalo region was 1.5 times more (CR(0-74)=5.9) compared to mean figures in Tbilisi (CR(0-74)=3.9) and 2.4 times more compared to lowest figures, registered in the Gldani region (CR(0-74)=2.5). The breast cancer incidence ration in entire oncology disease structure was 22% greater in Mtatsminda (PIR=122) and 19% greater in Didube (PIR=119) regions compared to mean figures in Tbilisi. According to Aged Specific Incidence indicators, the incidence of disease increases with older age and reaches the peak in 50-69 age groups. The breast cancer standardized indicator in Tbilisi at the beginning of the 1970s was 35.6%, it was stable for 10 years, but increased to 40,8% at the beginning of the 1980s. The decrease of disease incidence was noted (35.8%) in 1988-1992 and near the end of the 1990s it fell to 29.4%, which could be explained by the unstable political and economical situation in the country. The screening was conducted in females with low fertility syndrome, which increases the breast cancer risk three times, whereas, high fertility syndrome, plays the reduction role, protecting women from this disease. The highest diagnostic importance is the combination of physical and cytological examinations, 97.4%. Consequently, according to our study results, the optimal scheme of breast cancer screening is clinical plus cytological examination. The cost of for one patient screening test is 6$.