1. SCREENING PROGRAMS- GEORGIAN EXPERIANCE
Nino Kiknadze
Associated Professor of Family Medicine Department
Tbilisi State Medical University
Georgian Representative in EURACT
KIEV November 2016

3. SCREENING PROGRAMS IN GEORGIA
Antenatal Screening for high risk pregnant women
Newborn Screening for hereditary disease
Hepatitis C Screening
Childhood Developmental Screening
Cancer Screening

4. CANCER SCREENING - HISTORY
2006 y – Health and Social Affairs Department (HSAD) of the Tbilisi Municipality and UNFPA Georgia for Reproductive Tract (RT) cancers prevention and early detection was launched in Tbilisi.
2008 y -The project was redesigned to focus on breast and cervical cancer screening for the targeted population in Tbilisi. The NSC was selected to implement the project.
2009y – Replication of the project at the national level.
2011, the comprehensive cancer screening programme (breast, cervical, colorectal cancer screening and prostate cancer risk management) became available in Georgia through the national programme under NCDC&PH (MoLHSA)
2014y – Pilot programme launched in one region - PHC (Cervical cancer)

5. CANCER SCREENING PROGRAM
MoHLSA–NCDC-NSC
UNFPA
EB SCREENING PROGRAMS
Quality Management
Legislation
IT SYSTEM
PHC - ACTIVE RECRUETEMENT
POPULATION BEHAVIOR CHANGE
CME

6. CANCER SCREENING PROGRAM
Physical examination
BREAST CANCER
2008
MAMMOGRAPHY
Ultrasound
Biopsy + Cytology
CERVICAL CANCER
2008
PAP - Smear
Colposcopy
Biopsy
COLORECTAL CANCER
2011
FOBT
Colonoscopy
biopsy
PROSTATE CANCER
???
PSA

7. CANCER SCREENING 2010-2015 CANCER BREAST CERVICAL PROSTATE COLORECTAL
SCREENING METHOD
MAMMOGRAPHY
PAP-SMARE
PSA
FOBT
AGE RANGE
25- 60
50-70
INTERVAL
3 y 3y 1y
AVE. N SCREENED PER YAR
16180
16553
4268
1393
COVERAGE
14.70%
16.26%
3.40%
0.70%

8. SCREENING PROGRAMS - BUDGET

9. CANCER SCREENING PROGRAM POPULATION BEHAVIOR CHANGE

10. SCRINING PROGRAMS IN PHC - ACTIVE RECRUETEMENT
PILOT PROGRAM IN ONE REGION OF GEORGIA
KAKHETI IORI
Village doctors will counsel women about cervical screening and then take a Pap test.
The Pap test will be sent to the KIC for processing.
Screening results will be sent to the referring doctor who will report them to the women and counsel those having an abnormal result.
Refer for Further Evaluation
Recalls
village doctors will counsel women about cervical screening and then take a Pap test.
The Pap test will be sent to the KIC for processing.
Screening results will be sent to the referring doctor who will report them to the women
and counsel those having an abnormal result.
c) Women having an abnormal result will be referred to the KIC for follow-up (colposcopy
and biopsy).
d) Follow-up results will be sent to the referring doctor who will report them to the women
e) Women needing treatment for pre-cancerous disease (cervical intraepithelial neoplasia)
will be referred to the KIC for treatment, with treatment results and further follow-up
requirements sent to the referring doctor.
f) Women needing treatment for cancer will be referred to the Tbilisi for treatment, with
treatment results and further follow-up requirements sent to the referring doctor.

11. SCREENING PROGRAM CME/CPD

12. SCREENING PROGRAM CME/CPD
Local and International CME courses for
Radiologists, Morphologists, Gynecologists,
Mammologists
Village doctors
Program administration
IT Staff
Customer service staff

13. SCREENING PROGRAMS IT
New Information management system for the Screening Programme, developed through the UNFPA
The first module of the system – the patients’/clients’ visits registration
The second module of the system - management of clinical information - allows managing electronically all clinical information.

14. SCREENING PROGRAMS QUALITY MANAGEMENT
Unification of cytology results
Unification of Radiological Interpretation (BIRADS)
Development of indicators for each screening program
Quality assessment system in each provider

15. SCREENING PROGRAM EFFECTS
Stage distribution of breast cancer cases detected after treatment; the National Screening Programme, 2009 According national statistical data, only ~ 33% of new incidents of cancers were detected at I-II stages

16. SCREENING PROGRAM EFFECTS
Abnormal PAP - smear distribution (%) (N=1701) Total N of Screened Women NCC

17. FINANSIAL EFFECTS OF CANCER SCREENING
“ounce of prevention is worth a pound of cure,”
FINANSIAL EFFECTS OF CANCER SCREENING
AVIALLABLE STATISTICAL DATAS AND PROGRAM COVERAGE ARE NOT INOUGH FOR CALCULATE REAL FINANSIAL EFFECT OF CURRENT SCREENING PROGRAMS, BUT -
Benjamin Franklin ( ) one of the Founding Fathers of the US .