Study of spatial distribution of cervical cancer incidence created by geographical information system

[N. P. Pavlović]

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Medicina - Epidemiologija / Medicine - Epidemiology

Uvod. Rak grlića materice (RGM) pripada grupi pet najčešćih malignih tumora kod žena u Beogradu. Ciljevi ove studije su bili: sagledavanje potpunosti podataka o registrovanim slučajevima obolevanja od RGM u odnosu na uzrast, mesto stanovanja i ekonomsku aktivnost; prikazivanje rezultata primene Geografskog informacionog sistema (GIS) u sagledavanju prostorne distribucije obolevanja od RGM. Metod. U ovoj studiji primenjen je deskriptivni epidemiološki metod i tehnologije GIS-a. Uključeni su svi slučajevi RGM kod žena starijih od 15 godine u Beograda u periodu 2000-2014.god. Izvor podataka o obolelima od RGM bio je Registar za rak u Beogradu. Podaci o proceni obezbeđenosti ginekološke zaštite i obuhvata preventivnim ginekološkim pregledima preuzeti su iz Godišnjih izvestaja o izvršenju plana rada Službe za zdravstvenu zaštitu žena beogradskih domova zdravlja. Izračunate su nestandardizovane uzrasnospecifične stope i standardizovan stope incidencije, prema podacima popisa iz 2002. i 2011. i proceni broja stanovnika Republičkog zavoda za statistiku za međupopisne godine. Urađena je indirektna standardizacija stope incidencije, standardni incidentni odnos (SIR) za svaku opštinu Beograda. Kretanje stopa prikazano je linearnim trendovima. Obezbeđenost je izražena kroz broj žena po jednom ginekologu (6500/1) u odnosu na ukupnu populaciju žena starijih od 15 god. opštine na kojoj se nalazi dom zdravlja. Korišćeni su i podaci o broju poseta ginekologu na dnevnom nivou (mera izvršenja je 30 poseta). Posmatran je obuhvat preventivnim ginekološkim pregledima, pristupačnost ginekološke zdravstvene zaštite (izrađena kao razdaljina od adrese stanovanja obolelih do najbliže ginekološke ordinacije. Primenom tehnologija GIS-a razvijene su prostorne baze podataka i kreirana je kartografska osnova za izvođenje prostorne analize. Korišćene su tehnike: prostorno preklapanje objekata analize kombinovanjem slojeva mapa sa različitim sadržajima; osnovne transformacije i analize podataka; postavljanje upita i generisanje izveštaja po upitima; reklasifikacija, spajanje i druge operacije na objektima; formiranje bafera oko objekata; međusobno upoređivanje objekata analize. Prostorna distribucija RGM je procenjivana i analizirana korišćenjem prosečne razdaljine mesta stanovanja obolelih od ginekološke ordinacije pomoću Global Average Nearest-Neighbor Distance (ANN) i point pattern analize, a za mapiranje podataka SIR-a aktuelni open source GIS alat QGIS v.3.0. Detekcija klastera je obavljena primenom diskretnog Poisson-ovog modela, a ispitivanje promene prostornih obrazaca primenom prostorno-vremenskog permutacionog modela pomoću SaTScan sofvera v.9.6...

Introduction. Cervical cancer (CC) is among the five most common carcinoma in women in the Belgrade area. The goals of this study were to perceive completeness of cancer register data in relation to age groups, place of residence and economic activity for registered cases of CC; to present results of applying Geographic Information System functions (GIS) in consideration of spatial distribution of CC. Methods. In this study were applied a descriptive epidemiological method and GIS technology. The study included cases of CC registered among inhabitants of Belgrade older than 15 years, diagnosed during the period 2000-2014 (International classification of Diseases, Injuries and Causes of Death, 10th revision, code C53). The source of data was database for the Population Cancer Registry for Belgrade. Data of the provision of gynecological health care, including the daily workload of gynaecologist as a accessibility of healthcare use, coverage of preventive gynecological examination at the primary health care level were taken from the Annual report on the plan of work of the Women's Health Belgrade Primary Health Care Centers (PHCCs) for 2000-2014. We used proportions, crude, indirect standardized incidence ratio (SIR) and age-specific incidence rates per 100,000 female inhabitants. Crude and age-specific incidence rates were calculated using census data (2002 and 2011) and estimation of the number of inhabitants of Republic institute for statistics of RS for years outside of the census years. The incidence rates of CC during the observed period are shown by linear trends. Provision of gynecological health care is expressed through the number of women per one gynecologist (6500/1) among the total adult female population (age 15 and over at the municipality of the PHCC), and interpreted according to the Rulebook for providing health services in healthcare institutions. Daily workload of gynecologist is expressed through the number of visits to the gynaecologist on a daily level (the measure is 30 visits/day/gynecologist). The coverage of preventive gynecological examinations is expressed as a percentage of the female population (25 years of age and older from the municipality where the PHCC is located), which performed a systematic examination for the early detection of CC. Maps of CC density and maps of the distribution of gynecological practices at PHCCs were generated through the process of geocoding, using the precise data on residence at the time of diagnosis and the addresses of gynecological practices in period 2000-2014. GIS techniques used in the spatial analysis were: visualization, overlay analysis, buffer analysis and query...

rak grlića materice, incidencija, potpunost podataka, prostorna distribucija, GIS, obezbeđenost, dostupnost zdravstvene službe, preventivni pregledi

cervical cancer, incidence, completeness data, spatial distribution, GIS, accessibility, provision of health care, preventive examines

618.14-006.6-036.22(043.3)

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