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S. Metintas
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MINI 24 - Epidemiology, Early Detection, Biology (ID 140)
- Event: WCLC 2015
- Type: Mini Oral
- Track: Thymoma, Mesothelioma and Other Thoracic Malignancies
- Presentations: 1
- Moderators:J. Creaney, M. Carbone
- Coordinates: 9/08/2015, 16:45 - 18:15, 102+104+106
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MINI24.03 - Asbestos Knowledge and Awareness Level (ID 2610)
16:45 - 18:15 | Author(s): S. Metintas
- Abstract
- Presentation
Background:
Asbestos is an important carcinogen and people can be exposed to asbestos either occupationally or environmentally. There is naturally occurring asbestos in some regions of Turkey. The soil including asbestos was commonly used for plastering, whitewashing and roofing to build village house in these regions. The aim of this study is to determine knowledge and awareness level of people about asbestos in a region of Turkey where asbestos related diseases is endemic due to environmental exposure to asbestos in the rural area.
Methods:
The study is a questionnaire-based cross-sectional study included patients and their relatives admitted to a tertiary hospital in Eskisehir located central part of Turkey, in 2015. The questionnaire was applied by face-to-face interview after verbal consent from each participant. The questionnaire included 19 questions. The data was determined by percent and confidence interval. Chi-square test was used to compare the groups and multiple logistic regression analysis was used to determinate variables affecting knowledge level of asbestos.
Results:
A total number of 505 participants were included in this study. The mean age of them was 52.6±15.2 years (15-89) and 51.9% of them were male. About 41.2% of participants were born in the rural area and 14.5% of them still live in the villages. The educational status: 8.3% never, 55.7% elementary school; 19.0% secondary school; 17% university. About 4.4% of the participants were unemployed, 13.5% official, 20.8% worker, 2.8% farmer, 34.5% housewife and 24.2% others including retired, barber etc. About 76.4% of the participants who live in the villages had history of asbestos-contaminated soil in their villages. Only 20.5% of the group knew that white soil included asbestos. About 3.5% of the group mentioned that asbestos was useful, 44.1% harmful, 3.5% ineffective and the rest of them had no idea. Regarding the knowledge about asbestos related diseases among them, 34.9% stated that asbestos can cause lung cancer, 18.3% benign pleural or lung diseases and 23.1% mesothelioma. Most of the participants who never live in the village or moved to the city (62.9%) stated that asbestos was harmful and 30.9% had no idea. About 53.1% of them mentioned that asbestos can cause lung cancer, 26.9% benign pleural or lung diseases and 33.5% mesothelioma. In this group, the rate of true answers regarding usage of asbestos at workplace was 12.9% (8%-20%). Their knowledge about environmental usage of asbestos was low (16.6%) in this group. More than half of the participants (53.5%) pointed out that it is necessary to avoid from asbestos. The factors affecting knowledge level of asbestos were found to be young (p=0.016), live in the city (p=0.016) and high education level (p<0.001) by multiple logistic regression analysis.
Conclusion:
Although approximately 30 years passed after the first scientific report about hazards of environmental asbestos exposure on the respiratory system in this region, knowledge and awareness level of asbestos was quite low by sampling of this population. Health and environment authorities should inform the people as quickly and intensely about asbestos.
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P2.08 - Poster Session/ Thymoma, Mesothelioma and Other Thoracic Malignancies (ID 225)
- Event: WCLC 2015
- Type: Poster
- Track: Thymoma, Mesothelioma and Other Thoracic Malignancies
- Presentations: 1
- Moderators:
- Coordinates: 9/08/2015, 09:30 - 17:00, Exhibit Hall (Hall B+C)
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P2.08-015 - The Relationship between the Cost of Treatment and Prognosis in Malignant Mesothelioma in Turkey (ID 2558)
09:30 - 17:00 | Author(s): S. Metintas
- Abstract
Background:
Malignant mesothelioma (MM) is endemic in the population exposed to asbestos and has high healthcare cost with a limited life expectancy. The aim of this study is to evaluate the relationship between cost according to treatment type and prognosis in MM patients followed up from diagnosis to death.
Methods:
The demographics and healthcare costs of 239 patients with MM were obtained from hospital records in the tertiary university hospital between 2005 and 2014. Variance analysis and t-test were performed to compare the groups. The survival rates were estimated using the Kaplan-Meier method. To clarify health care cost in Turkey, the following information was given according to the national reimbursement price in April 2015. This study was supported by General Directorate of Health Researches, Republic of Turkey, Ministry of Health.
Results:
The mean age of the patients were 62.9±11.3 years and 125 (52.3%) of them were male. The median survival time was 9.0±0.8 months (95% CI: 7.3–10.7). Patients’ numbers according to treatment schema: 52 (21.8%) best supportive care (BSC); 3 (1.3%) BSC+palliative radiotherapy (pRT); 117 (49.0%) chemotherapy; 39 (16.3%) chemotherapy+pRT, 16 (6.7%) pleurectomy/decortication (P/D)+chemotherapy+RT; 4 (1.7%) P/D+chemotherapy; 8 (3.3%) extrapleural pneumonectomy (EPP)+chemotherapy+RT. BSC group had the lowest average cost with $1,355 (r:258-4,909) per patient. The average cost was $6,595 (r:1,621-21,371) for patients received only chemotherapy. When pRT added to chemotherapy, cost was increasing to $8,962 per patient. The average cost was $11,691 (r:6,567-19,064) per patient for P/D+chemotherapy+RT group. It decreased to $10,676 without RT. The highest average cost was seen in the group of EPP+chemotherapy+RT with $13,788 (r:6,168-19,577) per patient. The median survival times were 6 months (95%CI:5.3-6.7), 12 months (95%CI:9.8-14.2), 18 months (95%CI:11.5-24.5), 27 months (95%CI:7.6-46.4) for BSC, chemotherapy, P/D+chemotherapy+RT and EPP+chemotherapy+RT group, respectively. The median survival time was significantly different between BSC and chemotherapy groups (Log-Rank:10.607; p=0.001). The average cost of 6 months prolongation of lifetime was $5,239 in chemotherapy group and incremental cost was $873 per month gained. The median survival time was not different between chemotherapy and P/D+chemotherapy+RT groups (Log-Rank: 1.263; p=0.261). However, there was 6 months survival difference between the two groups. The average cost of 6 months prolongation of lifetime was $5,097 and incremental cost was $850 per month gained in EPP+chemotherapy+RT. The median survival time was significantly different between chemotherapy and EPP+chemotherapy+RT groups (Log-Rank: 8.082; p=0.004). The average cost of 15 months prolongation of lifetime was $7,194 and incremental cost was $480 per month gained in EPP+chemotherapy+RT group. There was a difference between surgical groups in terms of median survival (Log-Rank:4.421; p=0.036). The average cost for prolongation of lifetime was $2,097 and incremental cost was $233 per month gained.
Conclusion:
MM has a limited survival time despite antitumor treatment and treatment cost is relatively high by prolongation of lifetime. Treatment should be given to selected patients and EPP should be preferred to P/D as much as possible. It is clear that there is need well designed prospective studies for cost analysis of MM.
