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Background: The Turkish government has implemented several reforms to improve the Turkish Statistical Institute Death Reporting System (TURKSTAT-DRS) since 2009. However, there has been no assessment to evaluate the impact of these reforms on causes of death statistics. This study attempted to analyse the impact of these reforms on the TURKSTAT-DRS for Turkey, and in the case of Izmir, one of the most developed provinces in Turkey. Methods: The evaluation framework comprised three main components each with specific criteria. Firstly, data from TURKSTAT for Turkey and Izmir for the periods 2001-2008 and 2009-2013 were assessed in terms of the following dimensions that represent quality of mortality statistics (a. completeness of death registration, b. trends in proportions of deaths with ill-defined causes). Secondly, the quality of information recorded on individual death certificates from Izmir in 2010 was analysed for a. missing information, b. timeliness of death notifications and c. characteristics of deaths with ill-defined causes. Finally, TURKSTAT data were analysed to estimate life tables and summary mortality indicators for Turkey and Izmir, as well as the leading causes-of-death in Turkey in 2013. Results: Registration of adult deaths in Izmir as well as at the national level for Turkey has considerably improved since the introduction of reforms in 2009, along with marked decline in the proportions of deaths assigned illdefined causes. Death certificates from Izmir indicated significant gaps in recorded information for demographic as well as epidemiological variables, particularly for infant deaths, and in the detailed recording of causes of death. Life expectancy at birth estimated from local data is 3-4 years higher than similar estimates for Turkey from international studies, and this requires further investigation and confirmation. Conclusion: The TURKSTAT-DRS is now an improved source of mortality and cause of death statistics for Turkey. The reliability and validity of TURKSTAT data needs to be established through a detailed research program to evaluate completeness of death registration and validity of registered causes of death. Similar evaluation and data analysis of mortality indicators is required at regular intervals at national and sub-national level, to increase confidence in their utility as primary data for epidemiology and health policy. [ABSTRACT FROM AUTHOR]

Background: A person-list-based family medicine model was introduced in Turkey during health care reforms. This study aimed to explore from primary care workers' perspectives whether this model could achieve the cardinal functions of primary care and have an integrative position in the health care system. Methods: Four groups of primary care workers were included in this exploratory-descriptive study. The first two groups were family physicians (FP) (n = 51) and their ancillary personnel (n = 22). The other two groups were physicians (n = 44) and midwives/nurses (n = 11) working in community health centres. Participants were selected for maximum variation and 102 in-depth interviews and six focus groups were conducted using a semi-structured form. Results: Data analysis yielded five themes: accessibility, first-contact care, longitudinality, comprehensiveness, and coordination. Most participants stated that many people are not registered with any FP and that the majority of these belong to the most disadvantaged groups in society. FPs reported that 40-60% of patients on their lists have never received a service from them and the majority of those who use their services do not use FPs as the first point of contact. According to most participants, the list-based system improved the longitudinality of the relationship between FPs and patients. However, based on other statements, this improvement only applies to one quarter of the population. Whereas there was an improvement limited to a quantitative increase in services (immunisation, monitoring of pregnant women and infants) included in the performance-based contracting system, participants stated that services not among the performance targets, such as family planning, postpartum follow-ups, and chronic disease management, could be neglected. FPs admitted not being able to keep informed of services their patients had received at other health institutions. Half of the participants stated that the list-based system removed the possibility of evaluating the community as a whole. Conclusions: According to our findings, FPs have a limited role as the first point of contact and in giving longitudinal, comprehensive, and coordinated care. The family medicine model in Turkey is unable to provide a suitable structure to integrate health care services. [ABSTRACT FROM AUTHOR]

Objectives: To evaluate the synchronous gynecologic cancers in Turkish women., Materials and Methods: A population-based longitudinal cohort study was conducted using Izmir Cancer Registry (ICR) data on gynecologic cancer patients diagnosed in the period 1993 to 2005. The registry covers the 3.7 million population of Izmir and has been collecting data on cancer incidence and survival of cancer patients' since 1992. The ICR collects data on all new cases of cancer from all the hospitals (n = 22) in the city., Results: A total of 4,185 women were identified with gynecologic cancer between 1993 and 2005, 1,526 with endometrial, 1,206 with cervical, 1,198 with ovarian, 115 with vulvar, 67 with other uterine ( sarcoma etc.), 33 with vaginal and 40 with other gynecologic cancers ( tuba uterina etc.). Fifty-five (1.3%) patients with invasive synchronous primary cancers were identified, 43 of these tumor pairs being endometrium-ovaries (81%), 66 of all lesions being endometrioid adenocarcinomas., Conclusions: Independent primary tumors of the endometrium and ovary are the most commonly encountered synchronous tumors of the female genital tractus with endometrioid adenocarcinoma as the most frequent component.

Purpose: The purpose of this study is to provide a detailed report on cancer incidence in Turkey, a relatively large country with a population of 72 million. We present the estimates of the cancer burden in Turkey for 2006, calculated using data from the eight population based cancer registries which have been set up in selected provinces representative of sociodemographic patterns in their regions., Methods: We calculated age specific and age adjusted incidence rates (AAIR-world standard population) for each of registries separately. We assigned a weighting coefficient for each registry proportional to the population size of the region which the registry represents., Results: We pooled a total of 24,428 cancers (14,581 males, 9,847 females). AAIRs per 100 000 were: 210.1 in men and 129.4 in women for all cancer sites excluding non-melanoma skin cancer. The AAIR per 100 000 men was highest for lung cancer (60.3) followed by prostate (22.8), bladder (19.6), stomach (16.3) and colo-rectal (15.4) cancers. Among women the rate per 100 000 was highest for breast cancer (33.7) followed by colorectal (11.5), stomach (8.8), thyroid (8.8) and lung (7.7). The most striking findings about the cancer incidence in the provinces were the high incidence rates for stomach and esophageal cancers in Erzurum and high stomach cancer incidence rates in Trabzon for both sexes., Conclusions: We are thus able to present the most accurate and realistic estimations for cancer incidence in Turkey so far. Lung, prostate, bladder, stomach, colorectal, larynx cancers in men and breast, colorectal, stomach, thyroid, lung, corpus uteri cancers in women are the leading cancers respectively. This figure shows us tobacco related cancers, lung, bladder and larynx, predominate in men. Concurrently, we analyzed the data for each province separately, giving us the opportunity to present the differences in cancer patterns among provinces. The high incidences of stomach and esophageal cancers in East and high incidence of stomach cancer in Northeast regions are remarkable.