measuring the burden of morbidity and mortality, pvondadelszen, figo2012

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  • 7/31/2019 Measuring the Burden of Morbidity and Mortality, PVonDadelszen, FIGO2012

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    Gj`{zael ~fj oznje mi gmoana~q `en

    gm~`ca~q

    kf`ccjelj{ `en {mcz~ame{Rj'jkc`gr{a` {~`~jlak `rrm`kfj{ im agrmyael mz~kmgj{ ae njyjcmrael

    kmze~aj{

    Rj~j yme N`njc{tjeOGjn[k# GOKfO# NarMo{~# NRfac# I_@ETKML# I_K[K# I_KML

    Rmij{{m mi Mo{~j~ak{ `en Lqe`jkmcmlq# ZOK

    me ojf`ci mi

    \FM G`~je`c Gmoana~q \mhael Lmzr

    KCAR ^a`c \mhael Lmzr

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    O`khlmzen

    Rj'jkc`gr{a` ?en cj`nael k`z{j mi najk~ g`~je`c gm~`ca~q

    92#222 62#222 nj`~f{ `eez`ccq

    Rmo`ocq `nna~ame`c nj`~f{ kzje~cq `~~aoz~jn ~m

    RRF nzj ~m kme{zgr~ayj km`lzcmr`~fq mi NAK :22#222 rjae`~`c nj`~f{ `eez`ccq

    Njiaea~ame om`njeael Fqrj~je{ame

    Rm~jaeza`

    M~fj gzc~aml`e g`hj{ mi na{j`{j

    Emyjc oamg`hj{

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    O`khlmzen ^fj |anj j{~ag`~j jm im `~~aoz~`ocj

    g`~je`c `en rjae`~`c nj`~f {fmzcn oj em~jn G`~je`c gmoana~q4gm~`ca~q `~am 0240

    Rjae`~`c4g`~je`c jyje~ `~am 0240

    |j ~faeh

    ^fjjimj# |j ejjn ~m |mh ~m|`n{ `kkz`~jrmrzc`~ame'cjyjc j{~ag`~j{ mi g`~je`c &`enrjae`~`c! G)G

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    O`khlmzen ^fj |anj j{~ag`~j jm im `~~aoz~`ocj

    g`~je`c `en rjae`~`c nj`~f {fmzcn oj em~jn G`~je`c gmoana~q4gm~`ca~q `~am 0240

    Rjae`~`c4g`~je`c jyje~ `~am 0240

    |j ~faeh

    ^fjjimj# |j ejjn ~m |mh ~m|`n{ `kkz`~jrmrzc`~ame'cjyjc j{~ag`~j{ mi g`~je`c &`enrjae`~`c! G)G

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    O`khlmzen A{{zj{ |a~f njiaea~ame

    Kc`{{ak`c \FM g`~je`c gm~`ca~q `~am &GG_!njiaea~ame mi jyje~{ rj 022#222 cayj oa~f{%

    \j fmrj ~m jnzkj ~fj oznje mi {~accoa~f ae|mgje |a~f rj'jkc`gr{a`%

    ^fjjimj# jyje ae ~fj `o{jekj mi `eq `o{mcz~jkf`elj ae g`~je`c `nyj{j jyje~ `~j{ &rjrjle`ekq!# ~fj GG_ rj 022#222 cayj oa~f{ kmzcni`cc `~aiaka`ccq `{ ~fj rmrm~ame mi cayjome aei`e~{

    aekj`{j{% Im KCAR# |j |acc z{j ~fj g`~je`c nj`~f `~j

    &GN_! `en rjae`~`c nj`~f `~j &RN_! &nj`~f{rj 022#222 njkc`jn rjle`ekaj{!

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    Jva{~ael gj`{zjgje~ ~mmc{gm~`ca~q ) i`kaca~q'o`{jn gmoana~q

    ^fj lmcn {~`en`n im g`~je`c gm~`ca~q E`~ame`c ya~`c {~`~a{~ak{ jla{~`~ame {zrrm~jn oq

    Kmeianje~a`c Jepzaaj{ ae~m G`~je`c Nj`~f{

    [zrrcjgje~jn ae [km~c`en oq `e jepzaq ae~m g`dm

    g`~je`c gmoana~q M~fj ~mmc{

    Rmrzc`~ame'o`{jn {~`~a{~ak{

    I`kaca~q'o`{jn `zna~ G)G |a~f `~~aoz~ame mi k`z{`ca~q

    \FM Ej` Ga{{ ~mmc

    Kmggzea~q'o`{jn ~mmc{ Ojqmen ~fj ezgojr{ `en {agac` yjo`c `z~mr{q ~mmc{

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    Jva{~ael gj`{zjgje~ ~mmc{gmoana~q `km{{ cjyjc{ mi k`j

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    \FM GG\L

    \FM G`~je`c Gmoana~q \mhael Lmzr# izenjnoq ~fj Oacc ) Gjcaen` L`~j{ Imzen`~ame#

    Imgjn ae j{rme{j ~m ~fj c`kh mi ` njiaea~ame `enjca`ocj j{~ag`~j{ mi g`~je`c gmoana~q

    RA4 C`cj [`q# \FM

    ^fa{ imz qj` rmdjk~ |acc oj g`e`ljn oq `[jkj~`a`~ kmgrm{jn mi ~fj \FM _jrmnzk~ayj

    Fj`c~f _j{j`kf `en Njyjcmrgje~ `en _j{j`kf^`aeael ae Fzg`e _jrmnzk~ame &F_R! ~j`g{ `encjn oq ` ~jkfeak`c |mhael lmzr

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    Modjk~ayj{ im \FM GG\L

    ^fj modjk~ayj{ `j ~m agrmyj ~fj {kaje~aiak o`{a{im njiaeael# j{~ag`~ael ~fj mkkzjekj mi# `engmea~mael g`~je`c gmoana~q

    Njyjcmrgje~ mi `e anje~aiak`~ame ka~ja` ~f`~ |accoj z{jn ae `e `{{j{{gje~ ~mmc

    @{{j{{gje~ ~mmc {fmzcn oj r`lg`~ak# `k~amemaje~jn# jyanjekj o`{jn `en f`yj jlame`c `enae~je`~ame`c `kkjr~`ekj

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    @{{j{{gje~ ^mmc Njyjcmrgje~

    Gj~fmnmcmlq

    ^fj anje~aiak`~ame ka~ja` im g`~je`c gmoana~q `j4{qgr~mg{# {ale{# aeyj{~al`~ame{ `en g`e`ljgje~{~`~jlaj{

    \FMEJ@_ GA[[ @rrm`kf ~m G`~je`c Fj`c~f &?200!

    [ale{ Aeyj{~al`~ame{

    Ka~ak`c Ae~jyje~ame{ Rmkj{{ Aenak`~m{

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    @{{j{{gje~ ^mmc Njyjcmrgje~

    Gj~fmnmcmlq

    Ca{~ mi g`~je`c kmena~ame{ njayjn img AKN'02`rrm`kf ~m g`~je`c nj`~f{# rzoca{fjn ca~j`~zj`en jvrj~ mraeame

    Izek~ame`c k`r`ka~q `{{j{{gje~ ~m zenj{~`en ~fjagr`k~ mi g`~je`c gmoana~q

    Ij~`c kmena~ame{ aekcznjn ~m jy`cz`~j r{qkfmcmlak`c{~j{{ me ~fj gm~fj

    \FM GG\L

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    @{{j{{gje~ ^mmc Njyjcmrgje~

    Gj~fmnmcmlq

    G`~av mi myj ;22 g`~je`c kmena~ame{ kmyjaelnajk~# aenajk~# `en aekanje~`c k`z{j{ mi g`~je`cgmoana~q

    Aenjvjn ~fj kmena~ame{ oq ~fja AKN'02 kmnj{ `en

    k`~jlma{jn ae~m 0> ml`e {q{~jg{

    K`namj{ra`~mqNjg`~mcmlqJenmkaejL`{~mae~j{~ae`cLjea~mzae`qF`jgm~mcmlqAeijk~amz{ Na{j`{j{

    Mo{~j~akMekmcmlqEjzmcmlqEz~a~ame`cR{qkfa`~qM~fj_fjzg`~mcmlq \FM GG\L

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    @{{j{{gje~ ^mmc Njyjcmrgje~

    Gj~fmnmcmlq

    Kmena~ame{ |jj km{{ jijjekjn |a~f 021{qgr~mg{# 029 {ale{# 0?0 aeyj{~al`~ame{# `en 10g`e`ljgje~ {~`~jlaj{

    J`kf kmena~ame |acc oj |jalf~jn `kkmnael ~m a~{mkkzjekj `en agr`k~ me ~fj |mg`e

    ^fm{j anje~aiak`~ame ka~ja` `{{mka`~jn |a~f ~fjgm{~ falfcq |jalf~jn kmena~ame{ |acc oj aekcznjn ae` rmo`oaca{~ak gmnjc ~m nj~jgaej ~fj mkkzjekj`en k`z{j mi g`~je`c gmoana~q

    \FM GG\L

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    [qgr~mg Jyanjekj]O`{jn]_jijjekj @{{j{{gje~]^mmc Kmena~ame{

    @onmgae`c R`ae &aekcznael z~jaej#{zr`rzoak

    r`ae!

    D@G@ _`~ame`c Kcaeak`c Jv`g'Nmj{

    ~fa{ r`~aje~ f`yj `rrjenaka~a{= 0119

    gaeaRAJ_[ &rj'jkc`gr{a`!

    I:2%2#M20>%?#Q29-Q22-L>0#L>;#A90- A9;-A9>-L>9#L>:#M66%0#M?1#I00'

    I01#_21%?#G;?#G;2'

    G;0%1#M?9%9#_>0%2#I02-^:0#H#A>>-0>:-_22#H9#M??%:#E0>-0>:-_22#A;2- A>2#N91%9

    Kfacc{-_alm{

    L22#D0?'06#M0%0#@20#M6:#O:2'

    O:>#D02-D00#O1:%0#N:6%;

    Kmcn Ae~mcj`ekj

    Kme{~ar`~ame

    Kmzlf N:%?#D0?'06#K;>#M16%2#M16%%?#@>6%;#M16%>#N9:#N:1#E0%?#M?9%9#E0'0;-L>9#L:0%0

    ^ Iamt im \FM GG\L

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    [ale Jyanjekj]O`{jn]_jijjekj Kmena~ame{

    @onmgae`c ~jenjej{{ &aekcznael

    z~jaej#{zr`rzoak ~jenjej{{!

    D@G@ _`~ame`c Kcaeak`c Jv`g'

    Nmj{ ~fa{ r`~aje~ f`yj

    `rrjenaka~a{= 0119

    M0:#N:2#M16%>#O:2'O:>#M6:#@20#H?:'

    H?0%0#M#M%?#J?%>#J?

    @c~jjn Gje~ c [~`~z{ &njkj`{jn cjyjc mi

    kme{kamz{ej{{# njcjazg# jekjrf`cmr`~fq#

    kmg`!

    D@G@ _`~ame`c Kcaeak`c Jv`g'

    Nmj{ ~fa{ `nzc~ r`~aje~ f`yj

    gjeaela~a{= 0111

    M?9%9#A>9#H#A90- A9;-A9>-L>9#J?0#G;2'G;0%1#G;?#_21%?#I00'I01#Y20'

    Y11#M?1#L>:#L>;#L>2-L>0#O22#E0#L22#@2

    0#M??%:#_>0%2#J?>

    @geam~ak iczan rj m{

    @e {`k` M12%;#M20>%?#M?9%9#E02#A;>'0;%>#h#K??%2#M?:

    @{~java{ M16%>#I02-^:0#D>:#h9#T1>%;#I00'I01

    Oza{j N9:#N91%;#Q29-Q2 fmz zaej im km~a{mc

    @onmgae`c zc~`{mzen

    N:1#M20>%?#I02-^:0#K60'

    69#K??%2#N91%;#E06#E0#H#H60#H#H;:

    #M?9%9#M0:

    @IO {gj` en kzc~zj M16%2#L22

    @cozgae h:#I02-^:0#K??%2#M#M>>#M66%0#M>;%?#H#M

    ?9%9#M%>#h6%;#D0?'

    06#I02-^:0#M>#M>:#M#K60'69#K10'K1:#O:2'

    O:>#M

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    G`e`ljgje~ Rmvq Kmena~ame{

    @nje c {zljq &jvka{ame mi g`{{# `nje`cjk~mgq! J?>#J?0%0#D0?'06#M66%;#M16%0#O1:%2#M16%?#H;:#I02-^:0#M6:#H60#H:2-H:0#M?;#N:%?#J?9%2#M20;#E0>

    Om|jc {zljq H:2-H:0#H?:'H?>-0>:-_22#A>9

    Kjkc`lj

    Kj{`j`e {jk~ame

    Kfjgm~fj`rq K60'69#K10'K1:#K>;#M20#K:;#K??%2#K:2#K;>

    Kfmcjkq{~jk~mgq H60

    Kmcmem{kmrq H:2-H:0

    Kme~aezmz{ Rm{a~ayj @a|`q Rj{{zj &k R@R! J99#L>#I00'I01#M>#M66%0#G;0%0#N9:#T1>%2#E06#E0

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    @{{j{{gje~ ^mmc Njyjcmrgje~

    Gj~fmnmcmlq

    Kmena~ame{ |jj km{{ jijjekjn |a~f 021{qgr~mg{# 029 {ale{# 0?0 aeyj{~al`~ame{# `en 10g`e`ljgje~ {~`~jlaj{

    J`kf kmena~ame |acc oj |jalf~jn `kkmnael ~m a~{mkkzjekj `en agr`k~ me ~fj |mg`e

    ^fm{j anje~aiak`~ame ka~ja` `{{mka`~jn |a~f ~fjgm{~ falfcq |jalf~jn kmena~ame{ |acc oj aekcznjn ae` rmo`oaca{~ak gmnjc ~m nj~jgaej ~fj mkkzjekj`en k`z{j mi g`~je`c gmoana~q

    ^ Iamt im \FM GG\L

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    @{{j{{gje~ ^mmc Njyjcmrgje~

    Gj~fmnmcmlq

    Kmena~ame{ |jj km{{ jijjekjn |a~f 021{qgr~mg{# 029 {ale{# 0?0 aeyj{~al`~ame{# `en 10g`e`ljgje~ {~`~jlaj{

    J`kf kmena~ame |acc oj |jalf~jn `kkmnael ~m a~{mkkzjekj `en agr`k~ me ~fj |mg`e

    ^fm{j anje~aiak`~ame ka~ja` `{{mka`~jn |a~f ~fjgm{~ falfcq |jalf~jn kmena~ame{ |acc oj aekcznjn ae` rmo`oaca{~ak gmnjc ~m nj~jgaej ~fj mkkzjekj`en k`z{j mi g`~je`c gmoana~q

    ^ Iamt im \FM GG\L

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    @{{j{{gje~ ^mmc Njyjcmrgje~

    Gj~fmnmcmlq

    Kmena~ame{ |jj km{{ jijjekjn |a~f 021{qgr~mg{# 029 {ale{# 0?0 aeyj{~al`~ame{# `en 10g`e`ljgje~ {~`~jlaj{

    J`kf kmena~ame |acc oj |jalf~jn `kkmnael ~m a~{mkkzjekj `en agr`k~ me ~fj |mg`e

    ^fm{j anje~aiak`~ame ka~ja` `{{mka`~jn |a~f ~fjgm{~ falfcq |jalf~jn kmena~ame{ |acc oj aekcznjn ae` rmo`oaca{~ak gmnjc ~m nj~jgaej ~fj mkkzjekj`en k`z{j mi g`~je`c gmoana~q

    ^ Iamt im \FM GG\L

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    Gmoana~q `{{j{{gje~ {rjkaiak ~mrj'jkc`gr{a`

    izccRAJ_[ Njgml`rfak'# {qgr~mg'# {ale' ) c`om`~mq'

    o`{jn mz~kmgj rjnak~ame gmnjc im |mgje |a~frj'jkc`gr{a`

    Kmgrmeje~{ L@# kfj{~ r`ae-nq{remj`# [rM?# rc`~jcj~ kmze~# {jzg

    kj`~aeaej# @[^

    yme N`njc{tje j~ `c% C`ekj~ ?200

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    Om`njeael ~fj {kmrj jv~je`c y`can`~ame img Nz~kf RJ^_@ ~a`c

    @hhjg`e{ j~ `c% &zerzoca{fjn!

    Nz~kf _K^ Rj'Jkc`gr{a` ^a`c

    @g{~jn`g

    Ymczgj jvr`e{ame im{jyjj rj'jkc`gr{a`

    ?09 |mgje `enmga{jn Em naiijjekj ae g`dm

    g`~je`c gmoana~q &00*!

    Aekj`{jn K-[ ae ymczgjjvr`e{ame lmzr &16* y{

    12*8 r32%2:!L`etjymm~ j~ `c% ODML ?22:

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    Gmoana~q `{{j{{gje~ {rjkaiak ~mrj'jkc`gr{a`

    gaeaRAJ_[ Njgml`rfak'# {qgr~mg'# {ale'o`{jn

    mz~kmgj rjnak~ame gmnjc im |mgje |a~f`eq FNR

    Kmgrmeje~{ L@# fj`n`kfj-ya{z`c na{~zo`ekj{# kfj{~

    r`ae-nq{remj`# y`lae`c ocjjnael |a~f `onmgae`cr`ae# _ZP r`ae# {OR# nar{~akh rm~jaeza`

    R`qej j~ `c% C`ekj~ &{zoga~~jn!

    i

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    gaeaRAJ_[ rjimg`ekjnjyjcmrgje~ &e70?>1! y`can`~ame &e76;?!

    R`qej j~ `c% C`ekj~ &{zoga~~jn!

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    [zgg`q @kkz`~j `{{j{{gje~ mi g`~je`c

    gmoana~q `en gm~`ca~q a{ ya~`c ~m`kkjcj`~j jnzk~ame{ ae `nyj{jmz~kmgj{ jc`~jn ~m rj'jkc`gr{a`

    N`~` {fmzcn oj rmrzc`~ame'o`{jn Aeemy`~ayj gj~fmn{ z{ael rmo`oaca{~ak

    gmnjccael |acc oj jpzajn ~m nj~jgaej

    kmze~q j{~ag`~j{ mi G)G _a{h {~`~aiak`~ame a{ rm{{aocj im |mgje

    |a~f rj'jkc`gr{a`

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    \FM GG\L Raq` @l`|`c

    Fq`g O`{fmz

    Dm{j Lzacfjgj Kjkk`~~a I`ekj Nmee`q

    Mczozhmc` I`|mcj

    Ojkhq Ijlz{me

    Yjmeapzj Iacarra

    ^`o`{{zg Iamt @~i Lfa{{a

    Lacc Lq~j

    @~{zga Fam{j

    @emg` D`q`~fac`h`

    Q`kmzo` Hmej

    A{`ojccj C`elj

    @iij~~j GkK`|'Oaee{

    G`h Gml`e

    [~jrfje Gzed`ed`

    Kaf`e t~mrkz

    Jcat`oj~f [zccay`e Eqehj y`e nje Omjh

    Rj~j yme N`njc{tje

    _`kfjc Y`enjHzah

    \FM [JK_J^@_A@^

    Gakf`jc Goatym C`cj [`q

    Nma{ Kfmz

    Gj~ae Lcgjtmlcz

    tlj ^zek`cr

    C`za D`c`e~a

    G`~~fj|{ G`~f`a

    _`day O`fc

    Caen` Yj{jc

    KCAR ^ a c \ ha L

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    KCAR ^a`c \mhael Lmzr G`h @e{jgaem

    H`~aj Kf`rg`e

    ^`o`{{zg Iamt

    \acca`g Lmog`e

    Hjccq Fjenj{me

    Kfa`l H`aq`

    G`a`e Healf~

    ^`el Cjj [agme Cj|ae

    R`zc C`O`j

    L|qej~f Cj|a{

    Dael &C`q! Ca

    C`z` G`ljj Oj~f R`qej

    @e` Rac` Oj~e

    Na`ej [`|kfzkh

    [zgjnf` [f`g`

    @enq [fjee`e

    Dmjc [aelj

    G`a`eej Yancj

    Dag ^fme~me

    Rj~j yme N`njc{tje

    R@HA[^@E

    Tzciap` Ofz~~`

    _`f`~ Pzj{fa

    EALJ_A@ Mczijga Mc`n`rm

    Mc`cjh`e @nj~mm

    H`qmnj N`n`

    AENA@

    [fay`r`{`n Lmzn` Gz~qzed`q` Ojcc`n

    GMT@GOAPZJ

    J{rj`ek` [jyjej

    Gmf{ae [an`~

    Jz{joam G`kj~j