Cancer In Kazakhstan Research Articles

Regional Analysis and Stage-Specific Incidence of Breast Cancer in Kazakhstan: A Comprehensive Study

BackgroundBreast cancer is the most prevalent oncological pathology in Kazakhstan, ranking among the top three causes of cancer-related deaths in women. The objective of this study is to analyze the incidence of breast cancer, considering factors such as stage, age, sex, and morphological verification in the regional context in Kazakhstan. MethodsThe retrospective study employed descriptive and analytical oncoepidemiological methods. Breast cancer incidence data (2005-2019) were obtained from the Unified Nationwide Electronic Health System (ICD-10 code C50). Demographic data came from the Bureau of National Statistics. Statistical analyses included age-standardized, crude, and age-specific incidence rates, with trend analyses performed using linear regression and the Joinpoint Regression Program to assess average percentage change over time. ResultsThe analysis of breast cancer incidence in Kazakhstan shows significant regional variations and an overall upward trend. Nationally, the age-standardized incidence rate is 40.9 per 100,000, with an annual increase of +1.96%. Early-stage (I-II) breast cancer incidence is rising, particularly in Pavlodar, North Kazakhstan, and Almaty City. In contrast, advanced-stage (III-IV) incidence has generally declined, except in regions like Kostanay, North Kazakhstan, and Atyrau, where late-stage cases are increasing. High morphological verification rates across all regions ensure reliable and accurate diagnostic data. ConclusionThe study reveals a significant increase in early-stage breast cancer diagnoses in Kazakhstan, highlighting the effectiveness of the national screening program. However, regional disparities in late-stage cancer incidence suggest a need for targeted interventions and improved regional healthcare.

COVID-19 pandemic and lung cancer rates in Kazakhstan: a comparative study of pre-pandemic and pandemic periods

Aim of the study. To assess the impact of the COVID-19 pandemic on the incidence of lung cancer by component analysis.Materials and methods. The research material was the data of the Ministry of Health of the Republic of Kazakhstan concerning LC (Form 7). To analyze the dynamics of incidence based on the number of cases from 2011 to 2020, a component method was used.Results and discussion. Analyzing 2011 and 2020, we found a tendency to decrease the incidence of lung cancer (p=0.000). However, comparing 2019 and 2020, we found a sharp decline in the incidence. The overall decrease was −2,220/0000 and depended on changes in the age structure of the population (∑ΔA=+0,340/0000), the risk of getting illness (∑ΔR=−2,520/0000) and the combined effect of the age structure and the risk of getting illness (∑ΔAR=−0,040/0000). The decrease was mainly due to the impact of the risk of getting illness. According to the calculations of the component analysis, 3,856 patients were expected in 2020, but instead the number of patients decreased to 3,375 and this is characterized by a decrease in the number of cases as a result of changes in the risk of getting illness.Conclusions. The COVID-19 pandemic has significantly reduced the incidence rate of lung cancer in Kazakhstan. Additional analysis and research are needed to understand the full impact and take appropriate measures to combat cancer in a pandemic.

266P Incidence of early-onset rectal cancer in Kazakhstan

266P Incidence of early-onset rectal cancer in Kazakhstan

Liver Cancer Incidence in Kazakhstan: Fifteen-Year Retrospective Study.

The aim is to study the trends of liver cancer (LC) incidence in the regional context in Kazakhstan. The retrospective study was done using descriptive and analytical methods of oncoepidemiology. The extensive, crude and age-specific incidence rates are determined according to the generally accepted methodology used in sanitary statistics. The data were used to calculate the average percentage change (APС) using the Joinpoint regression analysis to determine the trend over the study period. Between 2005 and 2019, 13,510 cases of LC were documented, comprising 59.3% males and 40.7% females. Most diagnoses were seen in age groups 55-59 years (13.3%) to 75-79 years (11.7%). LC patients' average age increased from 63.6 to 64.5 years. Incidence rates per 100,000 peaked at ages 65-69 years (35.1±1.0) and 70-74 years (43.3±1.0). LC incidence notably rose in the 70-74 years age group (APC=+0.89), contrasting with declining trends in younger age groups. Regional incidence variations revealed diverse patterns, mostly demonstrating unimodal increases, and some regions displaying bimodal growth. The age-standardized incidence rate was 5.7±0.1 per 100,000, declining from 2005 to 2012 (APC: -3.93), then rising until 2019 (APC: +1.13). Gender-specific standardized rates showed varied trends. Analyses of standardized indicators indicated declining trends in most regions but increased values in specific areas. Thematic maps classified incidence rates based on standardized indicators: low (up to 5.22), average (5.22 to 7.11), high (above 7.11 per 100,000 for the entire population). The study on liver cancer in Kazakhstan reveals marked gender and age differences. The standardized incidence rate among men was twofold greater than that among women. A distinct rise in cases was noted among individuals aged 70-74 years. Regional variations in incidence were evident. These findings emphasize the necessity for focused research to comprehend the causes behind these differences, enabling customized interventions for Kazakhstan's population.

GASTRIC CANCER: EPIDEMIOLOGY AND PROSPECTS FOR THE DEVELOPMENT AND IMPLEMENTATION OF INNOVATIVE TECHNOLOGIES FOR EARLY DETECTION AND TREATMENT

Relevance: Gastric cancer is a heterogeneous group of malignant epithelial tumors arising from the cells of the gastric mucosa, one of the most common forms of malignant neoplasms in many countries of the world. But, despite repeated attempts, there are no convincing approaches to early large-scale (screening) detection technology for this form of cancer. This causes a high rate of late detection of advanced forms of gastric cancer in most countries of the world, a high one-year mortality rate of patients, and a low five-year survival rate. Currently, full screening for gastric cancer is carried out only in Japan, Korea, and China – countries with high incidence rates.
 The study aimed to assess the epidemiologically disadvantaged regions of Kazakhstan for cancer to select optimal early detection techniques to improve the treatment results.
 Methods:For the analysis, we used available epidemiological indicators on GC from the specialized literature, data obtained from annual reporting forms No. 7, approved by the Ministry of Health of the Republic of Kazakhstan, in the country code (ICD 10 – C16), publications with statistical and analytical materials on Kazakhstan. Morbidity and mortality rates were calculated based on data from the Bureau of National Statistics of the Agency for Strategic Planning and Reforms of the Republic of Kazakhstan website on the average annual population by region of Kazakhstan.
 Results: A long-term decrease in the incidence and mortality from gastric cancer in Kazakhstan since 2021 has been replaced by a stable increase in the incidence of gastric cancer against the backdrop of a high frequency of advanced forms, relatively high mortality, and low fiveyear survival of patients. At the same time, there is experience in the world of certain approaches to screening the population for early detection of gastric cancer.
 Conclusion: The high morbidity of gastric cancer in most regions of the country in recent years requires the search and development of optimal forms of screening for its early detection; this will reduce mortality from gastric cancer and increase the five-year survival rate of patients.

THE RESULTS OF THE JAPANESE GASTRIC CANCER ASSOCIATION MORPHOLOGICAL CLASSIFICATION ADAPTATION FOR THE KAZAKH POPULATION

Relevance: Gastric cancer is a heterogeneous group of malignant epithelial tumors arising from the cells of the gastric mucosa, one of the most common forms of malignant neoplasms in many countries of the world. But, despite repeated attempts, there are no convincing approaches to early large-scale (screening) detection technology for this form of cancer. This causes a high rate of late detection of advanced forms of gastric cancer in most countries of the world, a high one-year mortality rate of patients, and a low five-year survival rate. Currently, full screening for gastric cancer is carried out only in Japan, Korea, and China – countries with high incidence rates.
 The study aimed to was a retrospective analysis of literary data on the epidemiology of gastric cancer in the world, individual countries, but, above all, our own materials, summarized by specialists of the Joint Stock Company “Kazakh Research Institute of Oncology and Radiology” (JSC “KazNIIOiR”) on the situation with cancer stomach in Kazakhstan; analysis of information on the types and results of screenings for the early detection of gastric cancer in the world.
 Methods:For the analysis, we used available epidemiological indicators on GC from the specialized literature, data obtained from annual reporting forms No. 7, approved by the Ministry of Health of the Republic of Kazakhstan, in the country code (ICD 10 – C16), publications with statistical and analytical materials on Kazakhstan. Morbidity and mortality rates were calculated based on data from the Bureau of National Statistics of the Agency for Strategic Planning and Reforms of the Republic of Kazakhstan website on the average annual population by region of Kazakhstan.
 Results: A long-term decrease in the incidence and mortality from gastric cancer in Kazakhstan since 2021 has been replaced by a stable increase in the incidence of gastric cancer against the backdrop of a high frequency of advanced forms, relatively high mortality, and low fiveyear survival of patients. At the same time, there is experience in the world of certain approaches to screening the population for early detection of gastric cancer.
 Conclusion: The high morbidity of gastric cancer in most regions of the country in recent years requires the search and development of optimal forms of screening for its early detection; this will reduce mortality from gastric cancer and increase the five-year survival rate of patients.

GASTRIC CANCER: EPIDEMIOLOGY AND PROSPECTS FOR THE DEVELOPMENT
 AND IMPLEMENTATION OF INNOVATIVE TECHNOLOGIES FOR EARLY DETECTION
 AND TREATMENT

Relevance: Gastric cancer is a heterogeneous group of malignant epithelial tumors arising from the cells of the gastric mucosa, one of the
 most common forms of malignant neoplasms in many countries of the world. But, despite repeated attempts, there are no convincing approaches
 to early large-scale (screening) detection technology for this form of cancer. This causes a high rate of late detection of advanced forms of gastric cancer in most countries of the world, a high one-year mortality rate of patients, and a low five-year survival rate. Currently, full screening
 for gastric cancer is carried out only in Japan, Korea, and China - countries with high incidence rates.
 The study aimed was a retrospective analysis of literary data on the epidemiology of gastric cancer in the world, individual countries, but,
 above all, our own materials, summarized by specialists of the Joint Stock Company “Kazakh Research Institute of Oncology and Radiology”
 (JSC “KazNIIOiR”) on the situation with cancer stomach in Kazakhstan; analysis of information on the types and results of screenings for the
 early detection of gastric cancer in the world.
 Methods: For the analysis, we used available epidemiological indicators on GC from the specialized literature, data obtained from annual
 reporting forms No. 7, approved by the Ministry of Health of the Republic of Kazakhstan, in the country code (ICD 10 - C16), publications with
 statistical and analytical materials on Kazakhstan. Morbidity and mortality rates were calculated based on data from the Bureau of National
 Statistics of the Agency for Strategic Planning and Reforms of the Republic of Kazakhstan website on the average annual population by region
 of Kazakhstan.
 Results: A long-term decrease in the incidence and mortality from gastric cancer in Kazakhstan since 2021 has been replaced by a stable
 increase in the incidence of gastric cancer against the backdrop of a high frequency of advanced forms, relatively high mortality, and low fiveyear survival of patients. At the same time, there is experience in the world of certain approaches to screening the population for early detection
 of gastric cancer.
 Conclusion: The high morbidity of gastric cancer in most regions of the country in recent years requires the search and development of
 optimal f

Actual issues of secondary prevention of liver cancer in Kazakhstan

Liver cancer is characterized by high mortality and low survival rates in most countries of the world. According to the WHO data, more than 1.3 million people with liver cancer die annually in the world and according to the data of the 9th volume of "Cancer on five continents" - the highest standardized incidence rates are in Korea - 44.9 per 100 thousand population as well as in Thailand, Japan, China. Low rates were in Algeria, India, Belgium and the Netherlands. In Russia 61.5% of patients die of liver cancer progression in the first year after diagnosis [1,2].<br /> Information on the global burden of cancer in 2018 showed that the specific weight of liver cancer in the structure of malignant neoplasms (MN) is 8.2%, and in 2020 - 8.3% [3].  <br /> The worldwide peculiarity of liver cancer is its late diagnosis. Several evidence-based treatment options for liver cancer are currently available: liver transplantation for hepatocellular liver cancer (HCC) (according to the Milan criteria), radiofrequency ablation as a radical treatment option (RFA), chemoembolization for intrahepatic cholangiocarcinoma (TACE), and the administration of Sorafenib as systemic therapy [4].<br /> Current approaches for the treatment of early-stage primary liver cancer are represented by hepatic RFA, and the efficacy of this approach depends on the subjective attentiveness and visual acuity of the clinician. The latest technique used in liver RFA is the hyperspectral imaging which utilize objective assessment [2].<br /> Ultrasound is usually used to detect liver lesions, but the detection rate is low for many reasons, such as clinician skills and technical capabilities. Modern approaches of diagnostic capabilities, such as contrast-enhanced ultrasound integrated imaging (CEUS) and comprehensive ultrasound imaging - contrast-enhanced CT (CECT) or contrast-enhanced MRI (CEMRI) for visualization of focal liver lesions (FLL) - increase the confidence of the interventional physician so it should be recommended for use as a routine procedure [5-6].<br /> The ratio of morbidity and mortality in many countries reaches 91.6%, which represents the third most important cause of cancer deaths [7-9].

Draft genome sequence of a Fusobacterium nucleatum strain isolated from a patient in Kazakhstan with colorectal cancer.

Fusobacterium nucleatum is an invasive obligate anaerobe found in the oral microbiota and associated with colorectal cancer. Here, we announce the draft genome sequence of Fusobacterium nucleatum strain Fn11kaz from a patient with colorectal cancer in Kazakhstan.

Prevalence of high-grade HPV types among women in Astana, Kazakhstan (2018-2022)

Background: Cervical cancer is a significant public health concern worldwide, and human papillomavirus (HPV) is the leading cause of this disease. While there have been some studies on the prevalence of HPV in Kazakhstan, the country faces unique challenges in preventing and treating HPV-related diseases, including limited resources, a lack of awareness about HPV, and cultural attitudes toward sexual health. This research article aims to provide a comprehensive overview of HPV genotype distribution in Astana, Kazakhstan, for the last five years. Methods: A cross-sectional study was performed from 2018 to 2022. Study population: Kazakhstani women referring to “Olympus laboratories network” settings for HPV testing age 18-64. AmpliSens® Real-Time PCR kits for HPV genotyping 14 high-risk HPV types (16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 66, 68) were performed. Results: This study revealed the increasing trend in HR-HPV prevalence among women for five sequential year periods. As a result, approximately 43% of women referred to the HPV testing were HR-HPV positive, with the most prevalent type being HPV 16 (20%), followed by HPV types 31, 52, 51. Conclusion: By examining the latest research on HPV and cervical cancer in Kazakhstan, we hope to contribute to developing effective public health policies and interventions to help reduce these diseases' burden in this country. Furthermore, the database will be established for future large-scale studies after vaccination implementation.

Health-Related Quality of Life and Treatment Satisfaction of Patients with Blood Cancer in Kazakhstan: A Cross-Sectional Study.

This was a cross-sectional study, conducted from November 2022 to December 2022, which enrolled all adult blood cancer patients registered at the healthcare facilities of Semey. This study involved 87 respondents. A questionnaire of the authors' design and the SF-36 questionnaire were used to obtain the data, which was validated. Out of 87 patients, 47 (54,0%) were males whose mean age was 35,72 ± 1,64 years and 40 (46,0%) were females with the mean age of 45,83 ± 1,57 years. None of the patients were very satisfied with their current clinical management and status monitoring and the overall rate of patient dissatisfied or somewhat dissatisfied was 48.9%. The two questions of "How long have you been seen by a hematologist?" (p=0,019) and "How do you evaluate the organization of medical care in the field of hematology?" (p=0,000) were predictors of patient satisfaction in multiple linear regression analysis. There was a significant difference in the individual SF-36 dimensions and overall QOL scored in different age group participants. Overall, the study found that the five determinates affect QOL revealed significant differences between individual age groups and identified key determinants of patient dissatisfaction. Also, it is the first attempt to understand the experience of blood cancer patients in the healthcare system in Kazakhstan, and the results may contribute to a discussion between healthcare professionals and patients on initiatives that need to be taken to improve the quality of healthcare services provided.

Epidemiology of Lung Cancer in Kazakhstan: Trends and Geographic Distribution.

The aim is to study the trends of lung cancer (LC) incidence in the regional context in Kazakhstan. The retrospective study was done using descriptive and analytical methods of oncoepidemiology. The extensive, crude and age-specific incidence rates are determined according to the generally accepted methodology used in sanitary statistics. The data were used to calculate the average percentage change (APС) using the Joinpoint regression analysis to determine the trend over the study period. Over the 10 years under study, 36,916 new cases of LC were registered in the country (80.5% - in men and 19.5% - in women). During the studied years the average age of patients was 64.2±0.1 years (95%CI=63.9-64.4). The highest incidence rates per 100,000 in the entire population were found in the age groups 65-69 years (147.6±2.7), 70-74 years (159.3±2.5), and 75-79 years (147.1±3.2). The incidence of LC tended to increase only at the age of 80-84 years (APC=+1.26) and the most pronounced average annual decline rates were observed in the age groups of 45-49 years (APC=-4.09), 50-54 years (APC=-4.20) and 85+ years (APC=-4.07). The average annual standardized incidence rate was 22.2 per 100,000, and in dynamics tended to decrease (APC=-2.04). There is a decrease in incidence in almost all regions, with the exception of the Mangystau region (APC=+1.65). During the compilation of cartograms, incidence rates were determined on the basis of standardized indicators: low - up to 20.6, average - from 20.6 to 25.6, high - above 25.6 per 100,000 for the entire population. The incidence of lung cancer in Kazakhstan is decreasing. The incidence among the male population is six times higher than among the female, while the rate of decline is more pronounced. The incidence tends to decrease in almost all regions. High rates were found in the northern and eastern regions.

Assessment of Quality of Life in Patients with Colorectal Cancer in Kazakhstan.

The problem of quality of life (QOL) of patients with colorectal cancer (CRC) is particularly relevant due to the dynamics of CRC incidence growth. This study aims to assess QOL of patients with CRC in the Republic of Kazakhstan in order to give an idea about the impact of burden on QOL of patients. A total of 319 patients diagnosed with CRC participated in this one-stage cross-sectional study. The survey was conducted between November 2021 and June 2022 at cancer centers in Kazakhstan. Data were collected using the valid and reliable European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30, version 3.0). The average age of respondents was 59, 23 (SD=10,604) years. The main age group 50-69 years old accounted for 62.1% of the total sample. Among all ill respondents, 153 (48%) were male and 166 (52%) were female. The mean global health status was 59.24 ± 22.62. Two of the five functional scales were below the ≥66.7% threshold, namely, emotional functioning 61.65 (28.04) and social functioning 61.96 (31.84); while scores for the other three were: physical functioning 69.38 (22.06), role functioning 69.69 (26.45), and cognitive functioning 74.60 (25.07). This study gives an indication of good life functioning among our participants on the functional and symptom scales. However, they reported inadequate global health status.

Prevalence, incidence, and mortality rates of breast cancer in Kazakhstan: data from the Unified National Electronic Health System, 2014-2019.

Although there are numerous sources of epidemiologic information on breast cancer in Kazakhstan, none of them have specifically examined the burden of this disease. Therefore, this article aims to provide an overview of the breast cancer prevalence, incidence, mortality, and distribution and changes over time in Kazakhstan based on nationwide large-scale healthcare data from the National Registry in order to encourage more research on the impact of various diseases at the regional and national levels. The study cohort included all adult women older than 25 years who were diagnosed with breast cancer in any clinical setting of the Republic of Kazakhstan during the period of 2014-2019. The data were extracted from the Unified Nationwide Electronic Health System (UNEHS) to get an overview of descriptive statistics, incidence, prevalence, and mortality rate calculations and the Cox proportional hazards regression model. All survival functions and factors associated with mortality were tested for significance. The cohort population (n = 55,465) comprised subjects with the age at the diagnosis of breast cancer from 25 to 97 years, with a mean of 55.7 ± 12.0 years. The majority of the study population belonged to the age group 45-59 years, which is 44.8% of the cohort. The all-cause mortality rate of the cohort is 16%. The prevalence rate increased from 30.4 per 10,000 population in 2014 to 50.6 in 2019. The incidence rate varied from 4.5 per 10,000 population in 2015 to 7.3 in 2016. Mortality rates were stable and high in the senile age patients (75-89 years old). Breast cancer mortality was positively associated with women who had been diagnosed with diabetes, HR 1.2 (95% CI, 1.1-2.3), whereas it was negatively associated with arterial hypertension, HR 0.4 (95% CI, 0.4-0.5). Overall, Kazakhstan is experiencing an increase in the incidence of breast cancer cases, but the mortality rate has started to decline. The switch to population mammography screening could reduce the breast cancer mortality rate. These findings should be utilized to help Kazakhstan determine what cancer control priorities should be utilized, including the need to implement efficient and affordable screening and prevention programs.

Corpus Uteri Cancer in Kazakhstan: Recent Incidence Trends.

Endometrial cancer is the fifteenth most common malignant disease in the world. It is estimated that 417,367 new cases of this malignant neoplasm are diagnosed annually and 97,370 women die from it. The epidemiological features of the corpus uteri cancer (CUC) incidence and its spatial and temporal assessment in Kazakhstan were studied. The retrospective study was done for the period 2009-2018. Descriptive and analytical methods of epidemiology were used. Crude, age-specific, age-standardized, equalized incidence rates and approximation were calculated. The method of drawing up a cartogram based on the determination of the standard deviation (σ) from the mean (x) was applied. During the study period, 10,522 new cases of CUC were registered. The average annual age-standardized incidence rate was 11.1±0.2 cases per 100,000 population of female, (Т=+0.6%; R2=0.083). The analysis of ASIR showed unimodal growth with a peak at 65-69 years - 58.8±3.6 cases per 100,000 population of female. The most pronounced downward trend was revealed in the age group < 30 years (T=-2.6%), and the most pronounced annual average upward rates was in 80-84 years (T=+6.4%). The results of the spatial analysis showed regions with a higher levels of CUC incidence rate per 100,000 population of female: Pavlodar, Kostanay, Karaganda, Almaty city, North Kazakhstan and Astana city. In recent years, CUC incidence in Kazakhstan has been increasing. High incidence rates were found in the northern regions of the country, and the trend of incidence growth was more pronounced in the western and eastern regions.

Study on Breast Cancer in Kazakhstan Using the Functional Time Series.

In Kazakhstan and Central Asia, breast cancer (BC) is the most common malignancy among women. However, no large-scale study on breast cancer using the functional time series approach has been carried out in Kazakhstan. A functional assessment of the age-period-cohort model (APC) and the survival rate (period 2017-2021) was used in the retrospective study. Clinical and demographic information on patients was analysed, including age, gender, region of residence, kind and stage of tumour, occupation, socioeconomic standing, nationality, and specifics of treatment and its outcomes. Additionally, the relationship between nationality, stage, and residency region and the survival rate of breast cancer patients was investigated too. The data of n=22,736 breast cancer patients were analysed. The highest number of breast cancer cases reported was 4,945 (21.7%), in 2019. In 2021, n =4,939 (21.7%) cases were detected, while in 2020, n=4,222 (18.6%) cases were observed. The patients with breast cancer in stages I and Ia were recognized in 6,585 (29% of cases), while those in stages Ib and Ic were confirmed in 8687 (38.2% of cases). In n=10,147 (44.6%) cases, a malignant tumour of the upper outer quadrant of the breast (C50.4) was predominant. Kazakhs made up the majority (n=10,939, 48.1%) of patients with a primary validated diagnosis of breast cancer, followed by Russians (n=7527, 33.1%). Germans had the lowest survival rate overall (11.4 ± 1.7 months) (p ≤ 0.05) (95% CI: 8.0-14.7 months). Uzbeks showed relatively high survival rates of 18.3 ± 1.6 months (95% CI: 15.1-21.5 months) (p ≤ 0.05). The Aktobe region had the lowest breast cancer survival rates, measuring 12.1±0.9 months (95% CI: 10.3-13.9 months) (p ≤ 0.05). The highest survival rates, 18.0±1.3 months (95% CI: 15.5-20.5 months) and 17.9±1.4 months (95% CI: 15.3-20.7 months), were seen in Shymkent and Zhambyl regions (p ≤ 0.05), respectively. The prevalence of breast cancer increases after 37.5 years, according to the results of the APC analysis, with an indicator of 0.572 (95% CI: -0.41 - 1.56), maintaining a steady upward trend in the age range from 42.5 years to 62.5 years. Despite a slight drop in the disease's frequency, the incidence of breast cancer in women 37.5 years and older has been stable over the past five years. Additionally, it was shown that the country's northern regions had a higher incidence of breast cancer cases than the southern and western regions. Our results show the significance of demographic characteristics such as age and location for the development of preventive measures and effective treatment.

Prevalence of Precancerous Cervical Lesions among Nonvaccinated Kazakhstani Women: The National Tertiary Care Hospital Screening Data (2018).

At the present time, cervical cancer remains the fourth most prevalent cancer among women worldwide. Most cervical cancer cases are attributed to high-risk human papillomavirus (HPV) infection. Because the natural history of cervical cancer takes decades, the disease could be prevented if premalignant conditions are identified and appropriately managed. The aim of this study is to identify the prevalence of precancerous lesions among non-vaccinated women attending the national tertiary care hospital in Kazakhstan. This was a retrospective study of the cervical cancer screening database (2018) from the national tertiary care hospital in Kazakhstan. Records of 6682 patients, who had cervical cytology tests by Papanicolaou (Pap test), were analyzed. Out of the revised cases, 249 patients had abnormal cervical cytology reports. The Pap test was performed using liquid-based cytology (LBC). The data were analyzed using the statistical software STATA 16. A p-value of less than 0.05 was considered statistically significant. In this retrospective analysis of 6682 patients' records, we found 3.73% (249 patients) out of all Pap tests performed in 2018 were abnormal. The prevalence of high-grade squamous intraepithelial lesion (HSIL) was high at 19.28%, and the proportion of atypical squamous cells of undetermined significance (ASCUS) and atypical squamous cells (ASCs-H) was 18.47%, while low-grade squamous intraepithelial lesion (LSIL) were identified in 62.25% of the cases. Almost 25% of the women included in the study had concurrent lower and upper genital tract infections. Although the overall rate of abnormal Pap test results was not high, the study shows the elevated prevalence of HSIL. It calls the attention of local policymakers and gynecology specialists and requires immediate actions to improve the prophylactic measures to decrease morbidity and mortality from cervical cancer in Kazakhstan.

Evaluation Changes in Indicators of Oncological Service in Colon Cancer in Kazakhstan

According to World Health Organization (2020), about 1.148.515 new cases of colon cancer (СС) are registered annually. Colorectal cancer currently (2020) ranks fourth (9.4%) in the structure of cancer incidence in Kazakhstan. At the same time, about 4.9% of new cases of all registered cases of cancer annually account for CC. The purpose of the study was to evaluate some indicators of the oncological service of Kazakhstan on CC in 2010-2019. Methods. The material of study was the data of the Ministry of Health of the Republic of Kazakhstan – annual Form No. 7 and 35 concerning CC (ICD 10 – C18) for 2010-2019 – morbidity, mortality, early diagnosis, neglect, morphological verification. A retrospective study using descriptive and analytical methods of biomedical statistics was used as the main method. Results. In 2010-2019, 15.834 new cases of CC and 7.694 deaths from this pathology were registered in Kazakhstan. CC incidence tended to increase from 8.3±0.20/0000 (2010) to 8.8±0.20/0000 in 2019 (p=0.077). In dynamics, mortality rates from СC tended to decrease from 4.9±0.20/0000 (2010) to 3.9±0.10/0000 in 2019 (p=0.000). The study reveals a trend: the indicators of early diagnosis (the proportion of patients with stage I-II) improved from 31.4% (2010) to 57.4% in 2019, and, accordingly, the proportion of neglected patients decreased significantly with stage III (from 49.4% to 29.2%) and with stage IV (from 18.7% to 12.8%). Morphological verification indicators for СС improved by 34.2%, from 85.2% and 95.2%, respectively, in 2010 and 2019. Conclusions. Positive changes in the indicators of the oncological service were revealed: an increase in the proportion of morphological verification and early detection, a decrease in the proportion of patients with stage III-IV at the time of diagnosis and a decrease in mortality from СC. All this indicates a positive effect of the anti-cancer measures used, such as screening for CRC.

MAIN EPIDEMIOLOGICAL ASPECTS OF PANCREATIC CANCER IN KAZAKHSTAN

According to GLOBOCAN (2020), pancreatic cancer (PC) is in 12th place among oncopathology in terms of incidence - 4.9 cases per 100,000 population. Most cases of pancreatic cancer are registered in China, the USA, Japan, and Germany. In the structure of mortality among oncological diseases, pancreatic cancer occupies 9th place - 4.5 cases per 100 thousand of the population. According to epidemiological studies, by 2040, a 79.9% increase in mortality from pancreatic cancer is predicted. According to statistics, in the United States, there is an increase in the incidence of cancer in the distal pancreas. In addition, early stages of pancreatic cancer were diagnosed more often and less often - the 4th. One of the trends in the epidemiology of pancreatic cancer is an increase in the incidence of this pathology among young people. Factors contributing to the development of pancreatic cancer in people under 50 years of age are genetic mutations, smoking, and obesity. A retrospective statistical analysis of the epidemiological state of pancreatic cancer in Kazakhstan over 3 years was carried out (standardized WHO World indicators per 100,000 population and intensive indicators of morbidity, mortality, distribution by stage, age, and sex), and regional features of pancreatic cancer were studied.

Prevalence of Anxiety Symptoms in Women Newly Diagnosed with Breast Cancer in Kazakhstan and Its Associated Factors.

Diagnosis of breast cancer is associated with high psychological distress. There is a lack of studies examining the prevalence of anxiety among newly diagnosed breast cancer patients in Kazakhstan. This study aims to assess the mean prevalence and associated sociodemographic and clinical factors of anxiety symptoms in women newly diagnosed with breast cancer. It also aims to determine independent predictors of anxiety risk. An analysis of 162 newly diagnosed breast cancer patients at the oncology institute in Almaty was performed. Data were collected using a structured questionnaire on social, demographic, and clinical information, as well as the Beck Anxiety Inventory. In addition, multiple regression analysis was used to model the relationship between anxiety risk and independent predictors. The average age of the patients was 54.41 years (SD=8.1; min.-max: 32-75). The majority of the patients were married (52%), employed or self-employed (51%), had children (91%), had a bachelor's or a graduate degree (50%), lived in an urban area (54%), did not drink (41%), did not smoke (67%), did not engage in physical activity (54%), and had social support (91%). A total of 48% of patients had symptoms of moderate anxiety, and 33% had symptoms of severe anxiety. Based on the multivariate analysis, factors associated with a lower risk of anxiety symptoms included higher household income (OR -2.21 (95 CI: -1.35, -3.07)) and having reliable social support (OR -2.93 (95% CI: -2.25, -3.61)). The prevalence of anxiety symptoms is very high among newly diagnosed breast cancer patients. Anxiety is more likely to develop in patients from low-income households and those without reliable social support.