Background: Breast cancer is the most common malignant disease among the female population of Kazakhstan like in many developed countries of the world (Canada, UK, US, Western Europe), and it accounts for every 5th tumor. We aimed to assess the epidemiological aspects of breast cancer incidence and mortality among Almaty and Astana (Now Nur-Sultan), Kazakhstan residents in 2009-2018. Methods: A retrospective study using modern descriptive and analytical methods of epidemiology was conducted to evaluate the breast cancer incidence and mortality in megapolises of Kazakhstan. Results: The average annual age-standardized incidence rate of breast cancer amounted to 61.90/0000 (95% CI=56.2-67.6) in Almaty and 61.20/0000 (95% CI=56.765.7) in Astana. The average age-standardized mortality was 19.20/0000 (95% CI=17.3-21.1) in Almaty and 19.30/0000 (95% CI=17.1-21.4) in Astana. The standardized incidence in the megapolises tended to increase (Тgr=+0.8% in Almaty and Тgr=+1.4% in Astana), while the mortality was decreasing (Тdec=−4.2% in Almaty and Тdec=−1.1% in Astana). According to the component analysis, the growth in the number of breast cancer cases was due to a population increase (ΔP=+130.4% in Almaty and ΔP=+93.2% in Astana), with a notable decrease of factors related to the risk of getting sick (ΔR=−27.9% in Almaty, ΔR=−6.1% in Astana). Conclusion: This is the first epidemiological study to assess the changes in incidence and mortality from breast cancer in megapolises of Kazakhstan because of screening. The results of this study can be used to improve the government program to combat breast cancer.

Objective: The study is to conduct a component analysis of the dynamics of the incidence of BC (BC) in Kazakhstan, taking into account regions. Methods: Primary data were for registered patients with BC (ICD 10 -C50) in the whole country during the period of 2009-2018. Evaluation of changes in BC incidence in the population of Kazakhstan was performed using component analysis according to the methodological recommendations. Results: The study period, 40,199 new cases of BC were recorded. The incidence rate increased from 39.5 ( 2009) to 49.6 in 2018 and the overall growth was 2.8 per 100,000 population of female, including due to the age structure -∑Δ A =+2.99, due to the risk of acquiring illness -∑Δ R =+6.82 and their combined effect -∑Δ RA =+0.31. The component analysis revealed that the increase in the number of patients with BC was mainly due to the growth of the population (Δ P =+31.1%), changes in its age structure (Δ A =+18.0%) and changes associated with the risk of acquiring illness (Δ R =+41.0%). The increase in the number of patients in the regions of the republic is associated with the influence of demographic factors and with risk factors for getting sick, including mammographic screening. Conclusion: Thus, as a result of the component analysis, the role of the influence of demographic factors and the risk of acquiring illness on the formation of the number of patients and the incidence of BC was evaluated, while geographical variability was established. This research was the first epidemiological study of the dynamics of BC in the regional context by the method of component analysis in the population of Kazakhstan. The implementation of the results of this study is recommended in management of anticancer activities for BC.

Objective: The epidemiological features of the cervical cancer (CC) incidence and its spatial and temporal assessment in Kazakhstan were studied. Methods: The retrospective study was done for the period 2009-2018. Descriptive and analytical methods of oncoepidemiology were used. Results: During the study period, 16,441 new cases of CC were registered. The average annual crude and age-standardized incidence rate were 18.6±0.5 and 17.7±0.4 cases per 100,000 population of female, respectively, and their trends tended to increase (Т up =+2.3%; R 2 =0.708 and Т up =+1.9%; R 2 =0.615, respectively). The analysis of ASIR showed unimodal growth with a peak at 50-54 years -45.3±1.1 cases per 100,000 population of female. Trends of ASIR decreased up to 30 years (T down =−1.8%; R 2 =0.111) and 35-59 years (T down =−0.9%; R 2 =0.103), in other age groups the trends increased, and were most pronounced in 40-44 (Т up =+4.1%; R 2 =0.878) and 65-69 years (Т up =+4.4%; R 2 =0.537). Trends in ASR of СС tended to grow in almost all regions, with higher levels in Mangystau (Т up =+4.1%; R 2 =0.482) and Aktobe (Т up =+6.3%; R 2 =0.846) regions. The cartograms of ASR per 100,000 population of female were allocated according to the following criteria: low -up to 16.3, averagefrom 16.3 to 19.2, high -above 19.2. The results of the spatial analysis showed the regions with a higher levels of CC incidence rate per 100,000 population of female: East Kazakhstan (19.8), Aktobe (20.0), Almaty (20.1), Kostanay region (20.9), Atyrau (21.7) regions and Almaty city (22.0). Conclusion: The study of trends of the cervical cancer incidence has the theoretical and practical value: monitoring and evaluation of screening programmes, which are implemented in the country, and conduction of secondary prevention of cervical pathology. Health authorities should consider the obtained results in the in the organization of anti-cancer activities.

Epidemiological studies of cancer incidence in Kazakhstan have revealed an uneven distribution for cervical cancer. Incidence and mortality rates were calculated for different regions of the republic, including the two major cities of Almaty and Astana, in 1999-2008. Defined levels for cartograms for incidence were low (up to 12.8/100,000), medium (12.8 to 15.9) and high (above 15.9) and for mortality were up to 7.1, 7.1 to 10.8 and more than 10.8, respectively. Basically high incidence rates were identified in the eastern, central and northern parts of the country and in Almaty. Such differences in cervical cancer data, and also variation in mortality/ incidence ratios, from a low of 0.4 in Almaty to a high of 0.71 in Zhambyl, point to variation in demographic and medical features which impact on risk and prognistic factors for cervical cancer in the country. Further research is necessary to highlight areas for emphasis in cancer control programs for this important cancer.

Esophageal cancer (EC) incidence rates in Kazakhstan were assessed by component analysis based on primary registered cases in 2001-2010. It was found that despite an apparent general decrease in the number of EC patients in Kazakhstan, a potential increase should be evaluated, due to changes in aging as well as the increase in population. Some problems of EC patients' registration were broached with an emphasis on the importance of the expected absolute number and reasons for undercounting in the country. Based on these, ways of improving the recording and registration of such patients in the country were suggested.

Background and objective: Colorectal cancer (CRC) remains one of the most widespread human malignancies. The aim of this study was to study trends of the incidence of CRC in Kazakhstan. Materials and Method: This retrospective study was done using descriptive and analytical methods of oncoepidemiology. Results: During the study period from 2009 to 2018, 28,950 new cases of CRC were recorded, 13,779 (47.6%) cases were allocated to men and 15,171 (52.4%) to women. It was found that the incidence rate of CRC increased from 14.79 (2009) to 17.72 in 2018 and the overall growth was 2.93 cases per 100,000. This increase was due to the age structure -∑Δ A =+1.42, the risk of acquiring illness -∑Δ R =+1.31, and their combined effect -∑Δ RA =+0.20. The component analysis results revealed that the increase in the number of patients with CRC was mainly due to the growth of the population (ΔP=+37.7%), changes in age structure (Δ A =+26.6%), and changes associated with the risk of acquiring illness (Δ R =+24.6%). The number of patients (both sexes) was increasing in many regions largely due to the influence of the age structure of the population. In addition, it was found that growth in the number of patients in most regions, both men and women, was associated primarily with the risk of acquiring illness. Conclusion: The findings of the current study showed increasing trends in the incidence of CRC in all regions of the country. These changes were mainly influenced by demographic factors (population size and age structure), risk of acquiring the disease, and their combined effect.

Модератор экспертного совета: Даньярова Л.Б., к.м.н., зав. кафедрой внутренних болезней с курсом эндокринологии Департамента послевузовского и дополнительного образования НИИ кардиологии и внутренних болезней МЗ РК (НИИ КиВБ МЗ).

Background: The study conducted a component analysis of the dynamics of the incidence of breast cancer (BC) in Karaganda region. Methods: Primary data were for registered patients with BC (ICD 10–C50) in Kazakhstan, Karaganda region the period of 2009-2018. Evaluation of changes in BC incidence in the population of Karaganda was performed using component analysis according to the methodological recommendations. Results: Overall, 4,391 new cases of BC and 1,202 deaths were recorded. The incidence rate increased from 44.4 (2009) to 72.7 in 2018 and the overall growth was 28.37 per 100,000 population of female, including due to the age structure – ∑ΔA=3.13, due to the risk of acquiring illness – ∑ΔR=22.69 and their combined effect – ∑ΔRA=2.56. The component analysis revealed that the increase in the number of patients with BC was mainly due to the growth of the population (ΔP=+3.7%), changes in its age structure (ΔA=+10.3%) and changes associated with the risk of acquiring illness (ΔR=+75.0%). The mortality rate in the region changed from 18.6 (2009) to 10.9 (2018) and tended to decrease. Conclusion: The role of the influence of demographic factors and the risk of acquiring illness on the formation of the number of patients and the incidence of BC was evaluated. In this region, these indicators were the highest. The implementation of the results of this study is recommended in management of anticancer activities for BC.