Cancer incidence and cancer control in Mongolia: Results from the National Cancer Registry 2008–12

Abstract

Mongolia has a high burden from noncommunicable diseases, with cancer now the second leading cause of mortality. Given the paucity of situation analyses from the country, this study reports cancer data based on new cases 2008-12 from the National Cancer Registry of Mongolia covering the entire population (2.87 million). New cancer cases of 21,564 were diagnosed over the 5-year period, with a slight predominance of cases (52%) in men. Liver cancer was the leading cancer site in both sexes (ASRs of 114.7 and 74.6 per 100,000 males and females), and responsible for almost two-fifths of all cancer diagnoses, followed by cancers of stomach, lung and oesophagus in men and cervix, stomach and oesophagus in women. The cumulative risk of incidence for all cancers (27.7% and 20.8% in men and women, respectively) positions Mongolia above China (20.2% and 13.3%), below the United States (34.1% and 28.5%) and similar to Russia (26.1% and 19.1%). These figures shed light on the considerable magnitude of cancer in the country and the large fraction of cancers that can be prevented by lifestyle modifications and vaccine implementation. An expansion of activities of the cancer registry and the continued development of research are necessary steps in support of national cancer control planning in Mongolia.

Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries

“…In most high‐risk HCC areas (China, Eastern Africa), the key determinants are chronic HBV infection and aflatoxin exposure, whereas in other countries (Japan, Egypt), HCV infection is likely the predominant cause. In Mongolia, HBV and HCV virus and coinfections of HBV carriers with HCV or hepatitis δ virus, as well as alcohol abuse, all contribute to the high burden . The rising obesity prevalence is considered a contributory factor to the observed increasing incidence of HCC in low‐risk HCC areas …”

“…In Mongolia, HBV and HCV virus and coinfections of HBV carriers with HCV or hepatitis δ virus, as well as alcohol abuse, all contribute to the high burden. 54 The rising obesity prevalence is considered a contributory factor to the observed increasing incidence of HCC in low-risk HCC areas. 55 Primary prevention of the majority of liver cancer cases has been feasible through a vaccine against HBV since 1982, and future benefits of this vaccine will accrue as younger generations vaccinated in childhood reach the ages where liver cancer becomes common.…”

Projections of primary liver cancer to 2030 in 30 countries worldwide

“…Recent data from the International Agency for Research on Cancer show that 83% of PLC cases occur in countries in economic transition, with China accounting for >50% of the world's burden . The highest incidence rates in the world occur in Mongolia, with the disease contributing almost two fifths of the total cancer burden in the country …”

“…(1) The highest incidence rates in the world occur in Mongolia, with the disease contributing almost two fifths of the total cancer burden in the country. (2,3) Hepatocellular carcinoma (HCC) accounts for 75%-85% of PLC cases and intrahepatic cholangiocarcinoma (ICC) for 10%-15%, while the residual cases include other rare types. (4)(5)(6) An accurate estimate of the incidence of PLC by subtype is obscured by difficulties in detecting and definitively diagnosing it.…”

“…Patricia C. Valery , 1,2 Mathieu Laversanne, 3 Paul J. Clark, 1,2,4,5 Jessica L. Petrick, 6 Katherine A. McGlynn, 6 and Freddie Bray 3 Primary liver cancer (PLC) is the sixth most common cancer worldwide and the second most common cause of cancer death. Future predictions can inform health planners and raise awareness of the need for cancer control action.…”