Evaluation changes in indicators of oncological service in breast cancer in Kazakhstan

Abstract

According to estimates from the International Agency for Research on Cancer (IARC) by 2040 the global burden is expected to grow to 3 million new breast cancer cases and 1 million cancer deaths of this cause. Studying the indicators of the oncological service for breast cancer allows us to identify and evaluate the effectiveness of mammological screening in Kazakhstan. Aim. Evaluate some indicators of the oncological service at breast cancer in Kazakhstan in 2009 to 2018. Material and methods. The research material was data from the Ministry of Health of the Republic of Kazakhstan - annual form No.7 and No.35 regarding breast cancer (ICD 10 C50) for 2009-2018. - 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 and discussion. For 2009-2018, 40,199 new cases of breast cancer were registered in the republic for the first time and 12,971 women died from this disease. The average annual crude incidence rate of breast cancer was 45.4±1.40/0000 (95% CI=42.8-48.1) and increased in dynamics from 39.5±0.70/0000 (2009) to 49.6±0.70/0000 in 2018, the difference was statistically significant (t=10.2 and p=0.000). In dynamics, mortality rates from breast cancer tended to statistically significant (t=7.95 and p=0.000) decrease from 16.5±0.40/0000 (2009) to 12.0±0.40/0000 in 2018 year, and the average annual crude mortality rate from breast cancer was 14.8 0.50/0000 (95% CI=13.7-15.8). The indicators of early diagnosis (the proportion of patients with stage I-II) improved from 71.1% (2009) to 87.6% in 2018, the proportion of patients with stage III decreased (from 22.2% to 8.6 %) and stage IV (from 6.4% to 3.6%) for the studied years, i.e. neglect rates are declining. The indicators of morphological verification in breast cancer have always been high and over the studied years improved from 93.4% to 99.1%. Conclusion. An analysis of the indicators of the oncological service at breast cancer revealed an improvement in morphological verification and early diagnosis, a decrease in neglect and mortality rates, which is undoubtedly associated with ongoing anti-cancer measures in Kazakhstan, which a regularly mammological screening. Keywords: breast cancer, incidence, mortality, early diagnosis, neglect, morphological neglect.