The results of the Comprehensive Cancer Control Plan in the Republic of Kazakhstan for 2018-2022 realization in 2019

Abstract

Relevance: Cancer control is among the key social policy priorities in the Republic of Kazakhstan. 14,000 people
 die from cancer every year. As a result, our country faces an
 epidemiologic crisis caused by the increasing malignancy-related incidence and mortality, plus the increasing number
 of people living with cancer. In 2019, 186 326 patients with
 malignant neoplasms were under dynamic supervision in
 Kazakhstan; 52.5% lived for five years or more [1].
 WHO prognosis a 1.5-2 times growth of annual malignancy-related incidence and mortality worldwide by 2022.
 The Republic of Kazakhstan follows the same trend, taking
 into account the growing welfare and life expectancy of the
 population and an increase in the detection of malignant
 neoplasms due to the introduction of early detection programs [2].
 The purpose was to assess the implementation in 2019
 of the Comprehensive Cancer Control Plan in the Republic of
 Kazakhstan for 2018-2022.
 Results: Intermediate Comprehensive Plan implementation results showed the efficacy of the conducted measures
 as reflected by major cancer care indicators. Thus, the early detection has improved: stage 0-I detection amounted
 to 27.1% of all new cases (2019 target – 25.2%). This had a
 positive impact on cancer survival: in 2019, the proportion
 of 5-year or more survival was 54.7% for breast cancer (2019
 target – 54.5%), 56.8% for cervical cancer (2019 target –
 55.8%), 46.6% for colorectal cancer (2019 target – 45.8%) [1].
 Conclusion: The Comprehensive Cancer Control Plan
 implementation results evidence cancer care improvement
 in the Republic of Kazakhstan as of 2019 (increased 5-year
 survival and decreased mortality). However, a high share
 of detection of visually accessible malignant neoplasms at
 generalized and advanced stages should be addressed in the
 coming years.

Challenges for Developing Palliative Care Services in Resource- Limited Settings of Kazakhstan

“…According to the Standard, multidisciplinary palliative teams should be created in all major medical centers, general hospitals, and specialized clinics of the republican level. As part of the National Cancer Control Plan, terminal cancer patients across the country have access to mobile teams that provide in-home palliative care [ 12 ]. Moreover, 17 essential medicines, including 3 opioids, have been included into the free palliative package [ 13 , 14 ].…”

“…Currently, in-patient palliative care in Kazakhstan is provided mainly in stand-alone hospices and palliative care units of specialized cancer centers or general hospitals (see Figure 1 ). There are currently 12 hospices located in largest cities while palliative care units have been established as an integral part of cancer centers, distributed across all regions of the country under the “Comprehensive Cancer Control Plan for 2018–2022” [ 12 ]. In 2018, under this plan, mobile teams were introduced for in-home palliative care for cancer patients.…”