Lymphosarcoma Incidence in Kazakhstan: A Retrospective Survey (2010-2019).

OBJECTIVE: The aim is to study the trends of lymphosarcoma incidence in the regional context in Kazakhstan. METHODS: The retrospective study was done using descriptive method of oncoepidemiology. The extensive, crude and age-specific incidence rates are determined according to the generally accepted methodology used in 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. RESULTS: 3,987 new cases of lymphosarcoma were registered in the country (50.7% in men, 49.3% in women). During the studied years the average age of patients was 54.2±0.8 years. The highest incidence rates per 100,000 in the entire population were found in the age groups 65-69 years (10.4±0.6), 70-74 years (10.7±0.8), and 75-79 years (10.3±0.8). The highest tendency to increase in age-related incidence rates was at the age over 85 (APC=+8.26) and to decrease at the age under 30 (APC=-6.17). The average annual standardized incidence rate was 2.3 per 100,000, and in dynamics tended to increase (APC=+1.43). It was found that the downward trend was observed in five regions (Akmola, Atyrau, Karaganda, North and South Kazakhstan), and the most pronounced decline was in the Karaganda (APC=-3.61) and South Kazakhstan (APC=-2.93) regions. When compiling thematic maps, incidence rates were determined based on standardized indicators: low - up to 1.97, average - from 1.97 to 2.60, high - above 2.60 per 100,000 for both sexes. CONCLUSION: Trends in the incidence of lymphosarcoma in Kazakhstan are growing and have geographical variability, and a high incidence is observed in the eastern and northern regions of the country. Sex differences have been established the incidence in men is higher than in female population, but the rate of increase in the incidence in women is more pronounced.

Corpus Uteri Cancer in Kazakhstan: Recent Incidence Trends.

BACKGROUND: 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. OBJECTIVE: The epidemiological features of the corpus uteri cancer (CUC) 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 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. RESULT: 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. CONCLUSION: 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.

Epidemiology of Breast Cancer Mortality in Kazakhstan, trends and Geographic Distribution.

BACKGROUND: According to the International Agency for Research on Cancer, ongoing demographic changes will lead to an increase in the number of deaths from breast cancer (BC) per year in the vast majority of regions. In 2040 it is expected that 1.04 million people worldwide will die from this malignancy, including 2,380 women in Kazakhstan. METHODS: The retrospective study (2009-2018) 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. RESULTS: During 10 years 12,958 women died from BC. An average age of the death was 61.6 years (95%CI=60.6-62.6) and tended to increase (APC=+0.6%, R2=0.6117). Age-specific rates had a bimodal increase with peak rates at 70-74 years - 76.7±5.5 (APC=+3.4%, R2=0.2656) and 80-84 years - 78.0±9.1 (APC=+3.7%, R2=0.0875). The age-standardized rate was 13.9 per 100,000 of female population, and the trend has decreased. When compiling thematic maps, mortality rates were determined on the basis of standardized indicators: low - up to 12.5, average - from 12.5 to 15.2, high - above 15.2 per 100,000. The results of the spatial analysis showed the regions with a higher levels of BC mortality rate per 100,000: Pavlodar (16.9), Almaty (19.2) and Astana cities (19.3). CONCLUSIONS: Age-standardized mortality rates had a strong downward trend (APC=-4.0%, R2=0.9218). The decrease mostly is due to a large coverage of the population by mammography screening and to an improvement in the effectiveness of breast cancer treatment.

Hypopharynx Cancer Incidence in Kazakhstan: 2017-2021.

OBJECTIVE: The article studies the geographical features of the incidence of hypopharynx cancer (HPC) in Kazakhstan. METHODS: The retrospective study was done for the period 2017-2021. Descriptive and analytical methods of ecoepidemiology were used. Crude (CR), age-specific (ASIR), age-standardized (ASR), equalized incidence rates and approximation were calculated. The dynamics of indicators was investigated using component analysis according to methodological recommendations. The method of drawing up a cartogram based on the determination of the standard deviation (σ) from the mean (x) was applied. RESULT: During the study period, 814 new cases of HPC were registered. The incidence rate decreased from 0.898 (2017) to 0.895 in 2021 and the overall decline was 0.003 per 100,000 population, including due to the age structure - ∑ΔA=+0.04, due to the risk of acquiring illness - ∑ΔR=-0.05 and their combined effect - ∑ΔRA=+0.01. The component analysis revealed that the increase in the number of patients with HPC was mainly due to the growth of the population (ΔP=+37.0%), changes in its age structure (ΔA=+106.1%) and changes associated with the risk of acquiring illness (ΔR=-133.4%). The cartograms were allocated according to the following criteria: low - up to 0.730/0000, average - from 0.73 to 1.180/0000, high - above 1.180/0000. The results of the spatial assessment showed the highest levels of HPC incidence in following regions: Atyrau (1.960/0000) and West Kazakhstan (1.580/0000). CONCLUSION: Thus, this is the first epidemiological study of HPC, which assessed the role of the influence of various factors, including demographic and risk of acquiring illness, on the dynamics of incidence, taking into account gender differences and geographical variability.

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

OBJECTIVE: The aim is to study the trends of lung cancer (LC) incidence in the regional context in Kazakhstan. METHODS: 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. RESULTS: 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. CONCLUSION: 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.

Breast Cancer Incidence in Kyrgyzstan: Report of 15 Years of Cancer Registry.

OBJECTIVE: The epidemiological features of the breast cancer (BC) incidence in Kyrgyzstan were studied. METHODS: The retrospective study (2003-2017). Descriptive and analytical methods of oncoepidemiology were used. Crude (CR), age-specific (ASIR), age-standardized (ASR), 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. RESULTS: During the study period, 7,850 new cases of BC were registered. The average annual crude and age-standardized incidence rate were 18.8±0.5 and 24.0±0.5 cases per 100,000 population of female, respectively, and their trends tended to increase (Т=+1.0%; R2=0.242 and Т=+0.2%; R2=0.015, respectively). The analysis of ASIR showed unimodal growth with a peak at 60-64 years - 85.9±4.9 cases per 100,000 population of female. ASIR trends decreased in the age groups of 40-59 years, and the most pronounced decrease was in 50-54 years (T=-1.5%; R2=0.391), in other age groups the trend increased and were most pronounced up to 30 years (T=+4.4%; R2=0.180). Trends in ASR of BС tended to grow in almost all regions, with higher levels in Osh (Т=+3.6%; R2=0.665) and Jalal-Abad (Т=+3.8%; R2=0.551) regions. The cartograms of ASR per 100,000 population of female were allocated according to the following criteria: low - up to 17.2, average - from 17.2 to 26.5, high - above 26.5. The results of the spatial analysis showed the regions with a higher levels of BC incidence rate per 100,000 population of female: Chuy (31.3), Osh city (27.1) and Bishkek city (39.2). CONCLUSION: The study of the epidemiological spatio-temporal features of the incidence of breast cancer is of both theoretical and practical interest and plays an important role in monitoring and evaluating anticancer activities.

Evaluation of Breast Cancer Incidence Trends in the Karaganda Region of Kazakhstan.

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.

Colorectal Cancer Mortality in Kazakhstan: Spatio-Temporal Epidemiological Assessment.

OBJECTIVE: The aim is to study the trends in colorectal cancer (CRC) mortality in Kazakhstan. METHODS: The retrospective study was done using descriptive and analytical methods of oncoepidemiology. The extensive, crude and age-specific mortality rates are determined according to the generally accepted methodology used in sanitary statistics. RESULTS: CRC mortality in Kazakhstan is considered to be increasing. Therefore, this study (for the period 2009-2018) was undertaken to retrospectively evaluate data across the country available from the central registration bureau. Age standardized data for mortality was generated and compared across age groups. It was determined that during the studied period 15,200 died of this pathology. During the studied years an average age of the dead made 69.8 years (95%CI=69.5-70.0). The average annual standardized mortality rate was 10.2 per 100,000, and in dynamics tended to decrease. Peak of mortality was noted in aged 60-84 years. Trends in age-related mortality rates had a pronounced tendency to increase in 30-34 years (T=+11.7%, R2=0.7980) and to decrease in 75-79 years (T=-16.4%, R2=0.8881). In many regions, there is a decrease in the number of deaths. During the compilation of cartograms, mortality rates were determined on the basis of standardized indicators: low - up to 8.9, average - from 8.9 to 11.5, high - above 11.5 per 100,000 for the entire population. In addition, all calculations were made taking into account age-sex differences. CONCLUSION: Trends in mortality from CRC in recent years have decreased from 11.2 to 7.7 per 100,000 of the total population, while the trend is stable (T=-3.6%, R2=0.8745). The study of regional mortality has theoretical and practical significance: monitoring and evaluation of the effectiveness of early detection and treatment of detected pathology. Health authorities should take into account the results obtained when organizing anti-cancer measures.

Trend in Gastric Cancer Mortality in Kazakhstan.

OBJECTIVE: The aim is to study the trends in gastric cancer (GC) mortality in Kazakhstan. METHODS: Data on those who died from GC and on the annual population were obtained from the Bureau of National Statistics of the Agency for Strategic Planning and Reforms of the Republic of Kazakhstan. A retrospective study was carried out for the period 2009-2018 using descriptive and analytical methods of oncoepidemiology. The extensive, crude and age-specific mortality rates are determined according to the generally accepted methodology used in sanitary statistics. RESULTS: GC mortality in Kazakhstan is considered to be decreasing. It was determined that during the studied period 19,672 died of this cancer. The mean of death was 67.8 with 95% CI of 67.6 to 68.0. The highest mortality rates per 100,000 in the entire population were found in the age groups 75-79 years (145.9±24.1), 80-84 years (161.0±11.0), and 85+ years (116.5±16.4). Trends in age-related mortality rates had a pronounced tendency to increase in 70-74 years (T=+4.3%, R2=0.1924) and to decrease in the age of up to 30 (T=-8.7%, R2=0.2426). The average annual standardized mortality rate was 13.2 per 100,000, and in trends   tended to decrease (T=-5.8%; R2=0.9763). In all regions, there is a decrease in mortality, except for the city of Astana. During categorization mortality rates were determined on the basis of standardized indicators: low - up to 12.9, average - from 12.9 to 15.1, high - above 15.1 per 100,000 for the entire population. CONCLUSION: The mortality rates from GC tend to decrease, while the downward trends and the degree of their approximation are expressed in almost all regions. The study of regional mortality has theoretical and practical significance for monitoring and evaluating the effectiveness of early detection and treatment. Health authorities should take into account the results obtained when organizing antitumor measures.

Geographic Variability of Gastric Cancer Incidence in Kazakhstan.

OBJECTIVE: The article studies the geographical features of the incidence of gastric cancer (GC) in Kazakhstan. METHODS: The retrospective study was done for the period 2009-2018. Descriptive and analytical methods of oncoepidemiology were used. Crude (CR), age-specific (ASIR), age-standardized (ASR), equalized incidence rates and approximation were calculated. The dynamics of indicators was investigated using component analysis according to methodological recommendations. The method of drawing up a cartogram based on the determination of the standard deviation (σ) from the mean (x) was applied. RESULTS: During the study period, 27,467 new cases of GC were registered. The incidence rate increased from 16.80 (2009) to 15.10 in 2018 and the overall decline was 1.70 per 100,000 population, including due to the age structure - ∑ΔA=+1.51, due to the risk of acquiring illness - ∑ΔR=-2.91 and their combined effect - ∑ΔRA=-0.31. The component analysis revealed that the increase in the number of patients with GC was mainly due to the growth of the population (ΔP=+651.8%), changes in its age structure (ΔA=+433.9%) and changes associated with the risk of acquiring illness (ΔR=-832.1%). The cartograms were allocated according to the following criteria: low - up to 14.80/0000, average - from 14.8 to 19.20/0000, high - above 19.20/0000. The results of the spatial assessment showed the highest levels of GC incidence in following regions: Akmola (22.20/0000), North Kazakhstan (22.30/0000), and Pavlodar (23.20/0000). CONCLUSION: Thus, as a result of the epidemiological 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 GC was evaluated, while sex differences and geographical variability were established.

Prevalence and Potential Risk Factors of Helicobacter pylori Infection among Asymptomatic Individuals in Kazakhstan.

BACKGROUND: Helicobacter pylori (H. pylori) infection is associated with several risk factors such as demographic, socioeconomic status and personal habits, which vary in different populations. This is the most up-to-date data on H. pylori prevalence and potential risk factors for H. pylori infection among asymptomatic middle-aged individuals in Kazakhstan. METHODS: Apparently healthy individuals aged 40 to 64, who took part in the health control in the outpatient clinic, were invited to participate in the study; answered a questionnaire, donated a blood sample. The antibodies to H. pylori were analysed by latex agglutination method. The baseline characteristics of study subjects with or without H. pylori infection were compared using the Chi-square test. Odds ratio (OR) and 95% confidence intervals (CI) for the association between H. pylori infection and potential risk factors were estimated using multivariable logistic regression models. RESULTS: Altogether 166 subjects (59% male; the median age - 51 years old) were included; 104 (62.7%) were H. pylori positive. There were no statistically significant differences between H. pylori positive and H. pylori negative groups in respect to the gender, anthropometric measurements, socioeconomic factors and personal habits. The multiple variable analysis showed that age (OR, 1.99; 95% CI, 1.03 - 3.86; P=0.04) and increased salt intake (OR, 2.21; 95% CI, 1.12 - 4.35; P=0.02) were associated with H. pylori infection. CONCLUSIONS: More than half of the study subjects were infected with H. pylori in Kazakhstan. The prevalence of H. pylori infection was independently associated with older age and regular high salt consumption.

High-risk individuals for gastric cancer would be missed for surveillance without subtyping of intestinal metaplasia.

The use of Operative Link on Gastritis Assessment (OLGA) and Operative Link on Gastritis Assessment based on Intestinal Metaplasia (OLGIM) staging system is recommended for identifying subjects at risk for developing gastric cancer; usually high-risk lesions are considered only as stages III and IV. Accumulating evidence suggests that incomplete intestinal metaplasia (IM) is important in the development of gastric cancer. Our aim has been to identify the prevalence of incomplete IM in patients with low-risk OLGA/OLGIM stages among a high-risk general population. Healthy adult volunteers aged 40-64 years were invited to undergo upper endoscopy within a regional GISTAR pilot study in Kazakhstan (n = 166). Gastric lesions were staged according to OLGA/OLGIM staging system. High iron diamine-alcian blue (HID-AB) was used for subtyping IM. IM prevalence overall was 45.8%. Incomplete IM was present in 52.6% (type II in 30.3% and type III in 22.3%), whereas complete IM was found in 47.4% individuals. The prevalence of OLGIM I and II stage were 39.8 and 4.8%, respectively, whereas OLGIM III was observed in 1.2%. The prevalence of incomplete IM in patients stratified to OLGIM I was 54.5% (type II in 31.8% and type III in 22.7%). High prevalence of incomplete IM was detected not only in subjects with extensive IM, but in those stratified as at the OLGIM I stage. Without IM subtyping, patients with high risk of gastric cancer development would be missed for surveillance.

Impact of Screening on Breast Cancer Incidence in Kazakhstan: Results of Component Analysis.

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 - ∑ΔA=+2.99, due to the risk of acquiring illness - ∑ΔR=+6.82 and their combined effect - ∑ΔRA=+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 (ΔP=+31.1%), changes in its age structure (ΔA=+18.0%) and changes associated with the risk of acquiring illness (ΔR=+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.

New Trends of Cervical Cancer Incidence in Kazakhstan.

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 (Тup=+2.3%; R2=0.708 and Тup=+1.9%; R2=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 (Tdown=-1.8%; R2=0.111) and 35-59 years (Tdown=-0.9%; R2=0.103), in other age groups the trends increased, and were most pronounced in 40-44 (Тup=+4.1%; R2=0.878) and 65-69 years (Тup=+4.4%; R2=0.537). Trends in ASR of СС tended to grow in almost all regions, with higher levels in Mangystau (Тup=+4.1%; R2=0.482) and Aktobe (Тup=+6.3%; R2=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, average - from 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.

Trends of Colorectal Cancer Incidence in Kazakhstan.

AAMC: 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 ­ ΣΔA=+1.42, the risk of acquiring illness ­ ΣΔR=+1.31, and their combined effect ­ ΣΔRA=+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 (ΔA=+26.6%), and changes associated with the risk of acquiring illness (ΔR=+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.^ieng

Prediction Mortality Rate Due to the Road-Traffic Accidents in Kazakhstan.

BACKGROUND: As a result of the road traffic accidents 1.25 mln. of working-age people die each year on the roads. Frequency of the RTA is 11 times higher in our country than in Europe, that influence on demographic and economic situation in the republic. Creation of the math modeling and prediction of traffic mortality rate in Kazakhstan will allow to develop measure on its decrease. METHODS: Short-term dotted prediction of population mortality level of Kazakhstan was used, in particular - methods of regressive analysis. General prognosis throughout the country up to 2021 was made on the basis of data for 1999-2018. The more relevant method for prediction is exponential function taking into account the features of mortality rate level trend. RESULTS: Prediction of traffic fatalities without division into the age-related groups for 2019 is 2132±181 case with a probability 2/3. Expected levels for 2020-2027 cases, for 2021-1927 cases.Annual mortality decrease rate according to the 0-19 age-related at an average is 6.4% among men and 5.8% among women, according to age group as a whole - by 6.2%; from 20 up to 64 age related group - 5.1 % on all population category; older 65 age -group is by 2.2 %, 3.7 % among men, 2.9% among women as a whole. CONCLUSION: In the foreseeable future the number of traffic deaths in Kazakhstan will tend to decrease at a slower pace. Mortality rates due to road traffic accidents among working-age men will be 3 times higher than women in this age group.

Thyroid Cancer in Kazakhstan: Component Analysis of Incidence Dynamics.

Background: The International Agency for Research on Cancer (IARC) reports that 567,000 new cases of thyroid cancer (TC) were registered in the world in 2018, and the age-standardized incidence rate was 6.7 per 100,000. The Global Cancer Observation forecasts a 35% growth in the number of new cases worldwide by 2040. The number of patients with TC in Kazakhstan is also increasing steadily. This investigation was the first epidemiological study of TC trends by component analysis among the population of Kazakhstan. This paper presents the results of the component analysis of TC incidence trends in Kazakhstan. Methods: The study covers primary data of TC cases (ICD 10 ­ C73) registered throughout Kazakhstan from 2009 to 2018. TC incidence trends were evaluated using component analysis according to the methodological recommendations. Results: 5,559 new TC cases were registered during the 10-year study period. The average age of patients was 52.0±0.2 years, the average annual age-standardized rate in 2009-2018 was 3.3±0.20/0000, with a constant upward trend (Т=+6.6%). According to the component analysis results, the increase in incidence was mainly due to the combined effect of the two factors: the increased disease risk (ΔR=+61.7%), and the population growth (ΔP=+15.4%). Conclusion: The noted increase in incidence was mainly caused by the changes in risk factors, such as the worsening environmental aspects and the increase in detection of clinically non-manifesting cases. The results of the study shall be taken into account when planning anticancer activities for TC.

Breast Cancer in Megapolises of Kazakhstan: Epidemiological Assessment of Incidence and Mortality.

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 61.9 0 0000 (95% CI=56.2-67.6) in Almaty and 61.2 0 0000 (95% CI=56.765.7) in Astana. The average age-standardized mortality was 19.2 0 0000 (95% CI=17.3-21.1) in Almaty and 19.3 0 0000 (95% CI=17.1-21.4) in Astana. The standardized incidence in the megapolises tended to increase (Tgr=+0.8% in Almaty and Tgr=+1.4% in Astana), while the mortality was decreasing (Tdec=-4.2% in Almaty and Tdec=-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.

Prevalence of Atrophic Gastritis in Kazakhstan and the Accuracy of Pepsinogen Tests to Detect Gastric Mucosal Atrophy.

BACKGROUND: Atrophic gastritis is considered precursor condition for gastric cancer. There is so far limited evidence on the performance of pepsinogens for atrophy detection in Central Asia. The aim of our study was to detect the prevalence of atrophic gastritis in the asymptomatic adult population in Kazakhstan as well as address the accuracy of pepsinogen testing in atrophy detection. METHODS: Healthy individuals aged 40-64 were included. Upper endoscopy and pepsinogens (PG) evaluation were performed. PG were analysed in plasma by latex agglutination. Cut off values were used to define decreased PG values (PGR ≤ 3 and PG I ≤ 70 ng/mL); severely decreased PG values (PGR ≤ 2 and PG I ≤ 30 ng/mL). Biopsies were analyzed and obtained according to the updated Sydney System. PG test sensitivity, specificity and overall accuracy were assessed using the histological diagnosis as the "gold standard". RESULTS: Altogether 157 individuals - female 40,1% and male 59,9% were included. Histologically, moderate to severe corpus atrophy, was present only in 1,3% cases. From all study subjects, 26,8% had decreased plasma PG values with cut-off values PGR ≤ 3 and PG I ≤ 70 ng/mL. The sensitivity of the PG test with this cut-off values was 50,0%, specificity 73,5%, overall accuracy 73,2% for detection of moderate to severe atrophy in the corpus. The sensitivity of PG test with cut-off values PGR ≤ 2 and PG I ≤30 ng/mL was 50,0%, specificity 90,9% and overall accuracy 90,4%. CONCLUSIONS: The prevalence of gastric mucosal atrophy was low in the Kazakh population. Serological PG test screening nevertheless can play an important role in the diagnosis of gastric precancerous lesions. However, the diagnostic accuracy of the PG test is mainly dependent on the cut-off values for positive results.

Age and Spatial Peculiarities of Non-neoplastic Diseases of the Skin and Subcutaneous Tissue in Kazakhstan, 2003-2015.

BACKGROUND: Arrangement of effective management aimed at improving dermatological services and consistent care of patients with skin diseases depends on understanding the epidemiological situation. METHODS: This retrospective study presents an epidemiological assessment of non-neoplastic skin and subcutaneous tissue diseases in Kazakhstan registered in 2003-2015. RESULTS: The yearly incidence rate of the diseases among the whole population was in average 3,341.8±121.1 per 100000 population. This represents 4835.0±156.1 for children, 5503.2±141.8 for adolescents and 2646.6±106.7 for adults per 100000 inhabitants. Space and time incidence rate was evaluated according to the administrative division. The overall trend decreased to 3.5% in children to 2.8% in adolescents to 1.9%, and in adults to 3.9%. Considerable variation in rates was seen across the country, with highest rates in East Kazakhstan, Mangystau and Aktobe regions, the lowest - in Atyrau and South-Kazakhstan regions. CONCLUSION: Non-neoplastic diseases of skin and subcutaneous tissue continue to be an urgent public health problem, especially among children in many regions of Kazakhstan.