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

Association of Gene Polymorphisms with Breast Cancer Risk in the Kazakh Population

OBJECTIVE

The research aim is analyzing and identify reliable genetic markers of breast cancer risk in the Kazakh population.

METHODS

The databases were analyzed with the selection of polymorphisms associated with the development of breast cancer and further genotypic study of a group of women with a confirmed diagnosis of breast adenocarcinoma (group No. 1) and a group of relatively healthy women (group No. 2).

RESULT

The research presents the results of a study on the frequency of certain single-nucleotide polymorphisms in patients with breast cancer in the Republic of Kazakhstan. The frequency of single-nucleotide polymorphisms rs4646, rs1065852, rs4244285, rs67376798, rs6504950, rs2229774, rs1800056, rs16942, rs4987047 is statistically significant compared to the control group of patients. These polymorphisms in the Kazakh population have a direct association with an increased risk of breast cancer in women and may be used as cancer indicators during the genetic screening of patients with a complicated family history. Single-nucleotide polymorphisms such as rs55886062, rs3918290, rs12721655, rs4987117, rs2229774, rs11203289, rs137852576, rs11571833, rs80359062 and rs11571746 were found in more than 40. Zero percent of patients with breast cancer may be used as markers for detecting patients at increased risk of breast malignancy in the Kazakh population without a history of poor family history.

CONCLUSION

The usage of the data obtained in a set of state programs for early screening of patients will improve the rates of early breast tumor detection, form groups of patients with a high risk of disease development and improve the quality and expectancy of life.

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.

Prevalence of Anxiety Symptoms in Women Newly Diagnosed with Breast Cancer in Kazakhstan and Its Associated Factors

INTRODUCTION

Diagnosis of breast cancer is associated with high psychological distress. There is a lack of studies examining the prevalence of anxiety among newly diagnosed breast cancer patients in Kazakhstan.

OBJECTIVE

This study aims to assess the mean prevalence and associated sociodemographic and clinical factors of anxiety symptoms in women newly diagnosed with breast cancer. It also aims to determine independent predictors of anxiety risk.

METHODS

An analysis of 162 newly diagnosed breast cancer patients at the oncology institute in Almaty was performed. Data were collected using a structured questionnaire on social, demographic, and clinical information, as well as the Beck Anxiety Inventory. In addition, multiple regression analysis was used to model the relationship between anxiety risk and independent predictors.

RESULTS

The average age of the patients was 54.41 years (SD=8.1; min.-max: 32-75). The majority of the patients were married (52%), employed or self-employed (51%), had children (91%), had a bachelor's or a graduate degree (50%), lived in an urban area (54%), did not drink (41%), did not smoke (67%), did not engage in physical activity (54%), and had social support (91%). A total of 48% of patients had symptoms of moderate anxiety, and 33% had symptoms of severe anxiety. Based on the multivariate analysis, factors associated with a lower risk of anxiety symptoms included higher household income (OR -2.21 (95 CI: -1.35, -3.07)) and having reliable social support (OR -2.93 (95% CI: -2.25, -3.61)).

CONCLUSION

The prevalence of anxiety symptoms is very high among newly diagnosed breast cancer patients. Anxiety is more likely to develop in patients from low-income households and those without reliable social support.

Evaluation of the Dynamics of Breast Cancer Incidence in Kyrgyzstan: Component Analysis

BACKGROUND: In 2020, 19.2 million cases of all types of cancer were registered worldwide, of which 11.7%, that is, 2.3 million, related to breast cancer (BC). The global burden of cancer is increasing worldwide, with the majority of new cancer cases and related deaths occurring in low- and middle-income countries. OBJECTIVE: The study is to conduct a component analysis of the dynamics of the incidence of BC in Kyrgyzstan. METHODS: Primary data were for registered patients with BC (International Classification of Diseases – C50) in the whole country during the period of 2003–2017. Evaluation of changes in BC incidence in the population of Kyrgyzstan was performed using component analysis according to the methodological recommendations. RESULTS: The study period, 7850 new cases of BC were recorded. The incidence rate increased from 17.70°/0000 (2003) to 19.03°/0000 in 2017 and the overall growth was 1.34°/0000, including due to the age structure – ΣΔA=2.08°/0000, due to the risk of acquiring illness – ΣΔR=−0.55°/0000 and their combined effect – ΣΔRA=−0.19°/0000. The component analysis revealed that the increase in the number of patients with BC was mainly due to the growth of the population (ΔP=+71.8%), changes in its age structure (ΔA=+35.5%), and changes associated with the risk of acquiring illness (ΔR=+8.4%). The increase and, in some cases, the decrease in the number of patients in the regions of the republic is due to the influence of demographic factors and risk factors for getting sick. CONCLUSION: The component analysis assessed the role of the influence of demographic factors and the risk of acquiring the disease on the formation of the number of patients and the incidence of BC, while geographical variability was established. The implementation of the results of this study is recommended in the management of anticancer measures for BC.