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Ahmedin D, Makishev A, Telmanova Z, Turebayev D, Tarzhanova D, Shelestyuk A, Lyust V, Kassenova D, Grigorevskiy V, Igissinova G, Bilyalova Z, Syzdykov N, Muratbekova S, Igissin N. Hypopharynx Cancer Incidence in Kazakhstan: 2017-2021. Asian Pac J Cancer Prev 2023; 24:4043-4051. [PMID: 38156836 PMCID: PMC10909097 DOI: 10.31557/apjcp.2023.24.12.4043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2022] [Accepted: 12/16/2023] [Indexed: 01/03/2024] Open
Abstract
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.
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Affiliation(s)
- Darkhan Ahmedin
- Department of Oncology, Astana Medical University, Astana, Kazakhstan.
| | - Abay Makishev
- Department of Oncology, Astana Medical University, Astana, Kazakhstan.
| | | | - Dulat Turebayev
- Central Asian Institute for Medical Research, Astana, Kazakhstan.
- Department of Surgical Diseases with courses of Angiosurgery and Plastic Surgery, Astana Medical University, Astana, Kazakhstan.
| | - Dinara Tarzhanova
- Department of General Pharmacology, Astana Medical University, Astana, Kazakhstan.
| | - Alina Shelestyuk
- Department of Obstetrics and Gynecology No. 1, Astana Medical University, Astana, Kazakhstan.
| | - Vladimir Lyust
- Department of Surgical Diseases with courses of Angiosurgery and Plastic Surgery, Astana Medical University, Astana, Kazakhstan.
| | - Dinara Kassenova
- Department of ENT Diseases, Astana Medical University, Astana, Kazakhstan.
| | - Vladimir Grigorevskiy
- Department of Surgical Diseases with courses of Angiosurgery and Plastic Surgery, Astana Medical University, Astana, Kazakhstan.
| | - Gulnur Igissinova
- Central Asian Institute for Medical Research, Astana, Kazakhstan.
- Department of Oncology, Kazakh National Medical University Named After SD Asfendiyarov, Almaty, Kazakhstan.
| | - Zarina Bilyalova
- Central Asian Institute for Medical Research, Astana, Kazakhstan.
| | - Nariman Syzdykov
- Central Asian Institute for Medical Research, Astana, Kazakhstan.
- Health Department of the Akmola region, Kokshetau, Kazakhstan.
| | - Svetlana Muratbekova
- Higher School of Medicine, Kokshetau University named after Sh. Ualikhanov, Kokshetau, Kazakhstan.
| | - Nurbek Igissin
- Central Asian Institute for Medical Research, Astana, Kazakhstan.
- Research Institute of Life and Health Sciences, Higher School of Medicine, Kokshetau University named after Sh. Ualikhanov, Kokshetau, Kazakhstan.
- Asian Pacific Organization for Cancer Prevention, Bishkek, Kyrgyzstan.
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Igissin N, Toguzbayeva A, Khamidullina Z, Telmanova Z, Bilyalova Z, Kudaibergenova I, Muratbekova S, Igissinova G, Rustemova K, Kulmirzayeva D, Syzdykov N, Taszhanov R, Turebayev D, Orazova G, Kassenova D, Detochkina V, Baibosynov D, Kuandykov Y. Epidemiology of Breast Cancer Mortality in Kazakhstan, trends and Geographic Distribution. Asian Pac J Cancer Prev 2023; 24:3361-3371. [PMID: 37898839 PMCID: PMC10770671 DOI: 10.31557/apjcp.2023.24.10.3361] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Accepted: 10/10/2023] [Indexed: 10/30/2023] Open
Abstract
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.
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Affiliation(s)
- Nurbek Igissin
- Research Institute of Life and Health Sciences, Higher School of Medicine, Kokshetau University named after Sh. Ualikhanov, Kokshetau, Kazakhstan.
- Central Asian Institute for Medical Research, Astana, Kazakhstan.
- Asian Pacific Organization for Cancer Prevention, Bishkek, Kyrgyzstan.
| | - Assem Toguzbayeva
- Central Asian Institute for Medical Research, Astana, Kazakhstan.
- Asfendiyarov Kazakh National Medical University, Almaty, Kazakhstan.
| | | | - Zhansaya Telmanova
- Central Asian Institute for Medical Research, Astana, Kazakhstan.
- Asian Pacific Organization for Cancer Prevention, Bishkek, Kyrgyzstan.
| | - Zarina Bilyalova
- Central Asian Institute for Medical Research, Astana, Kazakhstan.
- Asian Pacific Organization for Cancer Prevention, Bishkek, Kyrgyzstan.
| | - Indira Kudaibergenova
- Asian Pacific Organization for Cancer Prevention, Bishkek, Kyrgyzstan.
- Akhunbaev Kyrgyz State Medical Academy, Bishkek, Kyrgyzstan.
| | - Svetlana Muratbekova
- Research Institute of Life and Health Sciences, Higher School of Medicine, Kokshetau University named after Sh. Ualikhanov, Kokshetau, Kazakhstan.
| | - Gulnur Igissinova
- Central Asian Institute for Medical Research, Astana, Kazakhstan.
- Asfendiyarov Kazakh National Medical University, Almaty, Kazakhstan.
| | - Kulsara Rustemova
- Central Asian Institute for Medical Research, Astana, Kazakhstan.
- Astana Medical University, Astana, Kazakhstan.
| | | | - Nariman Syzdykov
- Central Asian Institute for Medical Research, Astana, Kazakhstan.
- Health Department of the Akmola region, Kokshetau, Kazakhstan.
| | - Rustem Taszhanov
- Central Asian Institute for Medical Research, Astana, Kazakhstan.
- Kokshetau Higher Medical College, Kokshetau, Kazakhstan.
| | - Dulat Turebayev
- Central Asian Institute for Medical Research, Astana, Kazakhstan.
- Astana Medical University, Astana, Kazakhstan.
| | | | - Dinara Kassenova
- Central Asian Institute for Medical Research, Astana, Kazakhstan.
- Astana Medical University, Astana, Kazakhstan.
| | | | - Daulet Baibosynov
- Central Asian Institute for Medical Research, Astana, Kazakhstan.
- Astana Medical University, Astana, Kazakhstan.
| | - Yerlan Kuandykov
- Khoja Akhmet Yassawi International Kazakh-Turkish University, Shymkent, Kazakhstan.
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Yessenbayev D, Khamidullina Z, Tarzhanova D, Orazova G, Zhakupova T, Kassenova D, Bilyalova Z, Igissinova G, Sayakov U, Dzhumabayeva F, Imankulova A, Idrissov K, Urazova S, Omarbekov A, Turebayev D, Adaibayev K, Kozhakhmetov S, Rustemova K, Telmanova Z, Kudaibergenova I, Igissinov N. Epidemiology of Lung Cancer in Kazakhstan: Trends and Geographic Distribution. Asian Pac J Cancer Prev 2023; 24:1521-1532. [PMID: 37247271 PMCID: PMC10495898 DOI: 10.31557/apjcp.2023.24.5.1521] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Accepted: 05/23/2023] [Indexed: 05/31/2023] Open
Abstract
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.
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Affiliation(s)
- Daulet Yessenbayev
- Astana Medical University, Astana, Kazakhstan
- Central Asian Institute for Medical Research, Astana, Kazakhstan
- Akhunbaev Kyrgyz State Medical Academy, Bishkek, Kyrgyzstan
| | | | | | - Galiya Orazova
- Astana Medical University, Astana, Kazakhstan
- Central Asian Institute for Medical Research, Astana, Kazakhstan
| | | | - Dinara Kassenova
- Astana Medical University, Astana, Kazakhstan
- Central Asian Institute for Medical Research, Astana, Kazakhstan
| | - Zarina Bilyalova
- Central Asian Institute for Medical Research, Astana, Kazakhstan
- Eurasian Institute for Cancer Research, Bishkek, Kyrgyzstan
| | - Gulnur Igissinova
- Central Asian Institute for Medical Research, Astana, Kazakhstan
- Eurasian Institute for Cancer Research, Bishkek, Kyrgyzstan
- Asfendiyarov Kazakh National Medical University, Almaty, Kazakhstan
| | | | | | - Asel Imankulova
- Akhunbaev Kyrgyz State Medical Academy, Bishkek, Kyrgyzstan
- Eurasian Institute for Cancer Research, Bishkek, Kyrgyzstan
| | - Kaldybay Idrissov
- Khoja Akhmet Yassawi International Kazakh-Turkish University, Shymkent Campus, Kazakhstan
| | - Saltanat Urazova
- Astana Medical University, Astana, Kazakhstan
- Central Asian Institute for Medical Research, Astana, Kazakhstan
| | | | - Dulat Turebayev
- Astana Medical University, Astana, Kazakhstan
- Central Asian Institute for Medical Research, Astana, Kazakhstan
| | - Kairat Adaibayev
- Astana Medical University, Astana, Kazakhstan
- Central Asian Institute for Medical Research, Astana, Kazakhstan
| | - Saken Kozhakhmetov
- Astana Medical University, Astana, Kazakhstan
- Central Asian Institute for Medical Research, Astana, Kazakhstan
| | - Kulsara Rustemova
- Astana Medical University, Astana, Kazakhstan
- Central Asian Institute for Medical Research, Astana, Kazakhstan
| | - Zhansaya Telmanova
- Astana Medical University, Astana, Kazakhstan
- Central Asian Institute for Medical Research, Astana, Kazakhstan
- Eurasian Institute for Cancer Research, Bishkek, Kyrgyzstan
| | - Indira Kudaibergenova
- Akhunbaev Kyrgyz State Medical Academy, Bishkek, Kyrgyzstan
- Eurasian Institute for Cancer Research, Bishkek, Kyrgyzstan
| | - Nurbek Igissinov
- Astana Medical University, Astana, Kazakhstan
- Central Asian Institute for Medical Research, Astana, Kazakhstan
- Akhunbaev Kyrgyz State Medical Academy, Bishkek, Kyrgyzstan
- Eurasian Institute for Cancer Research, Bishkek, Kyrgyzstan
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4
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Azhetova Z, Khamidullina Z, Telmanova Z, Assylbek A, Bilyalova Z, Igissinova G, Orazova G, Kassenova D, Tarzhanova D, Kazbekova K, Idrissov K, Jakipbekova Z, Shuasheva Y, Dolanova G, Kuandykov Y, Mutagirov V, Kuandykov T, Igissinov N. Corpus Uteri Cancer in Kazakhstan: Recent Incidence Trends. Asian Pac J Cancer Prev 2023; 24:849-857. [PMID: 36974537 DOI: 10.31557/apjcp.2023.24.3.849] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Indexed: 03/29/2023] Open
Abstract
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.
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Affiliation(s)
- Zhanerke Azhetova
- Astana Medical University, Astana, Kazakhstan
- Central Asian Institute for Medical Research, Astana, Kazakhstan
| | | | - Zhansaya Telmanova
- Astana Medical University, Astana, Kazakhstan
- Central Asian Institute for Medical Research, Astana, Kazakhstan
- Eurasian Institute for Cancer Research, Bishkek, Kyrgyzstan
| | | | - Zarina Bilyalova
- Central Asian Institute for Medical Research, Astana, Kazakhstan
| | - Gulnur Igissinova
- Central Asian Institute for Medical Research, Astana, Kazakhstan
- Asfendiyarov Kazakh National Medical University, Almaty, Kazakhstan
| | | | | | | | - Kenzhetay Kazbekova
- Khoja Akhmet Yassawi International Kazakh-Turkish University, Shymkent Campus, Kazakhstan
| | - Kaldybay Idrissov
- Khoja Akhmet Yassawi International Kazakh-Turkish University, Shymkent Campus, Kazakhstan
| | - Zulpiya Jakipbekova
- Khoja Akhmet Yassawi International Kazakh-Turkish University, Shymkent Campus, Kazakhstan
| | - Yelizaveta Shuasheva
- Khoja Akhmet Yassawi International Kazakh-Turkish University, Shymkent Campus, Kazakhstan
| | - Gulzira Dolanova
- Khoja Akhmet Yassawi International Kazakh-Turkish University, Shymkent Campus, Kazakhstan
| | - Yerlan Kuandykov
- Khoja Akhmet Yassawi International Kazakh-Turkish University, Shymkent Campus, Kazakhstan
| | | | | | - Nurbek Igissinov
- Astana Medical University, Astana, Kazakhstan
- Central Asian Institute for Medical Research, Astana, Kazakhstan
- Eurasian Institute for Cancer Research, Bishkek, Kyrgyzstan
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5
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Taszhanov R, Telmanova Z, Zhadykova Y, Akhmetova L, Zhantureyeva A, Bukeyeva Z, Aimbetova G, Kassenova D, Azhetova Z, Kozhakhmetova Z, Orazbayev S, Adaibayev K, Ospanov K, Kulayev K, Kuandykov Y, Bilyalova Z, Igissinova G, Kozhakhmetov S, Leja M, Igissinov N. Geographic Variability of Gastric Cancer Incidence in Kazakhstan. Asian Pac J Cancer Prev 2022; 23:1935-1944. [PMID: 35763634 PMCID: PMC9587815 DOI: 10.31557/apjcp.2022.23.6.1935] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Indexed: 11/25/2022]
Abstract
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.
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Affiliation(s)
- Rustem Taszhanov
- Astana Medical University, Nur-Sultan, Kazakhstan.,Central Asian Institute for Medical Research, Nur-Sultan, Kazakhstan.,Akhunbaev Kyrgyz State Medical Academy, Bishkek, Kyrgyzstan
| | - Zhansaya Telmanova
- Astana Medical University, Nur-Sultan, Kazakhstan.,Central Asian Institute for Medical Research, Nur-Sultan, Kazakhstan
| | - Yerkezhan Zhadykova
- Astana Medical University, Nur-Sultan, Kazakhstan.,Central Asian Institute for Medical Research, Nur-Sultan, Kazakhstan
| | - Lyailya Akhmetova
- Khoja Akhmet Yassawi International Kazakh-Turkish University, Shymkent Campus, Kazakhstan
| | - Akmaral Zhantureyeva
- Astana Medical University, Nur-Sultan, Kazakhstan.,Central Asian Institute for Medical Research, Nur-Sultan, Kazakhstan
| | - Zhanar Bukeyeva
- Astana Medical University, Nur-Sultan, Kazakhstan.,Central Asian Institute for Medical Research, Nur-Sultan, Kazakhstan
| | | | - Dinara Kassenova
- Astana Medical University, Nur-Sultan, Kazakhstan.,Central Asian Institute for Medical Research, Nur-Sultan, Kazakhstan
| | - Zhanerke Azhetova
- Astana Medical University, Nur-Sultan, Kazakhstan.,Central Asian Institute for Medical Research, Nur-Sultan, Kazakhstan
| | - Zhanar Kozhakhmetova
- Astana Medical University, Nur-Sultan, Kazakhstan.,Central Asian Institute for Medical Research, Nur-Sultan, Kazakhstan
| | - Serikbay Orazbayev
- Astana Medical University, Nur-Sultan, Kazakhstan.,Central Asian Institute for Medical Research, Nur-Sultan, Kazakhstan
| | | | - Kadyr Ospanov
- Khoja Akhmet Yassawi International Kazakh-Turkish University, Shymkent Campus, Kazakhstan
| | - Kuanysh Kulayev
- Khoja Akhmet Yassawi International Kazakh-Turkish University, Shymkent Campus, Kazakhstan
| | - Yerlan Kuandykov
- Khoja Akhmet Yassawi International Kazakh-Turkish University, Shymkent Campus, Kazakhstan
| | - Zarina Bilyalova
- Central Asian Institute for Medical Research, Nur-Sultan, Kazakhstan
| | - Gulnur Igissinova
- Central Asian Institute for Medical Research, Nur-Sultan, Kazakhstan.,Asfendiyarov Kazakh National Medical University, Almaty, Kazakhstan
| | - Saken Kozhakhmetov
- Astana Medical University, Nur-Sultan, Kazakhstan.,Central Asian Institute for Medical Research, Nur-Sultan, Kazakhstan
| | - Marcis Leja
- Institute of Clinical and Preventive Medicine, University of Latvia, Riga, Latvia.,Faculty of Medicine, University of Latvia, Riga, Latvia.,Riga East University Hospital, Riga, Latvia.,Digestive Disease Centre GASTRO, Riga, Latvia
| | - Nurbek Igissinov
- Astana Medical University, Nur-Sultan, Kazakhstan.,Central Asian Institute for Medical Research, Nur-Sultan, Kazakhstan.,Eurasian Institute for Cancer Research, Bishkek, Kyrgyzstan
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