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.

Regenerative Properties of Recombinant Human Erythropoietin in the Wound Healing

BACKGROUND: Erythropoietin (EPO) is the main stimulator of erythropoiesis, but EPO also has non-hematopoietic effects. The recent data show the positive effects of EPO on tissue regeneration. AIM: This review aims to know highlights the pathophysiological mechanisms of EPO at different stages of tissue regeneration, and possible clinical applications in wound healing. METHODS: A review of the literature considering reviews, clinical studies, original papers, and articles from electronic data has been used. RESULTS: Analysis of animal studies and several clinical trials using EPO in context of wound healing revealed that EPO has a positive effect on all stages of regeneration process and may be a promising therapeutic strategy for the treatment of chronic wounds. CONCLUSION: An improved understanding of the functions and regulatory mechanisms of EPO in the context of wound healing may lead to new considerations of this growth hormone for its regular clinical application in patients.

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.

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.