Epidemiology of Esophageal Squamous Cell Carcinoma and Esophageal Adenocarcinoma in Kazakhstan: Incidence, Prevalence, Mortality, Survival Trends and Health System Utilization (2014-2023)

Abstract

Background: The incidence and survival of esophageal cancer have some significant geographical variation in the global pattern. Kazakhstan is a country that lacks an extensive rather, a full population-based epidemiological study, as it is located in the Asian esophageal cancer belt. The current study outlines the prevalence of the disease, its clinical characteristics and prognosis in Kazakhstan based on the work on non-exhaustible national registries. Methods: A cohort sample was obtained by the extraction of 1,830 participants who had been diagnosed with esophageal carcinoma between January 2014 and December 2023 out of the Kazakhstan National Electronic Registry of Oncological Patients. This information was then joined to the DERI healthcare database in order to derive comorbidity index and healthcare utilization measures. Prevalence, mortality rates and incidence were calculated and general survival estimated through the Kaplan-Meier approaches. Stratified Cox proportional hazards regression was used in analyzing multivariate differences with mortality. Results: The highest crude incidence was in 2017, 1.72 per 100,000, which gradually went down to 0.89 per 100,000 in 2023. The incidence of the age-standardized was approximately 3.5 per 100,000. The most dominant were males (61.0%), and the median age of the participants was 65 years. The percentage of pathology reports made was 89.8 in squamous cell carcinoma. Intermediate disease: Stage II (55.9), Stage III (34.3), early (Stage I, 5.3%), and late (Stage IV, 4.5%). The therapeutic interventions consisted of surgery (43.7%), radiotherapy (64.4%), and chemotherapy (39.2%). The five-year survival rate in total was a low 12.8%. An analysis of regions showed significant variations in survival by region, by urban and rural areas, by ethnic groups, and by tumour anatomic location. Conclusions: Esophageal cancer within the Kazakh setting portrays an intermediate incidence and dismal survival as compared to the global standards. Unequal clinical outcome owing to the conspicuous geographic and demographic disparities highlights the disparities in the availability of diagnostic and treatment resources. There is still urgent need to improve the provision of cancer services, reinforce infrastructures in staging, strengthen the loyalty of registries, advance multimodal treatment plans, and deal with the major risk factors.