Epidemiology Of Ovarian Cancer And Factors Associated With Late Diagnosis In Kazakhstan, 2014-2023

Abstract

Introduction: Ovarian cancer is a leading cause of gynecological cancer mortality due to its aggressive nature and lack of effective population screening. Most cases are diagnosed at late stages, and studies on factors associated with advanced-stage detection in Kazakhstan are limited. So, this study aims to assess the epidemiological burden and survival, and to identify factors related to late-stage diagnosis of malignant ovarian cancer in Kazakhstan. Methods: A retrospective analysis was conducted using the national Electronic Registry of Oncology Patients of Kazakhstan. Women first diagnosed with malignant ovarian cancer (C56.0-56.9) between 2014 and 2023 were included. The primary outcome was stage at diagnosis (early (FIGO I-II) vs. late (FIGO III-IV)). Independent variables were age, histology, residence, circumstance of detection, and social status. Logistic regression was used to assess factors associated with late-stage diagnosis, while survival analyses factors associated with mortality. Results: Among 9,502 women, most cases were diagnosed at advanced stages, with no improvement in pattern over time. Older age, high-grade serous type, unemployment, and disability were associated with late-stage diagnosis, while preventive check-ups were linked to earlier detection. Age (aHR: 1.40; p<0.001) and stage (aHR: 2.30, 5.90, 10.82 for stage II, III, IV respectively; p<0.001) were the strongest predictors of mortality, and rural residence was associated with higher risks of death, suggesting disparities in access (aHR: 1.22; p<0.001). Conclusion: Differences in outcome across key factors suggest important gaps in timely detection and limited access to care for some layers of population. This study lays a foundation for policy makers and future research, emphasizing the need for improving early detection strategies, enhancing access, and increasing awareness.