STOMACH CANCER EPIDEMIOLOGY IN KAZAKHSTAN: ANALYSIS OF THE NATIONAL ELECTRONIC HEALTHCARE SYSTEM (2012–2023)

Abstract

Background: Stomach cancer is one of the most widespread cancer types worldwide. There is a limited information on the epidemiology of the stomach cancer in Kazakhstan. This research presents demographic and clinical patterns of disease epidemiology, incidence, mortality rate, survival and associated risk factors of stomach cancer by analysing large-scale Kazakhstani healthcare data from the Unified Nationwide Electronic Health System (UNEHS). Methods: A population-based retrospective study among patients with stomach cancer treated in any healthcare setting of the Republic of Kazakhstan during the period of 2012–2023 was performed. The International Classification of Diseases (ICD) 10th edition was used to retrieve data on stomach cancer (from “C16” – “C16.9”). Descriptive analysis, Kaplan-Meier and cox proportional hazards regression analysis were used. Results: In total 33,992 records of patients diagnosed with stomach cancer were analysed. The most affected group was 60-69 years old, and majorly (33.5%) diagnosed on 3rd stage of disease progression. The most prevalent area was stomach cardia, with adenocarcinoma as a histological type. ASIR decreased from 17.46 to 13.63 per 100,000 people in 2012 and 2023 respectively. Almost two-fold decrease was seen in ASMR in the same years (from 16.16 to 8.74 per 100,000). 5-year survival analysis was 17.09%. Gastro-intestinal diseases (22%) and Cardiovascular (21%) were the most common comorbidities among patients. There was a significant association found between age, gender, stage, relapse, histological type and some comorbidities with survival in stomach cancer patients. Conclusion: study highlights late diagnosis and high mortality rates as a major challenge, emphasising critical gaps in early diagnosis and after-treatment follow up. Target population characteristics were summarised for use in development of national screening policies.