Evaluation changes in indicators of oncological service in colorectal cancer in Kazakhstan
Colorectal cancer is the third most common cancer worldwide: 1.93 million people were diagnosed with it in 2020. The prognosis of colorectal cancer is better with an earlier diagnosis. CRC is the only cancer for which screening has been proven to reduce cancer deaths in medium-risk women and medium-risk men. The diagnosis of precancerous diseases, as well as the detection of cancers in the early stages, is significantly important for reducing the burden of the disease due to early detection, since the prognosis for such patients is much more favorable. The aim of the study was to evaluate some indicators of the oncological service at the CRC in Kazakhstan for 2010-2019. The research material was data from the Ministry of Health of the Republic of Kazakhstan -annual form No. 7 and 35 regarding CRC (ICD 10 - C18-21) for 2010-2019 - incidence, mortality, early diagnosis, neglect, morphological verification. A retrospective study using descriptive and analytical methods of biomedical statistics was used as the main method. For 2010-2019, 28,950 new cases of CRC were registered in the republic for the first time and 15,161 people died from this disease. The average annual crude incidence rate of CRC was 17.1±0.3%000 (95% CI=16.5-17.8) and increased in dynamics from 15.7±0.3%000 (2010) to 18.0±0.3%000 in 2019, the difference was statistically significant (t=5.42 and p=0.000). In dynamics, mortality rates from CRC tended to statistically significant (t=7.07 and p=0.000) decrease from 9.5±0.2%000 (2010) to 7.5±0.2%000 in 2019, and the average annual crude mortality rate from CRC was 8.7±0.2%000 (95% CI=8.3-9.2). The research of the study period reveals a trend: early diagnosis indicators (specific weight of patients with I-II stage) improved from 42.2% (2010) to 64.3% in 2019, and accordingly the specific weight of neglected patients significantly decreased with stage III (from 40.4% to 23.1%) and with stage IV (from 17.2% to 12.0%). The morphological verification indicators for CRC improved by almost 10%, from 88.1% and 96.3%, respectively, in 2010 and 2019. An analysis of the indicators of the oncological service in CRC revealed an improvement in morphological verification and early diagnosis, a decrease in neglect and mortality rates, which is undoubtedly associated with regular anti-cancer activities in Kazakhstan, in particular screening of CRC.