Breast Cancer in Kazakhstan, 2004–2023: Successful Mortality Reduction Driven by Organized Screening and Stage Shift

Igissin, Nurbek; Telmanova, Zhansaya; Kudaibergenova, Indira; Igissinova, Gulnur; Turebayev, Dulat; Dyakov, Sergey; Jexenova, Akzhunis; Kulmirzayeva, Dariyana; Moldagali, Rustem; Baibosynov, Daulet; Toguzbayeva, Assem; Bilyalova, Zarina

doi:10.31557/APJCP.2025.26.11.4247

Breast Cancer in Kazakhstan, 2004–2023: Successful Mortality Reduction Driven by Organized Screening and Stage Shift

Document Type : Research Articles

Authors

¹ Research Institute of Life and Health Sciences, Higher School of Medicine, Kokshetau University named after Sh. Ualikhanov, Kokshetau, Kazakhstan.

² Central Asian Institute for Medical Research, Astana, Kazakhstan.

³ Asian Pacific Organization for Cancer Prevention, Bishkek, Kyrgyzstan.

⁴ Akhunbaev Kyrgyz State Medical Academy, Bishkek, Kyrgyzstan.

⁵ Asfendiyarov Kazakh National Medical University, Almaty, Kazakhstan.

⁶ Astana Medical University, Astana, Kazakhstan.

⁷ National Scientific Center of Traumatology and Orthopedics named after Academician Batpenov N.D. of the Ministry of Health of the Republic of Kazakhstan, Astana, Kazakhstan.

⁸ South Kazakhstan Medical Academy, Shymkent, Kazakhstan.

⁹ Kokshetau Higher Medical College, Kokshetau, Kazakhstan.

10.31557/APJCP.2025.26.11.4247

Abstract

Objective: To quantify two-decade national trends in the breast cancer burden in Kazakhstan and evaluate the performance of the organized mammography screening programme—including stage distribution and regional heterogeneity after its scale-up. Methods: We conducted a retrospective, population-based evaluation using national registry and screening data. Population indicators (incidence, mortality, years of potential life lost) were analysed for 2004–2023; screening performance (coverage, abnormal rate, cancer detection rate, positive predictive value, benign biopsy rate, number needed to screen, programme contribution) was assessed for 2010–2023. Trends were modelled with Joinpoint; staging followed TNM (I–II “early”, III–IV “advanced”). Results: ASIR increased from 39.3 per 100,000 women in 2004 to 54.4 in 2023 (with a transient dip to 44.9 in 2020), whereas ASMR declined from 16.6 to 10.2 per 100,000 over the same interval; the mortality-to-incidence ratio decreased from 0.42 to 0.19. YPLL_75 fell from 175.1 per 100,000 in 2004 to a nadir of 76.0 in 2018, then measured 104.9 in 2023. The proportion diagnosed at stages I–II rose from 71.1% (2010) to 88.6% (2023), with corresponding declines in stage III (22.2% → 8.7%) and stage IV (6.8% → 5.1%). Following the expansion of eligibility to ages 40–70 (from 2018), screening throughput and coverage increased, but performance remained heterogeneous across regions, with variability in recall rates, detection yield, and downstream diagnostic pathways. Conclusion: Across 2004–2023, Kazakhstan experienced a favourable divergence between rising incidence and falling mortality, substantial reductions in premature mortality, and a marked shift toward earlier-stage diagnosis. These gains coincide with the maturation of the organised screening programme and broader system improvements. Consolidation will require targeted, region-specific quality-improvement bundles and resilience strategies to protect screening coverage and diagnostic capacity during system shocks.

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