2026· Journal of Health Development· Vol 61, pp. jhd076-jhd076· 0 citations
TL;DR
Kazakhstan demonstrates the characteristic CRC epidemiological transition of rising incidence accompanied by slower mortality reduction, and further gains require strengthened screening participation, transparent reporting, timely treatment, and sustained implementation of evidence-based cancer control strategies.
Abstract
Background. Colorectal cancer (CRC) is the third most commonly diagnosed cancer and the second leading cause of cancer-related mortality worldwide. Its burden is increasingly shifting toward middle-income countries, including Kazakhstan, where CRC has become one of the leading malignancies. A comprehensive synthesis of Kazakhstan’s epidemiological profile within the global CRC context has been lacking.
Objective. To review the global epidemiology of colorectal cancer and evaluate current incidence, mortality, screening, and survival trends in the Republic of Kazakhstan.
Methods. A narrative review with systematic elements integrated international evidence from IARC/GLOBOCAN 2020 and 2022, the Global Burden of Disease 2019 and 2021, and other authoritative global sources with Kazakhstan-specific data on cancer registration, screening, survival, and behavioral factors published between 2001 and 2025. PubMed/PMC, IARC Cancer Today, WHO NCD Country Profiles, and reports from the Kazakhstan Ministry of Healthcare were searched between March 2024 and February 2026.
Results. Globally, CRC accounted for approximately 1.93 million new cases and 935,000 deaths in 2020. Although age-standardized rates have declined in many high-income countries, the absolute burden continues to increase because of population growth and aging. In Kazakhstan, crude CRC incidence increased from 14.79 to 17.72 per 100,000 between 2009 and 2018, whereas crude mortality declined from 11.2 to 7.7 per 100,000. Following the introduction of organized screening in 2011, early-stage (I–II) detection increased from 35.0% to 67.4%, while stage III and IV disease decreased. Survival analysis of 37,871 patients diagnosed during 2014–2023 identified older age and greater comorbidity burden as major predictors of poorer outcomes. Screening coverage exceeded 95% in 2021–2022 before declining to 68.5% in 2023, suggesting post-pandemic disruption and possible overestimation of administrative coverage. Kazakhstan’s mortality-to-incidence ratio (~0.56) remains higher than that reported in established East Asian screening programs.
Conclusions. Kazakhstan demonstrates the characteristic CRC epidemiological transition of rising incidence accompanied by slower mortality reduction. Organized screening has improved stage distribution; however, further gains require strengthened screening participation, transparent reporting, timely treatment, and sustained implementation of evidence-based cancer control strategies.
Keywords: colorectal cancer; epidemiology; incidence; mortality; Kazakhstan; screening.
The study indicates that skin cancer remains an important public health issue worldwide and countries and regions should attach great importance to the prevention and treatment of skin cancers, and develop and improve preventive measures.
This review identifies barriers to effective disease management and discusses the current and future cancer burden across the African continent for non-specialist readers and those seeking to understand oncological care in Africa.
C. Kimwele, Catherine Kaluwa, A. Nyongesa et al.· Cancer Plus· 0 citations
Pancreatic cancer (PC) remains a major global health burden characterized by high mortality and substantial socioeconomic inequality. This study compared long-term trends, inequality patterns, and risk-factor transitions of PC burden in China and the United States from 1990 to 2023.
Using Global Burden of Disease Study (GBD) 1990–2023 data, we analyzed incidence, prevalence, mortality, and disability-adjusted life years (DALYs) of PC. Temporal trends were assessed using Joinpoint regression analysis, calculating annual percent changes (APCs) and average annual percent changes (AAPCs). Socioeconomic inequalities were evaluated using the slope index of inequality (SII) and concentration index (CIX). Population attributable fractions (PAFs) were used to quantify major risk factors.
In 2023, China had more cases than the United States (103,000
vs.
66,000) but lower age-standardized prevalence (4.51
vs.
11.19), incidence (5.13
vs.
10.53), mortality (4.97
vs.
9.56) and DALYs per 100,000. From 1990 to 2023, burden increased in both countries, although age-standardized DALYs declined slightly in China (AAPC −0.15%) and increased in the United States (0.12%). Burden peaked at 60–74 years in China and shifted to older ages in the United States. Sex differences diminished with age and became non-significant in the oldest age groups. Globally, the burden remained concentrated in high socio-demographic index (SDI) with widening inequality. High fasting plasma glucose surpassed tobacco use as the leading attributable risk factor in the United States and became a major contributor in China.
China had a higher absolute burden but lower age-standardized rates (ASR) than the United States. The United States burden was more concentrated in older age groups, while the global burden remained concentrated in high-SDI regions with widening inequality. Rising high fasting plasma glucose underscores the need for metabolic risk management in PC prevention.
Miao Li, Bing-Qing Wu, Bo Ma et al.· Journal of Pancreatology· 0 citations
Introduction: In Serbia and other countries of Central and Eastern Europe, malignant disease incidence and mortality rates have risen continuously over recent decades. Despite progress in understanding cancer epidemiology, comprehensive analyses covering all tumor localizations across both sexes using modern statistical methods remain lacking for the full 2005-2024 period. Furthermore, the impact of socioeconomic factors, healthcare availability, and events such as the COVID-19 pandemic on cancer trends has not been sufficiently investigated. Aim: To determine the time trends of incidence and mortality rates of malignant diseases in central Serbia over the period 2005-2024, identify trend breakpoints and characteristic changes, and analyze risk factors and prevention strategies for each cancer localization. Material and Method: Incidence and mortality data for malignant diseases (both sexes, 2005-2024) were obtained from the official reports of the Institute for Public Health "Dr. Milan Jovanović Batut" Belgrade. Age-standardized rates per 100,000 inhabitants were calculated separately for women and men for each cancer type, including stomach (C16), colorectal (C18-C20), liver (C22), pancreas (C25), lung and bronchus (C34), bladder (C67), brain (C71), leukemias (C91-C95), all sites (C00-C97), and all sites except skin (C44), as well as sex-specific cancers (breast, cervix uteri, corpus uteri, ovary for women; mouth/pharynx, larynx, prostate, kidney for men). Trend analysis was performed using Joinpoint Regression Program version 5.4.0, calculating Annual Percent Change (APC), Average Annual Percent Change (AAPC), 95% confidence intervals, and p-values via t-test. The permutation test was used to determine the optimal number of breakpoints (0-3), with significance set at p < 0.05. Results: Overall cancer incidence increased significantly for both sexes: AAPC = 3.20% (95% CI 0.38-6.10; p = 0.028) for women and AAPC = 6.79% (95% CI 2.37-11.41; p = 0.004) for men. Mortality also rose significantly: AAPC = 3.93% (95% CI 2.87-5.00; p < 0.001) for women and AAPC = 5.34% (95% CI 1.01-9.84; p = 0.017) for men. In common cancers for both sexes, two trend breakpoints were identified around 2017 and 2020, with a sharp increase in incidence (APC for men = 19.05% in 2017-2020) and mortality (APC for women = 14.15% in 2017-2020), followed by a post-2020 decline. Conclusion: Cancer incidence and mortality in central Serbia rose significantly from 2005 to 2024, with men showing approximately twice the rate of increase compared to women. A sharp spike in trends during 2017-2020 likely reflects a combination of improved diagnostics, changes in healthcare organization, and indirect effects of the COVID-19 pandemic including delayed diagnoses and misattribution of mortality causes. Pancreatic, liver, bladder, and kidney cancers, and leukemias represent the most dynamically increasing malignancies. Conversely, the declining trends in stomach and cervical cancers reflect clear benefits from H. pylori eradication, improved hygiene, screening programs. Regarding HPV vaccination, its long-term efficacy and potential delayed adverse effects require multi-year monitoring; thus it should be applied exclusively on a voluntary basis by adults with signed informed consent. Prevention of the rising cancers requires targeted public health interventions addressing tobacco use, obesity, diabetes, alcohol consumption, and environmental exposures.
Tamara Bošković, Slobodan M. Janković· Hospital Pharmacology· 0 citations
Early-onset colorectal cancer (EOCRC) is increasing globally and represents an emerging public health concern. The BRICS countries (Brazil, Russia, India, China, and South Africa), accounting for ~40% of the global population, lack comprehensive epidemiological characterization. This study evaluates EOCRC burden, risk factors, trends (1990–2023), and projections to 2050.
Using Global Burden of Disease 2023 (GBD 2023) data, we analyzed incidence, prevalence, mortality, and disability-adjusted life years (DALYs) of EOCRC among individuals aged 15–49 years in BRICS countries from 1990–2023, stratified by age, sex, and region. Behavioral, dietary, and metabolic risk factors were assessed for DALY attribution. Decomposition analysis identified drivers of change. SHAP quantified feature importance. A Bayesian Age–Period–Cohort (BAPC) model projected trends to 2050. External corroboration was performed in a retrospective cohort of 236 CRC patients from a tertiary hospital in China using logistic and Cox regression analyses.
In 2023, China had the highest age-standardized incidence rate (ASIR) of EOCRC (3.83/100,000), while India had the lowest (1.26/100,000). From 1990–2023, Brazil showed the fastest ASIR increase (EAPC = 1.72), whereas China declined (EAPC =-1.19). Males consistently showed higher burden; in China, incidence in men aged 45–49 was 2.8-fold that of women. Key risk factors included low fiber intake, high red meat consumption, low milk intake, high BMI, and elevated fasting blood glucose, with strong co-occurrence. Decomposition analysis showed population growth and aging as main drivers, while epidemiological change varied, being positive in Brazil and negative for mortality in China. By 2050, India and South Africa are projected to show the largest increases, China will remain high with persistent sex disparities, and Russia will be stable or declining. In clinical corroboration, overweight/obesity was an independent risk factor (aOR = 2.14, 95% CI: 1.09–4.23), and diabetes predicted worse overall survival (HR = 4.35, 95% CI: 1.59–11.93), consistent with GBD-derived metabolic patterns.
EOCRC burden varies across BRICS countries and will rise in most regions. Targeted prevention focusing on dietary and metabolic risks, plus early risk-stratified screening, is urgently needed, particularly in high-risk young males. The findings could help inform or guide future prevention and screening strategies.
Lin Zhang, Shu-Hua Zhuo, Xue-Ying Wei et al.· Frontiers in Oncology· 0 citations
Gastric cancer (GC) remains a major global health challenge, contributing substantially to cancer incidence and mortality worldwide. This study aimed to evaluate the worldwide disease burden and evolving trends of GC utilizing the Global Burden of Disease 2023 database, intending to offer a robust scientific foundation for public health policy. Utilizing pertinent information from the Global Burden of Disease 2023 database, we calculated the estimated annual percentage change to measure temporal trends. We applied age-period-cohort models to analyze the impacts of time periods and cohorts from 1990 to 2023. Additionally, we explored the correlation between the burden of GC and the socio-demographic index through frontier analysis and health inequality evaluation while forecasting future trends utilizing Bayesian age-period-cohort models. From 1990 to 2023, the global cases of GC rose by 20.04%, reaching 1262,000; the total number of deaths increased from 912,483 to 934,795; however, cancer-related disability-adjusted life years (DALYs) declined by 8.85% compared to 1990. The age-standardized incidence rate, age-standardized mortality rate, and age-standardized DALY rate of GC have generally demonstrated a downward trend since 1990. The disease burden is notably greater in males than in females. Bayesian age-period-cohort projections indicate that by 2035, GC incidence is anticipated to reach 1,159,745, while the expected numbers of deaths and DALYs are forecasted to decline to 667,145 and 15,783,072, respectively; additionally, the impact of GC in older age demographics is projected to increase significantly. Although the age-standardized incidence, mortality, and disability rates of GC have declined globally from 1990 to 2023, the absolute number of incident cases, deaths, and DALYs remains substantial, indicating a persistent global health burden. Future prevention strategies should consider differences in demographic structure, socioeconomic development, and regional disease patterns.
Liying Ma, Juan Ou, Zi-Jun Qiu et al.· Medicine· 0 citations
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