Gender-related trends in key epidemiological indicators of lung cancer in the Republic of Kazakhstan, 2014-2018

Relevance: Over the past decades, lung cancer (LC) incidence worldwide is adding about 1.5% each year. The risk of LC development increases 4-5 times with age. The mortality-to-incidence ratio (MIR) in LC is the most unfavorable – up to 95.6% of patients die. The purpose of this study was to analyze the epidemiological situation with lung cancer in the Republic of Kazakhstan over the past five years, with the assessment of key epidemiological indicators by gender. Results: In the previous five years (2014-2018), the men to women ratio among LC patients was equal to 4.2:1 and remained stable. A gradual decline in mortality (16‰ in 2014 to 12.9‰ in 2018) correlated with the MIR dynamic pattern (67.5% in 2014 to 60.0% in 2018). The standardized LC incidence in men was declining steadily (46.8‰ in 2014 to 43.0‰ in 2018). A more evident decrease in male mortality from LC (32.0‰ in 2014 to 24.2‰ in 2018) was due to the progress recently achieved in LC diagnostics and treatment in the Republic of Kazakhstan. On the contrary, the LC incidence in women increased by 2.6% a year (7.6‰ in 2014 to 7.8‰ in 2018). The female mortality from LC was declining steadily (4.6‰ in 2014 to 3.5‰ in 2018), with a negative growth rate of minus 31.4%. Conclusion: The analysis of epidemiologic indicators for LC in the Republic of Kazakhstan showed a general downward trend in incidence and mortality regardless of gender. However, we can expect an increase in the female incidence of LC in sync with the global trend. The study period has witnessed the improvement in both the primary diagnostics (due to the renewal of diagnostic equipment in the country) and treatment of LC (through the introduction in the Republic of methods of molecular genetic studies which are the basis for the state-financed personalized drug therapy with targeted agents).