Esophageal cancer: analytical indicators of cancer service efficacy

Relevance: Esophageal cancer ranks eighth in the structure of malignant tumors in the Republic of Kazakhstan. According to the Kazakh Institute of Oncology and Radiology, in 2018, 1225 were primarily registered with esophageal cancer, and 825 patients died from this disease. The purpose of this study was to analyze the esophageal cancer incidence and mortality among the population of the Republic of Kazakhstan in 2009-2018 and determine the cancer service efficacy. Results: The analysis of intensive indicators of esophageal cancer incidence showed a decrease in the number of primary cases from 8.2‰ in 2009 to 6.7‰ in 2018, and the mortality – from 6.9‰ to 3.8‰. The share of early detection (Stage I-II) increased by 38.2% since 2009 to reach 52.1% in 2018. The share of stage IV esophageal cancer decreased from 7.2% in 2009 to 5.8% in 2018. One-year mortality decreased by 14.7% since 2009 to reach 41.2% in 2018, which speaks of the improvements in the timely diagnosis of esophageal cancer. The number of patients who received radical comprehensive treatment increased by 8.6% to reach 32.2% in 2018. The number of patients who received surgical treatment in 2009-2018 remained almost at the same level and amounted to 18.9 and 18.0%, respectively. However, during the years of screening for esophageal cancer, the proportion of surgical treatment increased from 26.6% to 30.4%. The ratio of incidence to mortality decreased from 91.4% to 68.8% in the study period indicating an improvement in the level of cancer service in the Republic of Kazakhstan. Conclusion: The analysis of intensive indicators of esophageal cancer incidence showed a decrease in primary incidence. The screening conducted in 2013-2016 has shown an improvement in early detection of esophageal cancer (stages I-II) and a decrease in the share of the advanced stage. The findings of this study shall serve as the basis for planning anti-cancer measures