Malignant Neoplasm Prevalence in the Aktobe Region of Kazakhstan

An oncopathological state assessment was conducted among adults, children and teenagers in Aktobe region for 2004-2013. Overall the burden of mortality was in the range of 94.8-100.2 per 100,000 population, without any obvious trend over time. Ranking by pathology, the highest incidences among women were registered for breast cancer (5.8-8.4), cervix uteri (2.9-4.6), ovary (2.4-3.6) and corpus uteri, stomach, esophagus, without any marked change over time except for a slight rise in cervical cancer rates. In males, the first place in rank was trachea, bronchus and lung, followed by stomach and esophagus, which are followed by bladder, lymphoid and hematopoietic tissues pathology. Agian no clear trends were apparent over time. In children, main localizations in cancer incidence blood (acute lymphocytic leukemia, lymphosarcoma, acute myeloid leukemia, Hodgkin’s disease), brain and central nervous system, bones and articular cartilages, kidneys, and eye and it’s appendages, in both sexes. Similarly, in young adults, the major percentage was in blood and lymphatic tissues (acute myeloid leukemia, acute lymphocytic leukemia, Hodgkin’s disease) a significant percentage accruing to lymphosarcoma, lymphoma, other myeloid leukemia and hematological malignancies as well as tumors of brain and central nervous system, bones and articular cartilages. This initial survey provides the basis for more detailed investigation of cancer epidemiology in Aktobe, Kazakhstan.


Introduction
The monitoring of prevalence peculiarities, cancer morbidity patterns and mortality among rural and urban residents is an overriding issue, giving the necessary information about the health of adults and children. Epidemiological research pursued in Kazakhstan has shown that the pattern of laryngeal cancer, leukemia and breast cancer prevalence depends on ethnic and gender differences, unfavorable environmental conditions (Bilyalova et al., 2012;Igissinov et al., 2012;Igissinov et al., 2013) . Previous research has shown that technogenic chrome biogeochemical province has a direct impact on the prevalence of malignant tumors among the urban residents and cancer pathologymortality rate . In such case the health status of rural residents inhabiting Aktobe region, physical and sexual development indicators depend not only on the nature of food, but also on environmentally neglected territory of inhabitation Battakova et al., 2014;Bermagambetova et al., 2015) it cannot be ruled out that the consequences of nuclear explosions conducted in West Kazakhstan have an impact on development of 1

Materials and Methods
All epidemiological surveys are carried out on the territory of Aktobe region, which includes 12 districts. In the present paper the official oncological statistics of new cancer cases is used. The "crude" one and standardized by age and sex markers of malignant tumors incidence are calculated. Epidemiological analysis of cancer incidence and mortality, built upon 100 thousand people, is conducted since 2004 till 2013 by extracting of statistical material from registration forms f №7, f 030-y, f025-y, f 090-y, f № 35, as well as from Department of statistics. Standardization is conducted by direct method. The average annual rates of growth (loss) are calculated by method of regression analysis. The list of diseases was based on the 'International Classification of Diseases, Injuries and Causes of Death Manual, 10 th Edition'

Results
The total prevalence of cancer pathology (per 100,000 people) was as follows: in 2004 -24.6; 2005 -241.0; 2006 -246.6; 2007 -229.4; 2008 -224.5; 2009 -214.2; 2010 -235.9; 2011 -240.0; 2012 -245.9; 2013 -254.3. Analysis of malignant neoplasms prevalence among adults in Aktobe region for 2004-2013 is represented in Figures 1  and 2. Ranking pathology on-studies, the highest incidence among women is registered from breast cancer, cervix uteri, ovary and corpus uteri, stomach, esophagus; they are following by trachea, bronchus, lungs and bladder. Some what different situation of the malignant tumors incidence is diagnosed among men. The first place in rank takes trachea, bronchus, lung, stomach and esophagus oncopathology , which are followed by bladder, lymphoid and hematopoietic tissues pathology. At the same time the spectrum of malignant tumors prevalence is quite wide, it includes the localization of malignant tumors in other organs and tissues, what is quite rare.
Main localizations in the structure of cancer incidence among girls are blood (acute lymphocytic leukemia, lymphosarcoma, acute myeloid leukemia, Hodgkin's disease), brain and central nervous system, bones and articular cartilages, kidneys, eye and it's appendages, pancreas and ovary ( Figure 3).
A substantial proportion of malignant neoplasms prevalence among boys also is detected in hematopoietic system (acute lymphocytic leukemia, lymphosarcoma, Hodgkin's disease, acute myeloid leukemia); followed by brain and central nervous system, bones and articular cartilages, kidneys, eye and it's appendages, bladder, pancreas and testicular ( Figure 4).
The malignancies incidence among young women and men is represented on Figures 5 and 6. The major percentage in the structure of cancer incidence among women is detected in blood and lymphatic tissues (acute myeloid leukemia, acute lymphocytic leukemia, Hodgkin's disease). A significant percentage accrues to lymphosarcoma, lymphoma, other myeloid leukemia and hematological malignancies as well as tumors of brain and central nervous system, bones and articular cartilages. The similar trend is found during research of malignant neoplasms prevalence among young men: the  DOI:http://dx.doi.org/10.7314/APJCP.2015.16.18.8149 Peculiarities of Malignant Neoplasms Prevalence in Aktobe Region of Kazakhstan major proportion in the structure of cancer morbidity takes oncopathology of blood and lymphatic tissue; the proportion of brain and central nervous system, bones and articular cartilages, and skin tumors is quite significant.
Top ten positions in the structure of both male and female population mortality (in absolute terms and per 100 thousand people) are ordered in the following way: first place -neoplasms of the trachea, bronchus, lung; the second -malignant tumors of the stomach; third  -tumors of the esophagus; fourth -tumors of breast cancer; fifth -tumors of the liver; six -tongue, oral cavity, pharynx mouth and throat cancer. Malignant neoplasms of the female reproductive system (tumors of the cervix and body of uteri, ovary) and tumors in the blood and lymphatic system (malignant lymphoma, leukemia) bring in a significant proportion in mortality rate of region population. Quite high mortality rates are caused by tumors settled in the colon and straight intestine, pancreas, kidneys, larynx, bladder and skin.

Discussion
As a result it is specified that within the territory of Aktobe region there are some special aspects of malignant tumors morbidity rates and patterns among adults as well as children and teenagers. The uptrend in cumulated measure of oncopathology rate for last ten years takes attention. The first place among women is taken by oncopathology of reproductive system, and among men the leading positions are taken up by neoplasms of trachea, bronchus, lung and stomach. Among children, both girls and boys, the significant proportion of malignant neoplasms prevalence is taken by oncopathology in hematopoietic system (acute lymphocytic leukemia, lymphosarcoma, Hodgkin's disease, acute myeloid leukemia); it is followed by brain and central nervous system, bones and articular cartilages, kidneys, eye and its appendages, bladder, testicular and pancreas tumors.The hematopoietic tissue and lymph are the main oncopathology among boys and girls.  DOI:http://dx.doi.org/10.7314/APJCP.2015.16.18.8149 Peculiarities of Malignant Neoplasms Prevalence in Aktobe Region of Kazakhstan Aggregate data of population mortality rate caused by oncopathology in Aktobe region, in absolute numbers as well as per 100 thousand people had a tendency to increase during research time. Wherein the mortality rate is absolutely differentiated by tumors localization in a particular organ or tissue.
Investigation of neoplasms prevalence and causes, cancer incidence structural features and blastemas mortality rate for different population groups, including children and teenagers, gives a new perspective for determination the oncology disease causes and the factors which hasten their onset. Numerous epidemiological research works in the sphere of malignant tumors incidence, based on geographical, mineralogical and geological environment features, the ethnic population make-up, social traditions, bad habits and occupational factors are presented in works of Moore et al., 2010;Kutikhin et al., 2012;Moore et al., 2009;Cambra et al., 2011;Crouse et al., 2010. A fair quantity of researches pursued in West Kazakhstan, more specifically in Aktobe region revealed the presence of ecological relationships between environmental, social factors and medical condition of local people. The decrease of immunologic responsiveness and accumulation of heavy metals in biological medias , the growth of allergic diseases occurrence , the formation of unfavourable social factors aggregation (Battakova et al., 2014;, lesion of nutritional status among local population (Battakova et al., 2014) have resulted in decline of general health indicators among adult as well as young population (Kenesariyev et al., 2012;. In addition to the above it is found out that the invalidism level among region population has increased; the nature of disability and incapacitation mortality rates are determined by structure of morbidity among children and adults (Mamyrbayev, Kurmashev et al., 2013)..
As it is known, a multi variant analysis, which defines the human environment, allows to substantiate the interpretation of malignant tumors prevalence and its causes. Where in the expression level of many risk factors is determined by regional specific features and lifestyle conditions. Aggregate factors affecting the population determine age specific patterns and stable structural relations of malignant neoplasms various nosological forms. The statistical and epidemiological data for the malignant neoplasms incidence among different population groups and mortality caused by them is the basis for development of regional and national antitumor programs and making of substantiated management decisions.