Epidemiological Insights into Colorectal Cancer Survival in Kazakhstan (2014–2023): A Retrospective Analysis Using the National Electronic Registry of Oncological Patients
Abdukhakimova D. Beyembetova A. Ablayeva A. Akhmedullin R. Aimyshev T. Biniyazova A. Zhakhina G. Orazbekova Z. Orazova G. Gaipov A.
July 2025Multidisciplinary Digital Publishing Institute (MDPI)
Cancers
2025#17Issue 14
Background: Colorectal cancer continues to be a leading cause of cancer-related deaths worldwide; therefore, it is important to monitor its burden patterns. The aim of this study was to analyze the epidemiology and survival trends of colorectal cancer in Kazakhstan from 2014 to 2023. Methods: Data from Kazakhstan’s National Electronic Registry of Oncological Patients were analyzed using descriptive statistics. Overall survival at 3 and 5 years was estimated with Kaplan–Meier analysis. Multivariable Cox proportional hazards models were used to evaluate factors associated with survival, incorporating stratification by cancer stage and dividing follow-up into two-time intervals (first and subsequent years). Time-varying covariates were applied to address violations of the proportional hazards’ assumption. Results: The total sample size of the colorectal cancer cohort was 37,871 cases. The crude incidence rate remained stable until 2019, followed by a decline in 2020–2021, whereas all-cause mortality and prevalence had an overall increasing pattern. The highest crude all-cause mortality was in stage IV patients. Males had a higher crude mortality rate than females. However, females had slightly better overall survival than males. There was noticeably increased overall mortality among patients aged 75 and older. The time-varying Cox models showed that the effect of demographic and clinical variables, including comorbidity burden, varied over time. A higher Charlson Comorbidity Index was associated with reduced overall survival, specifically during the extended follow-up period. Conclusions: The findings highlight the critical need for targeted interventions, especially for older patients (≥75) with certain primary tumor locations, histological subtypes and comorbidities.
colorectal cancer , Cox regression , epidemiology , incidence , mortality , survival
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Department of Medicine, School of Medicine, Nazarbayev University, Astana, 010000, Kazakhstan
Department of Public Health and Hygiene, Astana Medical University, Astana, 010000, Kazakhstan
Clinical Academic Department of Internal Medicine, CF “University Medical Center”, Astana, 010000, Kazakhstan
Department of Medicine
Department of Public Health and Hygiene
Clinical Academic Department of Internal Medicine
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