Epidemiology, outcomes of treatment, and survival of cervical cancer in Kazakhstan: a nationwide population-based study

Background: Cervical cancer remains one of the major medical and public health issues in Kazakhstan. In 2024, Kazakhstan launched a campaign to vaccinate 11- to 13-year-old girls, demonstrating successful implementation. This is a retrospective, population-based study aiming to investigate epidemiology, treatment outcomes, and survival of the cervical cancer pre-vaccination trends in a 10-year period (2014-2023). Methods: Data were obtained from the Electronic Registry of Oncological Patients, which records clinically relevant encounters (inpatient admissions, outpatient visits, and official follow-up). Results: Cervical cancer prevalence increased gradually over a 10-year period, while age-standardized incidence rate (ASIR) and age-standardized mortality rate (ASMR) peaked at approximately 2022 (17.22 and 6.92 per 100,000 women, respectively). Disability-adjusted life year (DALY) rates increased sharply to 255.24 per 100,000 women in 2022, and 5-year survival was 65.3%. Despite a moderate 5-year overall survival, outcomes in advanced stages are poor and contribute disproportionately to years of life lost. Chemotherapy, radiation, and later stages showed an increased adjusted hazard ratio, and more days lost were seen from the restricted mean survival time (RMST) analysis. Conclusion: This nationwide, registry-based analysis from Kazakhstan reveals that cervical cancer remains a major and growing public health burden. This study's findings suggest a baseline cervical cancer epidemiology for later comparison once the human papillomavirus vaccination program is fully implemented with high coverage.