We carried out an analysis of the total incidence of colon cancer throughout Kazakhstan. Retrospectively, according to the regional reports on endoscopic screening, the study showed an increase in the age-related incidence of colorectal cancer (CRC) cases from 2004-2008 to 2009-2014. The peak of morbidity in both periods was noted in the age category of >70 years. The indicators of the territorial distribution of CRC incidence make it possible to divide the regions into areas with low or high rates of CRC. Specific indicators showed newly diagnosed cases of CRC stages I, II, III, and IV in 2004-2018. The incidence rates of stages I and II showed a twofold increase (35%-67.4%) and the incidence of stage IV showed a decline from 19.3% to 13.1% and of stage III from 45.7% to 19.5% from 2004 to 2018, respectively. An analysis of CRC incidence throughout Kazakhstan showed an increase in the overall incidence. Since population-based CRC screening was introduced in 2011, the morbidity was found to increase for stages I and II.

e13056 Background: Cervical cancer (CC) is the second most frequent cancer of women after breast cancer. Prophylactic vaccines for human papillomavirus (HPV) are being introduced in many countries more than 10 years ago. The standardized incidence of СС in Kazakhstan (KZ) in 2017 was 17.1 per 100,000 women. From 2013 to 2016, there was a pilot project of school-based HPV vaccination of adolescent girls in four districts of KZ. Vaccination was carried out with two vaccines (Gardasil and Cervarix) on the choice of parents in a three-dose regimen. Due to the high rejection of vaccination, this program was completed in 2016. Aim of study was to analyze the results of HPV vaccination in KZ. Methods: The results of vaccination of adolescent girls from 9 to 15 years old were evaluated. We analyzed database registry of Kazakhstani vaccinated girls to evaluate vaccine coverage in four district of KZ. Results: A total 11,648 adolescent girls were fully vaccinated during the pilot program for 2013-2016. The average age of the vaccinated is 12.67 ± 1.04. In 2013, immunization was performed for 1,816 girls aged 11–13 years. In 2014, the age range of the target group was expanded to 15 years. The number of vaccinated girls increased to 5,699 adolescent girls. 7,136 girls were fully vaccinated in 2015. 10,004 girls have not received full doses of vaccine. Overall coverage rates of fully vaccinated were 14.8%. The majority of coverage results was stastically similar except for Almaty, where coverage was higher than the average coverage (17.9% vs. 14.8%, p < 0.05). Conclusions: Pilot project of vaccination in Kazakhstan was declared unsuccessful. This situation is associated with a lack of information campaigns on vaccination. This findings highlights the need for phased implementation of vaccination through an educational campaign of parents.

Background: Cervical cancer is the second most common cancer in women worldwide, where the majority of registered patients are in developing countries. Screening programs in developed countries have reduced morbidity and mortality from cervical cancer by more than 2 times. Cervical cancer (CC) is the most common gynecologic cancer in Kazakhstan. In 2016, the standardized incidence rate of CC was 19.1 per 100,000, while the mortality rate was 7.1 per 100,000. The National Cervical Screening program in Kazakhstan has been using cytology (The Papanicolaou test) since 2008, free for women aged 30 to 60 years and performed at 5-year intervals. Despite the introduction of cytologic screening, the mortality rate remains high. Aim: The purpose of this study is to analyze the effectiveness of cytologic screening in Kazakhstan. Methods: Coverage analysis, the number of screened women, the level of precancer detection and cervical cancer during screening have been obtained from specific reports (form no. 025, no. 08) for 2008-2016. Results: The number of screened women totaled at 4,460,320. There has been a decrease of 32% in the number of screened women within the nine-year period. Furthermore, the coverage rate has decreased within the said period by 27%, from 72.9% in 2008% to 45.9% in 2016, with the highest coverage in 2012. According to the results of the screening, 1576 cases of CC were registered. The analysis of the screening results showed a marked increase in the detection of CC with an increase of 37%. At the same time, the percentage of detection of the initial stage during screening remains insufficient and for 2016 was 50.8%. The percentage of registered cases of ASH+HSIL increased from 0.136% to 0.673%. Conclusion: An analysis of the cytologic screening for 2008-2016 showed a high incidence of CC. Despite sufficient coverage and relative success in detecting the initial stages of CC, the mortality rate remains high. Thus, it is necessary to improve the effectiveness of CC screening in Kazakhstan through the introduction of HPV-screening.

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