Twenty years of age-standardized prostate cancer mortality in Kazakhstan (2005-2024): joinpoint model and geographical hot spot and cold spot analysis
摘要
Prostate cancer mortality trends and spatial clustering in Kazakhstan over the last two decades require detailed national and regional assessment using time-trend and spatial statistics.
MethodsA nationwide population-based observational study evaluated prostate cancer deaths (ICD-10 C61) among men in Kazakhstan from 2005 to 2024, calculating crude and age-standardized mortality rates, assessing temporal changes using joinpoint regression, and identifying spatial hot spots/cold spots using Getis-Ord Gi* across five predefined periods (2005-2012, 2013-2017, 2018-2019, 2020-2021, 2022-2024).
ResultsA total of 7,411 deaths were recorded; the overall crude mortality rate (CMR) was 4.44 per 100,000 men and the age-standardized mortality rate (ASMR) was 6.54 per 100,000 men, with deaths concentrated in ages 65-79 (65-69: 19.2%; 70-74: 22.3%; 75-79: 18.9%) and age-specific mortality peaking at 103.04 per 100,000 in ages 80-84. National joinpoint analysis identified a statistically non-significant, essentially stable trend from 2005 to 2019 (annual percent change [APC] 0.7%, p = 0.397), followed by a statistically significant accelerated decline from 2019 to 2024 (APC =−8.4%, p < 0.001), with an overall average annual percent change (AAPC) of −2.8% (p=0.004) for 2005-2024. Regional ASMR varied substantially (3.1 per 100,000 in Kyzylorda to 10.5 per 100,000 in Almaty city), and mean regional ASMR decreased from 6.57 (2005-2012) to 4.30 (2022-2024) with shifting hot spot/cold spot patterns across periods.
ConclusionsProstate cancer mortality in Kazakhstan declined significantly over 2005-2024, but substantial and evolving geographic disparities persisted, supporting the need for continued surveillance and targeted regional cancer-control actions.