International Journal for Doctor of Medicine and  Medical Students (IJDMMS)

Abstract

Breast cancer is the most common malignancy among the women worldwide and it represents a major public health challenge due to its increasing incidence and its substantial mortality burden. Globally, the disease has been showing a consistent upward trend, particularly in low- and middle-income regions undergoing epidemiological transition. Across the Asia, breast cancer incidence has been rising steadily, reflecting shifts in the demographic structure, the reproductive behavior, and the lifestyle factors such as the delayed childbirth, reduction in the parity, the obesity, and the dietary changes.

Central Asia constitutes the transitional epidemiological region characterized by heterogeneous healthcare systems, which have varying levels of economic development, and the significant disparities in the cancer surveillance infrastructure. Despite sharing the historical and socio-political similarities, countries in this region including Kazakhstan, Kyrgyzstan, Uzbekistan, Tajikistan, and Turkmenistan demonstrate markedly very different capacities for cancer detection, reporting, and management.

The availability and the quality of the breast cancer data in Central Asia remain very uneven. Kazakhstan has relatively well-developed national cancer registries and the electronic health systems, which enable population-based analyses. Kyrgyzstan does maintain the functional registry but with the limitations in the long-term completeness and in the mortality linkage. In contrast, Uzbekistan, Tajikistan, and Turkmenistan largely depend on the modeled estimates derived from the global databases due to the absence of the robust national cancer registries. These disparities result in the substantial uncertainty regarding the true burden of disease in the region and which limit the ability to design targeted cancer control strategies.

Methods

This review synthesizes data from GLOBOCAN, Global Burden of Disease (GBD), and regional registry-based studies from 2014-2024 focusing on Kazakhstan, Kyrgyzstan, Uzbekistan, Tajikistan, and Turkmenistan.

Results:

Kazakhstan does that there is increasing incidence while there is decline in the mortality due to the organized screening (Midlenko et al., 2023 ; Igissinov et al., 2023). Kyrgyzstan demonstrates lower but its rising incidence without the national screening (Chokoev et al., 2022). Other countries rely on the modeled estimates, suggesting underreporting (Sharma, 2021; Ong et al., 2023).

Conclusion

Central Asia shows a pattern of rising incidence with relatively high mortality-to-incidence ratios, highlighting major gaps in cancer surveillance and screening systems.

Introduction

Breast cancer is the type of cancer which is most frequently diagnosed cancer globally, which accounts for approximately 2.3 million new cases in 2020 (Sung et al., 2021). The global age-standardized incidence rate (ASIR) is approximately 46 per 100,000, with lower rates in Asia (~34 per 100,000) but steadily increasing trends (Sharma, 2021; Fu et al., 2024).

In transitioning economies, increasing incidence is attributed to urbanization, lifestyle changes, and improvement in the detection, while mortality remains relatively high due to  the limited healthcare access (Xu et al., 2023; Wang et al., 2025).

Central Asia remains underrepresented in epidemiological literature, with reliable data primarily from Kazakhstan and Kyrgyzstan, while Uzbekistan, Tajikistan, and Turkmenistan lack comprehensive registry-based data (Ong et al., 2023).

Methods

• Data sources: GLOBOCAN, PubMed, GBD, national cancer registries

• Time period: 2014-2024

• Inclusion criteria: Population-based and registry studies

• Exclusion: Non-verifiable or anecdotal data

Results

Average Values of Breast Cancer Prevalence in Central Asia

Kazakhstan

Kazakhstan provides the most comprehensive epidemiological data in Central Asia.

1. Incidence increased from 45 to 73 per 100,000 (Midlenko et al., 2023)

2. Prevalence increased from 304 to 506 per 100,000 (Midlenko et al., 2023)

3. Mean age at diagnosis: 55.7 years

4. Mortality declining (ASMR ~13.9; APC −4.0%) (Igissinov et al., 2023)

Earlier studies show:

1. ASIR: 37.9 per 100,000

2. ASMR: 16.7 per 100,000

3. Increasing incidence trend (+2.3%) (Beysebayev et al., 2015)

Urban areas (Almaty, Astana) show higher incidence (~61 per 100,000) and declining mortality due to screening (Igissinov et al., 2019).

Recent data confirm:

1. Increasing early-stage detection

2. Improved survival outcomes (Aidarov et al., 2025; Igissin et al., 2024)

Kyrgyzstan

1. ASIR: ~24 per 100,000

2. Crude incidence: 18.8 per 100,000

3. Peak age: 60-64 years

4. Increasing trends in urban regions (Chokoev et al., 2022)

Uzbekistan, Tajikistan, Turkmenistan

Data are limited and largely modeled.

1. Tajikistan ASIR: ~19.5 per 100,000 (Sharma, 2021)

2. Mortality relatively high → indicates late diagnosis

3. Uzbekistan & Turkmenistan: no robust registry data

These countries depend heavily on GLOBOCAN and regional estimates (Fu et al., 2024; Wang et al., 2025).

Table 2. Epidemiological Trends

Discussion

Global Comparison

Breast cancer incidence is increasing globally, particularly in low- and middle-income countries, due to metabolic and lifestyle risk factors (Xu et al., 2023; Wang et al., 2025). Mortality has declined in high-income regions but remains high in transitioning economies (Kim et al., 2025).

Kazakhstan’s incidence is approaching global levels, while Kyrgyzstan remains lower but rising. Mortality rates remain relatively high compared to developed regions.

Urban-Rural Disparities

• Higher incidence in urban centers (Almaty, Astana, Bishkek)

  • Due to: Better detection, Higher risk exposure, Healthcare access differences

Table 3. Risk Factors and Health System Comparison

Risk Factors

Key contributors:

1. High BMI

2. High fasting glucose

3. Red meat diet

4. Reproductive factors

These are well-established in global and regional studies (Mubarik et al., 2023; Wang et al., 2025).

Screening

1. Kazakhstan: Organized mammography → ↓ mortality

2. Kyrgyzstan: No national screening

3. Others: Limited or absent

(Ong et al., 2023)

Cancer Registry Systems

1. Kazakhstan: Strong national registry (UNEHS)

2. Kyrgyzstan: Functional but limited

3. Others: Weak → underreporting

Conclusion

Central Asia demonstrates a clear epidemiological transition in breast cancer, characterized by rising incidence and relatively high mortality. Kazakhstan shows improvements due to screening and registry development, while Kyrgyzstan lags behind, and other countries remain poorly documented.

Key Priorities: Strengthening cancer registries, expanding screening programs, addressing metabolic risk factors, Reducing healthcare disparities

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