In Kazakhstan, oncology mortality takes second place in the structure of mortality causes (Fig. 18.2). Every year over 17,000 people die from cancer in our country, more than 40 % of them are working-age individuals. Over the past 5 years, there is an upward tendency in the absolute number of cases of malignant tumors; annual increase of such patients is 5 %. In 2009, there were 28.3 thousand of oncology affected; by the end of 2013 this number exceeded 32,000.

Mortality rate for the same period decreased by 14.1 % from 113.7 per 100,000 of population in 2006 to 99.6 per 100,000 of population in 2013 (in ppm).

Decrease of mortality rate is primarily due to the improvement of early diagnosis of malignant neoplasms and implementation of a national screening system, as well as the development of integrated treatment methods. At the same time, the rate is still below the rates of developed countries because mortality at later stages of cancer is hardly avoidable and very high.

The most common malignant tumors in 2013 in the country were breast cancer (12.1 %), lung cancer (11.7 %), skin cancer and melanoma (11.5 %), and colorectal cancer (9.2 %).

Key indicators describing current situation in Kazakhstan in terms of cancer are revealed in Tables 18.1, 18.2, 18.3, 18.4, 18.5, and 18.6 (Source: Kazakh Scientific Institute of Oncology and Radiology (2013). Indicators of Oncology Services in Kazakhstan. Almaty).

First place in the prevalence of cancer in the female population belongs to tumors of the breast which is more than 20 %. Then, it is followed by tumors of the skin, cervix, uterus, and stomach cancer. Another problem is that malignant neoplasms are affecting more and more young people. The mean age of women diagnosed with breast cancer is 60 (Tables 18.3 and 18.4).

Within the structure of morbidity among men, leading places are shared by lung cancer, stomach cancer, and skin tumors.

Geographically, leading positions in cancer morbidity and mortality for the last several years held by north and west regions of the country. Figure 18.3 demonstrates dissemination of cancer types among country regions.

Different forms of cancer closely refer to national traditions. Some cases of widely spread cancer are assignable, some—remain a mystery. For instance, the age profile of Kazakhs (both male and female) is very similar to a world one and dominated by young people, while age structure of Russians is closer to Europeans with a predominance of older groups.

There are also demographical differences that have influence on national peculiarities, though most commonly overlooked. The surveys show that breast cancer of Slavic women pertains to endocrine factors. At the same time, breast cancer of Kazakh women (Altay group) progresses aggressively and ongoing studies have identified the absence of BRCA1 and BRCA2 genes. Perhaps, these newly discovered facts will cause shifts of views on the genetic nature of breast cancer.

In recent years, ecological factors have become primary in terms of the epidemiology of malignant tumors because oncogenic risk factors are closely related to the environment; it has been developed into a new direction—“ecological epidemiology of oncological diseases.” As stated earlier, Kazakhstan is second in the world by uranium resources. Main uranium fields are located in the North of the country, where an open and underground mining of uranium ore has been conducted intensively for more than 40 years. A big share of radioactive wastes has been accumulated to the present moment. Active and suspended wells and storing facilities—sources of radioactive contamination—pose a big danger to health of local population for those who work on a production and live nearby.

There are following noteworthy environmentally unsafe areas in Kazakhstan.

The Semipalatinsk Nuclear Test Site is located in East region. Here, for 40 years, since 1949 the vast majority of Soviet nuclear tests, including nuclear fusion and neutron bombs were conducted. Even though it has been more than 25 years since nuclear tests are over, its bad influence is still affecting not only the inhabitants of the Semipalatinsk region, but also the residents of neighboring regions. These north regions hold stable leading place in morbidity rank, with lung cancer prevalence.

It is still unknown how and to what extent people in regions close to Baikonur spaceport are affected. Here, we should note two factors that are harmful to their health and lead to cancer pathology development. First, heptyl that is used as a fuel in heavy liquid-propellant missiles contains many carcinogens, even in products of combustion. While not being fully burned out in disconnected rocket stages, it brings even greater damage to health and nature. Moreover, in case of a crash during the first phase of a rocket launching, liquid heptyl transforms into a droplet suspension, which then can cover significant territory inhabited with people and used for livestock and crop. Less attention is paid to the fact that every launched satellite leads to a hole in the ozone layer of our planet. This process, in its turn, reduces protective features of the atmosphere and increases the ultraviolet impact of the Sun that inevitably leads to an increase in skin cancer incidence on the territory of Kazakhstan around the spaceport.