NUR-SULTAN – Kazakhstan will establish molecular genetic laboratories in its effort to boost support for early cancer diagnosis and treatment, said Minister of Healthcare Yelzhan Birtanov at the recent Mazhilis (lower house of Parliament) meeting.
This year, the nation will allocate an additional 309 million tenge (US$817,287) to conduct molecular genetic testing of lung, breast, colorectal and skin cancer in three laboratories in Almaty, Karaganda and the capital. The test, he noted, is required in Organisation for Economic Co-operation and Development (OECD) countries to determine individual patient therapy.
The meeting also emphasised the need to focus support on early detection and more efficient treatment by increasing access to advanced technologies and training high qualified specialists. As of January, 181,344 patients have been diagnosed with cancer, said Birtanov.
The country’s 2018-2022 comprehensive plan for fighting cancer is the main document overseeing the area. Its four key directions are regular checkups and controlling risk factors, developing a highly efficient early detection system, incorporating an integrated model of cancer care and treatment and developing specialists, research and science.
“Every year, around 40 billion tenge (US$105.8 million) is allocated from the national budget to provide medical services to cancer patients. The comprehensive plan envisions an additional eight billion tenge (US$21.2 million) every year to expand services as part of the guaranteed package of free health medical services. These include screening, molecular genetic testing and radioactive diagnosis. The plan is also to purchase equipment worth 3.2 billion tenge (US$8.46 million),” he noted.
Providing assistance to cancer patients is a state policy priority, said Birtanov. The country has implemented the Salamatty Kazakhstan health care development programme for 2011-2015 and cancer care development programme for 2012-2016.
“As a result, the mortality rate declined from 102.4 to 95.8 per 100,000 people in the population and early diagnosis [stages I-II] improved from 50.1 percent to 53.5 percent. As part of the national programme for health care development, in 2018 the goal was reached to reduce the mortality rate from 92.8 to 80.9 per 100,000 in the population. The proportion of patients living five years or more also increased from 50.2 percent to 51 percent in 2018,” he added.
Kazakhstan is in the group of countries with a moderately high cancer incidence and mortality rate. In the past 20 years, the nation’s incidence rate grew 8 percent, from 181.2 to 195.7 per 100,000, while the mortality rate has declined by 42 percent, from 136.4 to 78.3 per 100,000.
Kazakhstan will also open six positron emission tomography (PET) centres in the capital, Aktobe, Karaganda, Semei, Shymkent and Taldykorgan, said Birtanov. The scan is used to reveal abnormal activity in tissues and organs by injecting a small amount of radioactive substance into the body.
The nation currently has four such centres and the six new ones will help the country reach the international recommendation and standard of one PET per 1.5 million individuals.
“We are introducing teleconsultations with international experts for patients with severe diagnosis as well as telepathology of tissue specimen when the second opinion of a specialist is used. In OECD countries, this is a required component in cancer diagnosis and in Kazakhstan, we will now be conducting it as part of the guaranteed free package of medical services,” he noted.
Kazakhstan currently has five linear accelerators across the country used as part of external radiotherapy treatment, although coverage reaches only 20 percent of patients, he added. The comprehensive plan envisions installing ten additional devices in Shymkent and the Akmola, Karaganda, Kostanai, Kyzylorda, Mangistau, North Kazakhstan, Pavlodar and Zhambyl regions.
Radionuclide therapy, a systematic cancer treatment method using radio-pharmaceuticals to target specific tumours and destroy cancer cells, is also unavailable in Kazakhstan. A nuclear medicine centre to conduct such therapies will be opened in Semei and a department is being built in the National Oncology Centre in the capital, said Birtanov.
An additional 1.6 billion tenge (US$4.2 million) will be allotted to fund almost 100,000 computer tomography and magnetic particle tests for patients who display suspicious symptoms.
“The efficiency of cancer treatment depends on the organisation of preventive measures nationwide. In Kazakhstan, spending for preventive measures is 4 percent, while Organisation for Economic Cooperation and Development countries allocated up to 10 percent. The results of the World Health Organisation’s (WHO) country assessment revealed a high prevalence of risk factors, such as tobacco smoking and alcohol consumption, that are risk factors for developing cancer,” said Birtanov.
Kazakh hospitals currently offer three types of voluntary cancer screenings – breast cancer screening for women age 40 and older, cervical cancer screening for women beginning at age 30 and colorectal cancer screening for men and women age 50 and older. Participation is still below the WHO recommended threshold of 70 percent.
Since 2018, the screening programme has expanded the age for regular screening from 30 to 70, with target group coverage growing from 70 to 90 percent by 2022.
“Vaccination against hepatitis B allows preventing liver cancer. This can be ensured by the vaccination of target groups up to 98.7 percent. Over time, the efficiency of the screening programme has increased in increasing detection of cancer at early stages; for example, cervical cancer screening by 4.5 percent, breast cancer by 6.3 percent and colorectal cancer by 2.3 percent,” he said.
Raising awareness of symptoms and treatments through education is also underway.