Abstract
BACKGROUND: Cutaneous melanoma (CM) is a lethal skin malignancy with increasing global incidence and a growing economic burden. This study aimed to assess the epidemiological trends and healthcare expenditures associated with CM in Kazakhstan from 2019 to 2023. METHODS: We conducted a retrospective population-based study using data from the national oncology registry and the Healthcare Insurance Fund of Kazakhstan. Incident CM cases (ICD-10 C43-C43.9) diagnosed between 2019 and 2023 were analyzed. Demographic, clinical, and survival data were examined alongside healthcare expenditures for outpatient diagnostics, pharmaceutical treatment, and inpatient care. Multivariable Cox regression was used to assess factors associated with all-cause mortality. RESULTS: A total of 1,760 patients were included; 61% were female, and 46% were aged 51-70 years. Male patients had significantly higher rates of metastatic disease, nodal involvement, and mortality. From 2019 to 2023, CM prevalence increased from 24.7 to 62.7 per million, while mortality rose from 2.2 to 6.3 per million. Pharmaceutical spending surged nearly tenfold, from USD 4.1 million to USD 38.0 million, while outpatient diagnostic and inpatient treatment costs more than doubled. Whole-body PET scans and BRAF testing accounted for a growing share of outpatient costs. Significant mortality predictors included male sex (HR = 1.59), age ≥ 71 years (HR = 1.87), ECOG score, metastases, and lymph node involvement (p < 0.05). CONCLUSION: CM imposes an increasing clinical and financial burden on Kazakhstan's healthcare system. Rising prevalence and escalating treatment costs highlight the need for early detection, improved disease management, and cost-effective interventions to reduce the long-term impact of melanoma.