Abstract
BACKGROUND: Prostate cancer is one of the most common malignancies among men worldwide, with marked regional variability in incidence, mortality, and stage at diagnosis. Data from Central Asia remain limited, particularly in regions without organized prostate-specific antigen (PSA) screening programs. This study aimed to assess the epidemiology of prostate cancer in the Abay region of Kazakhstan during the post-screening period. METHODS: A retrospective population-based descriptive study was conducted using official cancer registry data from the Abay region. All newly diagnosed prostate cancer cases (ICD-10 code C61) registered between 2020 and 2024 were included. Incidence, mortality, stage distribution at diagnosis, one-year lethality, prevalence, and the proportion of patients under ≥5-year follow-up in the cancer registry were analyzed using descriptive epidemiological methods. Year-to-year relative changes were used to describe temporal patterns in incidence and mortality. RESULTS: A total of 260 new prostate cancer cases were registered during the study period. The incidence rate increased from 7.2 per 100,000 male population in 2020 to 9.2 per 100,000 in 2024, with a peak observed in 2023. In contrast, mortality declined steadily overall from 5.7 to 2.8 per 100,000 over the same period. Stage II disease predominated; however, advanced-stage cancer remained common. The proportion of stage IV disease ranged from 25.8% to 37.5%, indicating persistent late diagnosis. The proportion of patients registered in the cancer registry for ≥5 years increased from 42.1% to 56.4%, and prevalence rose from 55.4 to 63.6 per 100,000, reflecting the accumulation of patients under long-term observation. CONCLUSIONS: Despite increasing incidence, prostate cancer mortality in the Abay region declined during 2020-2024. However, the persistently high proportion of advanced-stage disease indicates substantial challenges in early detection in the absence of organized screening. These findings describe the current epidemiological profile of prostate cancer in a Central Asian region operating under opportunistic diagnostic practices.