Epidemiological Profile of Colorectal Cancer: Global Perspectives and Current Dynamics in Kazakhstan

Abstract

Background. Colorectal cancer (CRC) is the third most commonly diagnosed cancer and the second leading cause of cancer-related mortality worldwide. Its burden is increasingly shifting toward middle-income countries, including Kazakhstan, where CRC has become one of the leading malignancies. A comprehensive synthesis of Kazakhstan’s epidemiological profile within the global CRC context has been lacking. Objective. To review the global epidemiology of colorectal cancer and evaluate current incidence, mortality, screening, and survival trends in the Republic of Kazakhstan. Methods. A narrative review with systematic elements integrated international evidence from IARC/GLOBOCAN 2020 and 2022, the Global Burden of Disease 2019 and 2021, and other authoritative global sources with Kazakhstan-specific data on cancer registration, screening, survival, and behavioral factors published between 2001 and 2025. PubMed/PMC, IARC Cancer Today, WHO NCD Country Profiles, and reports from the Kazakhstan Ministry of Healthcare were searched between March 2024 and February 2026. Results. Globally, CRC accounted for approximately 1.93 million new cases and 935,000 deaths in 2020. Although age-standardized rates have declined in many high-income countries, the absolute burden continues to increase because of population growth and aging. In Kazakhstan, crude CRC incidence increased from 14.79 to 17.72 per 100,000 between 2009 and 2018, whereas crude mortality declined from 11.2 to 7.7 per 100,000. Following the introduction of organized screening in 2011, early-stage (I–II) detection increased from 35.0% to 67.4%, while stage III and IV disease decreased. Survival analysis of 37,871 patients diagnosed during 2014–2023 identified older age and greater comorbidity burden as major predictors of poorer outcomes. Screening coverage exceeded 95% in 2021–2022 before declining to 68.5% in 2023, suggesting post-pandemic disruption and possible overestimation of administrative coverage. Kazakhstan’s mortality-to-incidence ratio (~0.56) remains higher than that reported in established East Asian screening programs. Conclusions. Kazakhstan demonstrates the characteristic CRC epidemiological transition of rising incidence accompanied by slower mortality reduction. Organized screening has improved stage distribution; however, further gains require strengthened screening participation, transparent reporting, timely treatment, and sustained implementation of evidence-based cancer control strategies. Keywords: colorectal cancer; epidemiology; incidence; mortality; Kazakhstan; screening.