title: The Incidence of Malignant Tumors in Environmentally Disadvantaged Regions of Kazakhstan
abstract: Objective: To explore the prevalence of malignant tumors in the adult population through 2003-2014 in parts
  of the Aral Sea region: a zone of ecological disaster, a zone of ecological crisis and a zone of precritical conditions.
  Methods: The long-time average annual levels of cancer morbidity stratified by zones of the Aral Sea region and trends
  of long-time average annual incidence indicators of malignant tumors were identified. Leading cancer localizations
  in the adult population was established and associations between cancer incidence and environmental pollution were
  analyzed. In addition, associations between individual risk factors and cancer incidence in the adult population was
  established. Correlations between a hazard index and the cancer incidence in the adult population were calculated.
  Results: In all three Aral Sea regions, as well as in Zhanaarkinskii district, leading cancer in adult population was
  esophageal, stomach, tracheal, lung, hepatobiliary, and breast. Long-time average annual levels of cancer morbidity
  in adult population living in the Aral sea region is 1.5 times higher comparing to the control region. In particular,
  long-time average annual levels of cancer morbidity in adult population living in the zone of ecological disaster was
  57.2% higher, in the zone of ecological crisis - 61.9% higher, and in the zone of precritical condition – 16.8% higher.
  Long-time average annual levels in the adult population of the Aral Sea region significantly exceeded control levels
  for brain and central nervous system cancer, cancer of bone and articular cartilage, and thyroid cancer. Conclusion: It
  has was established that the total cancer morbidity depended on the total hazard index associated with the inhalation
  of nickel and the combined cadmium intake (r=0.8).
authors.affiliation: West Kazakhstan branch of “National Centre for Occupational Health and Occupational Diseases, Aktobe, Kazakhstan. Email: asemaika@mail.ru
authors.forename: Arstan
authors.initials: A
authors.lastname: Mamyrbayev
authors.forename: Timur
authors.initials: T
authors.lastname: Djarkenov
authors.forename: Askar
authors.initials: A
authors.lastname: Dosbayev
authors.forename: Nailya
authors.initials: N
authors.lastname: Dusembayeva
authors.forename: Anatolyi
authors.initials: A
authors.lastname: Shpakov
authors.forename: Gulmira
authors.initials: G
authors.lastname: Umarova
authors.forename: Yelena
authors.initials: Y
authors.lastname: Drobchenko
authors.forename: Temirgali
authors.initials: T
authors.lastname: Kunurkulzhayev
authors.forename: Mukhtar
authors.initials: M
authors.lastname: Zhaylybaev
authors.forename: Gulnar
authors.initials: G
authors.lastname: Isayeva
keywords: Cancer; prevalence; population of the Aral Sea region; adult population; environmental factors