en Biostatistics and Epidemiology Biostatistics and Epidemiology Original Research Original Research <span style="font-size:13pt"><span style="text-justify:kashida"><span style="text-kashida:0%"><span style="text-autospace:none"><span new="" roman="" style="font-family:" times=""><span style="font-style:italic"><b>&nbsp;&nbsp;</b><b><span style="font-size:9.0pt"><span style="font-style:normal">&nbsp; Background: </span></span></b><span style="font-size:9.0pt"><span style="font-style:normal">Colorectal cancer remains a significant public health concern globally and in Kazakhstan, with rising incidence rates partly attributed to improved screening and lifestyle changes. This study aimed to assess epidemiological trends in colorectal cancer in Kazakhstan from 2013 to 2023, focusing on incidence, mortality, and five-year survival rates. </span></span></span></span></span></span></span></span><br> <span style="font-size:13pt"><span style="text-justify:kashida"><span style="text-kashida:0%"><span style="text-autospace:none"><span new="" roman="" style="font-family:" times=""><span style="font-style:italic"><span style="font-size:9.0pt"><span style="font-style:normal">&nbsp;&nbsp; <b>Methods:</b> This population-based registry analysis utilized national cancer registry data on colorectal cancer (CRC) morbidity and mortality. All registered cases from 2013 to 2023 were included. Five-year survival was estimated using aggregated registry data (observed survival). Temporal trends were evaluated using simple linear regression. </span></span></span></span></span></span></span></span><br> <span style="font-size:13pt"><span style="text-justify:kashida"><span style="text-kashida:0%"><span style="text-autospace:none"><span new="" roman="" style="font-family:" times=""><span style="font-style:italic"><span style="font-size:9.0pt"><span style="font-style:normal">&nbsp;&nbsp; <b>Results: </b>Between 2013 and 2023, colorectal cancer incidence in Kazakhstan slightly increased (from 8.9 to 9.8 per 100,000), while mortality significantly decreased by 32.7% (from 4.9 to 3.3; B = &ndash;6.64, reflecting an overall downward trend over the study period; </span></span><span style="font-size:9.0pt">P</span><span style="font-size:9.0pt"><span style="font-style:normal"> < 0.001), particularly in East Kazakhstan. Rectal cancer incidence increased in South Kazakhstan (B = 5.46; </span></span><span style="font-size:9.0pt">P</span><span style="font-size:9.0pt"><span style="font-style:normal"> = 0.007) and Astana (B = 1.59; </span></span><span style="font-size:9.0pt">P</span><span style="font-size:9.0pt"><span style="font-style:normal"> = 0.014), but declined in the Almaty region (B = &ndash;1.88; </span></span><span style="font-size:9.0pt">P</span><span style="font-size:9.0pt"><span style="font-style:normal"> = 0.008). Mortality decreased notably in the Almaty region, Almaty city, and North Kazakhstan. Five-year observed survival rates for CRC improved from 44.1% to 52.0%, and for rectal cancer from 42.0% to 47.0%. </span></span></span></span></span></span></span></span><br> <span style="font-size:13pt"><span style="text-justify:kashida"><span style="text-kashida:0%"><span style="text-autospace:none"><span new="" roman="" style="font-family:" times=""><span style="font-style:italic"><span style="font-size:9.0pt"><span style="font-style:normal">&nbsp;&nbsp; <b>Conclusion:</b> Despite the decline in colorectal cancer mortality in Kazakhstan from 2013 to 2023, the persistently high rate of late-stage diagnoses underscores the urgent need to strengthen early detection efforts and implement region-specific interventions.</span></span></span></span></span></span></span></span><br> <br> <span style="font-size:11pt"><span style="line-height:200%"><span sans-serif="" style="font-family:Calibri,"><b><span lang="EN-US" style="font-size:10.0pt"><span style="line-height:200%"><span style="font-family:"Times New Roman","serif""></span></span></span></b></span></span></span> Colorectal Cancer, Incidence, Mortality Rate 17 24 http://mjiri.iums.ac.ir/browse.php?a_code=A-10-9662-1&slc_lang=en&sid=1 Dina Toleutayeva dina.seilkhanova@smu.edu.kz 200319475328460096244 200319475328460096244 No Department of Epidemiology and Biostatistics, NJSC Semey Medical University, Semey, Kazakhstan Gulnar Shalgumbayeva gul6868@mail.ru 200319475328460096245 200319475328460096245 No Department of General Medical Practice of Semey city, NJSC Semey Medical University, Semey, Republic of Kazakhstan Assel Tukinova tukinova.asel@bk.ru 200319475328460096246 200319475328460096246 Yes Department of Epidemiology and Biostatistics, NJSC Semey Medical University, Semey, Kazakhstan Lyazzat Dyussenova dyussenova_l@mail.ru 200319475328460096247 200319475328460096247 No Kazakh National Medical University named after S.D. Asfendiyarov, NCJSC, Almaty, Kazakhstan Tolegen Toleutayev t.toleutayev@mail.ru 200319475328460096248 200319475328460096248 No Department of Cardiovascular and Thorasic Surgery Named by B.S.Bulanov, NJSC Semey Medical University, Semey, Republic of Kazakhstan