Interregional Inequalities by Type of Residence in Ovarian Cancer in Uzbekistan, 2016-2024
D. U. Nabieva *
Department of Oncology, Center for the Development of Professional Qualifications of Medical Workers, Tashkent, Uzbekistan.
Ya. S. Mamadalieva
Department of Oncology, Center for the Development of Professional Qualifications of Medical Workers, Tashkent, Uzbekistan.
M. A. Gofur-Akhunov
Department of Oncology, Center for the Development of Professional Qualifications of Medical Workers, Tashkent, Uzbekistan.
R. R. Ibragimov
Department of Scientific Research, Innovation, and Training of Scientific and Pedagogical Personnel, Committee for Sanitary and Epidemiological Welfare and Public Health, Tashkent, Uzbekistan.
*Author to whom correspondence should be addressed.
Abstract
Background: Urban-rural differences in ovarian cancer remain insufficiently described in Central Asia, and evidence from Uzbekistan is limited. This study assessed national trends and interregional differences in registered ovarian cancer incidence by type of residence in Uzbekistan during 2016-2024.
Methods: A retrospective population-based descriptive analytical study was conducted using aggregated and anonymised registry data on newly diagnosed ovarian cancer cases among women. Crude incidence rates and age-standardised rates per 100,000 females were calculated for urban and rural residents using the WHO world standard population. Differences in case distribution were examined using Pearson's chi-squared test, and differences in age-standardised rates were assessed using two-tailed z-tests.
Results: Overall, 8,150 newly registered cases were included. Of these, 3,551 cases (43.6%) were registered among urban residents and 4,599 cases (56.4%) among rural residents. Rural cases predominated in eight of the nine study years, with the highest rural shares recorded in 2022 (62.1%) and 2023 (61.9%). Rural age-standardised rates exceeded urban rates in every year, with annual differences ranging from -0.96 to -3.54 rate points per 100,000 females; all differences were statistically significant (minimum p = 0.014). Regional heterogeneity was also observed. The largest rural excesses in age-standardised rates were found in Namangan, Andijan, Kashkadarya, and Jizzakh regions, whereas Fergana region and the Republic of Karakalpakstan showed near parity or non-significant differences in case distribution.
Conclusion: The findings indicate persistent territorial inequalities in the registered burden of ovarian cancer in Uzbekistan and support the strengthening of diagnostic routing, referral systems, and access to gynaecological oncology services for rural women.
Keywords: Ovarian cancer, urban-rural inequalities, age-standardised incidence, crude incidence rate, cancer registry, rural health, gynaecological oncology, interregional variation, health service access