CURRENT ISSUE

ABSTRACT: Welcome editorial from Editor in Chief

ABSTRACT: Cervical cancer remains a major public health concern in Kazakhstan despite ongoing prevention efforts. Although incidence has declined in many high-income countries due to effective screening and human papillomavirus vaccination programs, Kazakhstan continues to report relatively high incidence and still considerable mortality rates compared with many developed regions. This narrative review summarizes the current epidemiological trends, screening practices, and prevention strategies for cervical cancer in Kazakhstan. National screening programs based on cytology have been implemented since 2008 and have improved early detection; however, screening coverage remains below the World Health Organization target of 70%, with participation particularly low in rural areas due to limited awareness, access barriers, and logistical challenges. The prevalence of human papillomavirus infection among women in Kazakhstan is relatively high, with high-risk types contributing significantly to disease burden. The reintroduction of the national HPV vaccination program targeting adolescents represents an important step toward long-term cervical cancer prevention. In addition, emerging screening approaches such as HPV self-sampling offer promising opportunities to increase screening uptake, especially among under-screened populations. Integrating vaccination programs with innovative and accessible screening strategies, alongside improved awareness, follow-up systems, and health system support, could significantly enhance cervical cancer prevention efforts. Strengthening these interventions will be essential for Kazakhstan to reduce cervical cancer burden and move toward achieving the World Health Organization goal of cervical cancer elimination.

ABSTRACT: Central precocious puberty is an uncommon but important paediatrics endocrine condition that requires timely recognition and evaluation to prevent adverse auxological and psychosocial outcomes. We present the case of a 6-year-old girl with a 10-month history of progressive breast enlargement and pubic and axillary hair development. Clinical examination revealed markedly advanced secondary sexual characteristics, consistent with Tanner stage IV maturation. Endocrine evaluation demonstrated pubertal-range gonadotropin concentrations, and dynamic testing with a gonadotropin-releasing hormone agonist showed a pubertal luteinizing hormone response, supporting activation of the hypothalamic-pituitary-gonadal axis. Bone age assessment demonstrated advancement beyond chronological age, while pelvic ultrasonography showed pubertal uterine morphology. Brain magnetic resonance imaging revealed no hypothalamic-pituitary or other intracranial lesion. Following clinical, biochemical, radiological, and imaging assessment, a diagnosis of idiopathic central precocious puberty was made. The patient’s parents were counselled on the diagnosis, treatment options, expected benefits, and need for follow-up, and treatment with a gonadotropin-releasing hormone analogue was commenced. This case underscores the importance of a structured approach to children presenting with early progressive pubertal development, including careful clinical assessment, bone age evaluation, endocrine testing, pelvic imaging, and neuroimaging where indicated.