Pediatric oncology in Uzbekistan. Early diagnosis, treatment accessibility, and new survival rates
**Pediatric Oncology in Uzbekistan: Early Diagnosis, Treatment Availability, and New Survival Rates**
Every year, more than 2.5 thousand children in Uzbekistan are diagnosed with a malignant neoplasm or hemoblastosis for the first time. Although the capabilities of specialized care are expanding, late detection, drug availability, and the need to travel to Tashkent remain serious problems. The authorities plan to change the treatment system by 2030, focusing on early diagnosis, the development of regional infrastructure, and increased survival rates.
In total, about 5 thousand children in the country receive a diagnosis of an oncological, hematological, or immune disease for the first time each year. According to the National Registry, 2,416 new cases of malignant neoplasms and hemoblastoses were recorded in 2024, and 2,534 in 2025.
A Podrodno.uz correspondent spoke with Djamilya Polatova, Doctor of Medical Sciences, Professor, Director of the Scientific and Practical Medical Center for Pediatric Oncology, Hematology and Immunology; Dilnoza Agzamkhodjaeva, Deputy Director for Medical Work and Chief Physician of the center; and Lola Kasimbekova, Head of the center's Statistics Department, about how the pediatric oncology system is transforming, what results have already been achieved, and what difficulties patients and their families face.
### Thousands of Patients and the Problem of Late Diagnosis
More than 16.5 thousand children with oncological, hematological, immunological, and certain rare diseases are registered on the specialized registry in the country. At the same time, 7,897 children are monitored for oncological and hematological diseases.
As Lola Kasimbekova, head of the center's statistics department, explained, the total cohort includes patients with benign and malignant neoplasms, so these figures cannot be equated with the number of children with cancer.
An increase in the number of registered patients also does not necessarily mean an increase in incidence. Statistics are influenced by the completeness of registration, the duration of follow-up, and improved treatment outcomes. Creating a unified national registry allows for a more accurate assessment of regional needs for medicines, diagnostic equipment, hospital beds, and medical staff.
The stage at which a child reaches specialists is particularly important.
According to the center, more than 70% of children with solid malignant tumors were admitted at stages III–IV. In hemoblastoses, which include leukemias in particular, late diagnosis accompanied by severe complications was also frequently identified. At the same time, the division into four stages used for many solid tumors cannot be mechanically applied to hemoblastoses.
"Late detection is one of the factors of adverse outcomes," explained Djamilya Polatova, director of the center.
At the same time, recent data show positive dynamics. The share of early detection of solid malignant tumors increased from 23% in 2023 to 28% in 2025. One-year survival in malignant oncological diseases increased from 37% to 44.5%, and in hemoblastoses — from 17% to 42%.
By 2030, the national strategy provides for increasing the share of early detection to 65% and achieving a five-year survival rate of at least 60%. At the same time, a final assessment of long-term outcomes for new comparable groups of patients will require the accumulation of registry data.
### Why Children Get Cancer
Pediatric oncological diseases have characteristics that distinguish them from adult oncology. They are associated with changes in the genetic material of cells that occur during the growth and development of the body. Usually, such changes occur spontaneously, although some children have a hereditary predisposition.
As Djamilya Polatova, director of the center, said, in most cases, pediatric oncological diseases are not related to the child's lifestyle.
For most such diseases, there is as yet no reliable primary prevention. Therefore, timely access to medical care, recognition of warning symptoms, and accurate diagnosis are especially important.
Pediatric oncology requires a separate approach and a specialized medical service. Children differ in tumor structure, molecular characteristics, response to treatment, and risks of long-term complications. In addition, therapy must take into account the age, body weight, body surface area, and organ status of the patient.
According to Djamilya Polatova, a comprehensive approach is required, combining morphological and molecular diagnostics, risk assessment, and specialized treatment protocols. The work involves pediatric oncologist-hematologists, surgeons, radiologists, diagnosticians, pharmacists, and nurses. Prevention of complications, rehabilitation, psychological support, and the opportunity to continue education during long-term treatment are no less important.
"With timely diagnosis and proper treatment, many children have a real chance of recovery," emphasized Djamilya Polatova.
For comparison, in high-income countries, the five-year survival rate for children with cancer exceeds 80%. For Uzbekistan, achieving comparable results requires not only improving treatment methods, but also changing the entire patient pathway — from the first visit to the doctor to the completion of therapy and subsequent follow-up.
### Treatment in the Regions and Trips to Tashkent
Today, a significant proportion of children with oncological and hematological diseases are referred to Tashkent for complex diagnostics and high-tech treatment. The need for such a trip depends on the diagnosis, severity of the condition, and capabilities of the medical institution at the place of residence.
Departments of pediatric oncology and hematology operate in regional multidisciplinary pediatric hospitals and in the Republic of Karakalpakstan. They provide individual stages of treatment, supportive therapy, and follow-up. However, the capabilities of these units vary.
The Scientific and Practical Medical Center in Tashkent provides scientific and methodical support to regional institutions, helps implement clinical protocols, train specialists, and conduct telemedicine consultations. At the same time, regional departments are units of multidisciplinary pediatric hospitals, not branches of the center.
As Dilnoza Agzamkhodjaeva, deputy director for medical work and chief physician of the center, said, the National Strategy for 2025–2030 provides for the development of interregional high-tech complexes and the strengthening of specialized units of pediatric hospitals in the regions.
The Samarkand complex is preparing for commissioning, while other regions are connecting in stages. It is assumed that the development of infrastructure will expand the availability of specialized care and reduce the number of forced trips by families to the capital.
At the same time, the task is not to completely transfer all types of treatment to the regions, but to define the functions of each level of the medical system. Early detection, primary diagnosis, individual stages of therapy, complex surgical interventions, and long-term follow-up require different capabilities and levels of equipment.
### A Single Patient Pathway and New Diagnostic Timelines
Since 2021, an independent pediatric oncology, hematology, and clinical immunology service has been consistently developing in Uzbekistan. Important milestones were the presidential decree of May 21, 2024, and decree No. PP-186 of May 19, 2025, which defined the implementation of the National Strategy to Fight Childhood Cancer for 2025–2030.
One of the key areas of the reform is the creation of a single patient pathway. The system must connect primary healthcare, district and regional institutions, as well as the national specialized center.
"Our task is to build a single patient pathway so that a child can undergo timely diagnostics and receive the necessary treatment. For this purpose, a 'green corridor' mechanism, electronic patient registration, and telemedicine consultations are being introduced. A pilot project has already begun in the Samarkand region," chief physician of the center Dilnoza Agzamkhodjaeva said in an interview.
Target diagnostic timelines are up to four days for oncohematological diseases and up to 14 days for solid tumors. Reducing the overall period from suspicion of the disease to the start of treatment to 10–18 days is designated as a working goal of the service.
According to Dilnoza Agzamkhodjaeva, the implementation of the strategy involves the simultaneous development of infrastructure, training of specialists, improvement of diagnostics, and expansion of treatment capabilities.
A separate direction is the creation of the International Academic Hub for Childhood Cancer. It is intended to unite international clinical expertise, scientific research, modern technologies, and training of specialists for Uzbekistan and other countries of Central Asia.
Among the international partners with whom cooperation is developing are the World Health Organization, St. Jude Global, Dana-Farber Cancer Institute, SIOP, and Princess Máxima Center. Such interaction is aimed at improving clinical programs, developing national competencies, and introducing modern approaches to treatment.
### Medicines — Expansion of the List and the Problem of Uninterrupted Supplies
The availability of prescribed medications remains one of the key conditions for continuous treatment. Even with the necessary infrastructure in place, the absence of a single drug can complicate adherence to the prescribed therapy regimen.
According to the center, the overall list of medicines for children increased from 89 items in 2025 to 194 in 2026. Under the WHO and St. Jude Global Platform, the list of antitumor and targeted drugs grew from 30 to 53 items.
The level of medicine provision, according to service data, rose from 33% in 2023 to 88% today (for seven months of 2026). However, this aggregated indicator does not mean that every prescribed drug is available at any given time.
As Dilnoza Agzamkhodjaeva explained, one of the difficulties in drug supply is related to the fact that medications arrive at different times throughout the year. Because of this, it is necessary to separately coordinate deliveries of all components included in treatment regimens.
"Our task is to ensure not only the procurement of necessary drugs, but also control over medicines reaching medical institutions and specific patients in a timely manner. For this purpose, a national digital system is being formed, which will allow tracking the movement of drugs at all stages — from calculation of demand and procurement to distribution across regions and receipt of the medicine by the child," said Dilnoza Agzamkhodjaeva.
In parallel, mechanisms for forecasting needs and creating buffer stocks are being developed. The digital system is being implemented in stages.
If a prescribed medication is out of stock, parents are advised to contact the attending physician and the leadership of the specialized department to clarify expected delivery times and further strategy. The decision on a possible drug replacement or change in the treatment regimen must be made only by the attending team, taking into account medical indications.
There is no universal procurement timeline for a missing drug: it depends on the specific medication, established procedure, and supplier.
### What the State Pays For and What Help Families Can Count On
Specialized medical care for children with oncological, hematological, and immunological diseases is provided at the expense of the state budget within the framework of established guarantees and the referral system. Services provided for by state programs and available in specialized institutions upon an appropriate referral are rendered without charge to the family.
Presidential Decree No. PP-183 of May 21, 2024, provides for the free provision of necessary medicines and medical devices to children suffering from oncological, hematological, and immunological diseases in accordance with treatment protocols. This is one of the priority areas of work of the Scientific and Practical Medical Center for Pediatric Oncology, Hematology and Immunology.
To implement these measures, a Fund for Assisting the Recovery of Children Suffering from Oncological and Hematological Diseases was created at the center. It assists in timely diagnosis, treatment, and rehabilitation of children both in Uzbekistan and, if necessary, abroad. The fund can also assist in performing high-tech and expensive operations, providing social and financial assistance, as well as providing patients with necessary medicines and medical devices free of charge according to treatment protocols. Among other areas of its work is supporting children's education, including providing special educational literature and supplies.
The fund's resources are formed, among other things, from the state budget: based on justified calculations, the fund receives at least 100 billion sums annually starting from 2024. Other sources include voluntary donations, grants, fundraising funds, income from placing temporarily free funds on bank deposits, and other receipts not prohibited by law.
Separately, the document establishes a procedure according to which, from July 1, 2024, patients aged 18 to 21 inclusive continue free treatment in specialized institutions: in the Scientific and Practical Medical Center for Pediatric Oncology, Hematology and Immunology, the Department of Pediatric Hematology and Oncology of the National Children's Medical Center, pediatric multidisciplinary medical centers of Karakalpakstan and regions, as well as in other organizations where they received care before reaching majority. For certain diseases and cases, the list of which is determined by the Ministry of Health, follow-up and treatment up to age 22 may be provided.
### Additional Support
A significant role in the development of specialized infrastructure is played by the Zamin Charitable Foundation, which supports the modernization of medical institutions, the implementation of modern technologies, and improving the quality of care for children.
Families can also contact territorial divisions of the National Agency for Social Protection and district or city social service centers "Inson." These institutions help assess family needs and assist in obtaining social support measures provided by the state.
A separate direction is the development of pediatric palliative care, hospice services, and home-based support. Medical teams are responsible for clinical care, while social workers help organize care and family support. Hospital schools "Mehrli Maktab" allow children to continue their education during long-term treatment.
At the same time, the possibility of compensating expenses for travel, accommodation, additional examinations, and other needs is determined individually — in accordance with the rules of a specific state program or charitable organization.
### Goals Until 2030
The National Strategy to Fight Childhood Cancer for 2025–2030 combines several interconnected tasks: increasing the share of early detection, reducing diagnostic time, developing regional high-tech complexes, expanding medicine provision, and training specialists.
An increase in the share of early detection of solid malignant tumors from 23% to 28% has already been recorded, as well as one-year survival — from 37% to 44.5% in malignant oncological diseases and from 17% to 42% in hemoblastoses.
The next stage involves reaching an early detection share of at least 65% and a five-year survival rate of at least 60% by 2030.
The outcome will depend on how consistently all elements of the system can be linked: recognizing the first symptoms, timely referral to specialized experts, accurate diagnosis, availability of prescribed drugs, qualified therapy, and subsequent follow-up.
For families facing childhood cancer, these changes are of practical importance: not only medical outcomes depend on the speed of diagnosis and availability of treatment, but also the opportunity to complete the entire necessary journey without additional delays and financial hardships.