COLLECTIVE CANCER REGISTRY REPORT FROM DEC. 1994 UPTILL DEC. 2009 CANCER STATISTICS Distribution of neoplasms Of a total of 43,908 neoplasms, 21,549 were seen in males (49.08%) and 22,359 (50.92%) in females registered at the Shaukat Khanum Memorial Cancer Hospital and Research Center (SKMCH & RC) in a fifteen year period extending from December 29, 1994 till December 31, 2009. Thirty eight thousand nine hundred and twenty seven (38,927 (88.66%)) tumors were found in adults, whereas, 4,981 (11.34%) in children. Children were classified as patients 18 years or less in age and adults as patients more than 18 years of age. Table 1 shows the stratification of cases by behavior and age-groups whereas, Table 2 shows the counts of malignancies in males and females according to different age-groups. Table 1. Distribution of neoplasms by behavior and age-groups Behavior Age-groups Registered patients (43,616) Reported neoplasm* (43,908) Malignant~ Adults Pediatrics Total 37,090 4,799 41,889 37,348 4,815 42,163 Benign^ & Uncertain behavior Adults Pediatrics Total 1562 165 1727 1579 166 1745 Table 2. Malignancies registered at SKMCH & RC from Dec. 1994 to Dec. 2009, stratified by sex and age-groups. Figure 2: Distribution of malignancies by sex and age-groups. 1094 1446 1674 1981 1826 1698 1323 642 854 2061 2305 2573 2804 1195 729 1082 298 941 817 960 978 170 3132 1322 1334 2062 399 2089 165 404 500 340 618 852 319 76 0 500 1000 1500 2000 2500 3000 3500 0-4 5-9 10-14 15-19 20-24 25-29 30-34 35-39 40-44 45-49 50-54 55-59 60-64 65-69 70-74 75-79 80-84 85+ Male Female Data Source Cancer Registry & Clinical Data Management, SKMCH & RC Age range Male Female Total 0-4 729 399 1128 5-9 941 340 1281 10-14 817 404 1221 15-19 960 500 1460 20-24 978 618 1596 25-29 1082 854 2036 30-34 1094 1334 2428 35-39 1322 2061 3383 40-44 1446 2305 3751 45-49 1674 2573 4247 50-54 1981 2804 4785 55-59 1826 2089 3915 60-64 3132 2062 4194 65-69 1698 1195 2893 70-74 1323 852 2175 75-79 642 319 961 80-84 298 165 463 85+ 170 76 246 Total 21113 21050 42163 *The difference in the number of registered patients and reported neoplasms is attributed to multiple malignancies and benign neoplasms diagnosed in 274 and 18 patients respectively. Also 207 patients have both malignant and benign neoplasm simultaneously. ~Cases with behavior code /3 and /2 are considered as malignant cases. ^Cases with behavior code /0 and /1 are considered as benign and of uncertain behavior respectively. Page 1 of 11
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COLLECTIVE CANCER REGISTRY REPORT FROM DEC. 1994 UPTILL DEC. 2009
CANCER STATISTICS Distribution of neoplasms Of a total of 43,908 neoplasms, 21,549 were seen in males (49.08%) and 22,359 (50.92%) in females registered at the Shaukat Khanum Memorial Cancer Hospital and Research Center (SKMCH & RC) in a fifteen year period extending from December 29, 1994 till December 31, 2009. Thirty eight thousand nine hundred and twenty seven (38,927 (88.66%)) tumors were found in adults, whereas, 4,981 (11.34%) in children. Children were classified as patients 18 years or less in age and adults as patients more than 18 years of age. Table 1 shows the stratification of cases by behavior and age-groups whereas, Table 2 shows the counts of malignancies in males and females according to different age-groups.
Table 1. Distribution of neoplasms by behavior and age-groups Behavior
Age-groups
Registered patients (43,616)
Reported neoplasm* (43,908)
Malignant~
Adults Pediatrics Total
37,090 4,799
41,889
37,348 4,815
42,163 Benign^& Uncertain behavior
Adults Pediatrics Total
1562 165
1727
1579 166
1745
Table 2. Malignancies registered at SKMCH & RC from Dec. 1994 to Dec. 2009, stratified by sex and age-groups.
Figure 2: Distribution of malignancies by sex and age-groups.
*The difference in the number of registered patients and reported neoplasms is attributed to multiple malignancies and benign neoplasms diagnosed in 274 and 18 patients respectively. Also 207 patients have both malignant and benign neoplasm simultaneously. ~Cases with behavior code /3 and /2 are considered as malignant cases. ^Cases with behavior code /0 and /1 are considered as benign and of uncertain behavior respectively.
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Demographics Of the 42,163 malignancies, nearly 78.28% (33,005) belonged to the province of Punjab and approximately 13.08% (5,517) to the North West Frontier Province (N.W.F.P)♣. The fact that the geographic area of residence of a vast majority of patients was Punjab can be explained in light of the information that the SKMCH & RC is situated in the provincial capital of Punjab and that, this province account for almost 60% of the total population of the country.
Table 3. Distribution of malignancies, according to their geographic areas
Demographic area Malignancies (N=42,163)
Percent (%)
Punjab 33,005 78.28 NWFP♣ 5,517 13.08 Balochistan 549 1.30 Sindh 1,438 3.41 Federal Capital 472 1.12 F.A.T.A & North. areas 399 0.95 Azad Jammu & Kashmir 429 1.02 Others countries Not defined
307 47
0.73 0.11
Figure 3. Distribution of malignancies by geographic area
429, 1%307, 1%
472, 1%399, 1%
47, 0%
33,005, 79%
1,438, 3%
549, 1%5,517, 13%
Punjab
NWFP
Balochistan
Sindh
Federal Capital
F.A.T.A & North. areas
Azad Jammu & Kashmir
Others countries
Not defined
Data Source: Cancer Registry & Clinical Data Management, SKMCH & RC
♣ NWFP renamed as Khyber Pakhtoonkhwa on April 01, 2010.
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Distribution of malignancies Tables 4-8 display lists of top 10 cancers registered at the Hospital during the fifteen year period under study. The results have been divided into those for males, females, adults, children, and all age-groups combined. The results for all age-groups and both sexes combined shows that breast cancer, leukemias, non-Hodgkin’s lymphoma, oral cavity cancers, and liver & intrahepatic bile ducts were the commonest malignancies seen at the Hospital (Table 4). Table 4. Top 10 malignancies seen amongst all age-groups and both sexes combined at SKMCH & RC, from Dec. 1994 to Dec. 2009. Sr. No. ICD Category Count Percentage ICD 9 CM Code
Data Source: Cancer Registry & Clinical Data Mangement, SKMCH & RC
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Amongst adults (> 18 years), the commonest malignancies were breast cancer, lip & oral cavity cancer
and non-Hodgkin’s lymphoma (Table 5). Table 5. Top 10 malignancies seen amongst adults (> 18 years) in both sexes combined, from Dec. 1994 to Dec. 2009
Data Source: Cancer Registry & Clinical Data Mangement, SKMCH & RC
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In children (<= 18 years), the most frequent cancers were acute lymphoblastic leukemias, Hodgkin’s
disease, and non-Hodgkin’s lymphoma (Table 6). Table 6. Top 10 malignancies seen in children (<= 18 years) in both sexes combined, from Dec. 1994 to Dec. 2009 Sr. No. ICD Category Count % Morphology Code♠
♠ Classification of childhood cancers is based on tumor morphology using the ICD-9-CM coding scheme for childhood cancers. Figure 6: Top 10 malignancies seen in children (<= 18 years) in both sexes combined, from Dec. 1994 to Dec. 2009
163, 3.39%
186, 3.86%
206, 4.28%
219, 4.55%
231, 4.80%
251, 5.21%
313, 6.50%
513 10.65%
1138, 23.63%
738, 15.33%
0 200 400 600 800 1000 1200
Nephroblastoma
Acute myeloid leukemia
Germ cell tumor
Ewing’s sarcoma/PNET
Retinoblastoma
Glioma
Osteosarcoma
Non-Hodgkin's lymphoma
Hodgkin’s disease
Acute lymphoblastic leukemia
Data Source: Cancer Registry & Clinical Data Mangement, SKMCH & RC
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The most frequent cancers, amongst females were cancers of breast, ovary and uterine adnexa, lip & oral
cavity, and cervix uteri (Table 7), whereas, amongst males, lip & oral cavity, liver and intrahepatic bile ducts, non-Hodgkin’s lymphoma, cancers of trachea and bronchus and lungs (Table 8). Table 7. Top 10 malignancies seen in females (> 18 years), from Dec. 1994 to Dec. 2009.
Sr. No. ICD Category Count Percentage ICD 9 CM Code
Figure 8: Top 10 malignancies seen in males (> 18 years), from Dec. 1994 to Dec. 2009
647, 3.62%
658, 3.69%
945, 5.29%
1017, 5.70%
1128, 6.32%
1134, 6.35%
1266, 7.09%
1436, 8.04%
1455, 8.15%
1559, 8.73%
0 200 400 600 800 1000 1200 1400 1600 1800
Brain
Hodgkin's disease
Urinary bladder
Leukemias
Prostate
Colorectal
Trachea, bronchus, and lungs
Non-Hodgkin's lymphoma
Liver & intrahepatic bile ducts
Lip & oral cavity
Data Source: Cancer Registry & Clinical Data Mangement, SKMCH & RC
SUPPLEMENTAL INFORMATION
Table 9 the result stratified by primary sites, age-groups, and gender. According to this, cancers of the breast, leukemias, lymphoma, and oral cavity are the commonest site(s) for malignancies seen at the Hospital.
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Table 9. Distribution of Primary Malignant Sites, 1994 – 2009FEMALES