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Cancer registry pakistan 1994 2009
1. 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 Reported neoplasm*
(43,616) (43,908)
Malignant~ Adults 37,090 37,348
Pediatrics 4,799 4,815
Total 41,889 42,163
Benign^ Adults 1562 1579
& Pediatrics 165 166
Uncertain behavior Total 1727 1745
Table 2. Malignancies registered at SKMCH & RC from Dec. 1994 to Dec. 2009, stratified by sex and age-groups.
Age Male Female Total Figure 2: Distribution of malignancies by sex and age-groups.
range
0-4 729 399 1128 3500
5-9 941 340 1281 3132
10-14 817 404 1221 3000
15-19 960 500 1460 2804
20-24 978 618 1596 2573
2500
25-29 1082 854 2036 2305 2089
30-34 1094 1334 2428 2000
2061
1981 2062
35-39 1322 2061 3383 1826
1674 1698
40-44 1446 2305 3751
1500 1334 1446
45-49 1674 2573 4247 1323
1082 1322
1195
50-54 1981 2804 4785 1094
1000 941 960
978
55-59 1826 2089 3915 854
817 852
60-64 3132 2062 4194 729 642
618
500 399 500
65-69 1698 1195 2893 404 298
340 319 170
70-74 1323 852 2175 76
165
0
75-79 642 319 961 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+
80-84 298 165 463
Male Female
85+ 170 76 246
Data Source Cancer Registry & Clinical Data Management, SKMCH & RC
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.
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2. 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 Percent
(N=42,163) (%)
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 307 0.73
Not defined 47 0.11
Figure 3. Distribution of malignancies by geographic area
1,438, 3%
472, 1%
5,517, 13% 549, 1% 399, 1%
429, 1%
307, 1%
Punjab
47, 0%
NWFP
Balochistan
Sindh
Federal Capital
F.A.T.A & North. areas
Azad Jammu & Kashmir
Others countries
Not defined
33,005, 79%
Data Source: Cancer Registry & Clinical Data Management, SKMCH & RC
♣
NWFP renamed as Khyber Pakhtoonkhwa on April 01, 2010.
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3. 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
1 Breast 9,015 21.38 174,175, 233.0
2 Leukemias 2,950 7.00 204 - 208
3 Non-Hodgkin’s lymphoma 2,619 6.21 200, 202.0,1,8
4 Oral cavity 2,528 6.00 140 - 145
5 Liver and intrahepatic bile ducts 2,002 4.75 155 , 230.8
6 Colorectal 1,830 4.34 153 – 154, 230.3 -230.5
7 Hodgkin’s disease 1,636 3.88 201
8 Trachea, bronchus, lung 1,519 3.60 162 , 231.2
9 Ovary and uterine adnexa 1,218 2.89 183
10 Brain 1,168 2.77 191
Figure 4: Top 10 malignancies seen amongst all age-groups and both sexes combined at SKMCH & RC,
from Dec. 1994 to Dec. 2009.
Breast 9015, 21.38%
Leukemias 2950, 7.00%
Non-Hodgkin’s lymphoma 2619, 6.21%
Oral cavity 2528, 6.00%
Liver & intrahepatic bile
2002, 4.75%
ducts
Colorectal 1830, 4.34%
Hodgkin’s disease 1636, 3.88%
1519,
Trachea, bronchus, lung 3.60%
1218,
Ovary and uterine adnexa 2.89%
1168,
Brain
2.77%
0 1000 2000 3000 4000 5000 6000 7000 8000 9000 10000
Data Source: Cancer Registry & Clinical Data Mangement, SKMCH & RC
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4. 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
Sr. No. ICD Category Count Percentage ICD 9 CM Code
1 Breast 9,012 24.13 174,175, 233.0
2 Lip & oral cavity 2,489 6.66 140 -145
3 Non-Hodgkin's lymphoma 2,108 5.64 200, 202.0,1,8
4 Liver and intrahepatic bile ducts 1,969 5.27 155 , 230.8
5 Colorectal 1,774 4.75 153 – 154, 230.3 -230.5
6 Leukemias 1,529 4.09 204 - 208
7 Trachea, bronchus, and lung 1,518 4.06 162 - 231.2
8 Prostate 1,128 3.02 185, 233.4
9 Ovary and uterine adnexa 1,119 3.00 183
10 Urinary bladder 1,107 2.96 188, 233.7
Figure 5: Top 10 malignancies seen amongst adults (> 18 years) in both sexes combined, from Dec. 1994
to Dec. 2009.
Breast 9012, 24.13%
Lip & oral cavity 2489, 6.66%
Non-Hodgkin's lymphoma 2108, 6.64%
Liver & intrahepatic bile ducts 1969, 5.27%
Colorectal 1774, 4.75%
Leukemias 1529, 4.09%
Trachea, bronchus, and lung 1518, 4.06%
1128,
Prostate 3.02%
1119,
Ovary & uterine adnexa
3.00%
1107,
Urinary bladder 2.96%
0 1,000 2,000 3,000 4,000 5,000 6,000 7,000 8,000 9,000 10,000
Data Source: Cancer Registry & Clinical Data Mangement, SKMCH & RC
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5. 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♠
1 Acute lymphoblastic leukemia 1,138 23.63 M983
2 Hodgkin’s disease 738 15.33 M965-966
3 Non-Hodgkin's lymphoma 513 10.65 M959, M967-972
4 Osteosarcoma 313 6.50 M918
5 Glioma 251 5.21 M938-M948
6 Retinoblastoma 231 4.80 M951
7 Ewing’s sarcoma/PNET 219 4.55 M9260, M9364
8 Germ cell tumor 206 4.28 M906 - M909
M9840,9861, 9866-9874,9891-
9 Acute myeloid leukemia 186 3.86
9920
10 Nephroblastoma 163 3.39 M8960
♠
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
Acute lymphoblastic leukemia 1138, 23.63%
Hodgkin’s disease 738, 15.33%
Non-Hodgkin's lymphoma 513 10.65%
Osteosarcoma 313, 6.50%
Glioma 251, 5.21%
Retinoblastoma 231, 4.80%
Ewing’s sarcoma/PNET 219, 4.55%
Germ cell tumor 206, 4.28%
Acute myeloid leukemia 186, 3.86%
Nephroblastoma 163, 3.39%
0 200 400 600 800 1000 1200
Data Source: Cancer Registry & Clinical Data Mangement, SKMCH & RC
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6. 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
1 Female breast 8,915 45.73 174, 233.0
2 Ovary and uterine adnexa 1,119 5.74 183
3 Lip & oral cavity 930 4.77 140 - 145
4 Cervix uteri 797 4.09 180, 233.1
5 Non-Hodgkin’s lymphoma 673 3.45 200, 202.0,1,8
6 Colorectal 640 3.28 153 – 154, 230.3 -230.5
7 Liver and intrahepatic bile duct 512 2.63 155, 230.8
8 Leukemias 512 2.63 204 - 208
9 Corpus Uteri & Uterus 525 2.69 179,181,182
10 Gallbladder and extrahepatic bile ducts 464 2.38 156
Figure 7: Top 10 malignancies seen in females (> 18 years), from Dec. 1994 to Dec. 2009.
Female breast 8915, 45.73%
Ovary and uterine adnexa 1119, 5.74%
Lip & oral cavity 930, 4.77%
Cervix uteri 797, 4.09%
Non-Hodgkin’s lymphoma 673, 3.45%
Colorectal 640, 3.28%
Corpus Uteri & Uterus 512, 2.63%
Leukemias 512, 2.63%
Liver & intrahepatic bile duct 525, 2.69%
Gallbladder & extrahepatic bile ducts 464, 2.38%
0 1000 2000 3000 4000 5000 6000 7000 8000 9000 10000
Data Source: Cancer Registry & Clinical Data Mangement, SKMCH & RC
Page 6 of 11
7. Table 8. Top 10 malignancies seen in males (> 18 years), from Dec. 1994 to Dec. 2009
Sr. No. ICD Category Count Percentage ICD Code
1 Lip & oral cavity 1,559 8.73 140 - 145
2 Liver and intrahepatic bile ducts 1,455 8.15 155, 230.8
3 Non-Hodgkin's lymphoma 1,436 8.04 200 - 202.0,1,8
4 Trachea, bronchus, and lungs 1,266 7.09 162, 231.2
5 Colorectal 1,134 6.35 153 – 154, 230.3 -230.5
6 Prostate 1,128 6.32 185, 233.4, 233.4
7 Leukemias 1,017 5.70 204 - 208
8 Urinary bladder 945 5.29 188, 233.7
9 Hodgkin's disease 658 3.69 201
10 Brain 647 3.62 191
Figure 8: Top 10 malignancies seen in males (> 18 years), from Dec. 1994 to Dec. 2009
Lip & oral cavity 1559, 8.73%
Liver & intrahepatic bile ducts 1455, 8.15%
Non-Hodgkin's lymphoma 1436, 8.04%
Trachea, bronchus, and lungs 1266, 7.09%
Colorectal 1134, 6.35%
Prostate 1128, 6.32%
Leukemias 1017, 5.70%
Urinary bladder 945, 5.29%
Hodgkin's disease 658, 3.69%
Brain 647, 3.62%
0 200 400 600 800 1000 1200 1400 1600 1800
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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