ANNUAL CANCER REGISTRY REPORT-2005

Transcription

1 ANNUAL CANCER REGISTRY REPORT-25 CANCER STATISTICS Distribution of neoplasms Of a total of 3,115 new neoplasms diagnosed or treated at the Hospital from January 25 to December, 25, 1,473 were seen in males (47.28%) and 1,642 (52.72%) in females. Two thousand eight hundred and thirty five 2,835 (91%) neoplasms were found in adults, whereas, 28 (9.%) were seen in children. Children were classified as those 18 years or less in age and adults as more than 18 years of age. Table 1 shows the stratification of cases by behavior and age groups. Table 1. Distribution of neoplasms by behavior and age groups. Behavior Age Group Registered patients (3,99) Reported neoplasm (3,115) Malignant Benign & Uncertain Behavior Adults Pediatrics Total Adults Pediatrics Total 2, , , , The difference in the number of registered patients and reported neoplasms is attributed to multiple neoplasms in 16 patients. Cases with behavior code /3 and /2 are considered as malignant cases. Cases with behavior code / and /1 are considered as benign and uncertain respectively. Page 1 of 11

2 Distribution of malignancies In the year 25, 3,17 malignant cases were diagnosed at the Hospital with 1,447 seen amongst males and 1,57 amongst females. Table 2 displays the distributions of male and female patients according to age groups and gender. Table 2. Distribution of cancer cases by sex and age groups Age range Male Female Total & above Total 1,447 1,57 3,17 Figure 2. Distribution of malignancies by age groups and sex & above Male Female Demographics Of the 3,8 patients diagnosed with malignant, nearly 77% (2,32) belonged to the province of Punjab and approximately 14% to the North West Frontier Province (N.W.F.P) (Table 3).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 hospital is situated in the provincial capital of Punjab and that, this province accounts for almost 56% of the total population of the country. Table 3. Province-wise distribution of patients Province/Region Patients Punjab 2,32 N.W.F.P 422 Sindh 115 Federal Capital 44 Balochistan 36 F.A.T.A 3 Azad Jammu, Kashmir 28 Afghanistan 22 Northern Areas 9 Total 3, Punjab N.W.F.P Sind Federal Capital Balochistan FATA AJK Afghanistan Northern Areas Page 2 of 11

3 Top Ten Cancers Table 4 shows the list of the ten commonest malignancies seen at SKMCH & RC during the year 25. Breast cancer was the leading malignancy with 728 cases accessioned into the Registry. Non-hodgkin s lymphoma and cancer of the oral cavity were the second and third most frequently seen cancers, respectively. Table 4. Top 1 malignancies seen at SKMCH & RC, from January 25 till December 25, in all age groups and both sexes combined. Sr. No. ICD-O-3 Category Count Percentage ICD-O-3 Code 1 Breast C5. - C5.9 2 Non-Hodgkin s lymphoma M959,91 - M Oral cavity C. - C8.9 4 Liver and intrahepatic bile ducts C22. - C Hodgkin s disease M965 - M Leukemia M982 - M994 7 Colon, rectum, and anus C18. - C Trachea, bronchus, lung C C Brain C71. - C Prostate C All age groups (Both sexes) Breast Oral cavity Hodgkin s disease Colon, rectum, and anus Brain 1 Non-Hodgkin s lymphoma Liver and intrahepatic bile ducts Leukemia Trachea, bronchus, lung Prostate Page 3 of 11

4 Amongst adults, during the year 25, a total of 2,744 malignancies were diagnosed or treated at the Hospital. Breast cancer, NHL and cancer of the oral cavity were registered as the most frequently seen cancers. Table 5. Top 1 malignancies seen amongst adults (> 18 years) at SKMCH & RC, from January 25 till December 25. Sr. No. ICD-O-3 Category Count Percentage ICD-O-3 Code 1 Breast C5 - C5.9 2 Non-Hodgkin's lymphoma M959,91 - M Oral cavity C. - C8.9 4 Liver and intrahepatic bile duct C22. - C Colorectal C18 - C Trachea, bronchus, and lung C C Hodgkin s disease M965 - M Prostate C Leukemia M982 - M994 1 Brain C71. - C Adult patients (Both sexes) Breast Oral Cavity Colorectal Hodgkin s disease Leukemia 1 Non-Hodgkin's lymphoma Liver and intrahepatic bile duct Trachea, bronchus, and lung Prostate Brain Page 4 of 11

5 In children, using the classification based on tumor morphology, acute lymphoid leukemia, Hodgkin s disease, and non-hodgkin s lymphoma were identified as the three most common malignancies diagnosed or treated at the Hospital. Table 6 shows the distributions of the top ten malignancies seen in children at SKMCH and RC. Table 6. Top 1 malignancies seen in children ( 18 years) at SKMCH & RC, from January 25 till December 25. Sr. No. ICD-O-3 Category Count Percentage ICD-O-3 Code 1 Acute lymphoid leukemia M Hodgkin s disease M965 - M Non-Hodgkin's lymphoma M959, 91- M Osteosarcoma M Ewing s sarcoma/pnet M Retinoblastoma M951 7 Rhabdomyosarcoma M89 8 Germ cell tumor M Nephroblastoma M896 1 Medulloblastoma M Pediatric patients (Both sexes) Acute lymphoid leukemia Hodgkin s disease Non-Hodgkin's lymphoma Osteosarcoma Ewing s sarcoma/pnet Retinoblastoma Rhabdomyosarcoma Germ cell tumor Nephroblastoma Medulloblastoma Page 5 of 11

6 In adult males, the commonest malignancies were non-hodgkin s lymphoma, cancer of the oral cavity and liver cancer (Table 7). Table 7. Top 1 malignancies in adult males seen at SKMCH & RC from January 25 till December 25. Sr.No. ICD Category Count Percentage ICD-O-3 Code 1 Non-Hodgkin's lymphoma M959, 91- M Oral Cavity C. - C8.9 3 Liver and intra hepatic bile duct C22. - C Prostate C Trachea, bronchus, and lung C33 - C Colorectal C18 - C Hodgkin s lymphoma M965 - M Urinary bladder C67. - C Larynx C32. - C Leukemia M98 - M Male patients (Adult) Non-Hodgkin's lymphoma 1 Liver and intra hepatic bile duct Trachea, bronchus, and lung Hodgkin s Lymphoma Larynx Oral Cavity Prostate Colorectal Urinary Bladder Leukemia Page 6 of 11

7 The most frequent diagnosis in adult women was breast cancer accounting for 48.85% of the total cancers in females. Oral cancer was ranked as the second highest cancer accounting for 4.52% and, NHL the third most common malignancy with 3.98% of the total carcinomas in females. Table8: Top 1 malignancies seen at SKMCH & RC from January 25 till December 25 amongst adult females. Sr. No. ICD Category Count Percentage ICD-O 3 Code 1 Female breast C5. - C5.9 2 Lips and oral cavity C. - C8.9 3 Non Hodgkin s lymphoma M959, 91- M Ovary C C Cervix uteri C53. - C Liver and intrahepatic bile ducts C22. - C Corpus uteri, placenta, uterus C54. - C55.9, C Colorectal C18. - C Thyroid gland C Hodgkin s lymphoma M Female patients (Adult) Female breast Non Hodgkin s lymphoma Cervix uteri Corpus ut eri, placent a, uterus Thyroid gland 1 Lips and oral cavity Ovary Liver and intrahepatic bile ducts Colorectal Hodgkin s lymphoma Page 7 of 11

8 Staging The Registry uses the American Joint Commission on Cancer TNM staging system for all available cancer sites. TNM categorizes cancers in stages, 1, 2, 3, 4, and unstageable. Cancers may be unstageable due to non-availability of AJCC staging for that site. Also, the patients may choose not to receive any treatment or undergo further tests at the Hospital, needed to establish an appropriate stage. During the year 25, cancer staging for 3,17 patients showed that 26 (.9%) patients fell into or in situ category, 381 (13%) in stage I, 713 (24%) in stage II, 627 (21%) patients in stage III, and 642 (21%) in stage IV, (table 9); 492 (16.3%) patients were unstageable. Of these 136 (4.51%) had no AJCC stage for the site. Table 9. Cancer stage of patients at SKMCH & RC during year 25. AJCC Stage No. of Patients Stage 26 Stage I 381 Stage II 713 Stage III 627 Stage IV 642 Unstageable 492 AJCC stage not defined 136 Total 317 Stage III, 627 (21%) Cancer Stage Stage IV, 642 (21%) Stage II, 713 (23%) Stage I, 381 (13%) Stage, 26 (1%) AJCC stage not defined, 136 (5%) Unstageable, 492 (16%) Stage Stage II Stage IV AJCC stage not defined Stage I Stage III Unstageable Page 8 of 11

9 Extent of Disease (EOD) The SEER Summary Staging Manual-2 Codes and Coding Instructions were used to describe how far the tumor had spread from the organ or the site of origin. This manual consists of a one digit hierarchical code for each and every site. The cancer data for the year 25 reflects that there were.6% in situ cases, 26% localized cancers, 32% regional cases, 25% distant, and there were 16% cases in which the summary stage was unknown. Table 1. Classification according to the Extent of Disease during the year 25. EXTENT OF DISEASE Summary Stage LOCAL 786 REGIONAL , 16 % 2, 1% 786, 26% DISTANT 761 UNKNOWN 488 IN SITU 2 761, 25% 962, 32% TOTAL 3,17 LOCAL REGIONAL DISTANT UNKNOWN IN SITU SUPPLEMENTAL INFORMATION Table 11 depicts the results stratified by various systems according to the ICD-O-3 nomenclature. According to this, breast cancer, digestive cancers, and lymphoma are the commonest system/site(s) for the malignancies seen at the Hospital. Table 11. Distribution of primary malignant sites, 25 Primary site **ICD--3 Code Female Male Total Lip, Oral Cavity, Pharynx C-C Lip C 4 4 Tongue C1-C Salivary glands C7-C Gum C Floor and other Parts of mouth C4-C Oropharynx C Page 9 of 11

10 Nasopharynx C11-C Hypopharynx C Tonsil C Digestive system C15.-C Esophagus C Stomach C Small intestine C Colon C Rectum, anal canal, anus C Liver & Intrahepatic bile ducts C22.-C Gall bladder & Extra hepatic bile duct C23-C Pancreas C Retro peritoneum, Peritoneum C Respiratory system C3-C Nasal cavities, Ear, acc. sinuses C3-C Larynx C Trachea, bronchus, lungs C33-C Thymus, heart, mediastinum C37-C Bone C4-C Connective tissue C Skin C Breast C Female genital organ C51-C Cervix C Corpus uteri, Uterus & Placenta C54-C55.9, C Ovary, uterine adnexa C56.9-C Vagina C Vulva C Male genital organ C6-C Prostate C Testis C Penis C6 2 2 Page 1 of 11

11 Urinary system C64-C Bladder C Kidney, renal pelvis, ureter C64-C Others and unspecified C68 Eye C *Brain & CNS C7-C Brain C7-C Others C Endocrine glands C73-C Thyroid gland C Other endocrine gland and related structures C74-C Hematopoietic and Reticuloendothelial system C42.-C Myeloid leukemia M984-M Lymphoid leukemia M982-M Myelodysplastic syndrome M Others M Plasma cell tumor M973-M Plasmacytoma M Multiple myeloma M Lymphatic system C Hodgkin s disease M965-M Non-Hodgkin s lymphoma M959,91, Unknown Primary site C Others & ill defined sites C Note: ** Diseases are listed according to International Classification of disease for Oncology, 3 rd Edition. * Non-malignant primary intracranial and CNS tumors reported in 25 are also included in the table. CNS: Central Nervous System xendx Page 11 of 11