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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                 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.
                                                                                                                                               Page 1 of 11
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.
                                                                                                                      Page 2 of 11
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


                                                                                                                     Page 3 of 11
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




                                                                                                                           Page 4 of 11
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



                                                                                                                     Page 5 of 11
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
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.


                                                                                                                    Page 7 of 11
Table 9. Distribution of Primary Malignant Sites, 1994 – 2009
FEMALES
                                                                 10-   15-   20-                                                                                   75-   80-
IC9CM Code     Primary Site                        0-4     5-9
                                                                 14    19    24
                                                                                   25-29   30-34   35-39   40-44   45-49   50-54   55-59   60-64   65-69   70-74
                                                                                                                                                                   79    84
                                                                                                                                                                               85+   Total

140            Lip                                                           1              1       1               1       5       3       7       5       5                         29
141            Tongue                                       1          1     4      9       15      22      30      53      58      36      53      31      17     10    4           344
142            Salivary gland                                    4     8     10     10      14      11      8       13      14      5       8       4       4                        113
143            Gum                                          1          1            2       3       6       8       22      14      24      14      14      12     9     4     2     136
144            Floor of mouth                                                1                      2       3       4       2       2       2       1       1            1            19
145            Other parts of mouth                1                   3     4      6       13      19      28      32      55      38      46      22      18     12    6     2     305
146            Oropharynx                                                                                   4       5       1       5       7       2       2      1                  27
147            Nasopharynx                         1        1    7     9     11     10      9       9       7       7       7       5       1       3       4                         91
148            Hypopharynx                                             3     6      8       11      29      19      19      26      15      21      8       8      3     1     1     178
               Other & ill defined sites of lip,
149
               oral cavity & pharynx                                                1                               1       1       1       4       1                                 9
150, 230.1     Esophagus                                               2     5      8       17      16      31      46      55      56      36      34      20     7     4     3     340
151, 230.2     Stomach                                                 1     5      8       13      17      22      13      31      26      27      12      10           2           187
152            Small intestine                                         1     1              3               1       4       6       5       7       1       1                         30
153, 230.3     Colon                                             1     3     15     17      21      22      24      17      48      32      29      12      15     5     4     1     266
154, 230.4-6   Rectum & Anal canal                          1    2     9     29     45      35      27      28      41      52      39      31      20      15     11    2     3     390
155            Liver & intrahep. B.D               12            3     1     2      2       3       19      22      56      96      92      98      62      40     18    2     1     529
156            Gall Bladder                                            1            3       3       13      42      54      90      74      75      47      35     10    12    6     465
157            Pancreas                                                             2       5       6       4       25      20      25      24      29      21     7     4     2     174
158            Retroperitoneum                     2        1    2     1     1      2               4       3       3       3       3       1       2                                 28
               Other ill-defined sites of
159
               digestive organs                                                                     1                                                                                 1
               Nasal cavity, middle ear & acc.
160
               Sinuses                                           1     5     2      4       10      9       11      14      18      12      19      3       4      2     2           116
161, 231.0     Larynx                                       1                               6       4       9       5       11      14      13      2       5      2     2           74
162, 231.1-2   Trachea, Bronchus & Lung                                      1      7       10      9       17      19      36      34      42      32      26     9     9     1     252
163            Pleura                                                               1       1               2       1       1               1       1                                 8
164            Thymus, heart, mediastinum          3                         3      1       1       2       2               3               2       1       1      1                  20
170            Bone & articular cartilage          11      27    80    76    49     24      13      14      4       5       5       6       3       1              1                 319
171            Connective & soft tissue            19      13    18    41    28     46      29      44      24      24      23      13      16      14      13     5                 370
172            Melanoma of skin                                        2     5      1       3       5       1       7       4       6       7       5       1            4     1      52
173, 232       Other malignant neoplsm of skin              1    1     3     9      8       13      16      25      28      35      25      43      26      28     11    11    5     288
                                                                                                                                                                           Page 8 of 11
FEMALES
                                                               10-   15-   20-                                                                                   75-   80-
IC9CM Code        Primary Site                     0-4   5-9
                                                               14    19    24
                                                                                 25-29   30-34   35-39   40-44   45-49   50-54   55-59   60-64   65-69   70-74
                                                                                                                                                                 79    84
                                                                                                                                                                             85+   Total

174, 233.0        Female breast                                1     4     88    363     685     1159    1371    1368    1343    891     801     398     279     94    45    30    8920
179               Uterus                                       2           1      3       4       6       8       9       11      7       18      11      5      2     1            88
180, 233.1        Cervix uteri                                 1     7     3      16      35     105     122     122     141      86      73      46      33     6     6     2     804
181               Placenta                                           3     12     11      8       9       3       1                                                                 47
182               Body of uterus                                           4      5       5       28      20      29      74      65      76      45      23     13    6     1     394
183               Ovary & Uterine adnexa           2     10    46    56    60     70      72      95     121     158     159     134     127      53      36     13    5     1     1218
                  Other specified female genital
184, 233.3
                  organ                            3           2     1     3      6       9       11      9       18      15      18      18      14      11     3     2           143
188, 233.7        Urinary bladder                  1     1     2           1              7       9       14      16      17      23      25      17      17     10    3     3     166
189               Kidney & other urinary organ
                                                   42    18    2     7     8      7       3       17      13      17      21      24      22      21      7      7     2           238
190, 234.0        Eye                              86    18    3     2     4              2       1       3       5       3       2       4       1       1            1           136
191               Brain                            14    27    20    24    25     20      22      33      23      31      27      19      23      12      8      2     3           333
192               Other parts of nervous system
                                                   1     4     4           1      1       1       2       1       1                       1       1                                 18
193               Thyroid gland                          2     3     21    45     47      57      36      30      36      24      25      28      17      16     3     4     1     395
                  Endocrine gland and related
194
                  structure                        10    3     3     2            3               2       2       1       2       1       2               1                         32
195               Other and ill-defined sites      17    7     3     4     7      2       1       2       7       9       6       5       7       5       4      1           2      89
199               Unknown primary                  2     2     2     4     6      8       19      37      35      68      85      69      71      53      37     17    6     4     525
201               Hodgkin's lymphoma               7     48    54    49    47     35      36      33      25      20      11      4       11      7              1     1     1     390
200, 202.0-1, 8   Non-Hodgkin's lymphoma           17    29    41    47    40     50      38      62      53      71      81      67      69      66      42     17    6     2     798
202.2-6,9,        Other lymphatic, histeocytic &
238.4,6,7         hemato. Tissue                   3     2                                3       1       1       6               1       5       2       1                         25
                  Multiple myeloma & immuno.
203
                  neoplasms                                                1      1       1       4       3       13      24      20      17      11      9      1                 105
204               Lymphoid Leukemia                131   98    58    39    22     13      14      8       5       7       9       9       12      7       6      1                 439
205               Myeloid Leukemia                 10    24    34    54    40     57      54      61      48      38      28      19      11      9       8      2                 497
206-208           Other specified leukemia         1           1                  1       1       1               1                       1       2                                 9
*225, 227.3-4,
                  Other reportable CNS neoplasms
237.0-1, 239.6                                     3           3     5     8      10      5       12      9       9       3       4       3       2       2      2           1      81
                                 Total             399   340   404   500   618   954     1334    2061    2305    2573    2804    2089    2062    1195    852     319   165 76 21050
                                                                                                                                                                         Page 9 of 11
MALES
                                                               10-   15-   20-                                                                                   75-   80-
IC9CM Code     Primary Site                        0-4   5-9
                                                               14    19    24
                                                                                 25-29   30-34   35-39   40-44   45-49   50-54   55-59   60-64   65-69   70-74
                                                                                                                                                                 79    84
                                                                                                                                                                             85+   Total

140            Lip                                                   1     1      2       2       5       9       9       13      9       11      14      6      5           2      89
141            Tongue                              2     1           6     9      10      31      67      55      64      80      68      68      50      32     16    7     4     570
142            Salivary gland                            2     3     7     5      10      7       11      8       27      16      11      8       11      3      6     2     2     139
143            Gum                                             1     3     4      5       13      19      17      28      44      44      51      20      18     5     4     1     277
144            Floor of mouth                                              1                      2       1       4       2       3       2       2       6      2     1     1      27
145            Other parts of mouth                            2     1     4      14      22      42      61      77      76      58      50      30      21     18    2     2     480
146            Oropharynx                                                         1       2       7       4       6       4       6       11      3       4                         48
147            Nasopharynx                         2     3     24    20    26     15      21      24      23      25      30      22      16      13      5      4     1           274
148            Hypopharynx                                           2     12     9       19      19      14      18      21      21      31      20      13     6     7     1     213
               Other & ill defined sites of lip,
149
               oral cavity & pharynx                                              1               1               1               3       1               1                         8
150, 230.1     Esophagus                                 1           5     9      11      15      40      39      54      55      44      55      37      40     13    7     4     429
151, 230.2     Stomach                                         1     2     9      24      16      26      42      46      65      60      62      30      28     15    9     3     438
152            Small intestine                           1     1     1     2      1       4       8       5       3       4       6       8       3       2      2                  51
153, 230.3     Colon                                           6     14    13     22      33      37      56      54      55      42      51      31      23     13    8     1     459
154, 230.4-6   Rectum & Anal canal                       1     7     23    44     64      69      70      72      65      72      60      61      47      32     17    9     2     715
155            Liver & intrahep. B.D               10    3     2     4     7      7       24      47      75     147     232     238     263     200     131     54    24    5     1473
156            Gall Bladder                                                1      5       9       8       15      30      30      28      32      19      24     10    4     3     218
157            Pancreas                                  1           1            7       7       9       27      25      32      36      45      40      18     8     4     3     263
158            Retroperitoneum                     6     3     1     1     5      7       6       5       2       7       2       4       5       3       1      2                  60
               Other ill-defined sites of
159,
               digestive organs                                                                                                           1                                         1
               Nasal cavity, middle ear and acc.
160
               Sinuses                             1     1     3     5     7      13      12      9       16      19      31      10      19      10      12     2     1     2     173
161, 231.0     Larynx                                                1     4      5       15      33      41      53      76      90      88      82      63     32    15    9     607
162, 231.2     Bronchus & Lung                                       1     1      10      23      36      63      95     139     171     222     221     138     97    31    19    1267
163            Pleura                                                                             3       1       3       4       1       1       2                                 15
164            Thymus, heart, mediastinum          5     2     4     7     3      3       3       6       10      4       8       2       2       3              1                  63
170            Bone & articular cartilage          3     37    121   208   114    56      27      24      10      10      9       8       6       4       3      1     1          642
                                                                                                                                                                       Page 10 of 11
MALES
                                                                10-   15-    20-                                                                                   75-   80-
IC9CM Code        Primary Site                      0-4   5-9
                                                                14    19     24
                                                                                   25-29   30-34   35-39   40-44   45-49   50-54   55-59   60-64   65-69   70-74
                                                                                                                                                                   79    84
                                                                                                                                                                               85+   Total

171               Connective & soft tissue          35    16    30    58     82     73      65      53      55      28      45      28      46      33      25     8     5     1     686
172               Melanoma of skin                        3     1             2      6      3       9       8       6       11      9       7       8       4      2           1      80
173, 232          Other malignant neoplsm of skin
                                                          2     1      1      9     15      20      18      42      26      49      48      74      44      46     17    15    13    440
175               Male breast                                                 1      1      2       3       8       14      11      18      12      8       9      5     1     1      94
176               Kaposi's Sarcoma                                                   1      1       2                               1       1                                         6
185, 233.4        Prostate                                1            1             3      3       3       7       19      63     110     192     242     251     130   63    41    1129
186               Testis                            27    4     3     38    102    137      92      70      47      27      17      7       3       3                                577
                  Penis & Other male genital
187
                  organs                                                      1      1      1       1       3                       2       2       1       4      2     1            19
188, 233.7        Urinary bladder                   6           2      1      6     12      15      56      72      96      99     126     152     138     101     36    17    18    953
189               Kidney & other urinary organ      84    29    7      4      9      9      16      33      47      65      67      49      57      33      25     11    5     3     553
190, 234.0        Eye                               121   25    5      4      1      1      6       4       6       4       5       3       7       4       4      3     3     1     207
191               Brain                             26    73    60    36     54     66      80      87      65      80      71      44      41      29      13     8           2     835
192               Other parts of nervous system
                                                    6     1     2      5             8      8       2       3       2       3       1       3                                         44
193               Thyroid gland                           1     4      8     21     29      16      20      19      26      22      16      18      13      10     2     1     1     227
                  Endocrine gland and related
194
                  structure                         12    7     5      2             4      1       3       2       5               1       2       1                                 45
195               Other and ill-defined sites       24    8     8      1     15     13      11      6       10      13      17      3       9       10      4      2     3     2     159
199               Unknown primary                   1     3     2      4     18     22      28      35      54      68      86      78      82      67      63     31    12    8     662
201               Hodgkin's lymphoma                34    253   179   150   113    104      82      78      64      55      41      24      33      20      9      2     4     1     1246
200, 202.0-1, 8   Non-Hodgkin's lymphoma
                                                    64    134   97    109   111    114     124     154     131     148     151     123     143      81      78     33    17    10    1822
202.2-6,9,        Other lymphatic, histeocytic &
238.4,6,7         hemato. Tissue                    5     4     3      1      1      1              3       9       5       6       1       8       5       3      3     1            59
                  Multiple myeloma & immuno.
203
                  neoplasms                                            1             1      5       10      18      23      25      33      25      23      7      5     3     2     181
204               Lymphoid Leukemia                 239   278   168   146    58     38      25      17      24      21      39      28      25      20      18     7     8           1159
205               Myeloid Leukemia                  14    39    57    70     88    113     103      89      73      58      45      25      18      17      22     6     2           839
206-208           Other Leukemia                    2     1     1                    1              1       1                                                                         7
225, 227.3-4, *
                  Other reportable CNS neoplasms
237.0-1, 239.6                                             3     6     7     5      7       7       7       12      11      8       3       2       3       3                   1     85
                                 Total              729   941   817   960   978    1082    1094    1322    1446    1674    1981    1826    2132    1698    1323    642   298   170   21113
** Diseases are listed according the International Classification of Disease, Ninth Revision, Clinical Modification (ICD-9-CM) codes.
* Non-malignant primary intracranial and CNS tumors reported in 2004 and onward are also included in the Registry.
                                                                                                                                                                         Page 11 of 11

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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. Page 1 of 11
  • 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. Page 2 of 11
  • 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 Page 3 of 11
  • 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 Page 4 of 11
  • 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 Page 5 of 11
  • 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. Page 7 of 11
  • 8. Table 9. Distribution of Primary Malignant Sites, 1994 – 2009 FEMALES 10- 15- 20- 75- 80- IC9CM Code Primary Site 0-4 5-9 14 19 24 25-29 30-34 35-39 40-44 45-49 50-54 55-59 60-64 65-69 70-74 79 84 85+ Total 140 Lip 1 1 1 1 5 3 7 5 5 29 141 Tongue 1 1 4 9 15 22 30 53 58 36 53 31 17 10 4 344 142 Salivary gland 4 8 10 10 14 11 8 13 14 5 8 4 4 113 143 Gum 1 1 2 3 6 8 22 14 24 14 14 12 9 4 2 136 144 Floor of mouth 1 2 3 4 2 2 2 1 1 1 19 145 Other parts of mouth 1 3 4 6 13 19 28 32 55 38 46 22 18 12 6 2 305 146 Oropharynx 4 5 1 5 7 2 2 1 27 147 Nasopharynx 1 1 7 9 11 10 9 9 7 7 7 5 1 3 4 91 148 Hypopharynx 3 6 8 11 29 19 19 26 15 21 8 8 3 1 1 178 Other & ill defined sites of lip, 149 oral cavity & pharynx 1 1 1 1 4 1 9 150, 230.1 Esophagus 2 5 8 17 16 31 46 55 56 36 34 20 7 4 3 340 151, 230.2 Stomach 1 5 8 13 17 22 13 31 26 27 12 10 2 187 152 Small intestine 1 1 3 1 4 6 5 7 1 1 30 153, 230.3 Colon 1 3 15 17 21 22 24 17 48 32 29 12 15 5 4 1 266 154, 230.4-6 Rectum & Anal canal 1 2 9 29 45 35 27 28 41 52 39 31 20 15 11 2 3 390 155 Liver & intrahep. B.D 12 3 1 2 2 3 19 22 56 96 92 98 62 40 18 2 1 529 156 Gall Bladder 1 3 3 13 42 54 90 74 75 47 35 10 12 6 465 157 Pancreas 2 5 6 4 25 20 25 24 29 21 7 4 2 174 158 Retroperitoneum 2 1 2 1 1 2 4 3 3 3 3 1 2 28 Other ill-defined sites of 159 digestive organs 1 1 Nasal cavity, middle ear & acc. 160 Sinuses 1 5 2 4 10 9 11 14 18 12 19 3 4 2 2 116 161, 231.0 Larynx 1 6 4 9 5 11 14 13 2 5 2 2 74 162, 231.1-2 Trachea, Bronchus & Lung 1 7 10 9 17 19 36 34 42 32 26 9 9 1 252 163 Pleura 1 1 2 1 1 1 1 8 164 Thymus, heart, mediastinum 3 3 1 1 2 2 3 2 1 1 1 20 170 Bone & articular cartilage 11 27 80 76 49 24 13 14 4 5 5 6 3 1 1 319 171 Connective & soft tissue 19 13 18 41 28 46 29 44 24 24 23 13 16 14 13 5 370 172 Melanoma of skin 2 5 1 3 5 1 7 4 6 7 5 1 4 1 52 173, 232 Other malignant neoplsm of skin 1 1 3 9 8 13 16 25 28 35 25 43 26 28 11 11 5 288 Page 8 of 11
  • 9. FEMALES 10- 15- 20- 75- 80- IC9CM Code Primary Site 0-4 5-9 14 19 24 25-29 30-34 35-39 40-44 45-49 50-54 55-59 60-64 65-69 70-74 79 84 85+ Total 174, 233.0 Female breast 1 4 88 363 685 1159 1371 1368 1343 891 801 398 279 94 45 30 8920 179 Uterus 2 1 3 4 6 8 9 11 7 18 11 5 2 1 88 180, 233.1 Cervix uteri 1 7 3 16 35 105 122 122 141 86 73 46 33 6 6 2 804 181 Placenta 3 12 11 8 9 3 1 47 182 Body of uterus 4 5 5 28 20 29 74 65 76 45 23 13 6 1 394 183 Ovary & Uterine adnexa 2 10 46 56 60 70 72 95 121 158 159 134 127 53 36 13 5 1 1218 Other specified female genital 184, 233.3 organ 3 2 1 3 6 9 11 9 18 15 18 18 14 11 3 2 143 188, 233.7 Urinary bladder 1 1 2 1 7 9 14 16 17 23 25 17 17 10 3 3 166 189 Kidney & other urinary organ 42 18 2 7 8 7 3 17 13 17 21 24 22 21 7 7 2 238 190, 234.0 Eye 86 18 3 2 4 2 1 3 5 3 2 4 1 1 1 136 191 Brain 14 27 20 24 25 20 22 33 23 31 27 19 23 12 8 2 3 333 192 Other parts of nervous system 1 4 4 1 1 1 2 1 1 1 1 18 193 Thyroid gland 2 3 21 45 47 57 36 30 36 24 25 28 17 16 3 4 1 395 Endocrine gland and related 194 structure 10 3 3 2 3 2 2 1 2 1 2 1 32 195 Other and ill-defined sites 17 7 3 4 7 2 1 2 7 9 6 5 7 5 4 1 2 89 199 Unknown primary 2 2 2 4 6 8 19 37 35 68 85 69 71 53 37 17 6 4 525 201 Hodgkin's lymphoma 7 48 54 49 47 35 36 33 25 20 11 4 11 7 1 1 1 390 200, 202.0-1, 8 Non-Hodgkin's lymphoma 17 29 41 47 40 50 38 62 53 71 81 67 69 66 42 17 6 2 798 202.2-6,9, Other lymphatic, histeocytic & 238.4,6,7 hemato. Tissue 3 2 3 1 1 6 1 5 2 1 25 Multiple myeloma & immuno. 203 neoplasms 1 1 1 4 3 13 24 20 17 11 9 1 105 204 Lymphoid Leukemia 131 98 58 39 22 13 14 8 5 7 9 9 12 7 6 1 439 205 Myeloid Leukemia 10 24 34 54 40 57 54 61 48 38 28 19 11 9 8 2 497 206-208 Other specified leukemia 1 1 1 1 1 1 1 2 9 *225, 227.3-4, Other reportable CNS neoplasms 237.0-1, 239.6 3 3 5 8 10 5 12 9 9 3 4 3 2 2 2 1 81 Total 399 340 404 500 618 954 1334 2061 2305 2573 2804 2089 2062 1195 852 319 165 76 21050 Page 9 of 11
  • 10. MALES 10- 15- 20- 75- 80- IC9CM Code Primary Site 0-4 5-9 14 19 24 25-29 30-34 35-39 40-44 45-49 50-54 55-59 60-64 65-69 70-74 79 84 85+ Total 140 Lip 1 1 2 2 5 9 9 13 9 11 14 6 5 2 89 141 Tongue 2 1 6 9 10 31 67 55 64 80 68 68 50 32 16 7 4 570 142 Salivary gland 2 3 7 5 10 7 11 8 27 16 11 8 11 3 6 2 2 139 143 Gum 1 3 4 5 13 19 17 28 44 44 51 20 18 5 4 1 277 144 Floor of mouth 1 2 1 4 2 3 2 2 6 2 1 1 27 145 Other parts of mouth 2 1 4 14 22 42 61 77 76 58 50 30 21 18 2 2 480 146 Oropharynx 1 2 7 4 6 4 6 11 3 4 48 147 Nasopharynx 2 3 24 20 26 15 21 24 23 25 30 22 16 13 5 4 1 274 148 Hypopharynx 2 12 9 19 19 14 18 21 21 31 20 13 6 7 1 213 Other & ill defined sites of lip, 149 oral cavity & pharynx 1 1 1 3 1 1 8 150, 230.1 Esophagus 1 5 9 11 15 40 39 54 55 44 55 37 40 13 7 4 429 151, 230.2 Stomach 1 2 9 24 16 26 42 46 65 60 62 30 28 15 9 3 438 152 Small intestine 1 1 1 2 1 4 8 5 3 4 6 8 3 2 2 51 153, 230.3 Colon 6 14 13 22 33 37 56 54 55 42 51 31 23 13 8 1 459 154, 230.4-6 Rectum & Anal canal 1 7 23 44 64 69 70 72 65 72 60 61 47 32 17 9 2 715 155 Liver & intrahep. B.D 10 3 2 4 7 7 24 47 75 147 232 238 263 200 131 54 24 5 1473 156 Gall Bladder 1 5 9 8 15 30 30 28 32 19 24 10 4 3 218 157 Pancreas 1 1 7 7 9 27 25 32 36 45 40 18 8 4 3 263 158 Retroperitoneum 6 3 1 1 5 7 6 5 2 7 2 4 5 3 1 2 60 Other ill-defined sites of 159, digestive organs 1 1 Nasal cavity, middle ear and acc. 160 Sinuses 1 1 3 5 7 13 12 9 16 19 31 10 19 10 12 2 1 2 173 161, 231.0 Larynx 1 4 5 15 33 41 53 76 90 88 82 63 32 15 9 607 162, 231.2 Bronchus & Lung 1 1 10 23 36 63 95 139 171 222 221 138 97 31 19 1267 163 Pleura 3 1 3 4 1 1 2 15 164 Thymus, heart, mediastinum 5 2 4 7 3 3 3 6 10 4 8 2 2 3 1 63 170 Bone & articular cartilage 3 37 121 208 114 56 27 24 10 10 9 8 6 4 3 1 1 642 Page 10 of 11
  • 11. MALES 10- 15- 20- 75- 80- IC9CM Code Primary Site 0-4 5-9 14 19 24 25-29 30-34 35-39 40-44 45-49 50-54 55-59 60-64 65-69 70-74 79 84 85+ Total 171 Connective & soft tissue 35 16 30 58 82 73 65 53 55 28 45 28 46 33 25 8 5 1 686 172 Melanoma of skin 3 1 2 6 3 9 8 6 11 9 7 8 4 2 1 80 173, 232 Other malignant neoplsm of skin 2 1 1 9 15 20 18 42 26 49 48 74 44 46 17 15 13 440 175 Male breast 1 1 2 3 8 14 11 18 12 8 9 5 1 1 94 176 Kaposi's Sarcoma 1 1 2 1 1 6 185, 233.4 Prostate 1 1 3 3 3 7 19 63 110 192 242 251 130 63 41 1129 186 Testis 27 4 3 38 102 137 92 70 47 27 17 7 3 3 577 Penis & Other male genital 187 organs 1 1 1 1 3 2 2 1 4 2 1 19 188, 233.7 Urinary bladder 6 2 1 6 12 15 56 72 96 99 126 152 138 101 36 17 18 953 189 Kidney & other urinary organ 84 29 7 4 9 9 16 33 47 65 67 49 57 33 25 11 5 3 553 190, 234.0 Eye 121 25 5 4 1 1 6 4 6 4 5 3 7 4 4 3 3 1 207 191 Brain 26 73 60 36 54 66 80 87 65 80 71 44 41 29 13 8 2 835 192 Other parts of nervous system 6 1 2 5 8 8 2 3 2 3 1 3 44 193 Thyroid gland 1 4 8 21 29 16 20 19 26 22 16 18 13 10 2 1 1 227 Endocrine gland and related 194 structure 12 7 5 2 4 1 3 2 5 1 2 1 45 195 Other and ill-defined sites 24 8 8 1 15 13 11 6 10 13 17 3 9 10 4 2 3 2 159 199 Unknown primary 1 3 2 4 18 22 28 35 54 68 86 78 82 67 63 31 12 8 662 201 Hodgkin's lymphoma 34 253 179 150 113 104 82 78 64 55 41 24 33 20 9 2 4 1 1246 200, 202.0-1, 8 Non-Hodgkin's lymphoma 64 134 97 109 111 114 124 154 131 148 151 123 143 81 78 33 17 10 1822 202.2-6,9, Other lymphatic, histeocytic & 238.4,6,7 hemato. Tissue 5 4 3 1 1 1 3 9 5 6 1 8 5 3 3 1 59 Multiple myeloma & immuno. 203 neoplasms 1 1 5 10 18 23 25 33 25 23 7 5 3 2 181 204 Lymphoid Leukemia 239 278 168 146 58 38 25 17 24 21 39 28 25 20 18 7 8 1159 205 Myeloid Leukemia 14 39 57 70 88 113 103 89 73 58 45 25 18 17 22 6 2 839 206-208 Other Leukemia 2 1 1 1 1 1 7 225, 227.3-4, * Other reportable CNS neoplasms 237.0-1, 239.6 3 6 7 5 7 7 7 12 11 8 3 2 3 3 1 85 Total 729 941 817 960 978 1082 1094 1322 1446 1674 1981 1826 2132 1698 1323 642 298 170 21113 ** Diseases are listed according the International Classification of Disease, Ninth Revision, Clinical Modification (ICD-9-CM) codes. * Non-malignant primary intracranial and CNS tumors reported in 2004 and onward are also included in the Registry. Page 11 of 11