Karachi Cancer Registry

Karachi, Pakistan

Karachi Cancer Registry

Karachi, Pakistan

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Bhurgri Y.,Karachi Cancer Registry | Bhurgri Y.,Aga Khan University | Bhurgri Y.,Liaquat National Hospital and Medical College | Khan T.,Karachi Cancer Registry | And 9 more authors.
Asian Pacific Journal of Cancer Prevention | Year: 2011

Introduction: Karachi falls into a low risk region for colorectal (CRC). The incidence rate is known but detailed epidemiology and pathology data regarding the disease are not available. The aim of this study is to describe CRC with reference to incidence, gender; topographic sub-site, tumor morphology, grade and stage at diagnosis and to determine the trends of incidence. Materials and Methods: Four hundred and seventy three cases of colorectal cancer submitted to the Karachi Cancer Registry for Karachi South, years 1995-2002 were reviewed. Cases were analyzed in two time periods (1995-7 and 1998-2002) to facilitate the study of time trends. Results: A total of 151 CRC cases were registered during period one [86 (57%) males; 65 (43%) females] and 322 cases [210 (65%) males; 112 (35%) females] in period two. Age standardized rate (ASR) world per 100,000, crude incidence rate (CIR) and relative frequency in period one were 5.3, 3.2 and 4.1% in males and 5.5, 3.2 and 3.2% in females respectively. Corresponding figures for period two were 7.1, 4.5 and 4.7% for males and 5.2, 2.8 and 2.7% in females. The male, female ratio was equal for colon (1:1). Men had more rectal cancers (2:1) and overall CRC (1.7:1). The mean age of the patients varied with sub-site and gender from 43.7 years to 51.2 years. Cancers of the rectum presented at a relatively earlier age. Less then 5% of the cases were diagnosed in adolescents, 50% above 50 years of age and only 30% above 60 years. The ratio under-40 to above-40 for CRC patients was 0.3, which is much higher than the international average, indicating a younger age group at risk. The first cases were observed in adolescents (15-19 years) and a peak was observed in the seventh decade. Colon to rectum ratio was 1:1 in males and 2:1 in females. Most cases presented with advanced disease, though some down staging was observed in period 2 (1998-2002). Conclusion: The current low but increasing incidence (especially in men), the younger age and advanced stage of CRC at diagnosis reflects a low risk, unscreened population. With existing prevalence of high risk factors in Pakistan, the low CRC incidence may be an artifact. There are concerns that an aging population over the next decade and changing lifestyle patterns may translate into a higher CRC incidence. Screening must be considered as part of the health sector planning for the future and include the high risk younger age groups.


Bhurgri Y.,Karachi Cancer Registry | Bhurgri Y.,Aga Khan University | Bhurgri Y.,Liaquat National Medical College and Hospital | Bhurgri Y.,Panjwani Center for Molecular Medicine and Research | And 11 more authors.
Asian Pacific Journal of Cancer Prevention | Year: 2011

Introduction: Cancer ovary is the third most common malignancy diagnosed in women in Karachi, a moderate to high risk region for the disease. Materials and Methods: Three hundred and thirty seven cases of ovarian cancer registered at the Karachi Cancer Registry for the years 1995-2002 were reviewed. Results: The age-standardized incidence rate (ASR) world per 100,000, crude incidence rate per 100,000 (CIR) and frequency of ovarian malignancies in 1995-1997 were 10.9, 5.9 and 6.2% respectively. Corresponding figures for 1998-2002 were 8.1, 5.1 and 4.8%. The mean age at presentation in 1995-1997 was 45.7 years (95%CI 42.9, 48.4; SD±15.9), range 95 (3 to 98) years and in 1998-2002 it was 45.0 years (95%CI 42.8, 47.3; SD±16.1), range 79 (3 to 82) years. Eleven (3.3%) cases of childhood cancers, 13 (3.9%) adolescent cases, 126 (37.4%) reproductive age (20-44 years) and 187 (55.5%) cases in the 45+ age group were registered. Epithelial malignancies were the most common cancers above the age of 20 years (78.4%), the commonest amongst these was serous adenocarcinoma (33.3%). Germ cell tumors were more common (5.6%) in children and adolescents. Microscopic confirmation was 99.0%. Presentation was of a moderately differentiated (grade 2) malignancy with a regional or distant spread of disease in three fourths of the cases. Conclusions: The incidence of cancer ovary, though stable in Karachi, involves a relatively younger age group with a strong family history in a fourth of the cases. The disease presents at an advanced stage. An ageing population over time may translate into a higher incidence of ovarian cancer. The current incidence of cancer ovary in Karachi is an enigma and belies reproductive protective factors. Studies focused on the genetic risk factors in this population are recommended.


PubMed | Karachi Cancer Registry
Type: Journal Article | Journal: Asian Pacific journal of cancer prevention : APJCP | Year: 2010

Primary sarcomas of bone and cartilage (BS) are a group of rare neoplasms, with limited information from Pakistan. The present population-based study was conducted with the objective of examining descriptive epidemiological characteristics of BS in Karachi.Epidemiological data of 68 BS registered at Karachi Cancer Registry for Karachi South during 1st January 1995 to 31st December 1997 were reviewed.Forty-six (66.7%) cases were diagnosed in males and 23 (33.3%) in females. BS accounted for 2.2% and 1.1% of all cancers in males and females, respectively. The age standardized rate (ASR) world per 100,000 was 1.75 in males and 1.00 in females. Microscopic confirmation was 99.0%. The mean age of male and female patients were 26.7 years (SD-/+17.4) and 24.3 years (SD-/+16.0) respectively. In males 14 (30.4%) BS were diagnosed in the 0-14 year age group and 23 (50.0%) cases in the below 20 years age group. The distribution in females was 31 (67.4%) and 8 (34.8%) cases, respectively. Approximately half the cases (34.8% males; 47.8% females) were observed in the lower limbs. The most common morphology was osteosarcoma (30.5% males; 43.4% females), followed by Ewings sarcoma (23.9%) in males and giant cell tumor (13.0%) in females. Age-specific curves showed a gradual increase in risk from the first until the fifth decade in males, and second to fourth decade in females. The age-specific curves were bimodal. In both genders the first peak was observed at 10-14 years but a second peak was observed at 70-74 years in males and 65-69 years in females. The cardinal symptoms that led to the diagnosis of bone tumors were pain (22 cases; 32.4%) and spontaneous fractures (45 cases; 66.2%).Karachi falls into a high risk region for BS, which were observed in a relatively younger population, with a male predominance and a high frequency of osteosarcoma. The underlying factors for BS in Karachi need to be addressed considering the overwhelming proportion of youngsters at risk and the late presentation.


PubMed | Karachi Cancer Registry
Type: Journal Article | Journal: Asian Pacific journal of cancer prevention : APJCP | Year: 2012

This study was conducted to assess the patterns of primary central nervous system (CNS) malignancies in Karachi South (KS), a moderate risk population in Asia.Data for 321 registered cases were reviewed and analyzed in two periods 1995-1997 (111 cases, 75 (67.6%) male (M); 36 (32.4%) female (F)) and 1998-2002 (210 cases, 124 (59.1%) M; 86 (40.9%) F).Age standardized incidence rate per 100,000, crude incidence rate and relative frequency in 1995-1997 were 3.5, 2.8 and 3.5% (M) and 1.8, 1.6 and 1.7% (F). Corresponding figures for 1998-2002 were 3.3, 2.7 and 2.7% (M) and 3.3, 2.7 and 2.1% (F). Mean age of male and female patients during 1995-1997 was 33.3 years (SD 20.4) and 30.7 years (SD19.6). Mean ages for 1998-2002 were 33.2 years (SD19.5) and 28.7 years (SD18.5) for males and females respectively. In males, 199 malignancies were reported, 106 (86.9%) cases in the brain, 10 (5.5%) in meninges and 12 (6.0%) in the spinal cord; 122 cases were observed in females, 177 (89%) cases in the brain, 8 (6.6%) each in the meninges and spinal cord. The most common morphology was astrocytoma (72 (36.2%) (M); 40 (32.7%) (F)). Mean age of low grade astrocytoma was 27.8 years (M) and 27.0 years (F); anaplastic astrocytomas, 40.5 years (M), 34.1 years (F) and glioblastoma, 45.7 years (M) and 38.3 years (F). Youngest cases were registered for cerebellum and brain stem.The incidence of CNS malignancies is stable in males and gradually increasing in females. Astrocytoma is the commonest morphology; they affect a younger age group and show an age gradient in proportion to tumor grade. The mean age varied by sub-site and histology. Focus should be directed towards the understanding the biological nature and risk factors prevalent in this population.

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