The computerized cancer registry of the Shaukat Khanum Memorial Cancer Hospital and Research Center (SKMCH&RC), Lahore, Pakistan, is a data system designed for collection, management, and analysis of detailed data on patients registered at the facility. The hospital-based cancer registry has been functioning since the inauguration of the hospital in Lahore in December 1994. Every year, the Registry generates cancer statistics according to sex, age, demographic area, topography, morphology, stage, grade, etc. From December 1994 till December 2003, the International Classification of Diseases, Ninth Revision, Clinical Modification, was used to code the diseases. In January 2004, the Registry implemented the International Classification of Disease for Oncology, Third Edition (ICD-O-3) to code cancer cases. The Registry also implemented the International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) in 2013, to do an in-depth coding of cancer and non-cancer cases.
Patients included in this report include those registered at the centers affiliated with the Shaukat Khanum Memorial Trust and accessioned into the computerized cancer registry within the hospital information system in Lahore. The affiliated centers include two hospitals called the ‘Shaukat Khanum Memorial Cancer Hospital and Research Center’ in Lahore and Peshawar and the Karachi Diagnostic Center (KDC). SKMCH&RC Lahore is the oldest center and has been functioning since December 29, 1994, SKMCH&RC Peshawar since December 29, 2015, and the KDC since 2010.
During the last twenty-two years, a total of 82,866 neoplasms were registered at SKMCH&RC and KDC, of which 4,315 were benign and 78,551 malignant. The distributions seen amongst males and females were 48.63% and 51.37%, respectively. About 89.86% tumors were found in adults, whereas, 10.14% were diagnosed in children. The top three malignancies in all age-groups, both sexes combined were breast cancer, leukemia, and lip & oral cavity cancer. The top three malignancies amongst adult females were: cancers of the breast, ovary & uterine adnexa, and lip & oral cavity, while, in adult males, prostate, lip & oral cavity, and colon, rectum, anal canal and anus cancers.
In adults, regardless of gender, malignant neoplasm of the breast, lip & oral cavity, and colon, rectum, anal canal and anus, were established as the leading malignancies and in children, acute lymphoblastic leukemia, Hodgkin lymphoma, and non-Hodgkin Lymphoma were recorded as the commonest malignancies.
In the year 2016, a total of 7,046 neoplasms were added to the Registry database, of which 459 were benign and 6,587 malignant, reflecting an increase of about 19% of new cancer registrations from previous year (2015). Of a total of 6,587 malignant cases, 6,453 (97.97%) were analytical cases, whereas, 134 (2.03%) were non-analytical cases. Class of Case 0 to 2 are considered analytical and 3 to 9 non-analytical cases, according to the Facility Oncology Revised Data Standards (FORDS) Revised for 2004. In the area of cancer registration, analytical cases are included in treatment and survival analysis, while non-analytical cases are usually not included in routine treatment or survival statistics.
The top three malignancies in all age-groups, both sexes combined were breast, colon, rectum, anal canal and anus, and leukemia. In adult males, colon, rectum, anal canal and anus, prostate, and leukemia were the top malignancies, whereas, in adult females, breast, esophagus, and colon, rectum, anal canal and anus were the leading malignancies. In children, Hodgkin lymphoma, acute lymphoblastic leukemia, and non-Hodgkin lymphoma were the commonest malignancies.
The Registry uses the American Joint Committee on Cancer (AJCC 7th edition) staging manual for staging all available cancer sites. TNM categorizes cancers in stages 0, 1, 2, 3, 4, and also as unstageable and not applicable. Amongst 6,453 analytical cases, 0.67% cases were staged into Stage 0, 14.22% in Stage I, 28.27% in Stage II, 21.45% in Stage III, and 17.14% in Stage IV. In 11.14% of the patients, no AJCC stage was defined and 7.11% of the cases were unstageable.
According to the SEER Summary Staging Manual-2000 Codes and Coding instructions, 0.68% cases were in situ, 23.23% localized, 42.52% regional, and 22.36% distant. In 11.21% of the cases, the summary stage was unknown.
By histological grading/differentiation/immunophenotype, 7.25% presented in Grade I, 31.91% in Grade II, 21.96% in Grade III, 1.38% in Grade IV, 0.54% T-cell, 6.54% B-cell, 0.05% NK-cell, and grade/differentiation/immunophenotype not determined, not stated, or not applicable in 30.37%.
The details of these reports can be viewed by using the following links: Collective Cancer Registry Report - Dec. 1994 to Dec. 2016 (PDF file) Annual Cancer Registry Report - 2016 (PDF file) CRCDM - Confidentiality - June, 2016 (PDF file) Archived Cancer Registry Reports 2015 | 2014 | 2013 | 2012 | 2011 | 2010 | 2009… more details »