Cancer Incidence Report Saudi Arabia 1999 - 2000 · Cancer Incidence Report Saudi Arabia 1999 - 2000. Published by the Main Office, National Cancer Registry, ... Cervix Uteri (C53)

Kingdom of Saudi ArabiaMinistry of Health

National Cancer Registry

Cancer Incidence ReportSaudi Arabia1999 - 2000

Published by the Main Office, National Cancer Registry, under the Depository Number atKing Fahad National Library, 3840/22, date: 6/9/1422H, ISSN: 1658-0559, Riyadh May, 2004.

Report prepared by: Haya S. Al-Eid, BDS, DFE, CTR

Suad O. Arteh, MA

Reviewed by: Shouki Bazarbashi, MDEdward B. De Vol, PhD

Susan Young, CTR, CCHRA(C)

ACKNOWLEDGEMENT

The Board of Directors of the National Cancer Registry would like to acknowledge the manypeople who have facilitated the publication of this report. It is impossible to name every individualbut those who have helped us in any way should feel proud of the project and this report.

We take this opportunity to thank H.E. Professor Osama Shobokshi, the former Minister of Heath,for his support of the NCR. His inspiration and assistance encouraged the Board of Directors tocontinue in their endeavor. We also thank H.E. Dr. Qassim al Gasabi former Executive Deputyfor the Ministry of Health, for his commitment and supervision.

We are grateful for the continuing support of Dr. Anwar Al Jabarti, the Executive and Council forthe Management at King Faisal Specialist Hospital & Research Center, in extending technical andadministrative facilities to help maintain the NCR.

We would also like to thank former members of the Board of Directors and administrative staff fortheir involvement and contributions to the continued development of the NCR:

Dr. Peter Tallos, National Guard Hospitals, RiyadhDr. Osama Koreich, Armed Forces Hospitals, RiyadhDr. Salah Al Ghamdi, King Khalid University, AbhaDr. Assem Al Radi, King Abdulaziz Hospital & Oncology Center, JeddahDr. Abdulrahman Al Diab, Security Forces Hospital, RiyadhBrenda J. Lange, CTR, Administrative Director

We wish to extend our thanks and appreciation to the laboratories, pathology and medical recorddepartments in healthcare facilities throughout the Kingdom who have assisted the registry staff inthe data collection process.

Finally, we would like to thank Ms. Jinky B. Gomez for her assistance in formatting the final reportand the registry team, in both the Regional and Main Offices, whose skill and dedication havemade possible the data capture and analysis resulting in this report.

FOREWARD

The 1999-2000 Cancer Incidence Report is the fourth publication of the National Cancer Registry.The information in this report is a very important part of the infrastructure which is required in theefforts to reduce the burden of cancer. The registry data will assist researchers studying cancer andauthorities involved in the planning of cancer services (epidemiological research, identification ofrisk factors for use in cancer control, development of screening and prevention programs, planningfor diagnostic and treatment services.)

The registry continues to be committed to quality data focusing on improving case-ascertainment,patient and tumor linkage and editing processes through training and quality control procedures.Throughout the data collection and analysis process, every effort is made to ensure both patientand facility confidentiality.

Some changes from the previous reports have been made in the presentation of the data althoughwe have tried to maintain consistency to enable easy comparison of data over the years. Since it isour goal to present this report in a manner that will be easily understood by all, we welcome and,indeed, encourage feedback from readers for consideration in the preparation of future reports.

Dr. Shouki BazarbashiChairmanNational Cancer Registry

INTRODUCTION

This is the fourth report to be published in an effort designed to provide information on cancerincidence in Saudi Arabia. The first of its kind was the 1994 Summary Report, the second and thethird were the 1994-1996 and 1997-1998 Incidence Reports respectively, and this one coverscancer Incidence Report for the years 1999-2000. It is the objective of the National CancerRegistry of Saudi Arabia to present the data on a period of two-three years now and in a moreextended period of time in later years. Data on an extended period of time has advantages ofpresenting more stable incidence rates and time-trends studies.

The structure of this report can be outlined as follows:

Part I Materials and Methods

This part of the report contains information about the background of the National Cancer Registryand methods used in collecting and analyzing the data. We present the basics of coding andclassification of tumor topography, morphology and extent of disease at the time of diagnosis. Alsowe explain the software program we used to analyze the data.

Part II Overview

Part II contains figures and tables that show overall cancer incidence in Saudi Arabia for the years1999-2000. We present these figures and tables mainly by sex and in certain areas we have itanalyzed by different age groups. There are pie and bar charts representing the age distribution ofcancer incidence for the years 1994-2000 among Saudis by sex and age groups. We presentseparate incidence and morphology tables for the most common types of cancers among adultsand children. In addition, a bar chart depits the 10 most common types of cancer, by sex, in eachof the 13 administrative regions of Saudi Arabia.

Part III Incidence of Selected-Sites

In this part the incidences of selected cancer types among Saudis are outlined in order of relativefrequency. A standardized layout presents data for all patients and both sexes where applicable.For each selected site we list the number and the percentage of all newly diagnosed cases for theyears 1999 and 2000, the Age-Standardized Incidence Rate (ASR) per 100,000 population foreach sex, and the specific cancer rank for both sexes. In addition, we provide (whenever available)international statistics for the specified cancer including the ranking of the cancer worldwide, estimatednumber of cases for 1999-2000, and areas of the world that have the highest ranking.

Part IV Cancer Incidence among non-Saudis

In this part we have the incidence cases of cancer among non-Saudis. We present the most commontypes of cancer among them and the age-specific incidence rates. The age distribution of non-Saudis is over-represented in the 25-54 age-group as a result of the nature of the expatriatepopulation. For this reason we have opted to do the analysis separately.

Part V Tables of Incidences

Part V contains the following detailed tables for all newly diagnosed cancer types among Saudisand non-Saudis for 1999-2000.

For the years 1999 and 2000 we have separate tables for male and female

· age-distribution of cancer cases among Saudis

· age-standardized incidence rate for cancer cases among Saudis by age group (per 100,000 population)

For the years 1999 and 2000 we have for each region

· age-standardized incidence rate and relative frequencies for all cancer cases among Saudis by site and sex

For the years 1999 and 2000 we have separate tables for male and female

· age-distribution of cancer cases among non-Saudis

· crude incidence rates for cancer cases among non-Saudis by age group (per 100,000 population)

Part VI Appendices

Reporting hospitals list

· Includes hospital names in each administrative region. The objective is to receive feedback from hospitals in order to minimize under-reporting.· Addresss of the National Cancer Registry offices· Cancer Registration Form· The Data Request Form

TABLES OF CONTENTS

ACKNOWLEDGEMENT ................................................................................................................................. 3FOREWARD ................................................................................................................................................... 4INTRODUCTION ............................................................................................................................................ 5

PART IBackground on Saudi Arabia .................................................................................................................. 13NATIONAL CANCER REGISTRY .......................................................................................................... 15Definitions of Statistical Terms ............................................................................................................... 19

PART IICancer in Saudi Arabia 1994-2000 ........................................................................................................... 22Reported Cancer Incidence Cases in Saudi Arabia, 1999-2000 ................................................................ 25Distribution of Cancer Cases in Saudi Arabia by Nationality and Sex .................................................... 25Ten Most Common Types of Cancer Among Saudis, 1999-2000 (All Ages) ........................................... 27Adult Cancers in Saudi Arabia, 1999-2000 (above 14 years) ................................................................... 29Childhood Cancers in Saudi Arabia 1999-2000 (14 years and under) ...................................................... 32Cancer in the 13 Administrative Regions of the Kingdom ...................................................................... 35International comparison of age-standardized incidence rates ............................................................... 40

PART IIICancer Incidence for Specific Sites 1999-2000 ........................................................................................ 42Female Breast (C50) ................................................................................................................................ 43Non-Hodgkins Lymphoma (C82-C85;C96) .............................................................................................. 46Leukaemia (C91-C95) ............................................................................................................................... 49Colo-rectal (C18-C21) .............................................................................................................................. 51Liver (ICD-10 C22) .................................................................................................................................. 54Thyroid (C73) .......................................................................................................................................... 57Brain, nervous system (C70-C72) ............................................................................................................ 60Lung (C33-C34) ....................................................................................................................................... 63Hodgkin’s Disease (C81) ......................................................................................................................... 66Urinary Bladder (C67) ............................................................................................................................. 69Skin (Non-Melanoma) (C44) ................................................................................................................... 72Prostate Cancer (ICD-10 C61) ................................................................................................................. 74Ovary (C56) ............................................................................................................................................. 77Cervix Uteri (C53) .................................................................................................................................... 80

PART IVCancer among the non- Saudi Population 1999-2000 .............................................................................. 84

PART VTABLES OF INCIDENCE ........................................................................................................................ 87

PART VIAPPENDIX A .........................................................................................................................................117APPENDIX B .........................................................................................................................................118APPENDIX C .........................................................................................................................................119APPENDIX D .........................................................................................................................................120APPENDIX E .........................................................................................................................................121APPENDIX F .........................................................................................................................................122

FIGURES

PART IFigure 1-1 Administrative Regions of Saudi Arabia ................................................................................ 13Figure 1-2 Population Pyramid of Saudis by Sex and Age Groups, 2000 ................................................. 14Figure 1-3 Population Pyramid of non-Saudis by Sex and Age Groups, 2000 ......................................... 14Figure 1-4 Organizational Chart of the National Cancer Registry of Saudi Arabia .................................. 16

PART IIFig. 2-1 Percentage Distribution of Cancer Incidence among Saudis by Age Group and Sex, 1994-2000 22Fig. 2-2 A Most Frequent Types of Cancer by Age and Sex among Saudis, 1994-2000 .......................... 22Fig. 2-3 Ten Most Common Cancers for Saudis by Sex, 1999-2000 ......................................................... 27Fig. 2-4 Average Age-Specific Incidence Rates (AIR) for All Cancers among Saudis, 1999-2000 ........... 28Fig. 2-5Age Standardized Rate ( ASR) Regional Distribution of All Sites of Cancer among Saudis,1999-2000 ................................................................................................................................................ 28Fig. 2-6 Ten Most Common Types of Cancer among Adult Saudis by Sex, 1999-2000 ............................ 30Fig. 2-7 Ten Most Common Types of Cancer among Saudi Children by Sex, 1999-2000 ......................... 33Fig. 2-8-1 Riyadh Region, 1999-2000 (Percentage Distribution) .............................................................. 35Fig. 2-8-2 Najran Region, 1999-2000 (Percentage Distribution) ............................................................... 35Fig. 2-8-3 Eastern Region, 1999-2000 (Percentage Distribution) ............................................................. 36Fig. 2-8-4 Makkah Region, 1999-2000 (Percentage Distribution) ............................................................. 36Fig. 2-8-5 Northern Region, 1999-2000 (Percentage Distribution) ........................................................... 36Fig. 2-8-6 Qassim Region, 1999-2000 (Percentage Distribution) .............................................................. 37Fig. 2-8-7 Jazan Region, 1999-2000 (Percentage Distribution) ................................................................. 37Fig. 2-8-8 Hail Region, 1999-2000 (Percentage Distribution) ................................................................... 37Fig. 2-8-9 Madinah Region, 1999-2000 (Percentage Distribution) ........................................................... 38Fig. 2-8-10 Baha Region, 1999-2000 (Percentage Distribution) ................................................................ 38Fig. 2-8-11 Tabuk Region, 1999-2000 (Percentage Distribution) .............................................................. 38Fig. 2-8-12 Asir Region, 1999-2000 (Percentage Distribution) ................................................................. 39Fig. 2-8-13 Jouf Region, 1999-2000 (Percentage distribution) ................................................................. 39Fig. 2-9 Shows the 2000 ASR Estimation in Selected Countries among the Females and Male .............. 40

PART IIIFig. 3-1 Average Age-Specific Incidence Rate (AIR) for Female Breast Cancer in Saudi Arabia,1999-2000 ................................................................................................................................................ 43Fig. 3-2 ASR Regional Distribution of Female Breast Cancer in Saudi Arabia, 1999-2000 ....................... 44Fig. 3-3 Stage Distribution of Female Breast Cancer in Saudi Arabia, 1999-2000 .................................... 45Fig. 3-4 Average Age-Specific Incidence Rates (AIR) for NHL in Saudi Arabia, 1999-2000 .................... 46Fig. 3-5 ASR Regional Distribution of NHL in Saudi Arabia, 1999-2000 .................................................. 47Fig. 3-6 Stage Distribution of NHL in Saudi Arabia, 1999-2000 ............................................................... 48Fig. 3-7 Average Age-Specific Incidence Rate (AIR) for Leukaemia in Saudi Arabia, 1999-2000 ............. 49Fig. 3-8 ASR Regional Distribution of Leukaemia in Saudi Arabia, 1999-2000 ........................................ 50Fig. 3-9 Average Age Specific Incidence rate (AIR) for Colo-rectal Cancer in Saudi Arabia, 1999-2000 . 51Fig. 3-10 ASR Regional Distribution of Colo-rectal Cancer in Saudi Arabia, 1999-2000 .......................... 52Fig. 3-11 Stage Distribution of Colo-rectal Cancer, 1999-2000 ................................................................. 53Fig. 3-12 Average Age-Specific Incidence Rate (AIR) for Liver Cancer in Saudi Arabia, 1999-2000 ....... 54Fig. 3-13 ASR Regional Distribution of Liver Cancer in Saudi Arabia, 1999-2000 ................................... 55Fig. 3-14 Stage Distribution of Liver Cancer in Saudi Arabia, 1999-2000 ................................................. 56Fig. 3-15 Average Age-Specific Incidence Rate (AIR) for Thyroid Cancer in Saudi Arabia, 1999-2000 ... 57Fig. 3-16 ASR Regional Distribution of Thyroid Cancer in Saudi Arabia, 1999-2000 ............................... 58Fig. 3-17 Stage Distribution of Thyroid Cancer in Saudi Arabia, 1999-2000 ............................................ 59Fig. 3-18 Average Age-Specific Incidence Rate (AIR) for Brain, CNS Cancer in Saudi Arabia, 1999-200060

Fig. 3-19 ASR Regional Distribution of Brain, CNS Cancer in Saudi Arabia, 1999-2000 .......................... 61Fig. 3-20 Stage Distribution of Brain, CNS Cancer in Saudi Arabia, 1999-2000 ....................................... 62Fig. 3-21 Average Age-Specific Incidence Rate (AIR) for Lung Cancer in Saudi Arabia, 1999-2000 ....... 63Fig. 3-22 ASR Regional Distribution of Lung Cancer in Saudi Arabia, 1999-2000 ................................... 64Fig. 3-23 Stage Distribution of Lung Cancer in Saudi Arabia, 1999-2000 ................................................ 65Fig. 3-24 Average Age-Specific Incidence Rate (AIR) for Hodgkin’s Disease in Saudi Arabia,1999-2000 ................................................................................................................................................ 66Fig. 3-25 ASR Regional Distribution of Hodgkin’s Disease in Saudi Arabia, 1999-2000 ......................... 67Fig. 3-26 Stage Distribution of Hodgkin’s Disease in Saudi Arabia, 1999-2000 ....................................... 68Fig. 3-27 Average Age-Specific Incidence Rate (AIR) for Urinary Bladder Cancer in Saudi Arabia,1999-2000 ................................................................................................................................................ 69Fig. 3-28 ASR Regional Distribution of Urinary Bladder Cancer in Saudi Arabia, 1999-2000 .................. 70Fig. 3-29 Stage Distribution of Urinary Bladder Cancer in Saudi Arabia, 1999-2000 ............................... 71Fig. 3-30 Average Age-Specific Incidence Rates (AIR) for Skin Cancer in Saudi Arabia, 1999-2000 ....... 72Fig. 3-31 ASR Regional Distribution of Skin Cancer in Saudi Arabia, 1999-2000 ..................................... 73Fig. 3-32 Stage Distribution of Skin Cancer in Saudi Arabia, 1999-200 .................................................... 73Fig. 3-33 Average Age-Specific Incidence Rate (AIR) for Prostate Cancer in Saudi Arabia, 1999-2000 .. 74Fig. 3-34 ASR Regional Distribution of Prostate Cancer in Saudi Arabia, 1999-2000 .............................. 75Fig. 3-35 Stage Distribution of Prostate Cancer in Saudi Arabia, 1999-2000 ........................................... 76Fig. 3-36 Average Age-Specific Incidence Rate (AIR) for Ovary Cancer in Saudi Arabia, 1999-2000 ...... 77Fig. 3-37 ASR Regional Distribution of Ovary Cancer in Saudi Arabia, 1999-2000 .................................. 78Fig. 3-38 Stage Distribution of Ovary Cancer in Saudi Arabia, 1999-2000 ............................................... 79Fig. 3-39 Average Age-Specific Incidence Rate (AIR) for Cervix Uteri Cancer in Saudi Arabia,1999-2000 ................................................................................................................................................ 80Fig. 3-40 ASR Regional Distribution of Cervix Uteri Cancer in Saudi Arabia, 1999-2000 ......................... 81Fig. 3-41 Stage Distribution of Cervix Uteri Cancer in Saudi Arabia, 1999-2000 ...................................... 82

PART IVFig. 4-1 Ten Most Common Cancers among non-Saudis by Sex, 1999-2000 ........................................... 85Fig. 4-2 Average Age-Specific Incidence Rate (AIR) for All Cancers among non-Saudis in Saudi Arabia,1999-2000 ................................................................................................................................................ 85

TABLES

PART IITable 2-1 Distribution of Cancer Cases in Saudi Arabia by Nationality and Sex, 1999-2000 ................... 25Table 2-2 Number of New Cases by Primary Site and Sex among Saudis, 1999-2000 .............................. 26Table 2-3 Distribution of Adult’s Cancers Cases in Saudi Arabia by Nationality and Sex, 1999-2000 ..... 29Table 2-4 Number and Proportion of Morphological Types for the Most .............................................. 30Table 2-5 Distribution of Childhood Cancer Cases in Saudi Arabia by Nationality and Sex, 1999-2000 . 32Table 2-6 Number and Proportion of the Most Common Types of Childhood Cancer among Saudis,1999-2000 ................................................................................................................................................ 34

PART IIITable 3-1 Histology of Female Breast Cancer in Saudi Arabia, 1999-2000 ............................................... 44Table 3-2 Comparison of ASR for Breast Cancer among Saudi Females with 2000 ASR Estimation inSelected Countries .................................................................................................................................. 45Table 3-3 Histology of NHL, 1999-2000 ................................................................................................... 47Table 3-4 Comparison of ASR for NHL among Saudis with 2000 ASR Estimation in Selected Countries 48Table 3-5 Histology of Leukemia, 1999-2000 .......................................................................................................50Table 3-6 Comparison of ASR for Leukemia among Saudis with 2000 ASR Estimation inSelected Countries .................................................................................................................................. 50Table 3-7 Histology of Colo-rectal Cancer, 1999-2000 ............................................................................. 52Table 3-8 Comparison of ASR for Colo-rectal among Saudis with 2000 ASR Estimation inSelected Countries .................................................................................................................................. 53Table 3-9 Histology of Liver Cancer, 1999-2000 ...................................................................................... 55Table 3-10 Comparison of ASR for Liver Cancer among Saudis with 2000 ASR Estimation inSelected Countries .................................................................................................................................. 56Table 3-11 Histology of Thyroid Cancer, 1999-2000 ................................................................................ 58Table 3-12 Comparison of ASR for Thyroid Cancer among Saudis with 2000 ASR Estimation inSelected Countries .................................................................................................................................. 59Table 3-13 Histology of Brain, CNS Cancer, 1999-2000 ........................................................................... 61Table 3-14 Comparison of ASR for Brain, CNS Cancer among Saudis with 2000 ASR Estimation inSelected Countries .................................................................................................................................. 62Table 3-15 Histology of Lung Cancer, 1999-2000 .................................................................................... 64Table 3-16 Comparison of ASR for Lung Cancer among Saudis with 2000 ASR Estimation inSelected Countries .................................................................................................................................. 65Table 3-17 Histology of Hodgkin’s Disease, 1999-2000 .......................................................................... 67Table 3-18 Comparison of ASR for Hodgkin’s Disease among Saudis with 2000 ASR Estimation inSelected Countries .................................................................................................................................. 68Table 3-19 Histology of Urinary Bladder Cancer, 1999-2000 ................................................................... 70Table 3-20 Comparison of ASR for Urinary Bladder Cancer among Saudis with 2000 ASR Estimation inSelected Countries .................................................................................................................................. 71Table 3-21 Histology of Skin Cancer (Non-Melanoma), 1999-2000 ......................................................... 73Table 3-22 Histology of Prostate Cancer, 1999-2000 ............................................................................... 75Table 3-23 Comparison of ASR for Prostate Cancer among Saudis with 2000 ASR Estimation inSelected Countries .................................................................................................................................. 76Table 3-24 Histology of Ovary Cancer, 1999-2000 ................................................................................... 78Table 3-25 Comparison of ASR for Ovary Cancer among Saudis with 2000 ASR Estimation in Selected 79Table 3-26 Histology of Cervix Uteri, 1999-2000 ..................................................................................... 81Table 3-27 Comparison of ASR for Cervix Uteri Cancer among Saudis with 2000 ASR Estimation inSelected Countries .................................................................................................................................. 82

PART VTable 5-1-1 Age Distribution of Cancer Cases among Saudi Males, 1999 ............................................... 87Table 5-1-2 Age Distribution of Cancer Cases among Saudi Females, 1999 ............................................ 88Table 5-1-3 Incidence Rates for Cancer Cases among Saudi Males by Age Group (per 100,000), 1999 .. 89Table 5-1-4 Incidence Rates for Cancer Cases among Saudi Females by Age Group (per 100,000), 1999 90Table 5-1-5 Age Distribution of Cancer Cases among Saudi Males, 2000 ............................................... 91Table 5-1-6 Age Distribution of Cancer Cases among Saudi Females, 2000 ............................................ 92Table 5-1-7 Incidence Rates for Cancer Cases among Saudi Males by Age Group (per 100,000), 2000 .. 93Table 5-1-8 Incidence Rates for Cancer Cases among Saudi Females by Age Group (per 100,000), 2000 94Table 5-2-1 Age Standarized Rates and Relative Frequencies for All Cancer Cases among Saudis bySite and Sex, Riyadh Region, 1999-2000 .................................................................................................. 95Table 5-2-2 Age Standarized Rates and Relative Frequencies for All Cancer Cases among Saudis bySite and Sex, Najran Region, 1999-2000 ................................................................................................... 96Table 5-2-3 Age Standarized Rates and Relative Frequencies for All Cancer Cases among Saudis bySite and Sex, Eastern Region, 1999-2000 ................................................................................................. 97Table 5-2-4 Age Standarized Rates and Relative Frequencies for All Cancer Cases among Saudis bySite and Sex, Makkah Region, 1999-2000 ................................................................................................ 98Table 5-2-5 Age Standarized Rates and Relative Frequencies for All Cases among Saudis by Site and Sex,Northern Region, 1999-2000 .................................................................................................................... 99Table 5-2-6 Age Standarized Rates and Relative Frequencies for All Cancer Cases among Saudis bySite and Sex, Qassim Region, 1999-2000 ................................................................................................100Table 5-2-7 Age Standarized Rates and Relative Frequencies for All Cancer Cases among Saudis bySite and Sex, Jazan Region, 1999-2000 ...................................................................................................101Table 5-2-8 Age Standarized Rates and Relative Frequencies for All Cancer Cases among Saudis bySite and Sex, Hail Region, 1999-2000 ......................................................................................................102Table 5-2-9 Age Standarized Rates and Relative Frequencies for All Cancer Cases among Saudis bySite and Sex, Madinah Region, 1999-2000 ..............................................................................................103Table 5-2-10 Age Standarized Rates and Relative Frequencies for All Cancer Cases among Saudis bySite and Sex, Baha Region, 1999-2000 ....................................................................................................104Table 5-2-11 Age Standarized Rates and Relative Frequencies for All Cancer Cases among Saudis bySite and Sex, Tabuk Region, 1999-2000 ..................................................................................................105Table 5-2-12 Age Standarized Rates and Relative Frequencies for All Cancer Cases among Saudis bySite and Sex, Asir Region, 1999-2000 ......................................................................................................106Table 5-2-13 Age Standarized Rates and Relative Frequencies for All Cancer Cases among Saudis bySite and Sex, Jouf Region, 1999-2000 .....................................................................................................107Table 5-3-1 Age Distribution of Cancer Cases among non-Saudi Males, 1999 ......................................108Table 5-3-2 Age Distribution of Cancer Cases among non-Saudi Females, 1999 ...................................109Table 5-3-3 Incidence Rates for Cancer Cases among non-Saudi Males by Age Group (per 100,000),1999 ........................................................................................................................................................110Table 5-3-4 Incidence Rates for Cancer Cases among non-Saudi Females by Age Group (per 100,000),1999 ........................................................................................................................................................111Table 5-3-5 Age Distribution of Cancer Cases among non-Saudi Males, 2000 ......................................112Table 5-3-6 Age Distribution of Cancer Cases among non-Saudi Females, 2000 ...................................113Table 5-3-7 Incidence Rates for Cancer Cases among non-Saudi Males by Age Group (per 100,000),2000 ........................................................................................................................................................114Table 5-3-8 Incidence Rates for Cancer Cases among non-Saudi Females by Age Group (per 100,000),2000 ........................................................................................................................................................115

PART IMATERIALS AND METHODS

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Background on Saudi ArabiaSaudi Arabia is a vast country extending over four-fifths of the Arabian Peninsula. It stretches fromthe Arabian Gulf in the east to the Red Sea in the west. It is approximately 2,149,700* squarekilometers in area. It is divided into 13 administrative regions (Figure 1-1).

Figure 1-1 Administrative Regions of Saudi Arabia

The estimated Saudi National population for year 2000 was 15,588,805**. Of these 7,800,051were males and 7,788,754 were females. The estimated non-Saudi population in 2000 was5,258,079; of these 3,514,915 were males and 1,743,164 females.Figures 1-2 and 1-3 shows the Saudi and non-Saudi population pyramids by sex and age-group.

* Source: Demographic and Health Indicators for Countries of the East Meditranian, WHO, Regional Office for the EM, 1999

·** Source: Central Department for Statistics (CDS). Ministry of Planning.

13

14

Figure 1-3 Population Pyramid of non-Saudis by Sex and Age Groups, 2000

8,172

7,028

12,349

28,635

60,071

114,785

213,433

368,732

546,810

650,627

506,077

204,807

119,998

192,901

240,758

239,732

5,824

8,359

6,032

10,791

17,743

29,730

53,761

108,576

204,782

230,971

157,989

115,298

120,382

194,556

249,066

229,304

3,514,915 1,743,164Male Female

0 5 10 15 20

0- 5- 10- 15- 20- 25- 30- 35- 40- 45- 50- 55- 60- 65- 70- 75+

0 5 10 15 20

National Cancer Registry

The National Cancer Registry of Saudi Arabia is a population-based registry developed in 1992.It was established under the jurisdiction of the Ministry of Health (MOH) by the Order of HisExcellency the Minister of Health. The NCR commenced reporting cancer cases from 01 January1994.

Objectives:

The primary goal of the NCR is to define the population-based incidence of cancer in SaudiArabia. Programs for early detection and cancer screening, as well as cancer research projectsare planned for future consideration.

Organizational Structure:

A Board of Directors was appointed to include representatives from the MOH, King FaisalSpecialist Hospital and Research Center (KFSH&RC), and the Medical Services Departments ofthe Ministry of Defense and Aviation, Ministry of Interior, the National Guard, King Saud University,King Faisal University, King Abdul-aziz University and King Khalid University.

The Board is charged with the responsibility of overseeing the NCR’s establishment, definingdemographic and cancer-related data to be collected, approving research requests, and reportingfindings, as well as disseminating information collected while ensuring the confidentiality of all datareported to the NCR.

The NCR Main Office, including administrative and technical staff, is located on the premises ofthe KFSH&RC in Riyadh. Additionally, five regional branches and three hospital-based officeswere set up to ensure comprehensive data collection from all over the Kingdom Figure 1-4.

Central Region: King Khalid University Hospital in Riyadh, covering Riyadh, Qassim, andHail Health Regions.Eastern Region: King Fahad Hospital of the University, Khobar, covering Dammam, AlAhsa, and Hafr Al-Batin Health Regions.Western Region: King Abdulaziz Hospital and Cancer Center, Jeddah, covering Jeddah,Makkah, Taif and Qunfudah Health Regions.Southern Region: King Khalid University, Abha, covering Asir, Baha, Najran, Jazan andBisha Health Regions.Madinah/Northern: King Fahad Hospital, Madinah, covering Madinah, Tabuk, Jouf andNorthern Health Regions.Offices at the Medical Services Division or Oncology Department of the followingestablishments:

Ministry of Defense and Aviation, Armed Forces Hospital, RiyadhNational Guard, King Fahad Hospital, Riyadh covering KFNGH & KKNGH.Ministry of Interior, Security Forces Hospital, Riyadh.

15

Ministry of HealthSaudi Arabia

National Cancer RegistryMain Office

Each of these branches and offices are under the supervision of a member of the Board ofDirectors who is responsible for the daily management of that office and for ensuring the accuracyof information reported to the NCR. In addition to tumor registrars and secretarial staff, eachoffice is provided with the necessary computer facilities, printers, and other office equipment.

Functions of the NCR Main office include:♦ compilation of data collected from all the regions and offices♦ merging of all cases to ensure that each case is counted only once♦ verification of diagnosis♦ conducting quality control review of all abstracts submitted♦ preparation of regular reports for dissemination of information to the medical

community, government establishment, international organizations and the media.♦ training of staff.

Figure 1-4 Organizational Chart of the National Cancer Registry of Saudi Arabia

16

National GuardHospitals(Riyadh &Jeddah)

SecurityForces(Riyadh)

Armed ForcesHospitals(Riyadh &Jeddah)

Madinah Region

(Madinah, Tabuk,Jouf & Northern

Region)

WesternRegion(Jeddah,

Makkah, Taif &Gunfudah)

EasternRegion

(Dammam,Ahsa & H. Al

Batin)

CentralRegion(Riyadh,

Qassim & Hail)

King FaisalSpecialistHospital &Research

Centre(Riyadh)

SouthernRegion

(Asir, Baha,Jazan, Najran

& Bisha)

Format

The format of the current report is similar to the previous reports; however the first part has beenextended by adding a section for childhood and adult cancer and morphology of the most commontypes of childhood and adult cancer. We also report the ten most common cancers for each regionand present a comparative bar chart in which we compare age standardized rate (ASR) of cancerincidence among Saudis with other countries.

Data management

A ministerial decree has categorized cancer as a mandatory notifiable disease. This ensures theopportunity for comprehensive data collection. The NCR strives for full access to cancer datafrom all MOH, governmental and private hospitals, as well as clinics and laboratories throughoutthe Kingdom. Cancer data are abstracted from patients’ medical records based on clinical and/orhistopathological diagnosis, by NCR-trained cancer registrars.

The data abstract (see appendix E) includes the patient’s personal identification (name, ID Number,sex, age), demographic information (address, telephone number, nationality), and tumor details(diagnosis date, primary site, histology, behavior, grade, stage, basis of diagnosis). The primarysite (topography) and histology (morphology) of the malignancies are identified and coded accordingto the International Classification of Diseases for Oncology, 2nd Edition (ICD-O-2), publishedby the World Health Organization (WHO), 1990.

Every effort is made to accurately code patient and tumor information, to ensure that all data canbe reviewed, matched, and merged, as appropriate, so that each malignancy is counted only oncefor statistical analysis. The computer software program used for data entry and incidence tablesoutput is CanReg 3.21, developed by the International Agency for Research on Cancer, (IARC)Lyon, France.

The second part of the report includes the overall cancer incidence in Saudi Arabia and the relevantepidemiological and clinic-pathological details for the 14 most common cancers among Saudinationals for the years of 1999 and 2000. A standardized layout is used to present data for allpatients and both sexes where applicable.

For each cancer site the first paragraph includes the number and the percentage of all newlydiagnosed cases for the years 1999 and 2000, the age-standardized incidence rate for each sex(ASR) (per 100,000 population), and the specific cancer rank in comparison to all cancers forboth sexes.

The second paragraph contains useful international statistics for the specified cancer. It includesthe ranking of the cancer worldwide, the estimated number of cases for 1999-2000, and the highincidence areas of the world. The relevant source of this information is World Health Organization.GLOBOCAN 2000: Cancer Incidence Mortality and Prevalence Worldwide. InternationalAgency for research on Cancer (IARC), Lyon, 2001.

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The relevant data incorporate details for all patients presented over the years 1999 and 2000. Foreach cancer there are four figures- a line chart, a bar chart, a pie chart and a table outlined asfollows:

1. Arithmetic line graphs represent the change in average age-specific incidence rate (AIR)for all age groups at five-year intervals. The graphs are plotted by sex, where applicable.

2. Bar charts show regional distribution of ASR for particular cancer across theadministrative regions and are given separately for males and females.

3. Tables list the percentages of the most common histology subtypes for each cancer.

4. Pie charts show the distribution of the clinical stages of each cancer such as in-situ, localized,regional, distant metastasis and unknown.

5. Tables show comparison of age-standardized incidence rate (ASR) for each cancer typein Saudi Arabia with 2000 ASR estimation in selected countries

In reviewing the data and its collection and analysis, two qualifying statements can be made:a. The number of patients presenting with malignant disease from the Riyadh region exceeds

the anticipated number per population. The reason for this is that Riyadh has many referralcenters providing patients from outside the region with cancer-related care. Many of thesepatients fail to provide their permanent address, and instead, provide a temporary Riyadhaddress. It is anticipated that this situation will be resolved as soon as computerization ofidentification documents is completed.

b. As previously noted, the software used in analyzing this report, CanReg-3 Ver.3.21,did not enroll in-situ cases in the incidence tables. These cases were added to thetotal cancer cases in the overview.

Notification

The data used for this report was extracted in January 2003. Additional cases diagnosed in 1999and 2000 may be added later in subsequent incidence reports, which means an increase of thetotal cases for those two year, which has not been included in the analysis.

18

Definitions of Statistical TermsICD-10The World Health Organization’s International Classification of Diseases, tenth edition.

ICD-02The World Health Organization’s International Classification of Diseases for Oncology, 2nd Edition.

MetastasisIt is the distant spread of cancer from its original site to other organs of the body, includinglymph nodes, skeletal and or visceral organs.

Incidence RateIt is defined as the rate at which new event occur in a population. It is calculated as thenumber of new cases of disease arising in a population over a defined time period, dividedby the population at risk of developing that disease.

Crude Incidence RateThe crude incidence rate for a cancer site is the total number of cases registered as a proportionof the total population. It denotes the approximate number of cases occurring in each 100,000individuals. All rates are thus, expressed as per 100,000 population.Cancer rates vary greatly with age and the crude rate is strongly influenced by the demographicstructure of the population. Hence, if the population structure changes over time the cruderate over that period may be artificially altered. It is not appropriate to compare crude ratesacross geographical areas of cancer registries with different population age structures.Therefore, in order to assess time trends in registration data or compare incidence acrossgeographical areas or between registries it is necessary to first standardize the rates withrespect to age.

PrevalenceThis reflects the total number of patients with a disease in a specified population at a specifiedtime, including both new and old cases.

Relative FrequencyThis statistic is defined as the number of specific cancer cases registered relative to the totalnumber of all cancer. It is expressed as a percentage.

RankThis measure reflects the importance of a specific cancer site relative to other sites, in termsof the number of registrations. Ranking illustrates the most and least frequent cancer sites ina population according to their frequency.

Average Age-Specific Incidence Rate (AIR)The number of cancer cases occurring during a specific period in a population of a specificage and sex group, divided by the number of mid-year population of that age and sex group.

19

Age Class Age ClassPopulation Population0 - 45 - 9

10 - 1415 - 1920 - 2425 - 2930 - 3435 - 3940 - 44

12,00010,0009,0008,0008,0006,0006,0006,0006,000

45 - 4950 - 5455 - 5960 - 6465 - 6970 - 7475 - 7980 - 8485 +Total 100,000

6,0005,0004,0004,0003,0002,0001,000500500

Age-Standardized Rate (ASR)The Age-standardized rate is a summary measure of a rate that a population would have if ithad a standard age structure. Standardization is necessary when comparing several populationsthat differ with respect to age structure. The most frequently used standard population is theWorld Standard Population (see below). The calculated incidence is known as the WorldStandardized Incidence Rate. The rate is expressed per 100,000 populations.

The World Standard Population

20

The World Standard Population (Doll et al., 1966)

PART IIOVERVIEW OF CANCER

21

Cancer in Saudi Arabia 1994-2000The total number of cancer cases reported among Saudis during the years 1994-2000 were39209. Fifty two percent (20,532) of the cases were reported among men and 48% (18677)among women. In Saudi Arabia, taking into consideration the population structure and the factthat cancer is primarily a disease of the old, the pattern of cancer has some unique characteristics.During this period, 49% of the cases in men and 33% of the cases in women were found in theabove-59 age-group. This age-group accounts for only 5.2% of the Saudi population. This signifiesthat a large proportion of cancer cases in women occur in younger age-group. If we look at theage-group between 30-44 year, we will find that 22% of the cases in women and 12% of the casesin men were found in this group. It can be safely said that Saudi women are affected in early agesmore than men and this can be attributed to breast and thyroid cancer (figure 2-1).

10.78.3

11.5

20.3

32.2

17.0

9.310.8

22.125.3

23.8

8.8

0

5

10

15

20

25

30

35

1 2 3 4 5 6

Age Groups

MaleFemale

0-14 15-29 30-44 45-59 60-74 75 +

Fig. 2-1 Percentage Distribution of Cancer Incidence among Saudis by Age Group and Sex, 1994-2000

Fig. 2-2-A Most Frequent Types of Cancer by Age and Sex among Saudis, 1994-2000

%

22

01020304050 0 10 20 30 40 50

9.4

4.4

3.2

2.9

2.7

2.0

1.8

1.6

1.6

1.3

16.7

5.1

4.7

4.5

3.5

3.2

2.8

2.7

2.3

2.2

2.2

19.3

Breast

Thyroid

Leukaemia

Non-Hodgkin Lymphoma

Colo-rectal

Ovary

Liver

Brain, Nervous System

Cervix Uteri

Skin

Other Sites

Female (18677)*Male (20532)

Liver


Leukaemia

Lung

Colo-rectal

Prostate

Urinary Bladder


Stomach

Hodgkin’s Disease

Other Sites

All Ages

* One case of unknown age shows only in total as it could not be added to any age group.

Thyroid

Leukaemia

Hodgkin’s Disease


Ovary

Bone


Connective Tissue

Nasopharynx

Other Sites

Female (2014)Male (1712)

Leukaemia

Hodgkin’s Disease


Bone


Thyroid

Connective Tissue

Testis

Nasopharynx

Colo-rectal

Other Sites

15 - 29 Years

Breast

Thyroid

Colo-rectal

Cervix Uteri

Leukaemia


Ovary

Nasopharynx


Kidney

Other Sites


Non-Hodgkin’s Lymphoma

Leukaemia

Colo-rectal

Nasopharynx

Thyroid

Hodgkin’s Disease


Urinary Bladder

Lung

Skin

Other Sites

30 - 44 Years

Fig. 2-2-B Most Frequent Types of Cancer by Age and Sex among Saudis, 1994-2000

23

01020304050 0 10 20 30 40 50

12.3

6.1

5.7

5.3

3.6

3.1

2.6

2.5

1.9

1.4

9.5

8.3

8.2

5.4

4.5

3.6

2.1

2

2

1.7

1.5

6.6

Breast

01020304050 0 10 20 30 40 50

21.5

10.4

3.1

3.0

2.9

2.8

2.4

1.3

1.2

1.2

13.8

4.0

3.3

3.1

2.6

2.3

2.0

2.0

1.7

1.6

1.3

12.5

Leukaemia


Hodgkin’s Disease


Kidney

Connective Tissue

Bone

Eye

Ovary

Thyroid

Other Sites

Leukaemia


Hodgkin’s Disease


Connective Tissue

Bone

Eye

Kidney

Liver

Testes

Other Sites

0 - 14 Years

01020304050 0 10 20 30 40 50

14.2

7.2

3.4

3.1

2.6

2.5

2.5

2.1

1.0

0.7

4.7

18.3

8.6

5.9

5.5

3.4

2.8

2.5

2.4

0.9

0.8

4.8


24Fig. 2-2-C Most Frequent Types of Cancer by Age and Sex among Saudis, 1994-2000*

6.1

3.3

2.8

2.5

1.9

1.8

1.7

1.7

1.5

1.4

15.4

8.6

5.9

4.8

4.6

3.9

3.9

3.3

2.6

1.9

1.9

18.1

Breast

Colo-rectal


Liver

Thyroid

Skin

Ovary

Oesophagus

Stomach

Corpus Uteri

Other Sites


Liver

Lung

Prostate


Urinary Bladder

Colo-rectal

Stomach

Skin

Oesophagus

Leukaemia

Other Sites

60 - 74 Years

3.0

2.1

2.4

2.0

1.9

1.8

1.7

1.4

1.2

1.1

13.1

8.8

7.9

5.0

4.8

4.7

4.5

4.1

4.0

3.6

2.1

18.6

Breast


Colo-rectal

Skin

Liver

Stomach

Oesophagus

Lung

Ovary

Cervix Uteri

Other Sites


Prostate

Liver

Urinary Bladder

Lung


Stomach

Skin

Colo-rectal

Oesophagus

Leukaemia

Other Sites

75+ Years

01020304050 0 10 20 30 40 50

01020304050 0 10 20 30 40 50

01020304050 0 10 20 30 40 50

Breast

Colo-rectal

Thyroid


Liver

Ovary

Cervix Uteri

Corpus Uteri

Leukaemia

Stomach

Other Sites


Liver


Colo-rectal

Lung

Urinary Bladder

Nasopharynx

Leukaemia

Stomach

Skin


Other Sites

45 - 59 Years14.0

3.6

3.6

3.1

2.6

2.4

2.2

1.7

1.5

1.5

17.1

5.6

4.4

4.1

3.9

2.8

2.4

2.1

2.0

1.7

1.6

16.2

Reported Cancer Incidence Cases in Saudi Arabia, 1999-2000Between January 1999 and December 2000, the total number of cancer cases reported to theNCR was 14,856. Overall, cancer was more predominant in men than in women. Cancers affected7,616 (51.3%) males and 7,240 (48.7%) females, with a male to female ratio of 105:100. Eleventhousand three hundred eighty three (11,383) cases were reported among Saudis, 3,242 amongnon-Saudis and 231 are of unknown nationality. Histological and/or cytological diagnosis ofmalignancy was confirmed in 94.3% of the cases. One-sixth percent of the cases were confirmedclinically, 3.2% radiologically, and 0.6% were diagnosed by other methods. The method of diagnosiswas unknown for 0.3% of the cases.

Distribution of Cancer Cases in Saudi Arabia by Nationality and SexOut of 14,856 cancer cases reported, there were 231 cases of “unknown nationality” reported tothe NCR for 1999 and 2000. Since these cases can be included in neither the Saudi category norin the non-Saudis category, they were excluded from the overall analysis. There were also 68 in-situ cases reported during 1999 and 2000 (Table 2-1). The current software program, CanReg3.21, does not include in-situ cases in the statistical analysis. The total number of cases excludedfrom the analysis was 299.

Table 2-1 Distribution of Cancer Cases in Saudi Arabia by Nationality and Sex, 1999-2000

Based on the above, 14,557 cases were analyzed of which 11,330 (77.8%) were Saudis and3,227 (22.2%) were non-Saudis. Among the Saudis, 5,713 (50.4%) were male and 5,617 (49.6%) were female. The male to female ratio was 102:100. The crude incidence rate (CIR) of allcancers among the Saudi population was 37.2/100,000 (37.5/100,000 among males and 36.8/100,000 among females). The overall age-standardized incidence rate (ASR) for all Saudis with aworld standard population reference was 62.6/100,000 (61.6/100,000 in males and 63.5/100,000in females). For all sites, the age-specific incidence rate (AIR) increased with age for both malesand females. After the age of 65 years, the increase was twofold for males compared to females.The mean age at diagnosis was 52 years for men and 47years for women. The geographic regionswith the highest ASR were Riyadh region at 109.6/100,000, Eastern region at 80.3/100,000,Najran region at 60.7/100,000, Qassim region at 60.6/100,000, and Makkah and Madinah regionsat 58.4/100,000

25

Behavior Male Female Total Male Female Total Male Female Total TotalInvasive 5713 5617 11330 1765 1462 3227 120 111 231 14788

In-situ 14 39 53 4 11 15 0 0 0 68

Total 5727 5656 11383 1769 1473 3242 120 111 231 14856

Saudis Non-Saudis Unknown Nationality

Table 2-2 Number of New Cases by Primary Site and Sex among Saudis, 1999-2000

26

ICD(10) PRIMARY SITE Males Females AllAll sites 5713 5617 11330

C00 Lip 7 11 18C01-C02 Tongue 55 51 106C07-C08 Salivary gland 19 23 42C03-C06 Mouth 50 68 118C09-C10 Oropharynx 6 5 11C11 Nasopharynx 191 60 251C12-C13 Hypopharynx 10 27 37C14 Pharynx unspec. 0 2 2C15 Oesophagus 119 109 228C16 Stomach 210 124 334C17 Small intestine 24 17 41C18 Colon 201 201 402C19-C21 Rectum 188 163 351C22 Liver 512 184 696C23-C24 Gallbladder etc. 49 104 153C25 Pancreas 110 65 175C30-C31 Nose, sinuses etc. 19 13 32C32 Larynx 93 18 111C33-C34 Bronchus, lung 354 100 454C37-C38 Other thoracic organs 22 14 36C40-C41 Bone 112 74 186C47;C49 Connective tissue 123 94 217C45 Mesothelioma 8 5 13C46 Kaposi's sarcoma 30 11 41C43 Melanoma of skin 18 15 33C44 Other skin 226 154 380C50 Male breast 22 - 22C50 Female breast - 1157 1157C55 Uterus unspec. - 15 15C53 Cervix uteri - 167 167C58 Placenta - 18 18C54 Corpus uteri - 141 141C56 Ovary etc. - 205 205C51-C52;C57 Other female genital - 24 24C61 Prostate 304 - 304C62 Testis 70 - 70C60 Penis 2 - 2C63 Other male genital 4 - 4C67 Bladder 301 80 381C64-C66;C68 Kidney etc. 168 114 282C69 Eye 46 49 95C70-C72 Brain, nervous system 270 186 456C73 Thyroid 156 539 695C74-C75 Other endocrine 21 26 47C81 Hodgkin's disease 260 173 433C82-C85;C96 Non-Hodgkin lymphoma 528 354 882C88;C90 Multiple myeloma 71 49 120C91 Lymphoid leukaemia 278 191 469C92 Myeloid leukaemia 186 176 362C93 Monocytic leukaemia 6 3 9C94 Other leukaemia 1 3 4C95 Leukaemia unspec. 8 9 17

Other & unspecified 255 226 481

During 1999-2000, 9.6% of all cancers among Saudis occurred before the age of 15, and 20.6%occurred after the age of 64 years. For the total Saudi population the ten most common cancerswere as follows:

CANCER NO. OF CASES PERCENTAGE (%)

Female breastNon-Hodgkin’s lymphoma (NHL)LeukaemiaColo-rectalLiverThyroidBrain, nervous system (CNS)LungHodgkin’s diseaseBladder

Male

NHL 528 (9.2%)Liver 512 (9%)Leukaemia 479 (8.4%)Colo-rectal 389 (6.8%)Lung 354 (6.2%)Prostate 304 (5.3%)Bladder 301 (5.3%)Brain &CNS 270 (4.7%)Hodgkin’s 260 (4.6%)Skin 226 (4%)

Total = 5713

Female

Breast 1157 (20.6%)Thyroid 539 (9.6%)Leukaemia 382 (6.9%)Colo-rectal 364 (6.5%)NHL 354 (6.3%)Ovary 205 (3.6%)Brain & CNS 186 (3.3%)Liver 184 (3.3%)Hodgkin’s 173 (3.1%)Cervix uteri 167 (3%)

Total = 5617

Fig. 2-3 Ten Most Common Cancers for Saudis by Sex, 1999-2000

27

Ten Most Common Types of Cancer Among Saudis, 1999-2000 (All Ages)

10.2 7.8 7.6 6.6 6.1 6.1 4.0 4.0 3.8 3.4

1157 882 861 753 696 695 456 454 433 381

Fig. 2-4 Average Age-Specific Incidence Rates (AIR) for All Cancers among Saudis, 1999-2000

Male Female

0

50

100

150

200

250

300

350

400

0- 5- 10- 15- 20- 25- 30- 35- 40- 45- 50- 55- 60- 65- 70- 75+

Age groups

Rat

e p

er 1

00,0

00

male female

Fig. 2-5Age Standardized Rate ( ASR) Regional Distribution of All Sites of Cancer among Saudis, 1999-2000

28

24.7

29.7

33

33.7

42.4

48.5

55.1

58.8

60.5

64.3

65.2

79.1

108.7

0 20 40 60 80 100 120

Baha

Asir

Jazan

Jouf

Tabuk

Hail

Najran

Northern

Makkah

Madinah

Qassim

Easterm

Riyadh

ASR (PER 100,000)

27.4

28.8

31

42.3

47.7

49.1

49.4

52.7

56.2

56.2

66.2

81.7

110.2

0 20 40 60 80 100 120

Baha

Asir

Jazan

Tabuk

Northern

Jouf

Hail

Madinah

Qasim

Makkah

Najran

Easterm

Riyadh

ASR (PER 100,000)

Adult Cancers in Saudi Arabia, 1999-2000 (above 14 years)Between January 1999 and December 2000, the total number of adult cancer cases reported tothe NCR was 13,463. Overall, cancer was more predominant in males than in females. Canceraffected 6,859 (50.9%) males and 6,604(49.1%) females, with a ratio of 104:100. Of all cases,there were 10,205 Saudis, 3,033 non-Saudis and 225 of unknown nationality. As explained above,cases with unknown nationality - in this case 210 cases- and in-situ cases (68) were excluded fromthe analysis. Table 2-3 illustrates the distribution of adult cancer cases by nationality and sex.

Table 2-3 Distribution of Adult’s Cancers Cases in Saudi Arabia by Nationality and Sex, 1999-2000

As shown in table 2-3, the total number of cases analyzed was 13,185 including 10,152 (77%)Saudis and 3,033 (23%) non-Saudis. Among Saudis, 5,086 (50.1%) cases were male and 5,066(49.9%) were female. The male to female ratio was 100.4:100. For all sites, the age-specificincidence rate (AIR) increased with age for both males and females. The mean age at diagnosiswas 58 years in males and 51 years in females.

During the 1999-2000, adult cancers accounted for 89.6% of all cancers among Saudis. Thirtypoint nine percent (30.9%) of these cases occurred after the age of 60 years. For the total adultSaudi population the ten most common cancers were as follows:

29


Female breastNon-Hodgkin’s lymphoma (NHL)Colo-rectalThyroidLiverLeukaemiaLungBladderSkin (non-melanoma)Stomach

11.4 7.9 7.4 6.7 6.7 4.7 4.5 3.8 3.6 3.3

1157 800 749 683 678 479 454 381 369 334


In-situ 14 39 53 0 0 0 4 11 15 68

Total 5100 5105 10205 1648 1385 3033 111 114 225 13463


Fig. 2-6 Ten Most Common Types of Cancer among Adult Saudis by Sex, 1999-2000

Male

Liver 500 (9.8%)NHL 481 (9.5%)Colo-rectal 389 (7.6%)Lung 354 (7%)Prostate 303 (6%)Bladder 301 (5.9%)Leukaemia 280 (5.5%)Skin 220 (4.3%)Stomach 210 (4.1%)Nasopharynx 185 (3.6%)

Total = 5086

Female

Breast 1157 (22.8%)Thyroid 533 (10.5%)Colo-Rectal 360 (7.1%)NHL 319 (6.3%)Leukaemia 199 (4%)Ovary 191 (3.8%)Liver 178 (3.5%)Cervix uteri 166 (3.3%)Skin 149 (2.9%)Corpus uteri 141 (2.8%)

Total = 5066

Primary Site Morphology %*FemalesNo.

MalesNo. %*

Female breastcancer

Infiltrating duct carcinomaCarcinoma, NOSLobular carcinoma, NOSInfiltrating duct and lobular carcinomaMedullary carcinoma, NOSPaget’s disease and Infiltrating duct carcinomaAll other

-------

-------

913555218181685

78.94.84.51.61.61.47.3

NHL Malignant lymphoma large cell, diffuse NOSMalignant lymphoma, NOSMalignant lymphoma, non-Hodgkin’s, NOSMalignant lymphoma, small lymphocytic, NOSMalignant lymphoma, mixed small and large cell, diffuseMalignant lymphoma, follicular, NOSAll other

2105852161910

116

43.712.110.8

3.34.02.1

24.1

155402014

91467

48.612.5

6.34.42.84.4

21.0Colo-rectal Adenocarcinoma, NOS

Mucinous adenocarcinomaCarcinoma, NOSSignet ring cell carcinomaAdenocarcinoma in villous adenomaAll other

29734

996

34

76.38.72.32.31.58.7

2871615

57

30

79.74.44.21.41.98.3

Thyroid Papillary carcinoma, NOSPapillary and follicular carcinomaFollicular adenocarcinoma, NOSMedullary carcinoma, NOSAll other

11413

83

12

76.08.75.32.08.0

38478301130

72.014.6

5.62.15.6

Liver Hepatocellular carcinoma, NOSMalignant tumor, NOSCholangiocarcinomaAdenocarcinoma, NOSAll other

4253110

925

85.06.22.01.85.0

1358

157

13

75.84.58.43.97.3

30

31

Leukaemia Acute myeloid leukaemiaAcute lymphoblastic leukaemia, NOSChronic myeloid leukaemiaChronic lymphoblastic leukaemiaAll other

6863555143

24.322.519.618.215.4

5625672625

28.112.633.713.112.6

Lung Squamous cell carcinoma, NOSAdenocarcinoma, NOSCarcinoma, NOSSmall cell carcinoma, NOSAll other

10096383981

28.227.110.711.022.9

223910

524

22.039.010.0

5.024.0

Urinary bladder Papillary transitional cell carcinomaTransitional cell carcinoma, NOSSquamous cell carcinoma, NOSAdenocarcinoma, NOSAll other

134124

156

22

44.541.2

5.02.07.3

2938

418

36.347.5

5.01.3

10.0Skin(non-melanoma)

Basal cell carcinomaSquamous cell carcinomaDermatofibrosarcomaSquamous cell carcinoma, keratinizing, NOSBasosquamous carcinomaAll other

105681310

816

47.730.9

5.94.53.67.3

843410

73

11

56.422.8

6.74.72.07.4

Ovary Papillary serous cystadenocarcinomaAdenocarcinoma, NOSEndometrioid carcinomaSerous surface papillary carcinomaAll other

-----

-----

2922151480

15.211.57.97.3

41.9Nasopharynx Carcinoma, undifferentiated, NOS

Carcinoma, NOSSquamous cell carcinoma, large cell, nonkeratinizingSquamous cell carcinoma, NOSAll other

53523934

7

28.628.121.118.4

3.8

24111193

41.419.019.015.5

5.2

Cervix uteri Squamous cell carcinoma, NOSSquamous cell ca, non-keratinizing, NOSAdenocarcinoma, NOSSquamous cell, keratinizing, NOSAll other

-----

-----

9622161319

57.813.3

9.67.8

11.4

Stomach Adenocarcinoma, NOSSignet ring cell carcinomaAdenocarcinoma, intestinal typeCarcinoma, NOSAll other

12732191220

60.515.2

9.05.79.5

6036

76

15

48.429.0

5.64.8

12.1

Corpus uteri Adenocarcinoma, NOSEndometrioid carcinomaEndometrial stromal sarcomaMullerian mixed tumorAll other

-----

-----

6229

55

40

44.020.6

3.53.5

28.4

Prostate Adenocarcinoma, NOSCarcinoma, NOSAll other

2543613

83.811.94.3

---

---

Table 2-4 Number and Proportion of Morphological Types for the MostCommon Types of Cancer among Saudi Adults, 1999-2000

%*Primary Site Morphology FemalesNo.

MalesNo. %*

* Relative percentage of morphology type within primary site.

Childhood Cancers in Saudi Arabia 1999-2000 (14 years and under)The total of cases reported among children (0-14 years as defined by the WHO) between January1999 and December 2000 was 1,393. This represented 9.4 % of the total number of cancers inSaudi Arabia. The total reported incidence shows that cancer was more predominant in males thanin females. Seven hundred fifty eight (758) (54.4%) cases were reported among males and 635(45.6%) among females, with a male to female ratio of 119:100. Of all the cases reported, therewere 1,177 Saudis, 195 non-Saudis and 21 of “unknown nationality”.

Childhood cancer is very important not only because of the age of occurrence, but also becausemore than 45% of the Saudi population is under 15 years of age. In addition to this, recent yearshave shown a breakthrough for the cure of many childhood cancers. Childhood cancers accountedfor 10.4% of all cancers among Saudis.

As explained earlier, 21cases of unknown nationality were excluded from the statistical analysis.Table 2-5 demonstrates the distribution of childhood cancer cases by nationality and sex.

Table 2-5 Distribution of Childhood Cancer Cases in Saudi Arabia by Nationality and Sex, 1999-2000

Based on the above, the total number of cases analysed was 1,393 including 1,177 (85.8%)Saudis and 195(14.2%) non-Saudis. Among Saudis, 627 (53.3%) were male and 550(46.7%)were female. The male to female ratio was 114: 100. The leading cancer among the Saudi childrenwas leukaemia, which accounted for 32.5%, followed by Brain (CNS) and Hodgkin’s disease.The following is a listing of the ten most common types of cancer among Saudi children in order ofrelative frequency. Figure 2-7 shows the top ten sites by sex and frequency, and table 2-6 showsthe number and proportion of the morphological types for the most common types of cancer.

32


LeukaemiaBrain, nervous systemHodgkin’s diseaseNon-Hodgkin lymphomaBoneConnective tissueKidneyEyeLiverOvary

32.515.310.8 7.0

6.15.45.15.11.51.2

38218012782726460601814


In-situ 0 0 0 0 0 0 0 0 0 0

Total 627 550 1177 118 77 195 13 8 21 1393


Fig. 2-7 Ten Most Common Types of Cancer among Saudi Children by Sex, 1999-2000

33

Male

Leukaemia 199 (31.8%)Brain, nervous system 101 (16.1%)Hodgkin’s 76 (12.1%)NHL 47 (7.5%)Bone 39 (6.2%)Connective tissue 35 (5.6%)Kidney 30 (4.8%)Eye 28 (4.5%)Liver 12 (1.9%)Testes 10 (1.6%)

Total = 627

Female

Leukaemia 183 (33.3%)Brain, nervous system 79 (14.4%)Hodgkin’s 51 (9.3%)NHL 35 (6.4%)Bone 33 (6%)Eye 32 (5.8%)Kidney 30 (5.5%)Connective tissue 29 (5.3%)Ovary 14 (2.5%)Liver & Thyroid 6 (1.1%) each

Total = 550

Table 2-6 Number and Proportion of Morphological types of the Most Common Types of Childhood Canceramong Saudis, 1999-2000

* Relative percentage of morphology type within primary site

Primary Site Morphology %*FemalesNo.

MalesNo. %*

Leukaemia Acute lymphoblastic leukaemia, NOSAcute myeloid leukaemiaChronic myeloid leukaemiaAll other

15332

311

76.916.1

1.55.5

13428

714

73.215.3

3.87.7

Brain, nervoussystem

Medulloblastoma, NOSPilocytic astrocytomaGlioma, malignantEpendyomoma, NOSGlioblastoma, NOSAll other

391810

41119

38.617.8

104

10.918.8

142516

92

13

17.731.620.311.42.5

16.5Hodgkin’sdisease

Hodgkin’s disease, nodular sclerosis, NOSHodgkin’s disease, mixed cellularity, NOSHodgkin’s disease, lymphocytic predominance, NOSAll other

4216

315

55.321.1

3.919.7

31677

60.811.813.713.7

NHL Burkitt’s lymphoma, NOSMalignant lymphoma, large cell, diffuse, NOSMalignant lymphoma, lymphoblasticAll other

1877

15

38.314.914.931.9

1263

41

34.317.1

8.640.0

Bone Ewing’s sarcomaOsteosarcoma, NOSAll other

1716

6

43.641.015.4

1614

3

48.542.4

9.1Connectivetissue

Embryonal rhabdomyosarcomaGanglioneuroblastomaInfantile fibrosarcomaAll other

1055

15

28.614.314.342.9

491

15

13.831.0

3.451.7

Kidney Nephroblastoma, NOSAll other

282

93.30.7

273

90.010.0

Eye Retinoblastoma, NOSRetinoblastoma, undifferentiatedRetinoblastoma, differentiatedAll other

1783

-

60.728.610.7

-

161132

50.034.3

9.46.3

Liver HepatoblastomaAll other

93

7525

6-

100.0-

Ovary DysgerminomaEndodermal sinus tumorMixed germ cell tumorAll other

----

----

7223

50.014.314.321.4

Thyroid Papillary carcinoma, NOSMedullary carcinoma, NOSPapillary carcinoma, follicular variant

321

50.033.316.6

6--

100.0--

34

Cancer in the 13 Administrative Regions of the Kingdom

The following bar charts list the most common sites in the 13 administrative regions of SaudiArabia by sex. These sites are listed on the basis of the total number of cases reported by eachregion. In the majority of regions breast cancer was the leading cancer in women while amongmen, NHL, Liver, and Leukemia inter-change. It is worth noting that the major regions such asRiyadh, Makkah and Eastern Province reported the most cases. This can be attributed to theincreasing number of people seeking medical attention in these urbanized cities with modern hospitalfacilities.

Fig. 2-8-1 Riyadh Region, 1999-2000 (Percentage Distribution)

Fig. 2-8-2 Najran Region, 1999-2000 (Percentage Distribution)

35

36

4

4

5

5

6

6

6

8

9

12

0 10 20 30 40 50

Ot her sit es

Hodgkin's

Lung

Bladder

Skin

Brain, CNS

Colo-rectal

Prostat e

Leukaemia

NHL

Liver

M a l e s ( 18 2 5 )

34

3

3

3

4

4

6

7

7

12

18

0 10 20 30 40 50

Ot her sit es

Cervix ut er i

Hodgkin's

Ovary

Brain, CNS

Liver

NHL

Leukaemia

Colo-rect al

Thyroid

Breast

Fe ma le s ( 18 17 )

40

3

4

4

5

7

7

7

8

8

9

0 10 20 30 40 50

Ot her sit es

Prost at e

Hodgkin's

Skin

Brain, CNS

Colo-rectal

Leukaemia

Thyroid

NHL

Liver

Female breast

Al l ( 3 6 4 2 )

18

4

4

4

4

4

5

5

5

7

7

10

11

13

0 10 20 30 40 50

Ot her sit es

Hodgkin's

Kidney

Pancreas

St omach

Thyroid

Bone

Lung

Colo-rectal

Brain, CNS

Skin

Leukaemia

Liver

NHL

M a l e s ( 114 )

32

3

3

3

3

3

5

5

5

6

6

7

9

9

0 10 20 30 40 50

Other sit es

Thyroid

Brain, CNS

Bladder

Ovary

Salivary glands

Skin

Bone

St omach

Liver

Colo-rectal

Breast

Leukaemia

NHL

Fe ma l e s ( 8 7 )

31

3

3

3

4

4

5

6

6

6

9

10

11

0 10 20 30 40 50

Ot her sit es

Hodgkin's

Female breast

Lung

Thyroid

Stomach

Bone

Brain, CNS

Colo-rectal

Skin

Liver

Leukaemia

NHL

A l l ( 2 0 1)

Fig. 2-8-3 Eastern Region, 1999-2000 (Percentage Distribution)

Fig. 2-8-4 Makkah Region, 1999-2000 (Percentage Distribution)

Fig. 2-8-5 Northern Region, 1999-2000 (Percentage Distribution)36

34

4

4

5

6

6

6

8

9

9

10

0 10 20 30 40 50

Ot her sit es

Skin

Liver

Brain, CNS

Hodgkin's

Prostat e

Bladder

NHL

Leukaemia

Colo-rectal

Lung

M a le s ( 8 9 5 )

28

3

3

3

4

4

6

6

6

10

27

0 10 20 30 40 50

Ot her sit es

Corpus ut er i

Ovary

Cervix ut er i

Brain, CNS

Hodgkin's

Colo-rect al

Leukaemia

NHL

Thyroid

Breast

Fe ma l e s ( 8 6 4 )

37

3

4

4

5

6

6

7

7

7

13

0 10 20 30 40 50

Ot her sit es

Prost at e

Brain, CNS

Bladder

Hodgkin's

Lung

Thyroid

NHL

Leukaemia

Colo-rectal

Female breast

Al l ( 17 5 9 )

35

4

4

5

6

6

7

8

8

9

10

0 10 20 30 40 50

Ot her sit es

Brain, CNS

St omach

Hodkin's

Prostat e

Bladder

Colo-rectal

Lung

Liver

Leukaemia

NHL

M a l e s ( 12 0 9 )

31

3

3

3

4

4

6

6

7

7

27

0 10 20 30 40 50

Ot her sit es

Lung

Corpus ut er i

Liver

Cervix ut er i

Ovary

Leukaemia

NHL

Colo-rect al

Thyroid

Breast

Fe ma le s ( 12 5 2 )

39

3

3

4

4

5

6

7

7

8

14

0 10 20 30 40 50

Ot her sit es

Hodgkin's

Brain, CNS

Bladder

Thyroid

Lung

Liver

Colo-rectal

Leukaemia

NHL

Female breast

Al l ( 2 4 6 1)

12

4

4

4

4

8

8

8

8

10

12

12

0 10 20 30 40 50

Ot her sit es

Kidney

Bladder

Bone

Liver

Colo-rect al

Brain, CNS

Lung

Larynx

Nasopharynx

Leukaemia

NHL

M a l e s ( 4 9 )

15

5

5

5

5

5

5

10

10

13

21

0 10 20 30 40 50

Ot her sit es

NHL

Bladder

Lung

Liver

Colo-rect al

Tongue

Leukaemia

Pancreas

Thyroid

Breast

Fe ma l e s ( 3 9 )

22

5

5

5

5

5

6

7

7

7

9

9

11

0 10 20 30 40 50

Ot her sit es

Brain, CNS

Bladder

Larynx

Liver

Colo- rect al

Pancreas

Thyroid

Lung

Nasopharynx

NHL

Female breast

Leukaemia

Al l ( 8 8 )

Fig. 2-8-6 Qassim Region, 1999-2000 (Percentage Distribution)

Fig. 2-8-7 Jazan Region, 1999-2000 (Percentage Distribution)

Fig. 2-8-8 Hail Region, 1999-2000 (Percentage Distribution)37

34

4

5

5

5

6

6

7

9

10

10

0 10 20 30 40 50

Ot her sit es

Lung

Brain, CNS

Colo-rect al

Oesophagus

Hodgkin's

NHL

St omach

Liver

Leukaemia

Nasopharynx

M a l e s ( 2 8 2 )

32

3

3

4

5

5

7

8

8

13

14

0 10 20 30 40 50

Ot her sit es

Skin

Cervix ut er i

Corpus ut er i

Hodgkin's

Ovary

NHL

Leukaemia

Colo-rect al

Thyroid

Breast

Fe ma l e s ( 2 8 3 )

38

4

4

5

6

6

7

7

7

8

9

0 10 20 30 40 50

Ot her sit es

Oesophagus

St omach

Hodgkin's

Liver

Nasopharynx

Colo-rect al

NHL

Female breast

Thyroid

Leukaemia

Al l ( 5 6 5 )

36

4

4

5

5

5

6

7

7

9

12

0 10 20 30 40 50

Ot her sit es

Hodgkin's

Prostat e

Brain, CNS

Colo-rectal

Mout h

Skin

Bladder

Leukaemia

NHL

Liver

M a l e s ( 2 15 )

33

4

4

5

5

5

6

6

7

9

15

0 10 20 30 40 50

Other sit es

t hyroid

Ovary

NHL

Liver

Colo-rectal

Leukaemia

Skin

Tongue

Breast

Mout h

Fe ma l e s ( 2 0 3 )

39

4

4

5

5

5

6

7

7

8

10

0 10 20 30 40 50

Other sit es

Brain, CNS

Female breast

Bladder

Tongue

Colo-rectal

Skin

Leukaemia

NHL

Liver

Mout h

A l l ( 4 18 )

48

4

4

4

5

6

7

7

7

9

10

0 10 20 30 40 50

Ot her sit es

Pancreas

Prost at e

Lung

Bone

Liver

Hodgkin's

Colo-rect al

Nasopharynx

Leukaemia

NHL

M a l e s ( 13 9 )

30

3

3

4

4

4

5

6

6

18

19

0 10 20 30 40 50

Ot her sit es

Ovary

Nasopharynx

NHL

Hodgkin's

Skin

Leukaemia

Brain, CNS

Colo-rect al

Breast

Thyroid

Fe ma l e s ( 12 8 )

39

4

4

4

5

5

6

7

7

9

11

0 10 20 30 40 50

Ot her sit es

Bone

Brain, CNS

Liver

Nasopharynx

Hodgkin's

Colo-rect al

Leukaemia

NHL

Female breast

Thyroid

Al l ( 2 6 7 )

Fig. 2-8-9 Madinah Region, 1999-2000 (Percentage Distribution)

Fig. 2-8-10 Baha Region, 1999-2000 (Percentage Distribution)

Fig. 2-8-11 Tabuk Region, 1999-2000 (Percentage Distribution)38

30

4

4

6

6

6

7

8

9

10

11

0 10 20 30 40 50

Ot her sit es

Nasopharynx

Kidney

Brain, CNS

Bladder

Hodgkin's

Colo-rect al

Lung

NHL

Leukaemia

Liver

M a l e s ( 3 5 7 )

29

3

3

4

5

5

5

6

6

9

25

0 10 20 30 40 50

Other sit es

Brain, CNS

Bone

Ovary

NHL

Liver

Hodgkin's

Thyroid

Colo-rectal

Leukaemia

Breast

Fe ma l e s ( 3 7 1)

31

3

3

4

4

5

6

6

7

8

9

13

0 10 20 30 40 50

Other sit es

Kidney

Bladder

Thyroid

Brain, CNS

Lung

Hodgkin's

Colo-rectal

NHL

Liver

Leukaemia

Female breast

A l l ( 7 2 8 )

25

3

3

3

6

7

7

9

9

12

16

0 10 20 30 40 50

Ot her sit es

Thyroid

Prost at e

Bone

Lung

Skin

St omach

Leukaemia

Liver

Bladder

NHL

M a l e s ( 8 9 )

27

4

4

5

6

6

7

7

8

12

12

0 10 20 30 40 50

Ot her sit es

Corpus ut er i

Liver

St omach

Leukaemia

Oesophagus

Thyroid

Skin

NHL

Colo-rect al

Breast

Fe ma l e s ( 9 7 )

31

4

5

6

7

7

7

7

8

8

12

0 10 20 30 40 50

Ot her sit es

Oesophagus

Thyroid

St omach

Female breast

Liver

Bladder

Skin

Leukaemia

Colo-rect al

NHL

A l l ( 18 6 )

32

4

4

4

4

5

6

6

6

10

10

11

0 10 20 30 40 50

Other sit es

Thyroid

Bladder

Prost at e

Oesophagus

Brain, CNS

Bone

Hodgkin's

St omach

NHL

Lung

Leukaemia

M a le s ( 110 )

25

3

3

3

3

5

5

5

5

6

9

12

18

0 10 20 30 40 50

Ot her sit es

Brain, CNS

Kidney

Connect ive t issue

St omach

Hodgkin's

Thyroid

Ovary

Cervix ut eri

Colo-rectal

Leukaemia

NHL

Breast

Fe ma l e s ( 9 4 )

36

3

3

4

4

4

5

6

6

8

10

11

0 10 20 30 40 50

Ot her sit es

Bone

Oesophagus

Brain, CNS

Thyroid

Colo-rectal

St omach

Hodgkin's

Lung

Female breast

Leukaemia

NHL

Al l ( 2 0 4 )

Fig. 2-8-12 Asir Region, 1999-2000 (Percentage Distribution)

Fig. 2-8-13 Jouf Region, 1999-2000 (Percentage distribution)

39

38

4

4

4

4

5

6

8

9

10

11

0 10 20 30 40 50

Ot her sit es

Hodgkin's

Bone

Kidney

St omach

Skin

Bladder

Colo-rectal

Liver

NHL

Leukaemia

M a le s ( 2 8 7 )

29

3

4

4

4

4

7

10

11

12

14

0 10 20 30 40 50

Ot her sit es

Liver

Ovary

Cervix ut er i

Skin

Brain, CNS

Colo-rect al

NHL

Leukaemia

Thyroid

Breast

Fe ma l e s ( 2 8 6 )

38

3

4

4

4

6

7

7

8

10

11

0 10 20 30 40 50

Other sit es

Stomach

Brain, CNS

Bladder

Skin

Liver

Thyroid

Female breast

Colo-rectal

NHL

Leukaemia

A l l ( 5 7 3 )

11

3

3

3

3

3

3

3

3

4

6

6

7

9

10

11

14

0 10 20 30 40 50

Ot her sit es

Leukaemia

Mult iple myeloma

Test is

Connect ive t issue

Liver

Colo-rect al

Oesophagus

Salivary glands

Hodgkin's

Thyroid

Bladder

Prostate

Nasopharynx

Lung

Brain, CNS

NHL

M a l e s ( 7 1)

14

4

4

4

4

4

4

4

6

6

6

6

8

10

14

0 10 20 30 40 50

Ot her sit es

Thyroid

Eye

Kidney

Ovary

Larynx

Liver

Mout h

NHL

Hodgkin's

Cervix ut eri

Bone

Connect ive t issue

Leukaemia

Breast

Fe ma l e s ( 4 9 )

41

4

5

5

5

5

6

6

6

7

11

0 10 20 30 40 50

Ot her sit es

Prost ate

Hodgkin's

Thyroid

Connect ive t issue

Nasopharynx

Leukaemia

Female breast

Lung

Brain, CNS

NHL

A l l ( 12 0 )

International Comparison of Age-Standardized Incidence Rates

Worldwide, it is estimated that over 10,055,551 people developed cancer in 2000. Of these,53.5% were in developing countries and 46.5% were in more developed countries. According to2000 estimates, the most common cancer site in men was lung cancer. In developed countries itwas followed by prostate, colo-rectal and stomach cancers. In developing regions, stomach canceris the second most frequently appearing cancer, followed by liver, esophagus and colo-rectalcancers, with wide regional variations. In women, breast cancer was the most common followedby colo-rectal, lung and stomach cancers in developed countries and cancers of the cervix, stomachand lung in developing regions.

Comparison of ASR for Saudi Males and Females with 2000 ASR Estimation in Selected Countries

Fig. 2-9 Shows the 2000 ASR Estimation in Selected Countries among the Females and Male

40

63.5

71.1

78.0

87.1

102.7

111.1

111.6

174.0

176.8

182.5

250.1

253.4

275.9

283.0

296.9

303.2

0 50 100 150 200 250 300 350 400 450

* Saudi A rabia

Gambia

Oman

Congo Brazaville

Egypt

Jordan

Kuw ait

Mongolia

Haiti

Vanuatu

Sw eden

Netherlands

Hungary

United States of America

Denmark

New Zealand

ASR (per 100,000)

* Actual Rate (Not Estimation)

Mal

esFe

mal

es

55.8

61.6

70.7

96.0

97.1

120.2

123.6

163.3

184.9

238.6

262.0

278.7

299.6

361.4

375.3

405.0

0 50 100 150 200 250 300 350 400 450

Congo Brazav ille

* Saudi A rabia

Gambia

Oman

Kuw ait

Jordan

Egypt

V anuatu

Haiti

Mongolia

Sw eden

Denmark

Netherlands

United States of A merica

New Zealand

Hungary

ASR (pe r 100,000)

PART IIICANCER INCIDENCE FOR SPECIFIC SITES

1999-2000

41

Cancer Incidence for Specific Sites 1999-2000

In this section the incidence of the 14 most predominant cancers in Saudi Arabia is outlined inorder, according to their relative frequency in the whole Saudi population. The relevant dataincorporate details for all patients presented over the period of January 1999 through December2000.

42


Female breastNon-Hodgkin lymphomaLeukaemiaColo-rectalLiverThyroidBrain, nervous systemLungHodgkin’s diseaseBladderSkinProstateOvaryCervix uteri

1157882861753696695456454433381380304205167

10.27.87.66.66.16.14.04.03.83.43.42.71.81.5

Female Breast (C50)

Between January 1999 and December 2000, there were 1,157 cases of female breast cancer.Breast cancer is the most common cancer, ranked first among females and it accounted for 20.6%of all newly diagnosed female cancers (5,617). The ASR was 13.6/100,000 for female population.The mean age at diagnosis was 49 years. The five regions with the highest ASR were the Easternregion at 21.2/100,000, Riyadh region at 19.9/100,000, Madinah region at 16.9/100,000, Makkahregion at 16.4/100,000 and Hail Region at 9.4/100,000.

Cancer of the breast is the most common cancer in the world among women. The estimatednumber of cases diagnosed worldwide in 2000 was 1,050,346. Fifty-five point two percent (55.2%)were in more developed countries. Incidence rates were highest in Western Europe, North America,and Northern Europe.

0

5

10

15

20

25

30

35

40

45

50

0- 5- 10- 15- 20- 25- 30- 35- 40- 45- 50- 55- 60- 65- 70- 75+

Age groups

AIR

(per

100

,000

)

Fig. 3-1 Average Age-Specific Incidence Rate (AIR) for Female Breast Cancer in Saudi Arabia, 1999-2000

43

AIR

(per

100

,000

)

3.0

3.2

3.4

4.4

5.8

8.2

8.5

9.0

9.4

16.4

16.9

19.9

21.2

0 5 10 15 20 25

Baha

Najran

Jazan

Asir

Jouf

Qasim

Tabuk

Northern

Hail

Makkah

Madinah

Riyadh

Eastern

Female (1157)

Fig. 3-2 ASR Regional Distribution of Female Breast Cancer in Saudi Arabia, 1999-2000

Table 3-1 Histology of Female Breast Cancer in Saudi Arabia, 1999-2000

ICD-0 Code Histology %8500801085208522851085418480850190208140

Infiltrating duct carcinomaCarcinoma, NOSLobular carcinoma, NOSInfiltrating duct and lobular carcinomaMedullary carcinoma, NOSPaget’s disease and infiltrating duct CarcinomaMucinous adenocarcinomaComedocarcnimoa, NOSPhyllodes tumor, malignantAdenocarcinoma, NOSAll others

78.94.84.51.61.61.41.01.00.90.83.5

44

20.4%

48.1%

12.6%

18.6%0.3%

InsituLocalizedRegionalDistantUnknown

Fig. 3-3 Stage Distribution of Female Breast Cancer in Saudi Arabia, 1999-2000

Table 3-2 Comparison of ASR for Breast Cancer among Saudi Females with 2000 ASR Estimation inSelected Countries

* Source: GLOBOCAN 2000: Cancer Incidence Mortality and Prevalence Worldwide. International Agency for research onCancer (IARC), Lyon, 2001** Actual rate (not estimation)

45

CountryNetherlands 91.6United States of America 91.4France 83.2Pakistan 50.1Jordan 33.0Japan 31.4Saudi Arabia 13.6Korea, Republic 12.5Oman 11.7Haiti 4.7

ASR* (Female)

**

Non-Hodgkin’s Lymphoma (C82-C85;C96)

Between January 1999 and December 2000 there were 882 cases of non-Hodgkin’s lymphomaaccounting for 7.8% of all newly diagnosed cancers (11,330). The overall ASR was 4.9/100,000.The ASR was 5.7/100,1000 in males and 4.0/100,000 in females. This cancer ranked first inmales and fifth in females and affected 528(59.9%) males and 354(40.1%) females with a male tofemale ratio of 149:100. The mean age at diagnosis was 51 years in males and 48 years in females.The five regions with the highest incidence rates were Riyadh region at 8.5/100,000, Najranregion at 6.9/100,1000, the Eastern region at 5.8/100,000, the Northern region at 5.3/100,000and Tabuk region at 4.9/100,000.

NHL is the tenth most common cancer in the world. The estimated number of cases diagnosedworldwide in 2000 was 287,428, with 50.9% in more developed countries. Incidence rates werehighest in North America, Australia/New Zealand, Northern and Western Europe.

Fig. 3-4 Average Age-Specific Incidence Rates (AIR) for NHL in Saudi Arabia, 1999-2000

46

0

5

10

15

20

25

30

35

0- 5- 10- 15- 20- 25- 30- 35- 40- 45- 50- 55- 60- 65- 70- 75+

Age Groups

AIR

(per

100

,000

)

male female

Fig. 3-5 ASR Regional Distribution of NHL in Saudi Arabia, 1999-2000

Table 3-3 Histology of NHL, 1999-2000


Malignant lymphoma large cell, diffuse, NOSMalignant lymphoma, NOSMalignant lymphoma, non-Hodgkin’s, NOSBurkitt’s lymphomaMalignant lymphoma, small lymphocytic, NOSMalignant lymphoma, mixed small and large cell, diffuseMalignant lymphoma, follicular, NOSAll other

42.911.98.84.53.43.32.7

22.5

2.9

2.9

3.0

3.7

4.4

5.2

5.3

5.7

6.0

6.3

7.9

10.0

10.0

0 5 10 15 20 25

Jazan

Asir

Qassim

Baha

Madinah

Northern

Hail

Makkah

Tabuk

Eastern

Jouf

Riyadh

Najran

Male (528)

1.4

1.5

2.1

2.2

2.8

3.1

3.6

3.7

3.8

5.0

5.3

5.5

7.0

0 5 10 15 20 25

Jazan

Jouf

Baha

Hail

Asir

Madinah

Makkah

Tabuk

Najran

Qassim

Eastern

Northern

Riyadh

Female (354)

47

Fig. 3-6 Stage Distribution of NHL in Saudi Arabia, 1999-2000

28.3%

17.7%32.9%

21.1%

LocalizedRegionalDistantUnknown

Table 3-4 Comparison of ASR for NHL among Saudis with 2000 ASR Estimation in Selected Countries

* Source: GLOBOCAN 2000: Cancer Incidence Mortality and Prevalence Worldwide. International Agency for research onCancer (IARC), Lyon,2001** Actual rate (not estimation)

48

CountryUnited States of America 16.1 10.9Australia 14.4 10.8Germany 10.5 6.7China, Hong Kong 8.7 6.4Iraq 6.6 5.0Saudi Arabia 5.7 4.0Iran, Islamic Republic 4.1 3.8India 3.2 1.7Gambia 2.6 1.5Sri Lanka 1.0 0.4

ASR* (Male) ASR* (Female)

** **

Leukaemia (C91-C95)

Between January 1999 and December 2000 there were 861 cases of leukaemia accounting for7.6% of all 11,330 newly diagnosed cancers. The overall ASR was 3.3/100,000. The ASR was3.7/100,000 and 3.0/100,000 in males and females respectively. This cancer ranked third for bothmales and females and affected 479 (55.6%) males and 382 (44.4%) females with a male tofemale ratio of 125:100. The mean age at diagnosis is 28 years in males and 26 years in females.The five regions with the highest ASR were Riyadh region at 5.0/100,000, Najran region at 4.3/100,000, Madinah region at 4.0/100,000, the Eastern region at 3.9/100,000 and Qassim regionat 3.7/100,000.

Leukaemia is the twelveth most common cancer in the world. The estimated number of casesdiagnosed worldwide in 2000 was 257,076, with 58.8% in less developed countries. Incidencerates were highest in the Caribbean, Australia/New Zealand, Northern Europe, and Eastern Africa.

0

2

4

6

8

10

12

14

0- 5- 10- 15- 20- 25- 30- 35- 40- 45- 50- 55- 60- 65- 70- 75+

Age groups

male female

AIR

(per

100

,000

)

Fig. 3-7 Average Age-Specific Incidence Rate (AIR) for Leukaemia in Saudi Arabia, 1999-2000

49

AIR

(per

100

,000

)

Table 3-5 Histology of Leukaemia, 1999-2000


Acute lymphoblastic leukaemia, NOSAcute myeloid leukaemiaChronic myeloid leukaemiaChronic lymphocytic leukaemiaAcute promyelocytic leukaemiaAcute myelomonocytic leukaemiaAcute Leukaemia, NOSAll Others

43.621.415.38.91.71.61.56.0

Table 3-6 Comparison of ASR for Leukaemia among Saudis with 2000 ASR Estimation in Selected Countries

0.6

1.4

2.4

2.4

3.0

3.1

3.2

3.5

4.3

4.4

4.5

5.2

5.4

0 5 10 15 20 25

Jouf

Jazan

Tabuk

Asir

Baha

Hail

Makkah

Northern

Madinah

Qasim

Eastern

Riyadh

Najran

Male (479)

1.2

1.5

1.6

1.8

2

2.1

2.7

2.7

3

3.1

3.4

3.7

4.7

0 5 10 15 20 25

Jouf

Jazan

Hail

Tabuk

Baha

Northern

Makkah

Asir

Qasim

Najran

Eastern

Madinah

Riyadh

Female (382)

Fig. 3-8 ASR Regional Distribution of Leukaemia in Saudi Arabia, 1999-2000


50

CountryHaiti 15.2 10.2New Zealand 11.9 8.7Jordan 8.1 5.0China, Hong Kong 6.7 4.8Cuba 6.1 4.8Tunisia 4.8 4.4Saudi Arabia 3.7 3.0India 3.1 2.1Algeria 2.8 1.5Senegal 0.9 0.2


** **

Colo-rectal (C18-C21)

Between January 1999 and December 2000 there were 753 cases of colo-rectal cancer accountingfor 6.6% of all 11,330 newly diagnosed cases. The overall ASR was 4.9/100,000. The ASR was5.0/100,000 in males and 4.7/100,000 in females. This cancer ranked fourth in both males andfemales and affected 389 (51.7%) males and 364 (48.3%) females with a male to female ratio of107:100. The mean age at diagnosis was 59 years in males and 56 years for females. The fiveregions with the highest ASR were Riyadh region at 8.4/100,000, the Eastern region at 7.7/100,000,Qassim Region at 5.1/100,000, Makkah region at 4.5/100,000 and Madinah region at 4.2/100,000.

Colo-rectal cancer is the third most common cancer in the world. The estimated number of casesdiagnosed worldwide in 2000 was 944,717, with 64.6% in more developed countries. Incidencerates were highest in Australia/New Zealand, Eastern, Northern and Western Europe, and NorthernAmerica.

0

5

10

15

20

25

30

35

0- 5- 10- 15- 20- 25- 30- 35- 40- 45- 50- 55- 60- 65- 70- 75+

Age groups

male female

AIR

(per

100

,000

)

Fig. 3-9 Average Age Specific Incidence rate (AIR) for Colo-rectal Cancer in Saudi Arabia, 1999-2000

51

AIR

(per

100

,000

)

Fig. 3-10 ASR Regional Distribution of Colo-rectal Cancer in Saudi Arabia, 1999-2000

Table 3-7 Histology of Colo-rectal Cancer, 1999-2000


Adenocarcinoma, NOSMucinous adenocarcinomaCarcinoma, NOSSignet ring cell carcinomaAdenocarcinoma in villous adenomaMucin-producing adenocarcinomaAll Others

77.76.83.21.91.71.57.2

1.0

1.5

1.7

1.9

1.9

2.9

3.2

3.8

3.9

4.0

4.8

7.9

9.8

0 5 10 15 20 25

Baha

Tabuk

Jouf

Northern

Jazan

Asir

Najran

Qassim

Hail

Madinah

Makkah

Riyadh

Eastern

Male (389)

0.0

1.8

2.2

2.9

3.0

3.2

3.8

4.2

4.5

5.4

5.9

6.5

8.9

0 5 10 15 20 25

Jouf

Jazan

Asir

Hail

Baha

Tabuk

Najran

Makkah

Madinah

Eastern

Northern

Qassim

Riyadh

Female (364)

52

27.4%

38.7%

15.6%

17.9%0.3%


Fig. 3-11 Stage Distribution of Colo-rectal Cancer, 1999-2000

Table 3-8 Comparison of ASR for Colo-rectal among Saudis with 2000 ASR Estimation in Selected Countries


53

CountryNew Zealand 55.3 43.4United States of America 40.6 30.6China, Hong Kong 35.0 28.9Indonesia 12.0 10.6Bahrain 9.4 8.0Iraq 5.5 4.6Saudi Arabia 5.0 4.7India 4.7 3.2Malawi 3.5 1.6Bangladesh 1.0 0.9


** **

Liver (C22)

Between January 1999 and December 2000 there were 696 cases of liver cancer accounting for6.1% of all 11,330 newly diagnosed cases. The overall ASR was 4.5/100,000. The ASR was 6.5/100,000 in males and 2.6/100,000 in females. This cancer ranked second in males, and eighth infemales and affected 512 (73.6%) males and 184 (26.4%) females with a male to female ratio of279:100. The mean age at diagnosis was 64 years in males and 58 years in females. The fiveregions with the highest ASR were Riyadh region at 10.4/100,000, Najran region at 7.3/100,000,Madinah region at 5.6/100,000, Qassim region at 3.9/100,000 and Makkah region at 3.6/100,000.

Liver cancer is the fifth most common cancer in the world. The estimated number of cases diagnosedworldwide in 2000 was 564,336, with 81.1% in less developed countries. Incidence rates werehighest in Eastern Asia, Eastern and Western Africa, and South-Eastern Asia.

0

5

10

15

20

25

30

35

40

45

50

0- 5- 10- 15- 20- 25- 30- 35- 40- 45- 50- 55- 60- 65- 70- 75+

Age groups

male female

AIR

(per

100

,000

)

Fig. 3-12 Average Age-Specific Incidence Rate (AIR) for Liver Cancer in Saudi Arabia, 1999-2000

54

AIR

(per

100

,000

)

Fig. 3-13 ASR Regional Distribution of Liver Cancer in Saudi Arabia, 1999-2000

Table 3-9 Histology of Liver Cancer, 1999-2000


Hepatocellular carcinoma, NOSMalignant tumor, NOSCholangiocarcinomaAdenocarcinoma, NOSHepatoblastomaSolid carcinoma, NOSAll Others

80.55.73.62.32.21.64.1

1.0

1.9

2.0

2.8

3.2

3.4

3.9

4.0

5.0

5.9

6.6

10.5

15.2

0 5 10 15 20 25

Jouf

Tabuk

Northern

Asir

Hail

Baha

Jazan

Eastern

Makkah

Qassim

Madinah

Najran

Riyadh

Male (512)

0.8

0.8

1.1

1.7

1.8

1.9

1.9

1.9

2.0

2.3

4.1

4.5

5.6

0 5 10 15 20 25

Eastern

Baha

Asir

Jazan

Tabuk

Qassim

Jouf

Hail

Northern

Makkah

Najran

Madinah

Riyadh

Female (184)

55

Fig. 3-14 Stage Distribution of Liver Cancer in Saudi Arabia, 1999-2000

29.7%

13.9%

22.7%

33.6%LocalizedRegionalDistantUnknown

Table 3-10 Comparison of ASR for Liver Cancer among Saudis with 2000 ASR Estimation in Selected Countries


56

CountryMongolia 98.9 57.3Thailand 36.9 15.2Japan 29.2 8.1Sudan 8.3 3.0Spain 7.5 2.4Kuwait 6.8 2.3Saudi Arabia 6.5 2.6Turkey 3.6 1.0United Kingdom 2.2 1.1Sri Lanka 0.7 0.4


** **

Thyroid (C73)

Between January 1999 and December 2000 there were 695 cases of thyroid cancer accountingfor 6.1% of all 11,330 newly diagnosed cases. The overall ASR was 3.3/100,000. ASR in maleswas 1.6/100,000 and 5.1/100,000 in females. This cancer ranked fourth in males and second infemales and affected 156 (22.4%) males and 539 (77.6%) females with a male to female ratio of346:100. The mean age at diagnosis was 44 years in males and 39 years in females. The fiveregions with the highest ASR were Riyadh region at 6.3/100,000, Hail region at 4.8/100,000,Qassim region at 4.3/100,000, the Eastern region at 3.6/100,000, and Najran region at 2.4/100,000.

Thyroid cancer is the twelveth most common cancer in the world. The estimated number of casesdiagnosed worldwide in 2000 was 122,803, with 60.5% in less developed countries. Incidencerates were highest in Melanesia, Polynesia, Northern Europe, Western Asia, and South-EasternAsia.

0

2

4

6

8

10

12

14

0- 5- 10- 15- 20- 25- 30- 35- 40- 45- 50- 55- 60- 65- 70- 75+

Age groups

male female

AIR

(per

10 0

,000

)

Fig. 3-15 Average Age-Specific Incidence Rate (AIR) for Thyroid Cancer in Saudi Arabia, 1999-2000

57

AIR

(per

100

,000

)

Fig. 3-16 ASR Regional Distribution of Thyroid Cancer in Saudi Arabia, 1999-2000


Papillary carcinoma, NOSPapillary and follicular carcinomaFollicular adenocarcinoma, NOSMedullary carcinoma, NOSCarcinoma, anaplastic, NOSOxyphilic adenocarcinomaAll Others

72.913.25.52.31.61.43.1

Table 3-11 Histology of Thyroid Cancer, 1999-2000

0.3

0.6

0.6

0.7

1.0

1.1

1.5

1.5

1.5

2.0

2.4

2.9

3.3

0 5 10 15 20 25

Northern

Jazan

Asir

Tabuk

Makkah

Baha

Qassim

Hail

Madinah

Eastern

Jouf

Riyadh

Najran

Male (156)

1.5

1.5

1.7

1.9

1.9

3.1

3.3

3.4

3.8

5.4

7.2

8.1

9.9

0 5 10 15 20 25

Najran

Jazan

Jouf

Tabuk

Baha

Madinah

Asir

Makkah

Northern

Eastern

Qassim

Hail

Riyadh

Female (539)

58

Fig. 3-17 Stage Distribution of Thyroid Cancer in Saudi Arabia, 1999-2000

Table 3-12 Comparison of ASR for Thyroid Cancer among Saudis with 2000 ASR Estimation in Selected Countries


59

CountryVanuatu 4.1 23.2Iceland 3.9 10.8Philippines 2.5 8.2China, Hong Kong 2.1 7.3Germany 2.0 3.7Saudi Arab ia 1.6 5.1Japan 1.4 4.8Yemen 1.5 3.1India 1.0 1.9Mongolia 0.1 1.0


** **

44.0%

33.5%

7.1%

15.3%0.1%


Brain, nervous system (C70-C72)

Between January 1999 and December 2000 there were 456 cases of brain and central nervoussystem cancer accounting for 4% of all newly diagnosed cases. The overall ASR was 1.9/100,000.The ASR was 2.3/100,000 in males and 1.6/100,000 in females. This cancer ranked eighth inmales and seventh in females and affected 270(59.2%) males and 186 (40.8%) females with amale to female ratio of 145:100. The mean age diagnosis was 32 years in males and 30 years infemales. The five regions with the highest ASR were Riyadh region at 3.7/100,000, the Northernregion at 2.3/100,000, Qassim and the Eastern region at 2.0/100,000 for each, and both Hail andNajran regions at 1.9/100,000.

Brain and CNS cancer is the seventeenth most common cancer in the world. The estimated numberof cases diagnosed worldwide in 2000 was 176,056, with 58.2% in less developed countries.Incidence rates were highest in Northern and Southern Europe, and Western Asia.

0

1

2

3

4

5

6

7

8

9

0- 5- 10- 15- 20- 25- 30- 35- 40- 45- 50- 55- 60- 65- 70- 75+

Age groups

male female

AIR

(per

100

,000

)

Fig. 3-18 Average Age-Specific Incidence Rate (AIR) for Brain, CNS Cancer in Saudi Arabia, 1999-2000

60

AIR

(per

100

,000

)

Fig. 3-19 ASR Regional Distribution of Brain, CNS Cancer in Saudi Arabia, 1999-2000

0.8

0.9

1.0

1.2

1.5

1.7

2.1

2.3

2.9

2.9

3.5

4.2

4.6

0 5 10 15 20 25

Asir

Hail

Baha

Tabuk

Jazan

Makkah

Eastern

Madinah

Qassim

Najran

Jouf

Riyadh

Northern

Male (270)

Table 3-13 Histology of Brain, CNS Cancer, 1999-2000


Glioblastoma, NOSAstrocytoma, NOSMedulloblastoma, NOSPilocytic AstrocytomaMalignant gliomaEpendymoma, NOSAll Others

20.415.512.99.49.05.5

27.3

61

0.0

0.0

0.7

0.8

0.9

0.9

0.9

1.0

1.1

1.2

2.0

2.9

3.2

0 5 10 15 20 25

Northern

Jouf

Jazan

Baha

Tabuk

Najran

Asir

Madinah

Makkah

Qassim

Eastern

Hail

Riyadh

Female (186)

Fig. 3-20 Stage Distribution of Brain, CNS Cancer in Saudi Arabia, 1999-2000

61.0%16.4%

2.4%

20.2%


Table 3-14 Comparison of ASR for Brain, CNS Cancer among Saudis with 2000 ASR Estimation inSelected Countries


62

CountrySweden 11.1 11.3Greece 10.6 7.1Norway 8.0 6.6United States of America 6.5 4.4China, Hong Kong 4.4 3.4Bahrain 4.7 2.6Saudi Arabia 2.3 1.6Tunisia 2.1 1.2Indonesia 1.4 0.8Zambia 0.1 0.1


** **

Lung (C33-C34)

Between January 1999 and December 2000 there were 454 cases of lung cancer accounting for4.0% of all 11,330 newly diagnosed cases. The overall ASR was 2.9/100,000. The ASR was 4.5/100,000 in males and 1.4/100,000 in females and affected 354 (78%) males and 100 (22%)females with a male to female ratio of 355:100. Lung cancer ranked fifth in males and seventeenthin females. The mean age at diagnosis was 64 years for males and females. The five regions withthe highest ASR were the Eastern region at 6.3/100,000, Riyadh region at 4.2/100,000, bothMakkah and the Northern region at 3.4/100,000, and Madinah region at 3.2/100,000.

Lung cancer is the most common cancer in the world. The estimated number of cases diagnosedworldwide in 2000 was 1,238,861, with 52.2% in more developed countries. Incidence rateswere highest in Eastern Europe, Eastern Asia, South Europe, North America, and Western Europe.

0

5

10

15

20

25

30

35

0- 5- 10- 15- 20- 25- 30- 35- 40- 45- 50- 55- 60- 65- 70- 75+

Age groups

male female

AIR

(per

100

,000

)

Fig. 3-21 Average Age-Specific Incidence Rate (AIR) for Lung Cancer in Saudi Arabia, 1999-2000

63

AIR

(per

100

,000

)

0.9

1.1

1.7

2.1

2.5

4.0

4.7

4.7

4.9

5.1

5.7

5.8

10.1

0 5 10 15 20 25

Asir

Jazan

Baha

Qassim

Hail

Najran

Tabuk

Madinah

Northern

Makkah

Jouf

Riyadh

Eastern

Male (354)

Fig. 3-22 ASR Regional Distribution of Lung Cancer in Saudi Arabia, 1999-2000

0.0

0.0

0.0

0.0

0.4

0.5

0.6

1.1

1.7

1.9

2.0

2.3

2.6

0 5 10 15 20 25

Najran

Jazan

Jouf

Asir

Baha

Hail

Tabuk

Qassim

Madinah

Makkah

Northern

Eastern

Riyadh

Female (100)

Table 3-15 Histology of Lung Cancer, 1999-2000


Adenocarcinoma, NOSSquamous cell carcinoma, NOSCarcinoma, NOSSmall cell carcinoma, NOSLarge cell carcinoma, NOSAll Others

29.726.910.69.76.2

16.9

64

Fig. 3-23 Stage Distribution of Lung Cancer in Saudi Arabia, 1999-2000

11.7%

22.5%

39.2%

26.7%


Table 3-16 Comparison of ASR for Lung Cancer among Saudis with 2000 ASR Estimation in Selected Countries

* Source: GLOBOCAN 2000: Cancer Incidence Mortality and Prevalence Worldwide. International Agency forresearch on Cancer (IARC), Lyon,2001** Actual rate (not estimation)

65

CountryHungary 95.5 22.6China, Hong Kong 74.7 32.1United States of America 58.6 34.0Japan 40.3 12.1Yemen 31.2 4.8Morocco 25.6 2.7India 9.0 2.0Saudi Arabia 4.5 1.4Sri Lanka 1.9 1.1Senegal 1.3 0.1


** **

Hodgkin’s Disease (C81)

Between January 1999 and December 2000 there were 433 cases of Hodgkin’s disease accountingfor 3.8% of all 11,330 newly diagnosed cases. The overall ASR was 1.5/100,000. The ASR was1.9/100,000 in males and 1.2/100,000 in females. This cancer ranked ninth in both males andfemales and affected 260 (60%) males and 173 (40%) females with a male to female ratio of150:100. The mean age at diagnosis was 27 years in males and 26 years in females. The fiveregions with the highest ASR were Riyadh region at 2.3/100,000, both the Eastern and Madinahregions at 2.2/100,000, Qassim region at 1.9/100,000 and Hail region at 1.7/100,000.

Hodgkin’s disease is the twenty-fourth most common cancer in the world. The estimated numberof cases diagnosed worldwide in 2000 was 62,158, with 56.5% in less developed countries.Incidence rates were highest in Western Asia, Western Europe, and Northern Africa.

0

0.5

1

1.5

2

2.5

3

3.5

4

4.5

5

0- 5- 10- 15- 20- 25- 30- 35- 40- 45- 50- 55- 60- 65- 70- 75+

Age groups

male female

AIR

(per

100

,000

)

Fig. 3-24 Average Age-Specific Incidence Rate (AIR) for Hodgkin’s Disease in Saudi Arabia, 1999-2000

66

AIR

(per

100

,000

)

Fig. 3-25 ASR Regional Distribution of Hodgkin’s Disease in Saudi Arabia, 1999-2000

0.0

0.7

0.7

0.9

1.1

1.2

1.3

1.7

1.9

2.3

2.5

2.6

2.6

0 5 10 15 20 25

Northern

Jouf

Asir

Jazan

Baha

Tabuk

Najran

Makkah

Qassim

Madinah

Riyadh

Eastern

Hail

Male (260)

0.2

0.3

0.4

0.4

0.4

0.8

0.8

1.2

1.5

1.8

1.8

2.0

2.2

0 5 10 15 20 25

Baha

Asir

Northern

Najran

Jazan

Makkah

Hail

Jouf

Tabul

Eastern

Qassim

Riyadh

Madinah

Female (173)

Table 3-17 Histology of Hodgkin’s Disease, 1999-2000


Hodgkin’s disease, nodular sclerosis, NOSHodgkin’s disease, mixed cellularity, NOSHodgkin’s disease, NOSHodgkin’se disease, lymphocytic predominanceAll Others

53.116.413.96.99.7

67

Fig. 3-26 Stage Distribution of Hodgkin’s Disease in Saudi Arabia, 1999-2000

26.7%

26.9%

28.3%

18.2%


Table 3-18 Comparison of ASR for Hodgkin’s Disease among Saudis with 2000 ASR Estimation inSelected Countries


68

CountryOman 8.0 5.5Jordan 7.0 6.1Kuwait 6.8 6.0Austria 6.4 6.3Bahrain 6.0 3.6Qatar 6.0 3.6United Arab Emirates 6.0 3.6Canada 2.7 2.2Saudi Arabia 1.9 1.2Egypt 0.1 0.1


** **

Urinary Bladder (C67)

Between January 1999 and December 2000 there were 381cases of urinary bladder cancersaccounting for 3.4% of all 11,330 newly diagnosed cases. The overall ASR was 2.4/100,000. TheASR was 3.7/100,000 in males and 1.1/100,000 in females. This cancer ranked seventh in maleand nineteenth in females and affected 301 (79%) males and 80 (21%) females with a male tofemale ratio of 376:100. The mean age at diagnosis was 62 in males and 61 in females. The fiveregions with the highest ASR were the Northern region at 5.3/100,000, the Eastern region at 4.2/100,000, Riyadh region at 4.0/100,000, Jazan region at 2.3/100,000 and both Madinah andMakkah regions at 2.2/100,000 for each.

Bladder cancer is the ninth most common cancer in the world. The estimated number of casesdiagnosed worldwide in 2000 was 335,795, with 58.6% in less developed countries. Incidencerates were highest in Northern Africa, Western Asia, Southern Europe and Eastern Africa.

0

5

10

15

20

25

30

0- 5- 10- 15- 20- 25- 30- 35- 40- 45- 50- 55- 60- 65- 70- 75+

Age groups

Male female

AIR

(per

100

,000

)

Fig. 3-27 Average Age-Specific Incidence Rate (AIR) for Urinary Bladder Cancer in Saudi Arabia, 1999-2000

69

AIR

(per

100

,000

)

Fig. 3-28 ASR Regional Distribution of Urinary Bladder Cancer in Saudi Arabia, 1999-2000

0.7

1.3

1.7

1.7

2.0

2.0

2.4

3.0

3.2

3.5

3.6

6.1

6.1

0 5 10 15 20 25

Najran

Qassim

Hail

Asir

Tabuk

Northern

Jazan

Jouf

Baha

Madinah

Makkah

Eastern

Riyadh

Male (301)

0.0

0.0

0.0

0.6

0.6

0.7

0.9

1.0

1.2

1.7

1.9

2.1

8.8

0 5 10 15 20 25

Qassim

Jouf

Hail

Tabuk

Baha

Asir

Makkah

Madinah

Jazan

Najran

Riyadh

Eastern

Northern

Female (80)

Table 3-19 Histology of Urinary Bladder Cancer, 1999-2000


Papillary transitional cell carcinomaTransitional cell carcinoma, NOSSquamous cell carcinoma, NOSAdenocarcinoma, NOSCarcinoma, NOSAll Others

42.842.5

51.81.66.3

70

47%

20%

10%

23%0.3%


Fig. 3-29 Stage Distribution of Urinary Bladder Cancer in Saudi Arabia, 1999-2000

Table 3-20 Comparison of ASR for Urinary Bladder Cancer among Saudis with 2000 ASR Estimationin Selected Countries


71

CountryEgypt 45.4 8.6Italy 28.0 5.0United States of America 23.4 5.4United Kingdom 19.0 6.0Algeria 13.8 2.0Japan 9.2 2.0Pakistan 8.8 3.4Saudi Arabia 3.7 1.1India 3.2 0.7Bangladesh 1.3 0.1


** **

Skin (Non-Melanoma) (C44)

Between January 1999 and December 2000 there were 380 cases of skin cancers. Accountingfor 3.4% of all 11,330 newly diagnosed cases. The overall ASR was 2.2/100,000. The ASR was2.5/100,000 in males and 2.0/100,000 in females. This cancer ranked tenth in males and eleventhin females and affected 226 (59.5%) males and 154 (40.5%) females with a male to female ratioof 147:100. The mean age at diagnosis was 62 years in males and 58 years in females. The fiveregions with the highest ASR were Riyadh region at 4.6/100,000, Najran region at 3.8/100,000,the Eastern region at 2.5/100,000, Madinah region at 2.0/100,000 and both Qassim and Jazanregions at 1.9/100,000 for each.

0

5

10

15

20

25

30

0- 5- 10- 15- 20- 25- 30- 35- 40- 45- 50- 55- 60- 65- 70- 75+

Age groups

male female

AIR

(per

100

,000

)

Fig. 3-30 Average Age-Specific Incidence Rates (AIR) for Skin Cancer in Saudi Arabia, 1999-2000

72

AIR

(per

100

,000

)

Fig. 3-31 ASR Regional Distribution of Skin Cancer in Saudi Arabia, 1999-2000

0.0

1.2

1.3

1.4

1.5

1.5

1.6

1.6

1.9

1.9

3.3

3.5

5.8

0 5 10 15 20 25

Jouf

Asir

Baha

Hail

Qassim

Madinah

Tabuk

Jazan

Northern

Makkah

Eastern

Najran

Riyadh

Male (226)

0.0

0.0

0.9

1.3

1.5

1.7

1.8

1.9

2.3

2.5

2.6

3.4

4.2

0 5 10 15 20 25

Northern

Jouf

Tabuk

Asir

Makkah

Eastern

Baha

Hail

Jazan

Qassim

Madinah

Riyadh

Najran

Female (154)

Table 3-21 Histology of Skin Cancer (Non-Melanoma), 1999-2000


Basal cell carcinomaSquamous cell carcinomaDermatofibrosarcoma, NOSSquamos cell carcinoma, keratinizing, NOSBasosquamous carcinomaAll Others

51.127.66.34.52.48.1

Fig. 3-32 Stage Distribution of Skin Cancer in Saudi Arabia, 1999-200

67.8%

7.7%

4.5%

20.0%


73

Prostate (C61)

Between January 1999 and December 2000 there were 304 cases of prostate cancer accountingfor 5.3% of all 5,713 newly diagnosed cases among males. The ASR was 3.5/100,000 amongmales. This cancer ranked sixth in males. The mean age at diagnosis was 71 years. The five regionswith the highest ASR were Riyadh region at 8.0/100,000, the Eastern region at 5.9/100,000,Makkah region at 3.6/100,000, Jouf region at 3.5/100,000 and Najran region at 3.2/100,000.

Prostate cancer is the sixth most common cancer in the world among males. The estimated numberof cases diagnosed worldwide in 2000 was 542,990, with 76.5% in more developed countries.Incidence rates were highest in Northern America, Australia/New Zealand, Caribbean, and NorthernEurope.

0

5

10

15

20

25

30

35

40

45

50

0- 5- 10- 15- 20- 25- 30- 35- 40- 45- 50- 55- 60- 65- 70- 75+

Age groups

M ale

AIR

(per

10 0

,000

)

Fig. 3-33 Average Age-Specific Incidence Rate (AIR) for Prostate Cancer in Saudi Arabia, 1999-2000

74

AIR

(per

100

,000

)

Fig. 3-34 ASR Regional Distribution of Prostate Cancer in Saudi Arabia, 1999-2000

0.6

0.9

1.0

1.2

1.6

1.7

1.7

2.2

3.2

3.5

3.6

5.9

8.0

0 5 10 15 20 25

Baha

Northern

Asir

Jazan

Qassim

Hail

Madinah

Tabuk

Najran

Jouf

Makkah

Eastern

Riyadh

Male (304)

Table 3-22 Histology of Prostate Cancer, 1999-2000


Adenocarcinoma, NOSCarcinoma, NOSAll Others

83.611.84.6

75

32.2%

11.6%27.3%

28.9%


Fig. 3-35 Stage Distribution of Prostate Cancer in Saudi Arabia, 1999-2000

Table 3-23 Comparison of ASR for Prostate Cancer among Saudis with 2000 ASR Estimationin Selected Countries


76

CountryUnited States of America 104.3Canada 102.2France 56.5Philippines 18.8Jordan 11.2Egypt 5.6Thailand 4.4Saudi Arab ia 3.5Iran, Islamic Republic 3.1China 1.7

ASR* (Male)

**

Ovary (C56)

Between January 1999 and December 2000 there were 205 cases of ovary cancer among femalesaccouning for 3.6% of all 5,617 newly diagnosed cases among females. The ASR was 2.3/100,000female populations. This cancer ranked sixth in females. The mean age at diagnosis was 46 years.The five regions with the highest ASR were Riyadh region at 3.4/100,000, Jouf region at 3.0/100,000 and Madinah, Makkah and Tabuk regions at 2.6/100,000 each.

Ovarian cancer is the sixth most common cancer in the world among women. The estimatednumber of cases diagnosed worldwide in 2000 was 192,379, with 53.3% in less developedcountries. Incidence rates were highest in Northern Europe, South America, Eastern Europe, andEastern Africa.

0

2

4

6

8

10

12

14

0- 5- 10- 15- 20- 25- 30- 35- 40- 45- 50- 55- 60- 65- 70- 75+

Age groups

female

AIR

(per

100

,000

)

Fig. 3-36 Average Age-Specific Incidence Rate (AIR) for Ovary Cancer in Saudi Arabia, 1999-2000

77

AIR

(per

100

,000

)

0.0

0.2

1.1

1.3

1.5

2.2

2.4

2.5

2.6

2.6

2.6

3.0

3.4

0 5 10 15 20 25

Northern

Baha

Asir

Jazan

Hail

Najran

Eastern

Qassim

Tabuk

Makkah

Madinah

Jouf

Riyadh

Female (205)

Fig. 3-37 ASR Regional Distribution of Ovary Cancer in Saudi Arabia, 1999-2000

Table 3-24 Histology of Ovary Cancer, 1999-2000


Papillary serous cystadenocarcinomaAdenocarcinoma, NOSDysgerminomaEndometrioid carcinomaSerous surface papillary carcinomaTeratoma, malignant, NOSPapillary serous cystadenoma, borderline malignancySerous cystadenocarcinoma, NOSMucinous cystadenocarcinoma, NOSAll Others

14.110.78.87.36.85.94.94.44.4

32.7

78

27.8%

15.6%41.5%

15.1%


Fig. 3-38 Stage Distribution of Ovary Cancer in Saudi Arabia, 1999-2000

Table 3-25 Comparison of ASR for Ovary Cancer among Saudis with 2000 ASR Estimation inSelected Countries


79

CountryDenmark 16.1Iceland 15.8Ethiopia 14.7United Kingdom 12.2China, Hong Kong 7.5Yemen 5.9India 4.9Tunisia 3.0Saudi Arabia 2.3Egypt 1.2

ASR* (Female)

**

Cervix Uteri (C53)

Between January 1999 and December 2000, there were 167 cases of cervix uteri cancer amongfemales accounting for 3.0 % of all 5,617 newly diagnosed cases for females. The ASR was 2.0/100,000 among female population. This cancer ranked tenth in females. The mean age at diagnosiswas 51 years. The five regions with the highest ASR were Jouf region at 3.8/100,000, Riyadhregion at 2.8/100,000, both Makkah and the Eastern regions at 2.7/100,000, and Qassim regionat 2.4/100,000.

Cervix uteri cancer is the second most common cancer in the world among women. The estimatednumber of cases diagnosed worldwide in 2000 was 470,606, with 80.6% in less developedcountries. Incidence rates were highest in the Caribbean, Eastern Africa, Central and South America.

0

1

2

3

4

5

6

7

8

9

0- 5- 10- 15- 20- 25- 30- 35- 40- 45- 50- 55- 60- 65- 70- 75+

Age groups

female

AIR

(per

100

,000

)

Fig. 3-39 Average Age-Specific Incidence Rate (AIR) for Cervix Uteri Cancer in Saudi Arabia,1999-2000

80

AIR

(per

100

,000

)

0.0

0.4

0.5

0.6

0.8

1.1

1.2

2.3

2.4

2.7

2.7

2.8

3.8

0 5 10 15 20 25

Northern

Madinah

Najran

Baha

Jazan

Hail

Asir

Tabuk

Qassim

Eastern

Makkah

Riyadh

Jouf

Female (167)

Fig. 3-40 ASR Regional Distribution of Cervix Uteri Cancer in Saudi Arabia, 1999-2000

Table 3-26 Histology of Cervix Uteri, 1999-2000


Squamous cell carcinoma, NOSSquamous cell carcinoma, non-keratinizing, NOSAdenocarcinoma, NOSSquamous cell, keratinizing, NOSAll Others

57.513.29.67.8

11.9

81

28.1%

41.9%

8.4%

21.0%0.6%


Fig. 3-41 Stage Distribution of Cervix Uteri Cancer in Saudi Arabia, 1999-2000

Table 3-27 Comparison of ASR for Cervix Uteri Cancer among Saudis with 2000 ASR Estimation inSelected Countries


82

CountryHaiti 93.9Tanzania 61.4Zimbabwe 52.1Peru 40.0Egypt 14.0Japan 11.1China 5.2Yemen 4.8Turkey 3.9Syrian Arab Republic 3.0Saudi Arabia 2.0

ASR* (Female)

**

PART IVCANCER INCIDENCE AMONG NON-SAUDIS IN

SAUDI ARABIA, 1999-2000

83

Cancer among the non- Saudi Population 1999-2000

Between January 1999 and December 2000, 3,242 non-Saudi cases were reported to the NCR.Males accounted for 1,769 (54.6%) cases while females accounted for 1,473 (45.4%) . The maleto female ratio is 120:100.

The 15 in-situ cases reported during this period were excluded from the analysis as the currentsoftware program, CanReg 3.21, does not include in-situ cases in the statistical analysis. Therefore,the total number of cases analyzed was 3,227 (1,765 (54.7%) males and 1,462 (45.3%) females).The male to female ratio is 121:100.

Taking into consideration the population structure of non-Saudis and the fact that cancer is primarilya disease of the elderly, the pattern of cancer had some significant differences. Those over 60years represented only 1.7% and the 25 to 54 age-group represented 61% of non-Saudi population.During the 1999 and 2000, just over 6.0% of all cancers occurred before the age of 15, and 60%occurred between age 25 to 54 years. The mean age at diagnosis was 46 years in males and 45years in females. The crude incidence rate (CIR) of all cancers in the non-Saudi population was31.4/100,000 (25.8/100,000 in males and 42.7/100,000 in females). The ten most common cancersseen among the non-Saudi population are as follows:

The distribution of cancer cases among the different nationalities in order of relative frequency is asfollows 612 Yemenis (19%), 435 Sudanese (13.5%), 325 Egyptians (10.1%), 215 Pakistanis(6.7%), 210 Philippines (6.5%), 135 Syrians (4.2%), 133 Indians (4.1%), 118 Jordanians (3.7%),106 Bangladeshis (3.3%), 85 Palestinians (2.6%), 75 Americans (2.3%),71 Indonesians (2.2%),70 Eritreans (2.2%), 49 Bahrainis (1.5%), 48 Ethiopians (1.5%), 43 Lebanese (1.3%), 42 Somalis(1.3%), 41 Nigerians (1.3%), 41 British (1.3%), and 373 cases (11.6%) among other nationalities.

Figure 4-1 represents the most common sites of cancer among all non-Saudi patients designatedby sex. The data were ranked using ICD-9 to include the frequency for the two years.

84


Female breastColo-rectalLeukaemiaNon-Hodgkin lymphomaSkin (non-melanoma)BladderLiverLungBrain, CNSStomach

505255229208149134111110110107

15.67.97.16.44.64.23.43.43.43.3

Male

Colo-rectal 186(10.5%)Leukaemia 159 (9%)NHL 159 (9%)Bladder 110 (6.2%)Skin 102 (5.8%)Liver 89 (5%)Lung 85 (4.8%)Brain & CNS 81 (4.6%)Stomach 80 (4.5%)Prostate 65 (3.7%)

Total = 1765

Female

Breast 505 (34.5%)Cervix uteri 106 (7.3%)Leukaemia 70 (4.8%)Colo-rectal 69 (4.7%)Thyroid 65 (4.4%)Ovary 57 (3.9%)NHL 49 (3.4%)Skin 47 (3.2%)Corpus uteri 40 (2.7%)Hodgkin’s 31 (2.1%)

Total = 1462

Fig. 4-1 Ten Most Common Cancers among non-Saudis by Sex, 1999-2000

0

100

200

300

400

500

600

700

800

0- 5- 10- 15- 20- 25- 30- 35- 40- 45- 50- 55- 60- 65- 70- 75+

Age groups

male female

AIR

(pe r

100

,000

)

Fig. 4-2 Average Age-Specific Incidence Rate (AIR) for All Cancers among non-Saudis in SaudiArabia, 1999-2000

85

AIR

(per

100

,000

)

PART VTABLES

86

Tabl

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Age

Dis

trib

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83

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51

43

74

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ly

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55

45

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93

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& u

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15

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sit

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22

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78

91

81

12

91

70

22

22

29

21

82

15

23

82

88

19

41

98

24

71

00

Tabl

e 5-

1-3

Inci

denc

e R

ates

for

Can

cer

Cas

es a

mon

g Sa

udi M

ales

by

Age

Gro

up (p

er 1

00,0

00),

1999

89

ICD

(10

)A

LL

SIT

ES

To

t.U

NK

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15

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0 -

25

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35

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45

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55

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0-

75

+C

IRA

SR

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--

--

--

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--

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--

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1-C

02

To

ng

ue

25

--

--

--

0.2

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4.6

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08

Sa

liva

ry g

lan

d1

2-

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0.2

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C0

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06

Mo

uth

29

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9.9

4.7

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15

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49

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16

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ma

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98

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11

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10

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lon

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26

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25

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cre

as

50

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31

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13

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32

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ryn

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18

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40

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49

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nn

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tive

tis

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72

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46

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no

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of

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44

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skin

11

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50

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ast

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61

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sta

te1

38

--

--

--

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17

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35

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r m

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68

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y e

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83

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85

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69

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23

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0.2

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0.8

1.1

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0.3

0.4

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72

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in,

ne

rvo

us

syst

em

12

8-

1.3

2.1

0.7

0.9

0.7

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1.9

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1.4

2.8

2.4

8.6

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73

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3.3

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dg

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96

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n0

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dg

kin

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ph

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69

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2.1

3.3

2.8

71

3.3

19

.53

4.7

24

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42

7.6

3.6

6.1

C8

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90

Mu

ltip

le m

yelo

ma

34

--

--

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0.5

0.7

0.9

1.2

4.7

5.9

1.6

3.4

7.1

0.5

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ymp

ho

id l

eu

ka

em

ia1

37

-2

.33

1.3

1.4

1.2

0.6

0.5

0.5

0.7

0.9

1.8

2.3

7.9

2.4

5.7

5.5

1.8

1.9

C9

2M

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eu

ka

em

ia1

07

-0

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31

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2.4

4.6

6.3

1.4

1.8

C9

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on

oc

ytic

leu

ka

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--

0.1

--

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1-

--

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C9

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the

r le

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--

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--

--

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95

Le

uk

ae

mia

un

spe

c.5

-0

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0.3

--

0.3

--

--

1-

--

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er

& u

nsp

eci

fied

13

4-

0.2

--

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4.9

20

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9.7

1.8

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All

site

s2

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60

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0.0

9.7

8.5

11

.51

3.4

14

.52

2.4

31

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8.4

68

.71

12

.71

83

.73

03

.42

58

.43

29

.83

74

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8.8

63

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Tabl

e 5-

1-4

Inci

denc

e R

ates

for

Can

cer

Cas

es a

mon

g Sa

udi F

emal

es b

y A

ge G

roup

(per

100

,000

), 19

99

90

ICD

(10

)A

LL

SIT

ES

To

t.U

NK

.0

5-

10

-1

5-

20

-2

5-

30

-3

5-

40

-4

5-

50

-5

5-

60

-6

5-

70

-7

5+

CIR

AS

RC

00

Lip

7-

--

--

--

-0

.3-

-0

.6-

0.9

-3

.62

.40

.10

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01

-C0

2T

on

gu

e2

9-

0.1

--

--

--

--

0.5

1.7

4.9

4.4

3.3

10

.93

.60

.40

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07

-C0

8S

aliv

ary

gla

nd

8-

-0

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0.9

0.6

--

-1

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0.1

0.2

C0

3-C

06

Mo

uth

41

--

--

--

0.2

-0

.50

.71

.82

.92

.85

.34

.47

.31

0.9

0.6

1.2

C0

9-C

10

Oro

ph

ary

nx

1-

--

--

--

0.2

--

--

--

--

--

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11

Na

so

ph

ary

nx

36

--

-0

.10

.10

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0.9

1.6

2.1

0.5

1.7

4.2

4.4

1.1

1.8

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.50

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12

-C1

3H

ypo

ph

ary

nx

17

--

--

--

0.2

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.30

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1.1

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14

Ph

ary

nx

un

sp

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.0

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--

--

--

--

--

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--

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15

Oe

so

ph

ag

us

55

--

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1.4

0.7

0.5

1.7

2.1

12

.48

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13

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16

Sto

ma

ch

68

--

--

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1.8

21

.80

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17

Sm

all

inte

sti

ne

7-

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--

--

--

--

0.6

1.4

--

1.8

3.6

0.1

0.2

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olo

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10

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19

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tum

86

--

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6.9

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24

Ga

llbla

dd

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etc

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9-

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0.5

1.4

3.2

3.5

4.9

7.1

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13

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25

Pa

nc

rea

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30

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os

e,

sin

us

es

etc

.7

--

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0.7

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32

La

ryn

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33

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4B

ron

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us

, lu

ng

52

--

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0.5

11

.43

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6.9

0.7

1.5

C3

7-C

38

Oth

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Th

ora

cic

org

an

s6

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--

--

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0.6

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0.1

C4

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41

Bo

ne

39

--

0.3

11

.50

.90

.50

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.50

.60

.70

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0.5

0.5

C4

7;C

49

Co

nn

ec

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93

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80

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25

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61

00

Tabl

e 5-

1-7

Inci

denc

e R

ates

for

Can

cer

Cas

es a

mon

g Sa

udi M

ales

by

Age

Gro

up (p

er 1

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00),

2000

93

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(10

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LL

SIT

ES

To

t.U

NK

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10

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20

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30

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61

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site

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70

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11

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4.5

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48

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04

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79

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41

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75

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6.1

59

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Tabl

e 5-

1-8

Inci

denc

e R

ates

for

Can

cer

Cas

es a

mon

g Sa

udi F

emal

es b

y A

ge G

roup

(per

100

,000

), 20

00

94

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(10

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LL

SIT

ES

To

t.U

NK

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10

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20

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30

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50

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5-

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70

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RC

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11

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Age

Sta

ndar

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Rat

es a

nd R

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Freq

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ies f

or A

ll C

ance

r C

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ong

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95

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A

SR

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A

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A

SR

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A

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30

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01

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70

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30

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30

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40

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0.8

0.9

60

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10

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ph

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20

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68

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42

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29

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20

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20

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Tabl

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Age

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ndar

ized

Rat

es a

nd R

elat

ive

Freq

uenc

ies f

or A

ll C

ance

r C

ases

am

ong

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is b

y Si

te a

nd S

ex, N

ajra

n R

egio

n, 1

999-

2000

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ICD

(10

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A

SR

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A

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A

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A

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00

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03

61

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00

12

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nx

00

00

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02

42

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11

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ph

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00

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00

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23

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24

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11

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14

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91

Lym

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My

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eu

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999-

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199

9-20

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67

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ll C

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31

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21

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32

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72

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rvo

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es a

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ll C

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am

ong

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is b

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te a

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ex, J

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ion,

199

9-20

00

101

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54

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18

17

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1.8

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43

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22

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Lym

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33

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44

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ex, H

ail R

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999-

2000

102

ICD

(10

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A

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A

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etc

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53

10

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36

10

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10

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10

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99

20

00

19

99

20

00

Tabl

e 5-2

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ge S

tand

ariz

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ates

and

Rel

ativ

e Fre

quen

cies

for A

ll C

ance

r Cas

es a

mon

g Sa

udis

by S

ite a

nd S

ex, T

abuk

Reg

ion,

199

9-20

00

105

ICD

(10

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LL

SIT

ES

To

t.%

A

SR

To

t.%

A

SR

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t.%

A

SR

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t.%

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SR

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11

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00

00

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01

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00

11

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00

12

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nd

00

00

00

00

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06

Mo

uth

00

00

00

00

01

2.6

31

58

1.8

C0

9-C

10

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ph

ary

nx

00

00

00

00

00

00

C1

1N

as

op

ha

ryn

x1

2.1

10

00

11

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00

C1

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13

Hyp

op

ha

ryn

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00

00

00

00

12

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14

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ary

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un

sp

ec

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00

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15

Oe

so

ph

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12

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4.8

4.5

23

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00

C1

6S

tom

ac

h2

4.3

1.5

57

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3.6

2.6

12

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17

Sm

all

inte

sti

ne

12

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00

11

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35

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24

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00

00

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34

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nc

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po

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of

sk

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44

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ce

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51

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01

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68

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12

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11

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12

.10

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00

00

00

00

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72

Bra

in,

ne

rvo

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sy

ste

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14

6.3

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se

24

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kin

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11

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00

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ye

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00

00

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91

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ph

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le

uk

ae

mia

36

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4.8

0.7

23

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le

uk

ae

mia

24

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6.3

2.5

23

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2.6

0.8

C9

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le

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00

00

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r le

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pe

c.

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& u

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pe

cif

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12

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6.3

40

00

25

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All

sit

es

47

10

03

4.9

63

10

05

0.2

56

10

05

0.2

38

10

03

4.1

Ma

leF

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ale

19

99

20

00

19

99

20

00

Tabl

e 5-

2-12

Age

Sta

ndar

ized

Rat

es a

nd R

elat

ive

Freq

uenc

ies f

or A

ll C

ance

r C

ases

am

ong

Saud

is b

y Si

te a

nd S

ex, A

sir

Reg

ion,

199

9-20

00

106

ICD

(10

)A

LL

SIT

ES

To

t.%

A

SR

To

t.%

A

SR

To

t.%

A

SR

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t.%

A

SR

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00

00

01

0.7

0.3

00

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01

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2T

on

gu

e1

0.6

0.2

21

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2.8

11

0.7

0.3

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7-C

08

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liva

ry g

lan

d1

0.6

0.2

00

01

0.7

0.3

10

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03

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6M

ou

th2

1.3

0.4

10

.80

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0.7

0.3

00

0C

09

-C1

0O

rop

ha

ryn

x0

00

00

00

00

10

.70

.1C

11

Na

so

ph

ary

nx

31

.90

.53

2.3

0.8

10

.70

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1.4

0.3

C1

2-C

13

Hyp

op

ha

ryn

x2

1.3

0.5

10

.80

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00

10

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14

Ph

ary

nx

un

sp

ec

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00

00

00

00

00

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15

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so

ph

ag

us

21

.30

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2.3

0.8

00

03

2.1

0.8

C1

6S

tom

ac

h7

4.5

1.3

53

.81

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0.7

0.3

64

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17

Sm

all

inte

sti

ne

00

01

0.8

0.3

00

00

00

C1

8C

olo

n7

4.5

1.9

75

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2.8

1.1

10

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ec

tum

74

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2.3

0.8

11

7.8

2.4

32

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22

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er

12

7.7

2.7

13

9.8

2.8

42

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23

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allb

lad

de

r e

tc.

10

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1.5

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21

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31

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30

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us

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us

, lu

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cic

org

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00

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21

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32

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47

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9C

on

ne

cti

ve

tis

su

e5

3.2

0.7

32

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2.1

0.4

32

.10

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45

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so

the

liom

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0.3

00

01

0.7

0.3

00

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46

Ka

po

si's

sa

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ma

00

00

00

00

00

00

C4

3M

ela

no

ma

of

sk

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00

21

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00

00

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44

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sk

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53

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62

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sti

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12

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54

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51

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31

21

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69

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53

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00

21

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70

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erv

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42

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32

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14

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74

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dg

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53

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10

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82

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96

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n-H

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iple

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32

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00

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eu

ka

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96

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6.4

1.3

85

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92

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elo

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eu

ka

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53

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53

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5.5

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uk

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00

00

00

00

00

00

C9

4O

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r le

uk

ae

mia

10

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00

10

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00

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5L

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ka

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pe

c.

10

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00

00

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00

Oth

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74

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2.3

21

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4.8

1.8

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sit

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15

51

00

30

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32

10

02

7.7

14

11

00

29

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45

10

03

0

Ma

leF

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ale

19

99

20

00

19

99

20

00

Tabl

e 5-

2-13

Age

Sta

ndar

ized

Rat

es a

nd R

elat

ive

Freq

uenc

ies f

or A

ll C

ance

r C

ases

am

ong

Saud

is b

y Si

te a

nd S

ex, J

ouf R

egio

n, 1

999-

2000

107

ICD

(10

)A

LL

SIT

ES

To

t.%

A

SR

To

t.%

A

SR

To

t.%

A

SR

To

t.%

A

SR

C0

0L

ip0

00

00

00

00

00

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on

gu

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00

00

00

00

00

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aliv

ary

gla

nd

12

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3.0

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00

00

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C0

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Mo

uth

00

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, s

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28

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of

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r m

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rain

, n

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37

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75

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ne

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00

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gk

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dis

ea

se

12

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85

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kin

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15

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41

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88

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iple

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12

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14

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03

12

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40

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92

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elo

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ka

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93

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no

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00

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94

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00

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95

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uk

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sp

ec

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r &

un

sp

ec

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13

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00

28

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sit

es

38

10

05

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33

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04

52

41

00

36

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51

00

30

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Ma

leF

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ale

19

99

20

00

19

99

20

00

Tabl

e 5-

3-1

Age

Dis

trib

utio

n of

Can

cer

Cas

es a

mon

g no

n-Sa

udi M

ales

, 199

9

108

ICD

(10

)A

LL

SIT

ES

To

t.U

NK

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-5

-1

0-

15

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0-

25

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0-

35

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45

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0-

55

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65

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75

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C

00

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1-

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1-C

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ng

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14

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08

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liva

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lan

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3-

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03

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11

1-

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09

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--

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11

Na

so

ph

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32

--

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12

32

10

43

12

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13

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12

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63

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lad

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76

14

78

66

46

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64

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68

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19

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12

16

21

11

12

C6

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70

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rain

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ou

s s

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27

91

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11

32

21

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14

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73

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1-

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26

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75

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se

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63

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96

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n-H

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ma

83

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23

25

59

71

17

11

64

31

38

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62

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uk

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mia

45

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23

44

76

38

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14

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93

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uk

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mia

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95

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uk

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mia

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sp

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the

r &

un

sp

ec

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48

51

08

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21

25

All

site

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44

01

61

73

01

92

34

25

39

11

17

10

91

30

87

75

46

38

51

10

0

Tabl

e 5-

3-2

Age

Dis

trib

utio

n of

Can

cer

Cas

es a

mon

g no

n-Sa

udi F

emal

es, 1

999

109

ICD

(10

)A

LL

SIT

ES

To

t.U

NK

.0

-5

-1

0-

15

-2

0-

25

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0-

35

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0-

45

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0-

55

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0-

65

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0-

75

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C

00

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gu

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--

--

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gla

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ph

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11

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11

24

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11

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all

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12

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ne

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49

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nn

ec

tiv

e t

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11

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45

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so

the

liom

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46

Ka

po

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Me

lan

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kin

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1-

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r s

kin

19

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11

62

21

12

32

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74

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83

05

25

44

93

41

11

88

53

37

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rus

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ec

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51

--

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81

35

64

62

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58

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54

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s u

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21

--

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15

13

23

32

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56

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etc

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33

4-

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12

25

3.8

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52

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the

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ma

le g

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ita

l5

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--

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21

1-

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67

Bla

dd

er

11

--

--

--

1-

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11

22

11

11

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64

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6;C

68

Kid

ne

y e

tc.

9-

21

--

--

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11

1-

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1.2

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--

--

--

--

--

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70

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2B

rain

, n

erv

ou

s s

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m1

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18

2-

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1-

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1-

1-

1-

2.2

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hyr

oid

35

--

--

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15

87

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14

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74

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the

r e

nd

oc

rin

e2

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--

--

--

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--

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81

Ho

dg

kin

's d

ise

as

e1

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-1

22

33

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22

--

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-1

2.6

C8

2-C

85

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6N

on

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dg

kin

lym

ph

om

a2

2-

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22

41

--

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31

2-

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88

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ult

iple

mye

lom

a1

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--

--

--

--

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4-

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1.6

C9

1L

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ho

id l

eu

ka

em

ia1

4-

33

-2

1-

22

-1

--

--

--

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on

ocy

tic le

uk

ae

mia

1-

--

--

--

0.4

--

--

--

--

-0

.1-

C9

4O

the

r le

uk

ae

mia

0-

--

--

--

--

--

--

--

--

--

C9

5L

eu

ka

em

ia u

nsp

ec.

2-

--

--

--

0.4

--

-3

.6-

--

--

0.1

0.2

Oth

er

& u

nsp

eci

fied

29

-0

.4-

--

0.8

0.5

1.5

1.2

3.5

6.8

14

.5-

17

.56

2.7

26

.44

01

.75

.6

All

site

s7

31

06

83

11

14

12

26

53

12

42

32

26

04

12

57

74

64

66

05

00

43

.71

20

.5

Tabl

e 5-

3-5

Age

Dis

trib

utio

n of

Can

cer

Cas

es a

mon

g no

n-Sa

udi M

ales

, 200

0

112

ICD

(10

)A

LL

SIT

ES

To

t.U

NK

.0

-5

-1

0-

15

-2

0-

25

-3

0-

35

-4

0-

45

-5

0-

55

-6

0-

65

-7

0-

75

+%

C

00

Lip

2-

--

--

--

--

-1

--

--

-1

0.2

C0

1-C

02

To

ng

ue

8-

--

--

--

-1

1-

-4

-1

-1

1C

07

-C0

8S

aliv

ary

gla

nd

5-

--

--

--

11

21

--

--

--

0.6

C0

3-C

06

Mo

uth

8-

--

--

--

--

-2

12

-2

-1

1C

09

-C1

0O

rop

ha

ryn

x2

--

--

--

-1

--

--

-1

--

-0

.2C

11

Na

so

ph

ary

nx

19

--

--

1-

-1

15

61

31

--

-2

.3C

12

-C1

3H

ypo

ph

ary

nx

7-

--

--

-1

-2

-1

11

--

1-

0.9

C1

4P

ha

ryn

x u

nsp

ec

.1

--

--

--

--

--

-1

--

--

-0

.1C

15

Oe

sop

ha

gu

s1

8-

--

--

-1

--

35

21

3-

-3

2.2

C1

6S

tom

ac

h3

7-

--

--

-5

12

34

36

43

33

4.5

C1

7S

ma

ll in

test

ine

2-

--

--

--

--

--

2-

--

--

0.2

C1

8C

olo

n4

3-

--

--

-1

44

82

68

71

11

5.2

C1

9-C

21

Re

ctu

m4

7-

--

--

22

36

71

14

45

3-

-5

.7C

22

Liv

er

40

--

1-

--

--

22

45

11

38

13

4.9

C2

3-C

24

Ga

llbla

dd

er

etc

.4

--

--

-1

--

-1

11

--

--

-0

.5C

25

Pa

ncr

ea

s8

--

--

--

--

--

11

21

11

11

C3

0-C

31

No

se

, s

inu

ses

etc

.1

--

--

--

--

--

1-

--

--

-0

.1C

32

La

ryn

x1

2-

--

--

--

-1

11

12

42

--

1.5

C3

3-C

34

Bro

nch

us,

lu

ng

48

--

--

--

41

36

49

44

65

25

.8C

37

-C3

8O

the

r T

ho

rac

ic o

rga

ns

5-

--

--

--

--

2-

--

2-

-1

0.6

C4

0-C

41

Bo

ne

15

-1

21

-1

31

21

1-

11

--

-1

.8C

47

;C4

9C

on

ne

ctiv

e t

iss

ue

9-

--

11

11

--

11

--

11

-1

1.1

C4

5M

eso

the

liom

a0

--

--

--

--

--

--

--

--

-0

C4

6K

ap

osi

's s

arc

om

a3

--

--

--

-1

-1

--

-1

--

-0

.4C

43

Me

lan

om

a o

f sk

in2

--

--

--

--

-2

--

--

--

-0

.2C

44

Oth

er

sk

in5

1-

--

--

-1

13

58

91

36

23

-6

.2C

50

Bre

ast

3-

--

--

--

--

--

12

--

--

0.4

C6

1P

ros

tate

28

--

--

--

--

--

14

65

53

43

.4C

62

Te

stis

15

-1

--

1-

41

12

41

--

--

-1

.8C

60

Pe

nis

1-

--

--

--

--

1-

--

--

--

0.1

C6

3O

the

r m

ale

ge

nit

al

1-

--

--

--

--

--

--

1-

--

0.1

C6

7B

lad

de

r4

8-

1-

--

11

26

74

55

34

45

5.8

C6

4-C

66

;C6

8K

idn

ey

etc

.2

9-

21

-1

-1

1-

53

55

13

1-

3.5

C6

9E

ye7

-4

--

--

-1

--

1-

-1

--

-0

.9C

70

-C7

2B

rain

, n

erv

ou

s s

yste

m3

5-

-1

-3

-2

36

35

43

22

-1

4.3

C7

3T

hyr

oid

16

--

-1

23

1-

21

51

--

--

-1

.9C

74

-C7

5O

the

r e

nd

oc

rin

e6

-5

--

--

-1

--

--

--

--

-0

.7C

81

Ho

dg

kin

's d

ise

as

e2

4-

-6

21

21

41

5-

2-

--

--

2.9

C8

2-C

85

;C9

6N

on

-Ho

dg

kin

lym

ph

om

a7

6-

2-

51

34

45

13

91

56

51

3-

9.3

C8

8;C

90

Mu

ltip

le m

yelo

ma

15

--

--

--

-1

41

43

1-

1-

-1

.8C

91

Lym

ph

oid

leu

ka

em

ia3

1-

66

2-

11

22

33

2-

-2

-1

3.8

C9

2M

yelo

id le

uk

ae

mia

46

-1

12

42

39

48

44

2-

-2

-5

.6C

93

Mo

no

cyt

ic le

uk

ae

mia

1-

--

--

--

--

--

--

1-

--

0.1

C9

4O

the

r le

uk

ae

mia

0-

--

--

--

--

--

--

--

--

0C

95

Le

uk

ae

mia

un

sp

ec

.4

--

--

--

--

12

--

1-

--

-0

.5O

the

r &

un

sp

ec

ifie

d3

8-

--

--

14

22

95

55

31

1-

4.6

All

site

s8

21

02

31

81

41

51

84

14

66

21

11

10

39

99

86

64

92

92

91

00

Tabl

e 5-

3-6

Age

Dis

trib

utio

n of

Can

cer

Cas

es a

mon

g no

n-Sa

udi F

emal

es, 2

000

113

ICD

(10

)A

LL

SIT

ES

To

t.U

NK

.0

-5

-1

0-

15

-2

0-

25

-3

0-

35

-4

0-

45

-5

0-

55

-6

0-

65

-7

0-

75

+%

C

00

Lip

2-

--

--

--

-1

--

--

--

-1

0.3

C0

1-C

02

To

ng

ue

8-

--

-1

--

--

2-

1-

3-

1-

1.1

C0

7-C

08

Sa

liva

ry g

lan

d5

--

--

--

-1

2-

2-

--

--

-0

.7C

03

-C0

6M

ou

th6

--

--

--

-1

-1

2-

11

--

-0

.8C

09

-C1

0O

rop

ha

ryn

x1

--

--

--

--

--

--

-1

--

-0

.1C

11

Na

so

ph

ary

nx

7-

-1

--

-1

--

22

1-

--

--

1C

12

-C1

3H

ypo

ph

ary

nx

8-

--

--

-1

-1

1-

11

12

--

1.1

C1

4P

ha

ryn

x u

ns

pe

c.

0-

--

--

--

--

--

--

--

--

0C

15

Oe

so

ph

ag

us

7-

--

--

--

-1

-1

--

3-

11

1C

16

Sto

ma

ch

13

--

--

--

--

22

--

14

-4

-1

.8C

17

Sm

all

inte

sti

ne

4-

--

--

--

--

-1

2-

--

1-

0.5

C1

8C

olo

n1

7-

--

--

-1

11

52

33

1-

--

2.3

C1

9-C

21

Re

ctu

m1

8-

--

--

2-

3-

52

2-

11

11

2.5

C2

2L

ive

r1

0-

--

--

--

12

11

-1

1-

12

1.4

C2

3-C

24

Ga

llbla

dd

er

etc

.9

--

--

--

-3

--

-2

11

2-

-1

.2C

25

Pa

nc

rea

s8

--

--

-1

--

21

--

12

-1

-1

.1C

30

-C3

1N

os

e,

sin

us

es

etc

.0

--

--

--

--

--

--

--

--

-0

C3

2L

ary

nx

0-

--

--

--

--

--

--

--

--

0C

33

-C3

4B

ron

ch

us

, lu

ng

6-

--

--

--

-1

-1

-3

1-

--

0.8

C3

7-C

38

Oth

er

Th

ora

cic

org

an

s3

-1

--

--

-1

--

--

--

1-

-0

.4C

40

-C4

1B

on

e1

2-

13

23

--

1-

--

--

11

--

1.6

C4

7;C

49

Co

nn

ec

tiv

e t

iss

ue

7-

1-

1-

-2

--

-1

-1

1-

--

1C

45

Me

so

the

liom

a1

--

--

--

--

--

--

1-

--

-0

.1C

46

Ka

po

si's

sa

rco

ma

2-

--

--

--

--

--

1-

1-

--

0.3

C4

3M

ela

no

ma

of

sk

in7

--

--

-1

--

2-

22

--

--

-1

C4

4O

the

r s

kin

28

--

--

--

-2

-5

75

24

11

13

.8C

50

Bre

as

t2

31

--

--

--

42

53

45

44

52

41

51

66

53

31

.6C

55

Ute

rus

un

sp

ec

.4

--

--

--

--

3-

--

1-

--

-0

.5C

53

Ce

rvix

ute

ri5

5-

--

--

--

58

10

88

27

52

-7

.5C

58

Pla

ce

nta

1-

--

--

-1

--

--

--

--

--

0.1

C5

4C

orp

us

ute

ri1

9-

--

--

-1

-1

-1

52

34

-2

2.6

C5

6O

va

ry e

tc.

29

--

-1

2-

-1

39

51

21

21

14

C5

1-C

52

;C5

7O

the

r fe

ma

le g

en

ita

l1

-1

--

--

--

--

--

--

--

-0

.1C

67

Bla

dd

er

13

--

--

-1

-1

-1

3-

31

12

-1

.8C

64

-C6

6;C

68

Kid

ne

y e

tc.

17

-1

3-

--

-1

3-

41

3-

1-

-2

.3C

69

Eye

5-

5-

--

--

--

--

--

--

--

0.7

C7

0-C

72

Bra

in,

ne

rvo

us

sys

tem

13

-2

--

1-

-3

4-

-1

2-

--

-1

.8C

73

Th

yro

id3

0-

--

12

34

24

54

31

1-

--

4.1

C7

4-C

75

Oth

er

en

do

cri

ne

5-

11

-2

--

--

--

1-

--

--

0.7

C8

1H

od

gk

in's

dis

ea

se

12

--

-4

-1

1-

22

--

-1

1-

-1

.6C

82

-C8

5;C

96

No

n-H

od

gk

in l

ymp

ho

ma

27

-1

1-

-1

32

14

11

23

23

23

.7C

88

;C9

0M

ult

iple

mye

lom

a7

--

--

-1

--

--

21

1-

-2

-1

C9

1L

ymp

ho

id l

eu

ka

em

ia1

8-

52

--

-3

11

12

-1

11

--

2.5

C9

2M

yelo

id l

eu

ka

em

ia2

1-

--

1-

23

33

42

21

--

--

2.9

C9

3M

on

oc

ytic

le

uk

ae

mia

0-

--

--

--

--

--

--

--

--

0C

94

Oth

er

leu

ka

em

ia0

--

--

--

--

--

--

--

--

-0

C9

5L

eu

ka

em

ia u

ns

pe

c.

0-

--

--

--

--

--

--

--

--

0O

the

r &

un

sp

ec

ifie

d3

4-

2-

--

11

14

57

2-

33

23

4.7

All

sit

es

73

10

21

11

10

11

14

26

59

86

12

01

08

70

52

64

34

28

17

10

0

Tabl

e 5-

3-7

Inci

denc

e R

ates

for

Can

cer

Cas

es a

mon

g no

n-Sa

udi M

ales

by

Age

Gro

up (p

er 1

00,0

00),

2000

114

ICD

(10

)A

LL

SIT

ES

To

t.U

NK

.0

5-

10

-1

5-

20-

25-

30

-3

5-

40

-4

5-

50

-5

5-

60-

65

-7

0-

75+

CIR

AS

RC

00

Lip

2-

--

--

--

--

-0

.5-

--

--

12

.20

.10

.3C

01

-C0

2T

on

gu

e8

--

--

--

--

0.2

0.3

--

6.6

-8

.1-

12

.20

.20

.8C

07

-C0

8S

aliv

ary

gla

nd

5-

--

--

--

0.2

0.2

0.5

0.5

--

--

--

0.1

0.1

C0

3-C

06

Mo

uth

8-

--

--

--

--

-0

.90

.93

.3-

16

.2-

12

.20

.21

C0

9-C

10

Oro

ph

ary

nx

2-

--

--

--

0.2

--

--

-3

.5-

--

0.1

0.1

C1

1N

aso

ph

ary

nx

19

--

--

0.8

--

0.2

0.2

1.4

2.8

0.9

53

.5-

--

0.5

0.7

C1

2-C

13

Hyp

op

ha

ryn

x7

--

--

--

0.2

-0

.4-

0.5

0.9

1.7

--

14

.2-

0.2

0.5

C1

4P

ha

ryn

x u

nsp

ec.

1-

--

--

--

--

--

0.9

--

--

--

-C

15

Oe

sop

ha

gu

s1

8-

--

--

-0

.2-

-0

.82

.31

.71

.71

0.5

--

36

.60

.51

.5C

16

Sto

ma

ch3

7-

--

--

-1

0.2

0.4

0.8

1.9

2.6

10

13

.92

4.2

42

.63

6.6

1.1

3.7

C1

7S

ma

ll in

test

ine

2-

--

--

--

--

--

1.7

--

--

-0

.10

.1C

18

Co

lon

43

--

--

--

0.2

0.6

0.7

2.2

0.9

5.2

13

.32

4.4

8.1

14

.21

2.2

1.2

2.8

C1

9-C

21

Re

ctu

m4

7-

--

--

10

.40

.51

.11

.95

.13

.56

.61

7.4

24

.2-

-1

.32

.5C

22

Liv

er

40

--

0.4

--

--

-0

.40

.51

.94

.31

8.3

10

.56

4.6

14

.23

6.6

1.1

4.5

C2

3-C

24

Ga

llbla

dd

er

etc

.4

--

--

-0

.5-

--

0.3

0.5

0.9

--

--

-0

.10

.1C

25

Pa

ncr

ea

s8

--

--

--

--

--

0.5

0.9

3.3

3.5

8.1

14

.21

2.2

0.2

1.1

C3

0-C

31

No

se,

sin

use

s e

tc.

1-

--

--

--

--

-0

.5-

--

--

--

0C

32

La

ryn

x1

2-

--

--

--

-0

.20

.30

.50

.93

.31

3.9

16

.2-

-0

.31

.3C

33

-C3

4B

ron

chu

s, lu

ng

48

--

--

--

0.8

0.2

0.5

1.6

1.9

7.8

6.6

13

.94

8.5

71

24

.41

.44

.9C

37

-C3

8O

the

r T

ho

raci

c o

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4.3

PART VIAPPENDICES

Reporting HospitalsRiyadh region Western regionKing Khaled University Hospital King Abdul Aziz University HospitalKing Faisal Specialist Hospital King Khaled National Guard HospitalSecurity Forces Hospital King Abdul Aziz Hospital & Oncology CenterKing Fahad National Guard Hospital King Fahad Armed Forces HospitalAFH Millitary (RKH Programe) King Fahad General HospitalKing Abdul Aziz University Hospital King Abdul Aziz, Al Zaher HospitalKing Khaled Eye Specialist Hospital King Faisal Hospital (Taif)Riyadh Medical Complex Al Jedaani HospitalPrince Salman Bin Abdul Aziz Hospital Al Salamah HospitalKing Khaled General Hospital (Kharj) United Doctors HospitalKing Khaled General Hospital (Majmaa) Bugshan General HospitalAl Hammadi Hospital Al Dhagastani HospitalAl Mobarak Hospital Bakhsh HospitalAl Yamamah Hospital Dr Erfan & Bagedo HospitalSocial Insurance Hospital (GOSI) Dr Soliman Fakeeh HospitalDallah Hospital New Jeddah Clinic HospitalDr Abdlrhmn Al Mishari Hospital Children & Maternity Hospital (Jeddah)Watani Hospital Aziziyah for Children & Maternity Hospital

Saudi German HospitalEastern region Saudi Medical ServicesDhahran Health Center (ARAMCO) Al Noor Specialist HospitalKing Fahad Hospital of the University Hera General HospitalDammam Central Hospital Maternity & Children Hospital (Taif)Hofuf Hospital Al Qunfudah General HospitalAl Qatif Central Hospital Royal Commission Medical (Janboa)Al Mana General Hospital (Khobar)Almana General Hospital (Dammam) Madinah regionKing Khalid General Hospital Al Hanakyah HospitalAl Mouwasat Hospital Al Miqat HospitalPrince Saud Bin Jalawi Hospital Badr HospitalDr Fakhry Hospital Chest Diseases HospitalMaternity & Children’s Hospital Heatstroke HospitalAl Jubail Hospital King Fahad HospitalAl Salama Hospital Maternity & Children’s HospitalAl-Dossary Hospital Madina National HospitalAl Thomairy Hospital Ohoud HospitalChest Disease Hospital Al Ula General HospitalArabian Oil Comp Hospital Khaybar General HospitalAbqaiq Health Centre Al Mahd HospitalAl Qatif General HospitalKing Fahad Hospital (Hofuf)

117

APPENDIX A

Qassim region Tabuk regionKing Fahd Specialist Hospital King Fahad HospitalKing Saud University Hospital King Khalid General HospitalOnaizah General Hospital Maternity & Children’s HospitalBuraidah Central Hospital Umm Lujj General HospitalAl Midhnab General Hospital Al Wajh General HospitalAr Rass General HospitalBukairiya General Hospital Asir region

Asir Central HospitalHail region Al Zafer HospitalHail General Hospital Chest & Fever HospitalKing Khaled General Prince Abdullah Bin Abdul Aziz HospitalAl Rashid HospitalBaqa Hospital Baha region

King Fahd HospitalJazan region Al Mandaq HospitalKing Fahad Central HospitalJazan General Hospital Najran regionJazan Millitary Hospital King Khaled General HospitalFarasan General Hospital

118

APPENDIX B

National Cancer Registry Offices

119

APPENDIX C

Armed Forces Hospital P.O. Box 7897, Riyadh 11159Tel.: 01-477-7714 x6747Fax: 01-477-7714 x6743

Central Region P.O. Box 2925, Riyadh 11461Tel.: 01-467-9488 / 467-2398Fax: 01-467-9487

Eastern Region P.O. Box 4004, Al Khobar 31952Tel.: 03-896-6741Fax: 03-896-6741

Madinah & Northern Region King Fahd Hospital, Madinah Al MonawarahTel.: 04-846-1500 x3134/3146Fax: 04-846-0951

Main Office P.O. Box 3354 MBC 64, Riyadh 11211Tel.: 01-442-3938Fax: 01-442-3941

National Guard Hospitals P.O. Box 6615, Jeddah 21452Tel.: 02-624-0000 x4085/4086Fax: 02-624-7242

Security Forces Hospital P.O. Box 3643, Riyadh 11481Tel.: 01-477-4480 x1193Fax: 01-467-4757

Southern Region P.O. Box 641, AbhaTel.: 07-226-0711/224-7800 x118Fax: 07-224-0964/224-7570

Western Region P.O. Box 31467, Jeddah 21497Tel.: 02-637-5555 x2283/2200Fax: 02-637-9811/637-9830

APPENDIX D

NATIONAL CANCER REGISTRYBOARD OF DIRECTORS

CHAIRMAN:Dr. Shouki Bazarbashi, King Faisal Specialist Hospital & Research Centre

DEPUTY CHAIRMAN:Dr. Nasser Al Hamdan, Ministry of Health

BOARD MEMBERS:Dr. Dahish Ajarim, King Saud University, RiyadhDr. Edward De Vol, Director, King Faisal Specialist Hospital & Research CenterProf. Hassan Al Idrissi, King Faisal University, DammamDr. Hadir Meir, King Abdulaziz Hospital and Cancer Center, JeddahDr. Hassan Trabulsi, King Khalid University, AbhaDr. Mohamoud Shaheen Al Ahwal, King Abdulaziz University, JeddahDr. Rizq Allah Assiri, Armed Forces Hospital, RiyadhDr. Abdulwahab Andejani, National Guard Hospitals, JeddahDr. Abdulaziz Saleh Aba Hussein, Security Forces Hospital, RiyadhDr. Hisham Ali Yousef, King Fahad Hospital, Madinah

NCR ADMINISTRATIVE STAFF:Susan Young, CCHRA(C), CTR, Administrative Director (2003-present)Mohammed Haydar, CTR, Tumor RegistrarHaya Al Eid, BDS, DFE, Epidemiologist, CTRSuad O. Arteh, MA, Data Manager

ADDRESS:NATIONAL CANCER REGISTRYP.O. BOX 3354, MBC 64Riyadh 11211, Saudi Arabia

Website:www.kfshrc.edu.sa/NCR/

E-mail:[email protected]@kfshrc.edu.sa

PHONE: 966-1-442- 3938FAX: 966-1-442-3941

120

APPENDIX E

121

NATIONAL CANCER REGISTRY MINISTRY OF HEALTH KINGDOM OF SAUDI ARABIA

Request for data from the National Cancer Registry All requests should be submitted to the attention of the Chairman, Board of Directors, National Cancer Registry, MBC 64, P.O. Box 3354, Riyadh, 11211,

Saudi Arabia, Fax: 966 1 442 3941

Name: ______________________ Date Submitted: _________ Department: __________________ Hospital: _____________________ Telephone number: _____________ Information Requested: (Specify patient population, Time period, Year/s, Anatomic site/Histology, Staging information, region, etc.) Purpose of Request: (Specify presentation at conference/meeting/publication, clinical/epidemiological study, personal information, etc.) Collaborators and Co-authors: Requesters affirmation statement: I hereby, the requester of the above data affirm that the data given to me by the NCR will be treated with utmost confidentiality in relation to patient’s identity. I also affirm that the data given to me will not be presented or published by me or any of my collaborators as an original work but rather can be cited in my presentations and / or publication with acknowledgment to the NCR. Requester signature:_______________________ Date: _________________ ************************************************************************************ For Official use only: Request: Approved____________ Denied____________ Chairman NCR Board of Directors Signature: _______________________________________ Dr. Nasser Al Hamdan Date: _____________

APPENDIX F

122

KINGDOM OF SAUDI ARABIA MINISTRY OF HEALTH

NATIONAL CANCER REGISTRY

CANCER REGISTRATION REPORT

1. ACCESSION NUMBER

2. ACCESSION DATE / /

d d m m y y y y

NAME

7. SAUDI ID Number

8. MARITAL STATUS 9. SEX 10. DATE OF BIRTH / / d d m m y y y y

11. AGE 1-Single 2-Married 3-Divorced 4-Widowed 9-Unknown

1-Male 2-Female 9-Unkown

12. NATIONALITY code text

13. ADDRESS code text

14. 15. TEL. NO.

16. DATE OF DIAGNOSIS / / d d m m y y y y

17. TOPOGRAPHY C code text

18. MORPHOLOGY code text

19. BEHAVIOR 0-Benign 1-Uncertain 2-Insitu 3-Malignant

20. GRADE 1-Well diff 2-Moderately diff 3-Poorly diff 4-Undifferentiated

5-T.cell 6-B.cell 7-Null cell 8-Natural killer cell

9-Unknown

21. EXTENT 1-Insitu 2-Localized 3-Regional by direct extension 4-Regional by lymph nodes

5-Regional (both 2 and 3) 6-Regional NOS 7-Distant metastases/systemic Disease 9-Unknown

22. T= 23. N= 24. M=

25. BASIS OF DIAGNOSIS 0-DCO

1-Clinical

2-Radiology

3-Surg/Autopsy

4-LAB test

5-Cyto/Hematology

6-Histology of Metastasis

7-Histology of Primary

8-Histology/Autopsy

9-Unknown

26. LATERALITY 0-Not paired, unknown, ill – defined 1-Right 2-Left 3-One side, But unknown

4-Bilateral involvement 9-Paired site, Laterality unknown

27. REPORTING HOSPITAL code text

28. PATIENT M.R. No. 29. PATHOLOGY No.

30. SURGERY 1-Yes 2-No 3-Unknown

31. CHEMOTHERAPY 1-Yes 2-No 3-Unknown

32. HORMONE 1-Yes 2-No 3-Unknown

33. RADIATION 1-Yes 2-No 3-Unknown

34. IMMUNOTHERAPY 1-Yes 2-No 3-Unknown

35. LAST CONTACT / / d d m m y y y y

38. CANREG No.

36. STATUS 1-Dead 2-Alive

9-Unknown

37. CAUSE OF DEATH 1-Cancer 2-Other 9-Unknown

39. SIGNATURE

3. FIRST 4. FATHER 5. GRAND FATHER 6. FAMILY

Documents

Cancer Incidence Report Saudi Arabia 1999 - 2000 · Cancer Incidence Report Saudi Arabia 1999 - 2000. Published by the Main Office, National Cancer Registry, ... Cervix Uteri (C53)