Hospital-Based Tumor Registry. Srinagarind Hospital, Khon Kaen University

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1 Hospital-Based Tumor Registry Srinagarind Hospital, Khon Kaen University Statistical Report 2012 Cancer Unit, Faculty of Medicine Khon Kaen University Khon Kaen, Thailand Tel & Fax:+66(43) Website:

2 SUBCOMMITTEE OF THE CANCER REGISTRY SRINAGARIND HOSPITAL, FACULTY OF MEDICINE, KHON KAEN UNIVERSITY, KHON KAEN, THAILAND 1. Assoc. Prof. Surapon Wiangnon Chairman 2. Prof. Dr. Supannee Promthet Committee 3. Assist. Prof. Supinda Koonmee Committee 4. Assoc. Prof. Bandit Chumworathayi Committee 5. Assist. Prof. Aumkhae Sookprasert Committee 6. Assist. Prof. Patravoot Vatanasapt Committee 7. Dr. Chat Sumananont Committee 8. Dr. Khomsun Tumrongarnuntasakul Committee 9. Dr. Suphatcha Prasertcharoensuk Committee 10. Mr. Thamrong Krittasin Committee 11. Ms. Krittika Suwanrungruang Secretariat 12. Mr. Supot Kamsa-ard Assistant Secretariat JOB DESCRIPTION 1. Collecting data and reporting for the population-based tumor registry of Khon Kaen province and preparing manuscript for monographs on cancer in Thailand; 2. Submitting data from the population-based tumor registry of Khon Kaen province for reports in Cancer Incidence on the world s five continents; 3. Collecting for, and reporting on, the hospital-based tumor registry of Srinagarind Hospital; 4. Evaluating the results of the cancer registry, clinical conferences, and making recommendations to improve the care and control of cancer; 5 Supporting and encouraging resources used for cancer research using the cancer registry as baseline data; 6 Conducting work related to the Cancer Registry as defined by the policy of the Faculty of Medicine; 7. Reporting on work of the committee; and, 8. Two-year commitment 2

3 ACKNOWLEDGEMENTS We would like to gratefully acknowledge: - All staff of Cancer Unit for their tireless afford to improve and maintain the quality of data collection; - The Faculty of Medicine, Khon Kaen University, and the Anti-cancer Foundation of Srinagarind Hospital for it s continuous support of the data collection; - The Registration Processing Center, Ministry of Internal Affairs for the data from death certificates and; - The National Institute of Health for additional data. - The Khon Kaen Regional Hospital Cancer Committee September 2013 CANCER UNIT STAFF 1. Ms. Krittika Suwanrungruang Head of unit, Epidemiologist 2. Mr. Supot Kamsa-ard Biostatistician, Computer programmer 3. Ms. Pakanant Usantia Coder 4. Ms. Sophita Pituso Coder 5. Ms. Prasitporn Meunhast Registra 6. Mr. Somjit Tongya Registra 3

4 Table of contents Table of tables... 5 Table of figures... 6 CHAPTER I... 8 Registry procedure and Statistical methods... 8 Purpose of the registry... 8 Materials and Methods... 8 Data sources... 8 Morphologically verified cases (% MV)... 8 CHAPTER II Overall Characteristic of Cancer CHAPTER III Overall Cancer CHAPTER IV Childhood cancer CHAPTER V Survival, Material and methods Statistical methods Definition

5 Table of tables Table 1 Number of cancer cases by type of patiens Table 2 Number of cancer cases by age groups, Table 3 Ten leading sites of cancer in males Table 4 Ten leading sites of cancer in females Table 5 Comparative the number of case in eight consecutive years ( ) of ten leading sites of cancer in males Table 6 Comparative the number of case in eight consecutive years ( ) of ten leading sites of cancer in females Table 7 Basis of Diagnosis*, all sites Table 8 Number of cancer case by staging of disease (Selected Sites), Males Table 9 Number of cancer case by staging of disease (Selected Sites), Females Table 10 Number of cases of cancer by residence Table 11 Number of cases of cancer by site, and age; Males Table 12 Number of cases of cancer by site, and age; Females Table 13 Percentage of morphologically verified cancer diagnosis Srinagarind Hospital, 2012, Males Table 14 Percentage of morphologically verified Srinagarind Hospital, 2012, Females Table 15 Status at last seen, both sexes Table 16 Ten leading sites of cancer in childhood, both sexes (age < 15) Table 17 Number of cases and 1-, 2-, 3- cumulative survival rates by selected tumor site

6 Table of figures Figure 1 Flow chart of Srinagarind Hospital Tumor Registry... 9 Figure 2 Number of cancer cases by type of patients, Figure 3 Cancer patien by age groups, Figure 4 Comparative graphs showing the number of in eight consecutive years ( ) of ten leading sites of cancer in males Figure 5 Comparative graphs showing the number of case in eight consecutive years ( ) of ten leading sites of cancer in females Figure 6 Percentage of cases of cancer by residence Figure 7 Breast cancer survival in Srinagarind Hospital between by stage Figure 8 Breast cancer survival in Srinagarind Hospital between by surgery Figure 9 Breast cancer survival in Srinagarind Hospital between by chemotherapy Figure 10 Lung cancer survival in Srinagarind Hospital both sexes Figure 11 Lung cancer survival in Srinagarind Hospital between by stage Figure 12 Lung cancer survival in Srinagarind Hospital between by surgery Figure 13 Lung cancer survival in Srinagarind Hospital between by chemotherapy Figure 14 Colon cancer survival in Srinagarind Hospital between both sexes Figure 15 Colon cancer survival in Srinagarind Hospital between by stage Figure 16 Colon cancer survival in Srinagarind Hospital between by surgery Figure 17 Liver and bile duct cancer survival in Srinagarind between both sexes Figure 18 Liver and bile duct cancer survival in Srinagarind Hospital between by stage Figure 19 Liver and bile duct cancer survival in Srinagarind Hospital between by surgery Figure 20 Cervical cancer survival in Srinagarind Hospital between by stage Figure 21 Cervical cancer survial in Srinagarind Hospital between by surgery Figure 22 Ovarian cancer survival in Srinagarind Hospital between by stage Figure 23 Ovarian cancer survival in Srinagarind Hospital between by surgery

7 Figure 24 Non-Hodgkin lymphoma (age 15 year) survival in Srinagarind Hospital between both sexes Figure 25 Hodgkin disease (age 15 year) survival in Srinagarind Hospital between both sexes Figure 26 Acute lymphoblastic leukemia ( age 15) survial in Srinagarind Hospital between both sexes Figure 27 Acute myeloid leukemia (age 15) survival in Srinagarind Hospital between both sexes

8 CHAPTER I Registry procedure and Statistical methods Purpose of the registry Khon Kaen Cancer Registry (KKCR) was established in 1984 at the Faculty of Medicine operating both Hospital-based cancer registry and Population-based cancer registry. Srinagarind Cancer Registry is a hospital-based cancer registry aimed to collect on all information of the cancer cases treated in Srinagarind Hospital. The epidemiology is including incidence and survival data for all cancer patients. The registry has been continuously operating to collect all cancer data for epidemiology study, research information, and planning and monitoring of cancer control. Materials and Methods Data sources Information and quality control on newly diagnosed cancer was based on data collected by staff of Khon Kaen Cancer Registry (Cancer Unit). All information of cancer from various sources is included and abstracted by registra before submitting to secured electronic storage. Sources include the medical records section, pathology laboratory records, and surgery and radiology department. The data and status of patient have been regularly monitored to ascertain the quality and updated. To obtain complete and qualified data, various efforts eg linkage with national statistic data set, personal contact, and networking have been collaborated. The cancer registry committee has supervised the policy. Morphologically verified cases (% MV) The percentage of cases was based on cytology or histology confirmation from primary site or metastasis site, peripheral blood and bone marrow aspiration, and autopsy. 8

9 Figure 1 Flow chart of Srinagarind Hospital Tumor Registry 9

10 CHAPTER II Overall Characteristic of Cancer Table 1 Number of cancer cases by type of patiens Type of patients Number of cases (2011) Number of cases (2012) Total of number patients at OPD 521, ,188 Total of number new patients 68,758 53,967 Total of number new malignancies 5,293 5,778 The cancer patients account of 10.7% of all new patients. Figure 2 Number of cancer cases by type of patients, 2012 Number of cases Total of number patients at OPD Total of number of new patients Total of number new malignancies 10

11 Table 2 Number of cancer cases by age groups, 2012 Age groups Male Female Number of cases % Number of cases % Total Mean S.D

12 Figure 3 Cancer patien by age groups, 2012 Histogram of Age group, Males Age group Histogram of Age group, Females Age group 12

13 CHAPTER III Overall Cancer Table 3 Ten leading sites of cancer in males Site Number of cases % Liver and bile duct Trachea, Bronchus and lung Colorectal Nasopharynx Non-Hodgkin lymphoma Oral cavity Prostate Stomach Skin Thyroid Other Total * Oral cavity: ICD-O Code = C00 - C06 Table 4 Ten leading sites of cancer in females Site Number of cases % Liver and bile duct Breast Thyroid Cervix uteri Trachea, Bronchus and lung Colorectal Oral cavity Corpus uteri Ovary Skin Other Total * Oral cavity: ICD-O Code = C00 - C06 13

14 Table 5 Comparative the number of case in eight consecutive years ( ) of ten leading sites of cancer in males Site Liver and bile duct ,138 1,102 1,252 Trachea, Bronchus and lung Colorectal Nasopharynx Non-Hodgkin lymphoma Oral cavity Prostate Stomach Skin Thyroid Total 2,133 2,170 2,302 2,401 2,363 2,705 2,701 3,026 Figure 4 Comparative graphs showing the number of in eight consecutive years ( ) of ten leading sites of cancer in males Liver&bile duct Lung Colorectal Nasopharynx Non-Hodgkin Oral cavity Prostate Stomach Skin Thyroid * Log scale 14

15 Table 6 Comparative the number of case in eight consecutive years ( ) of ten leading sites of cancer in females Site Liver and bile duct Breast Thyroid Cervix uteri Trachea, Bronchus and lung Colorectal Oral cavity Corpus uteri Ovary Skin Total 2,229 2,199 2,247 2,209 2,249 2,607 2, Figure 5 Comparative graphs showing the number of case in eight consecutive years ( ) of ten leading sites of cancer in females Liver&bile duct Breast Thyroid Cervix uteri Lung Colorectal Oral cavity Corpus uteri Ovary Skin * Log scale 15

16 Table 7 Basis of Diagnosis*, all sites Basis Number of cases % Number of cases % Clinical X-Ray or endoscopy 1, , Surgery/Autopsy but no histology Specific biochemistry Cytology of hematology Histology of metastasis Histology of primary 3, , Total 5, , ** % MV without liver 87.34%, 2012 Note: *Basis of diagnosis = Most valid basis of diagnosis of cancer Non-microscopic 1. Clinical only 2. Clinical investigation (including X-ray, ultrasound etc.) 3. Exploratory surgery/autopsy 4. Specific biochemical and/or immunological tests Microscopic* 5. Cytology or hematology 6. Histology of metastasis 7. Histology of primary 8. Autopsy with concurrent or previous histology 16

17 Table 8 Number of cancer case by staging of disease (Selected Sites), Males Site Number of cases Stage % Unknown Liver and bile duct Trachea, Bronchus and lung Colorectal Nasopharynx Non-Hodgkin lymphoma Oral cavity Prostate Stomach Skin Table 9 Number of cancer case by staging of disease (Selected Sites), Females Site Number of cases Stage % Unknown Liver and bile duct Breast Thyroid Cervix uteri Trachea, Bronchus and lung Colorectal Oral cavity Corpus uteri Ovary

18 Table 10 Number of cases of cancer by residence Province Number Percentage Khon Kaen Maha Sarakham Kalasin Roi Et Chaiyaphum Loei Sakon Nakhon Udon Thani Nong Bua Lam Phu Buriram Nong Khai Nakhon Phanom Nakhon Ratchasima Laos Yasothon Surin Mukdahan Ubon Ratchathani Sisaket Amnat Charoen Phetchabun Other Total 5,

19 Figure 6 Percentage of cases of cancer by residence

20 Table 11 Number of cases of cancer by site, and age; Males Site Total Lip Tongue Mouth Salivary glands Tonsil Other oropharynx Nasopharynx Hypopharynx Pharynx unspecified Oesophagus Stomach Small intestine Colon Rectum Anus Liver and bile duct Gallbladder Pancreas Nose, sinuses etc Larynx Trachea, Bronchus and lung Other thoracic organs Bone Melanoma of skin Other skin Mesothelioma Kaposi's sarcoma Connective tissue

21 Table 11 Number of cases of cancer by site, and age; Males (cont.) Site Total Breast Penis Prostate Testis Other male genital organs Kidney Renal pelvis Bladder Eye Brain, nervous system Thyroid Adrenal gland Other endocrine Hodgkin disease Non-Hodgkin lymphoma Multiple myeloma Lymphoid leukemia Myeloid leukemia Leukemia unspecified Other and unspecified Total

22 Table 12 Number of cases of cancer by site, and age; Females Site Total Lip Tongue Mouth Salivary glands Tonsil Other oropharynx Nasopharynx Hypopharynx Pharynx unspecified Oesophagus Stomach Small intestine Colon Rectum Anus Liver and bile duct Gallbladder Pancreas Nose, sinuses etc Larynx Trachea, Bronchus and lung Other thoracic organs Bone Melanoma of skin Other skin Mesothelioma Kaposi's sarcoma Connective tissue

23 Table 12 Number of cases of cancer by site, and age; Females (cont.) Site Total Breast Vulva Vagina Cervix uteri Corpus uteri Uterus unspecified Ovary Other female genital organs Placenta Kidney Renal pelvis Bladder Eye Brain, nervous system Thyroid Adrenal gland Other endocrine Hodgkin disease Non-Hodgkin lymphoma Multiple myeloma Lymphoid leukemia Myeloid leukemia Leukemia unspecified Other and unspecified Total

24 Table 13 Percentage of morphologically verified cancer diagnosis, Srinagarind Hospital, 2012, Males Site Total Cases Percent Lip Tongue Mouth Salivary glands Tonsil Other oropharynx Nasopharynx Hypopharynx Pharynx unspecified Oesophagus Stomach Small intestine Colon Rectum Anus Liver and bile duct Gallbladder Pancreas Nose, sinuses etc Larynx Trachea, Bronchus and lung Other thoracic organs Bone Melanoma of skin Other skin Kaposi's sarcoma Connective tissue Breast Penis Prostate Testis Other male genital organs

25 Table 13 Percentage of morphologically verified cancer diagnosis, Srinagarind Hospital, 2012, Males (cont.) Site Total Cases Percent Kidney Renal pelvis Bladder Eye Brain, nervous system Thyroid Adrenal gland Other endocrine Hodgkin disease Non-Hodgkin lymphoma Multiple myeloma Lymphoid leukemia Myeloid leukemia Other and unspecified All sites All sites without liver

26 Table 14 Percentage of morphologically verified cancer diagnosis, Srinagarind Hospital, 2012, Females Site Total Cases Percent Lip Tongue Mouth Salivary glands Tonsil Other oropharynx Nasopharynx Hypopharynx Pharynx unspecified Oesophagus Stomach Small intestine Colon Rectum Anus Liver and bile duct Gallbladder Pancreas Nose, sinuses etc Larynx Trachea, Bronchus and lung Other thoracic organs Bone Melanoma of skin Other skin Mesothelioma Connective tissue Breast Vulva Vagina Cervix uteri Corpus uteri

27 Table 14 Percentage of morphologically verified cancer diagnosis, Srinagarind Hospital, 2012, Females (cont.) Site Total Cases Percent Uterus unspecified Ovary Other female genital organs Placenta Kidney Renal pelvis Bladder Eye Brain, nervous system Thyroid Adrenal gland Other endocrine Hodgkin disease Non-Hodgkin lymphoma Multiple myeloma Lymphoid leukemia Myeloid leukemia Leukemia unspecified Other and unspecified All sites All sites without liver

28 Table 15 Status at last seen, both sexes Sex Alive Death Total Number of cases % Number of cases % Male Female Updated patient status by December 31,

29 CHAPTER IV Childhood cancer Table 16 Age and Sexes of childhood cancer case Age groups Male Female Number of cases % Number of cases % Total Mean S.D Table 16 Ten leading sites of cancer in childhood, both sexes (age < 15) Site Number of cases % Leukemias, myeloproliferative disease, and myelodysplastic disease CNS and miscellaneous intracranial and intraspinal neoplasms Soft tissue and other extraosseous sarcomas Retinoblastoma Lymphomas and reticuloendothelial neoplasm Malignant bone tumors Other malignant epithelial neoplasms and malignant melanomas Hepatic tumors Germ cell tumors, trophoblastic tumors, and neoplasms of gonads Other Total

30 CHAPTER V Survival, Material and methods All registrations of Srinagarind Hospital in the period were extracted and the cases were tabulated according to basis of diagnosis and the standard indicators of data quality in cancer registration: the percentage of cases with histological verification of diagnosis (HV%). Srinagarind hospital is an 995-bed hospital providing centralized cancer care service to patients from whole of the northeast region of Thailand. The main sources of cancer registration data are medical records of both outpatients and inpatients. The relevant information abstracted manually and recorded on a data form. The complete data form is checked and entered into the data based using CANREG4 data entry software. Cancer registry staff also collect follow-up information from clinical notes. In addition, they collect follow-up information from a data based of National Health Security Office (NHSO). International Classification of Disease for Oncology (ICD-O) is used to code both morphology and topography. And they patient status was censored on December 31, 2012 Statistical methods Cumulative observed survival rates were calculated by the method of Kaplan and Meier. Definition Age The age in year at the time of diagnosis 30

31 Incidence date Date of first diagnosis of the cancer by physician or the date of the first pathology report Expected survival The survival in a group of patients given that they experience the mortality of group from the general population that is equally composed with respect to sex, age and calendar period of diagnosis 31

32 Table 17 Number of cases and 1-, 2-, 3- year cumulative survival rates by selected tumor site Site Number of Observed survival rate (95% CI) cases 1 year 2 year 3 year Breast cancer by stage I 53 98(.94-1) 92( ) 90( ) stage II ( ) 88( ) 81( ) stage III ( ) 72( ) 60( ) stage IV ( ) 50( ) 41( ) Unknown ( ) 86( ) 81( ) Lung cancer by stage I 32 76( ) 56( ) 50( ) stage II 45 63( ) 39( ) 31( ) stage III ( ) 20( ) 12( ) stage IV ( ) 16( ) 11( ) Unknown ( ) 30( ) 23( ) Liver and bile duct by stage I 2 75(.42-1) - - stage II 32 48( ) 31( ) 20( ) stage III 64 40( ) 28( ) 18( ) stage IV ( ) 9( ) 6( ) Unknown ( ) 25( ) 21( ) Colon cancer by stage II 21 92(.82-1) 82(.68-1) 73( ) stage III 48 82( ) 77( ) 70( ) stage IV ( ) 37( ) 32( ) Unknown ( ) 80( ) - Cervical cancer by stage I (.95-1) 94( ) 92( ) stage II ( ) 82( ) 74( ) stage III ( ) 62( ) 46( ) stage IV ( ) 32( ) 19( ) Unknown 63 65( ) 54( ) 41( ) 32

33 Survival probability Survival probability Figure 7 Breast cancer survival in Srinagarind Hospital between by stage Breast cancer by stage, Stage 1 Stage 2 Stage 3 Stage 4 Unknown stage Figure 8 Breast cancer survival in Srinagarind Hospital between by surgery Breast cancer by surgery, Done Not done 33

34 Survival probability Figure 9 Breast cancer survival in Srinagarind Hospital between by chemotherapy Breast cancer by chemotherapy, Done Not done 34

35 Survival probability Survival probability Figure 10 Lung cancer survival in Srinagarind Hospital both sexes Lung cancer both sexes, Male Female Figure 11 Lung cancer survival in Srinagarind Hospital between by stage Lung cancer by stage, Stage 1 Stage 2 Stage 3 Stage 4 Unknown 35

36 Survival probability Survival probability Figure 12 Lung cancer survival in Srinagarind Hospital between by surgery Lung cancer by surgery, Done Not done Figure 13 Lung cancer survival in Srinagarind Hospital between by chemotherapy Lung cancer by chemotherapy, Done Not done 36

37 Survival probability Survival probability Figure 14 Colon cancer survival in Srinagarind Hospital between both sexes Colon cancer both sexes, Male Female Figure 15 Colon cancer survival in Srinagarind Hospital between by stage Colon cancer by stage, Stage 2 Stage 3 Stage 4 Unknown 37

38 Survival probability Figure 16 Colon cancer survival in Srinagarind Hospital between by surgery Colon cancer by surgery, Done Not done 38

39 Survival probability Survival probability Figure 17 Liver and bile duct cancer survival in Srinagarind between both sexes Liver and bile duct both sexes, Male Female Figure 18 Liver and bile duct cancer survival in Srinagarind Hospital between by stage Liver and bile duct by stage, Stage 1 Stage 2 Stage 3 Stage 4 Unknown 39

40 Survival probability Figure 19 Liver and bile duct cancer survival in Srinagarind Hospital between by surgery Liver and bile duct by surgery, Done Not done 40

41 Survival probability Survival probability Figure 20 Cervical cancer survival in Srinagarind Hospital between by stage Cervical cancer by stage, Stage 1 Stage 2 Stage 3 Stage 4 Unknown Figure 21 Cervical cancer survial in Srinagarind Hospital between by surgery Cervical cancer by surgery, Done Not done 41

42 Survival probability Survival probability Figure 22 Ovarian cancer survival in Srinagarind Hospital between by stage Ovary cancer by stage, Stage 1 Stage 2 Stage 3 Stage 4 Unknown Figure 23 Ovarian cancer survival in Srinagarind Hospital between by surgery Ovary cancer by surgery, Done Not done 42

43 Survival probability Survival probability Figure 24 Non-Hodgkin lymphoma (age 15 year) survival in Srinagarind Hospital between both sexes Non-Hodgkin lymphoma both sexes, Male Female Figure 25 Hodgkin disease (age 15 year) survival in Srinagarind Hospital between both sexes Hodgkin disease both sexes, Male Female 43

44 Survival probability Survival probability Figure 26 Acute lymphoblastic leukemia ( age 15) survial in Srinagarind Hospital between both sexes ALL both sexes, Male Female Figure 27 Acute myeloid leukemia (age 15) survival in Srinagarind Hospital between both sexes AML both sexes, Male Female 44

45 Survival probability Survival probability Figure 28 Acute lymphoblastic leukemia (age 14) survival in Srinagarind Hospital between both sexes ALL both sexes, Male Female Figure 29 Acute myeloid leukemia (age 14) survival in Srinagarind Hospital between both sexes AML both sexes, Male Female 45

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