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)-202485 E-mail: srcancer@kku.ac.th Website: http://kkcr.kku.ac.th
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
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
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... 10 Overall Characteristic of Cancer... 10 CHAPTER III... 13 Overall Cancer... 13 CHAPTER IV... 29 Childhood cancer... 29 CHAPTER V... 30 Survival, 2003-2007... 30 Material and methods... 30 Statistical methods... 30 Definition... 30 4
Table of tables Table 1 Number of cancer cases by type of patiens... 10 Table 2 Number of cancer cases by age groups, 2012... 11 Table 3 Ten leading sites of cancer in males... 13 Table 4 Ten leading sites of cancer in females... 13 Table 5 Comparative the number of case in eight consecutive years (2005-2012) of ten leading sites of cancer in males... 14 Table 6 Comparative the number of case in eight consecutive years (2005-20120) of ten leading sites of cancer in females... 15 Table 7 Basis of Diagnosis*, all sites... 16 Table 8 Number of cancer case by staging of disease (Selected Sites), Males... 17 Table 9 Number of cancer case by staging of disease (Selected Sites), Females... 17 Table 10 Number of cases of cancer by residence... 18 Table 11 Number of cases of cancer by site, and age; Males... 20 Table 12 Number of cases of cancer by site, and age; Females... 22 Table 13 Percentage of morphologically verified cancer diagnosis Srinagarind Hospital, 2012, Males... 24 Table 14 Percentage of morphologically verified Srinagarind Hospital, 2012, Females... 26 Table 15 Status at last seen, both sexes... 28 Table 16 Ten leading sites of cancer in childhood, both sexes (age < 15)... 29 Table 17 Number of cases and 1-, 2-, 3- cumulative survival rates by selected tumor site... 32 5
Table of figures Figure 1 Flow chart of Srinagarind Hospital Tumor Registry... 9 Figure 2 Number of cancer cases by type of patients, 2012... 10 Figure 3 Cancer patien by age groups, 2012... 12 Figure 4 Comparative graphs showing the number of in eight consecutive years (2005-2012) of ten leading sites of cancer in males... 14 Figure 5 Comparative graphs showing the number of case in eight consecutive years (2005-2012) of ten leading sites of cancer in females... 15 Figure 6 Percentage of cases of cancer by residence... 19 Figure 7 Breast cancer survival in Srinagarind Hospital between 2003-2007 by stage... 33 Figure 8 Breast cancer survival in Srinagarind Hospital between 2003-2007 by surgery... 33 Figure 9 Breast cancer survival in Srinagarind Hospital between 2003-2007 by chemotherapy... 34 Figure 10 Lung cancer survival in Srinagarind Hospital 2003-2007 both sexes... 35 Figure 11 Lung cancer survival in Srinagarind Hospital between 2003-2007 by stage... 35 Figure 12 Lung cancer survival in Srinagarind Hospital between 2003-2007 by surgery... 36 Figure 13 Lung cancer survival in Srinagarind Hospital between 2003-2007 by chemotherapy... 36 Figure 14 Colon cancer survival in Srinagarind Hospital between 2003-2007 both sexes... 37 Figure 15 Colon cancer survival in Srinagarind Hospital between 2003-2007 by stage... 37 Figure 16 Colon cancer survival in Srinagarind Hospital between 2003-2007 by surgery... 38 Figure 17 Liver and bile duct cancer survival in Srinagarind between 2003-2007 both sexes... 39 Figure 18 Liver and bile duct cancer survival in Srinagarind Hospital between 2003-2007 by stage... 39 Figure 19 Liver and bile duct cancer survival in Srinagarind Hospital between 2003-2007 by surgery... 40 Figure 20 Cervical cancer survival in Srinagarind Hospital between 2003-2007 by stage... 41 Figure 21 Cervical cancer survial in Srinagarind Hospital between 2003-2007 by surgery... 41 Figure 22 Ovarian cancer survival in Srinagarind Hospital between 2003-2007 by stage... 42 Figure 23 Ovarian cancer survival in Srinagarind Hospital between 2003-2007 by surgery.. 42 6
Figure 24 Non-Hodgkin lymphoma (age 15 year) survival in Srinagarind Hospital between 2003-2007 both sexes... 43 Figure 25 Hodgkin disease (age 15 year) survival in Srinagarind Hospital between 2003-2007 both sexes... 43 Figure 26 Acute lymphoblastic leukemia ( age 15) survial in Srinagarind Hospital between 2003-2007 both sexes... 44 Figure 27 Acute myeloid leukemia (age 15) survival in Srinagarind Hospital between 2003-2007 both sexes... 44 7
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
Figure 1 Flow chart of Srinagarind Hospital Tumor Registry 9
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 521,452 536,188 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
Table 2 Number of cancer cases by age groups, 2012 Age groups Male Female Number of cases % Number of cases % 0-4 22 0.73 23 0.84 5-9 17 0.56 10 0.36 10-14 17 0.56 21 0.76 15-19 39 1.29 16 0.58 20-24 24 0.79 32 1.16 25-29 29 0.96 50 1.82 30-34 33 1.09 80 2.91 35-39 93 3.07 116 4.22 40-44 136 4.49 228 8.28 45-49 240 7.93 322 11.7 50-54 418 13.81 354 12.86 55-59 467 15.43 410 14.9 60-64 494 16.33 353 12.83 65-69 412 13.62 288 10.47 70-74 300 9.91 215 7.81 75+ 285 9.42 234 8.5 Total 3026 100 2752 100 Mean 57.71 54.98 S.D. 14.68 15.09 11
0 200 400 0 200 Figure 3 Cancer patien by age groups, 2012 Histogram of Age group, Males 0-10- 25-40- 55-70- Age group Histogram of Age group, Females 0-10- 25-40- 55-70- Age group 12
CHAPTER III Overall Cancer Table 3 Ten leading sites of cancer in males Site Number of cases % Liver and bile duct 1252 41.37 Trachea, Bronchus and lung 300 9.91 Colorectal 187 6.18 Nasopharynx 95 3.14 Non-Hodgkin lymphoma 94 3.11 Oral cavity 90 2.97 Prostate 67 2.21 Stomach 59 1.95 Skin 77 2.54 Thyroid 59 1.95 Other 746 24.66 Total 3026 100 * Oral cavity: ICD-O Code = C00 - C06 Table 4 Ten leading sites of cancer in females Site Number of cases % Liver and bile duct 507 18.42 Breast 446 16.21 Thyroid 261 9.48 Cervix uteri 217 7.89 Trachea, Bronchus and lung 184 6.69 Colorectal 155 5.64 Oral cavity 122 4.43 Corpus uteri 119 4.32 Ovary 110 4 Skin 80 2.9 Other 551 20.05 Total 2752 100 * Oral cavity: ICD-O Code = C00 - C06 13
Table 5 Comparative the number of case in eight consecutive years (2005-2012) of ten leading sites of cancer in males Site 2005 2006 2007 2008 2009 2010 2011 2012 Liver and bile duct 777 829 887 769 742 1,138 1,102 1,252 Trachea, Bronchus and lung 301 276 252 275 250 300 276 300 Colorectal 81 111 113 132 135 167 172 187 Nasopharynx 79 75 91 81 79 80 81 95 Non-Hodgkin lymphoma 91 77 64 72 54 114 113 94 Oral cavity 76 69 76 89 79 91 96 90 Prostate 39 47 39 46 46 60 83 67 Stomach 22 31 30 47 50 28 40 59 Skin 45 32 52 47 47 62 59 77 Thyroid 33 43 36 35 32 52 47 59 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 (2005-2012) of ten leading sites of cancer in males 200 20 2005 2006 2007 2008 2009 2010 2011 2012 Liver&bile duct Lung Colorectal Nasopharynx Non-Hodgkin Oral cavity Prostate Stomach Skin Thyroid * Log scale 14
Table 6 Comparative the number of case in eight consecutive years (2005-20120) of ten leading sites of cancer in females Site 2005 2006 2007 2008 2009 2010 2011 2012 Liver and bile duct 401 393 427 318 285 443 473 507 Breast 264 297 311 299 320 370 367 446 Thyroid 119 145 145 149 156 196 255 261 Cervix uteri 358 317 321 322 299 323 278 217 Trachea, Bronchus and lung 120 79 99 102 117 116 154 184 Colorectal 54 57 58 69 76 143 140 155 Oral cavity 111 115 125 114 129 155 126 122 Corpus uteri 108 83 92 107 107 139 86 119 Ovary 119 105 106 83 129 113 122 110 Skin 44 55 50 36 38 46 61 80 Total 2,229 2,199 2,247 2,209 2,249 2,607 2,593 2752 Figure 5 Comparative graphs showing the number of case in eight consecutive years (2005-2012) of ten leading sites of cancer in females 300 30 2005 2006 2007 2008 2009 2010 2011 2012 Liver&bile duct Breast Thyroid Cervix uteri Lung Colorectal Oral cavity Corpus uteri Ovary Skin * Log scale 15
Table 7 Basis of Diagnosis*, all sites 2011 2012 Basis Number of cases % Number of cases % Clinical 87 1.6 45 0.78 X-Ray or endoscopy 1,478 27.9 1,656 28.66 Surgery/Autopsy but no histology 56 1.5 93 1.61 Specific biochemistry 111 2.1 118 2.04 Cytology of hematology 89 1.7 115 1.99 Histology of metastasis 171 3.2 85 1.47 Histology of primary 3,303 62.4 3,666 63.45 Total 5,259 100 5,778 100 ** % 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
Table 8 Number of cancer case by staging of disease (Selected Sites), Males Site Number of cases Stage % 1 2 3 4 Unknown Liver and bile duct 1252 5 2 40 388 817 Trachea, Bronchus and lung 300 4 6 47 171 72 Colorectal 187 5 25 38 81 38 Nasopharynx 95 2 8 14 38 33 Non-Hodgkin lymphoma 94 6 11 7 17 53 Oral cavity 90 10 10 24 32 14 Prostate 67 0 0 0 29 38 Stomach 59 0 0 7 33 19 Skin 77 7 7 6 11 46 Table 9 Number of cancer case by staging of disease (Selected Sites), Females Site Number of cases Stage % 1 2 3 4 Unknown Liver and bile duct 507 1 5 15 159 327 Breast 446 58 120 126 71 71 Thyroid 261 35 17 18 36 155 Cervix uteri 217 56 62 66 25 8 Trachea, Bronchus and lung 184 2 5 20 124 33 Colorectal 155 6 26 37 49 37 Oral cavity 122 16 17 17 39 33 Corpus uteri 119 56 10 15 8 30 Ovary 110 21 11 24 37 17 17
Table 10 Number of cases of cancer by residence Province Number Percentage Khon Kaen 1067 18.47 Maha Sarakham 614 10.63 Kalasin 584 10.11 Roi Et 558 9.66 Chaiyaphum 483 8.36 Loei 394 6.82 Sakon Nakhon 311 5.38 Udon Thani 249 4.31 Nong Bua Lam Phu 244 4.22 Buriram 238 4.12 Nong Khai 201 3.48 Nakhon Phanom 142 2.46 Nakhon Ratchasima 136 2.35 Laos 92 1.59 Yasothon 89 1.54 Surin 69 1.19 Mukdahan 68 1.18 Ubon Ratchathani 61 1.06 Sisaket 59 1.02 Amnat Charoen 43 0.74 Phetchabun 27 0.47 Other 49 0.82 Total 5,778 100 18
Figure 6 Percentage of cases of cancer by residence 1.59 6.82 4.22 3.48 4.31 5.38 2.46 10.11 1.18 10.63 18.47 9.66 1.54 0.74 8.36 4.12 1.19 1.02 1.06 2.35 19
Table 11 Number of cases of cancer by site, and age; Males Site 0-5 -10-15 -20-25 -30-35 -40-45 -50-55 -60-65 -70 75+ Total Lip 0 0 0 0 0 0 0 0 1 0 0 1 1 1 0 0 4 Tongue 0 0 0 0 0 0 1 4 5 3 4 5 6 3 7 8 46 Mouth 0 0 0 0 0 0 0 0 3 2 6 7 8 3 8 3 40 Salivary glands 0 0 0 0 0 0 0 0 4 1 3 1 5 0 0 3 17 Tonsil 0 0 0 0 0 0 0 1 0 3 2 2 0 1 1 2 12 Other oropharynx 0 0 0 0 0 0 0 0 1 0 0 1 1 0 0 0 3 Nasopharynx 0 0 1 1 1 2 1 5 4 17 13 16 18 9 7 0 95 Hypopharynx 0 0 0 0 0 0 0 1 1 5 7 6 3 4 3 4 34 Pharynx unspecified 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 2 Oesophagus 0 0 0 0 0 0 0 0 2 3 7 9 6 3 4 2 36 Stomach 0 0 0 0 0 1 1 4 5 3 8 6 9 11 7 4 59 Small intestine 0 0 0 0 0 0 1 1 0 1 1 1 0 0 1 2 8 Colon 0 0 0 1 0 0 1 2 1 2 7 24 16 8 11 8 81 Rectum 0 0 0 1 0 1 1 2 1 10 19 19 16 19 11 6 106 Anus 0 0 0 0 0 0 0 0 0 0 2 0 0 1 2 1 6 Liver and bile duct 3 0 0 0 0 5 10 30 42 106 215 216 236 184 120 85 1252 Gallbladder 0 0 0 0 0 0 0 0 1 2 5 5 6 4 2 3 28 Pancreas 0 0 0 0 0 1 0 2 2 1 5 7 5 2 4 2 31 Nose, sinuses etc. 0 0 1 0 0 0 0 1 3 3 6 1 5 4 2 3 29 Larynx 0 0 0 0 0 0 0 0 1 2 2 7 11 12 5 9 49 Trachea, Bronchus and lung 0 0 0 1 0 2 2 4 11 20 29 44 57 47 41 42 300 Other thoracic organs 0 0 1 3 5 0 0 0 1 0 3 1 2 2 2 0 20 Bone 0 0 3 15 4 1 1 1 3 1 5 1 1 0 0 0 36 Melanoma of skin 0 0 0 0 1 2 0 1 0 2 2 3 4 2 3 1 21 Other skin 1 0 0 0 0 0 1 3 3 3 2 12 3 2 10 16 56 Mesothelioma 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Kaposi's sarcoma 0 0 0 0 0 1 1 0 0 0 0 0 1 2 0 0 5 Connective tissue 1 2 0 4 1 1 1 3 6 3 1 4 2 1 4 2 36 20
Table 11 Number of cases of cancer by site, and age; Males (cont.) Site 0-5 -10-15 -20-25 -30-35 -40-45 -50-55 -60-65 -70 75+ Total Breast 0 0 0 0 0 0 0 0 1 0 1 2 0 0 0 1 5 Penis 0 0 0 0 0 0 1 4 4 1 1 3 4 3 2 2 25 Prostate 0 0 0 0 0 0 0 0 0 0 2 9 11 16 15 14 67 Testis 1 1 0 1 1 0 1 1 2 1 1 0 0 1 0 0 11 Other male genital organs 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 1 Kidney 2 0 0 0 0 0 0 0 2 4 3 5 6 6 1 2 31 Renal pelvis 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 2 Bladder 0 0 0 0 1 1 1 0 5 2 8 4 5 9 5 11 52 Eye 3 2 0 0 1 0 1 0 1 3 0 1 0 2 2 5 21 Brain, nervous system 2 3 1 3 2 1 2 5 3 5 4 3 2 2 2 1 41 Thyroid 0 0 1 0 3 1 0 5 3 8 4 7 10 7 3 7 59 Adrenal gland 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 2 Other endocrine 0 0 1 0 0 0 0 0 0 1 0 0 1 0 0 0 3 Hodgkin disease 0 1 0 1 0 1 0 1 0 1 0 0 0 1 0 1 7 Non-Hodgkin lymphoma 2 1 1 3 1 1 3 5 5 11 16 10 5 10 5 15 94 Multiple myeloma 0 0 0 0 0 0 1 0 1 2 3 5 6 4 1 5 28 Lymphoid leukemia 4 7 3 2 0 0 1 0 1 0 0 1 2 2 2 0 25 Myeloid leukemia 2 0 4 2 0 2 0 2 0 1 3 3 2 3 2 0 26 Leukemia unspecified 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Other and unspecified 1 0 0 0 2 4 0 5 7 6 18 12 18 21 5 15 114 Total 22 17 17 39 24 29 33 93 136 240 418 467 494 412 300 285 3026 21
Table 12 Number of cases of cancer by site, and age; Females Site 0-5 -10-15 -20-25 -30-35 -40-45 -50-55 -60-65 -70 75+ Total Lip 0 0 0 0 0 0 0 0 0 0 1 2 3 4 12 13 35 Tongue 0 0 0 0 0 0 1 2 2 5 3 6 2 3 2 3 29 Mouth 0 0 1 0 0 0 1 1 1 0 2 5 9 5 11 22 58 Salivary glands 1 0 0 1 1 0 0 0 0 2 5 1 3 1 2 0 17 Tonsil 0 0 0 0 0 1 0 0 0 0 1 0 1 0 0 1 4 Other oropharynx 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 1 Nasopharynx 0 0 1 0 0 1 2 6 1 1 6 1 3 3 1 1 27 Hypopharynx 0 0 0 0 0 0 0 0 3 1 2 0 1 2 0 2 11 Pharynx unspecified 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 1 Oesophagus 0 0 0 0 0 0 0 0 0 1 0 2 2 0 0 1 6 Stomach 0 0 0 0 0 2 3 0 3 8 4 6 6 8 0 3 43 Small intestine 0 0 1 0 0 0 0 1 0 0 2 0 0 0 0 0 4 Colon 0 0 0 0 0 1 3 0 4 6 12 13 9 6 12 9 75 Rectum 0 0 0 0 0 0 1 1 8 2 8 20 16 9 5 10 80 Anus 0 0 0 0 0 0 0 0 0 0 1 0 1 1 3 0 6 Liver and bile duct 2 0 0 0 0 1 1 8 25 46 47 88 81 85 64 59 507 Gallbladder 0 0 0 0 0 0 0 2 0 1 2 2 5 4 2 4 22 Pancreas 0 0 0 0 0 0 2 2 1 1 4 6 7 3 5 3 34 Nose, sinuses etc. 0 0 0 0 0 0 0 0 0 3 2 1 1 0 3 1 11 Larynx 0 0 0 0 0 0 0 0 0 2 0 1 0 1 0 0 4 Trachea, Bronchus and lung 0 1 0 0 1 1 2 3 17 16 22 33 21 28 15 24 184 Other thoracic organs 0 0 0 0 0 1 0 0 0 2 0 1 0 1 1 0 6 Bone 0 1 2 1 1 0 1 1 2 1 1 0 1 0 0 2 14 Melanoma of skin 0 0 0 0 0 0 0 0 1 1 0 1 3 0 0 1 7 Other skin 0 0 0 0 0 1 1 2 4 2 4 12 7 14 6 20 73 Mesothelioma 0 0 0 0 0 0 0 0 0 0 0 1 0 0 1 0 2 Kaposi's sarcoma 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Connective tissue 4 0 1 1 1 2 1 0 3 1 2 2 2 1 0 1 22 22
Table 12 Number of cases of cancer by site, and age; Females (cont.) Site 0-5 -10-15 -20-25 -30-35 -40-45 -50-55 -60-65 -70 75+ Total Breast 0 0 0 0 2 5 18 31 58 82 94 66 40 28 11 11 446 Vulva 0 0 0 0 0 0 0 0 1 0 0 1 1 0 0 2 5 Vagina 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 1 2 Cervix uteri 0 0 0 0 1 1 10 23 29 32 33 32 25 14 13 4 217 Corpus uteri 0 0 0 0 0 0 0 1 9 14 27 25 21 12 8 2 119 Uterus unspecified 0 0 0 0 1 0 0 1 1 0 1 1 0 1 1 0 7 Ovary 0 0 1 2 4 0 3 4 10 23 15 15 17 7 5 4 110 Other female genital organs 0 0 0 0 0 0 0 0 0 1 0 0 0 1 0 0 2 Placenta 0 0 0 0 1 3 1 0 0 0 0 0 0 0 1 0 6 Kidney 0 0 0 0 0 0 1 0 1 0 2 1 4 1 0 1 11 Renal pelvis 0 0 0 0 0 0 0 0 0 0 0 1 0 1 0 0 2 Bladder 0 0 0 0 0 0 0 0 0 0 0 1 5 1 1 2 10 Eye 1 1 0 0 0 2 0 0 1 2 1 0 0 1 0 3 12 Brain, nervous system 3 3 5 0 4 3 2 0 3 2 1 0 2 2 0 1 31 Thyroid 0 0 2 8 12 19 21 18 27 43 32 27 19 20 9 4 261 Adrenal gland 1 1 0 0 0 0 0 0 0 1 0 0 2 0 0 0 5 Other endocrine 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 Hodgkin disease 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 2 4 Non-Hodgkin lymphoma 0 1 1 2 2 1 2 1 4 9 4 7 8 7 4 4 57 Multiple myeloma 0 0 0 0 0 0 0 1 1 1 2 5 6 1 2 0 19 Lymphoid leukemia 6 1 4 0 0 0 1 1 0 0 1 0 0 0 2 1 17 Myeloid leukemia 3 1 1 0 0 1 2 1 2 3 0 3 5 2 2 1 27 Leukemia unspecified 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 1 Other and unspecified 1 0 1 0 1 4 0 5 5 6 9 21 13 9 11 11 97 Total 23 10 21 16 32 50 80 116 228 322 354 410 353 288 215 234 2752 23
Table 13 Percentage of morphologically verified cancer diagnosis, Srinagarind Hospital, 2012, Males Site Total Cases Percent Lip 4 4 100 Tongue 46 45 97.83 Mouth 40 38 95 Salivary glands 17 17 100 Tonsil 12 11 91.67 Other oropharynx 3 3 100 Nasopharynx 95 93 97.89 Hypopharynx 34 33 97.06 Pharynx unspecified 2 2 100 Oesophagus 36 29 80.56 Stomach 59 52 88.14 Small intestine 8 7 87.5 Colon 81 64 79.01 Rectum 106 99 93.4 Anus 6 6 100 Liver and bile duct 1252 231 18.45 Gallbladder 28 18 64.29 Pancreas 31 8 25.81 Nose, sinuses etc. 29 26 89.66 Larynx 49 47 95.92 Trachea, Bronchus and lung 300 192 64 Other thoracic organs 20 17 85 Bone 36 36 100 Melanoma of skin 21 21 100 Other skin 56 56 100 Kaposi's sarcoma 5 5 100 Connective tissue 36 34 94.44 Breast 5 4 80 Penis 25 22 88 Prostate 67 48 71.64 Testis 11 11 100 Other male genital organs 1 1 100 24
Table 13 Percentage of morphologically verified cancer diagnosis, Srinagarind Hospital, 2012, Males (cont.) Site Total Cases Percent Kidney 31 29 93.55 Renal pelvis 2 2 100 Bladder 52 48 92.31 Eye 21 20 95.24 Brain, nervous system 41 39 95.12 Thyroid 59 57 96.61 Adrenal gland 2 2 100 Other endocrine 3 3 100 Hodgkin disease 7 7 100 Non-Hodgkin lymphoma 94 94 100 Multiple myeloma 28 28 100 Lymphoid leukemia 25 25 100 Myeloid leukemia 26 26 100 Other and unspecified 114 69 60.52 All sites 3026 1729 57.14 All sites without liver 1774 1498 84.44 25
Table 14 Percentage of morphologically verified cancer diagnosis, Srinagarind Hospital, 2012, Females Site Total Cases Percent Lip 35 35 100 Tongue 29 29 100 Mouth 58 58 100 Salivary glands 17 17 100 Tonsil 4 3 75 Other oropharynx 1 1 100 Nasopharynx 27 25 92.59 Hypopharynx 11 10 90.91 Pharynx unspecified 1 1 100 Oesophagus 6 5 83.33 Stomach 43 41 95.35 Small intestine 4 4 100 Colon 75 65 86.67 Rectum 80 74 92.5 Anus 6 6 100 Liver and bile duct 507 125 24.65 Gallbladder 22 8 36.36 Pancreas 34 15 44.12 Nose, sinuses etc. 11 10 90.91 Larynx 4 4 100 Trachea, Bronchus and lung 184 139 75.54 Other thoracic organs 6 6 100 Bone 14 12 85.71 Melanoma of skin 7 7 100 Other skin 73 73 100 Mesothelioma 2 2 100 Connective tissue 22 22 100 Breast 446 400 89.69 Vulva 5 4 80 Vagina 2 2 100 Cervix uteri 217 208 95.85 Corpus uteri 119 118 99.16 26
Table 14 Percentage of morphologically verified cancer diagnosis, Srinagarind Hospital, 2012, Females (cont.) Site Total Cases Percent Uterus unspecified 7 6 85.71 Ovary 110 95 86.36 Other female genital organs 2 2 100 Placenta 6 4 66.67 Kidney 11 8 72.73 Renal pelvis 2 2 100 Bladder 10 10 100 Eye 12 12 100 Brain, nervous system 31 26 83.87 Thyroid 261 255 97.7 Adrenal gland 5 4 80 Other endocrine 1 1 100 Hodgkin disease 4 4 100 Non-Hodgkin lymphoma 57 57 100 Multiple myeloma 19 19 100 Lymphoid leukemia 17 17 100 Myeloid leukemia 27 27 100 Leukemia unspecified 1 1 100 Other and unspecified 97 58 59.79 All sites 2752 2137 77.65 All sites without liver 2245 2012 89.62 27
Table 15 Status at last seen, both sexes Sex Alive Death Total Number of cases % Number of cases % Male 2058 68.01 968 31.99 3026 Female 2307 83.83 445 16.17 2752 Updated patient status by December 31,2012 28
CHAPTER IV Childhood cancer Table 16 Age and Sexes of childhood cancer case Age groups Male Female Number of cases % Number of cases % 0-4 22 39.3 23 42.6 5-9 17 30.4 10 18.5 10-14 17 30.4 21 38.9 Total 56 100 54 100 Mean 6.2 6.9 S.D. 4.4 4.9 Table 16 Ten leading sites of cancer in childhood, both sexes (age < 15) Site Number of cases % Leukemias, myeloproliferative disease, and myelodysplastic disease 36 32.73 CNS and miscellaneous intracranial and intraspinal neoplasms 17 15.45 Soft tissue and other extraosseous sarcomas 8 7.27 Retinoblastoma 7 6.36 Lymphomas and reticuloendothelial neoplasm 7 6.36 Malignant bone tumors 6 5.45 Other malignant epithelial neoplasms and malignant melanomas 6 5.46 Hepatic tumors 5 4.55 Germ cell tumors, trophoblastic tumors, and neoplasms of gonads 3 2.73 Other 15 13.65 Total 110 100 29
CHAPTER V Survival, 2003-2007 Material and methods All registrations of Srinagarind Hospital in the period 2003-2007 were extracted and the 22.483 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
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
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(.85-.99) 90(.78-.97) stage II 336 96(.94-.98) 88(.84-.92) 81(.76-.86) stage III 345 88(.87-.93) 72(.62-.79) 60(.51-.66) stage IV 225 67(.60-.74) 50(.42-.59) 41(.33-.51) Unknown 377 95(.93-.98) 86(.80-.92) 81(.74-.89) Lung cancer by stage I 32 76(.61-.95) 56(.38-.82) 50(.32-.77) stage II 45 63(.44-.89) 39(.20-.75) 31(.14-.68) stage III 141 44(.36-.52) 20(.14-.30) 12(.07-.22) stage IV 191 35(.31-.41) 16(.12-.22) 11(.07-.15) Unknown 475 51(.44-.59) 30(.23-.40) 23(.16-.33) Liver and bile duct by stage I 2 75(.42-1) - - stage II 32 48(.33-.72) 31(.18-.53) 20(.10-.42) stage III 64 40(.29-.56) 28(.17-.43) 18(.09-.33) stage IV 1851 18(.15-.20) 9(.07-.11) 6(.04-.08) Unknown 4598 35(.32-.37) 25(.23-.27) 21(.19-.23) Colon cancer by stage II 21 92(.82-1) 82(.68-1) 73(.56-.94) stage III 48 82(.69-.97) 77(.62-.95) 70(.54-.92) stage IV 159 54(.45-.65) 37(.28-.49) 32(.24-.44) Unknown 180 87(.80-.94) 80(.71-.91) - Cervical cancer by stage I 320 97(.95-1) 94(.90-.98) 92(.87-.96) stage II 518 94(.91-.97) 82(.76-.88) 74(.68-.81) stage III 556 79(.74-.84) 62(.55-.69) 46(.39-.54) stage IV 123 43(.32-.57) 32(.22-.47) 19(.10-.34) Unknown 63 65(.52-.80) 54(.41-.71) 41(.28-.61) 32
Survival probability Survival probability Figure 7 Breast cancer survival in Srinagarind Hospital between 2003-2007 by stage Breast cancer by stage, 2003-07 Stage 1 Stage 2 Stage 3 Stage 4 Unknown stage Figure 8 Breast cancer survival in Srinagarind Hospital between 2003-2007 by surgery Breast cancer by surgery, 2003-07 Done Not done 33
Survival probability Figure 9 Breast cancer survival in Srinagarind Hospital between 2003-2007 by chemotherapy Breast cancer by chemotherapy,2003-07 Done Not done 34
Survival probability Survival probability Figure 10 Lung cancer survival in Srinagarind Hospital 2003-2007 both sexes Lung cancer both sexes, 2003-07 Male Female Figure 11 Lung cancer survival in Srinagarind Hospital between 2003-2007 by stage Lung cancer by stage, 2003-07 Stage 1 Stage 2 Stage 3 Stage 4 Unknown 35
Survival probability Survival probability Figure 12 Lung cancer survival in Srinagarind Hospital between 2003-2007 by surgery Lung cancer by surgery, 2003-07 Done Not done Figure 13 Lung cancer survival in Srinagarind Hospital between 2003-2007 by chemotherapy Lung cancer by chemotherapy, 2003-07 Done Not done 36
Survival probability Survival probability Figure 14 Colon cancer survival in Srinagarind Hospital between 2003-2007 both sexes Colon cancer both sexes, 2003-07 Male Female Figure 15 Colon cancer survival in Srinagarind Hospital between 2003-2007 by stage Colon cancer by stage, 2003-07 Stage 2 Stage 3 Stage 4 Unknown 37
Survival probability Figure 16 Colon cancer survival in Srinagarind Hospital between 2003-2007 by surgery Colon cancer by surgery, 2003-07 Done Not done 38
Survival probability Survival probability Figure 17 Liver and bile duct cancer survival in Srinagarind between 2003-2007 both sexes Liver and bile duct both sexes, 2003-07 Male Female Figure 18 Liver and bile duct cancer survival in Srinagarind Hospital between 2003-2007 by stage Liver and bile duct by stage, 2003-07 Stage 1 Stage 2 Stage 3 Stage 4 Unknown 39
Survival probability Figure 19 Liver and bile duct cancer survival in Srinagarind Hospital between 2003-2007 by surgery Liver and bile duct by surgery, 2003-07 Done Not done 40
Survival probability Survival probability Figure 20 Cervical cancer survival in Srinagarind Hospital between 2003-2007 by stage Cervical cancer by stage, 2003-07 Stage 1 Stage 2 Stage 3 Stage 4 Unknown Figure 21 Cervical cancer survial in Srinagarind Hospital between 2003-2007 by surgery Cervical cancer by surgery, 2003-07 Done Not done 41
Survival probability Survival probability Figure 22 Ovarian cancer survival in Srinagarind Hospital between 2003-2007 by stage Ovary cancer by stage, 2003-07 Stage 1 Stage 2 Stage 3 Stage 4 Unknown Figure 23 Ovarian cancer survival in Srinagarind Hospital between 2003-2007 by surgery Ovary cancer by surgery, 2003-07 Done Not done 42
Survival probability Survival probability Figure 24 Non-Hodgkin lymphoma (age 15 year) survival in Srinagarind Hospital between 2003-2007 both sexes Non-Hodgkin lymphoma both sexes, 2003-07 Male Female Figure 25 Hodgkin disease (age 15 year) survival in Srinagarind Hospital between 2003-2007 both sexes Hodgkin disease both sexes, 2003-07 Male Female 43
Survival probability Survival probability Figure 26 Acute lymphoblastic leukemia ( age 15) survial in Srinagarind Hospital between 2003-2007 both sexes ALL both sexes, 2003-07 Male Female Figure 27 Acute myeloid leukemia (age 15) survival in Srinagarind Hospital between 2003-2007 both sexes AML both sexes, 2003-07 Male Female 44
Survival probability Survival probability Figure 28 Acute lymphoblastic leukemia (age 14) survival in Srinagarind Hospital between 2003-2007 both sexes ALL both sexes, 2003-07 Male Female Figure 29 Acute myeloid leukemia (age 14) survival in Srinagarind Hospital between 2003-2007 both sexes AML both sexes, 2003-07 Male Female 45