Hyderabad (Sindh, Pakistan) Cancer Registry Report of Four Years (2020-2023).

Objective: To collect and analyse cancer data of all malignancies from the Hyderabad Cancer Registry (HCR) for the estimation of cancer incidence (2020-2023) in various age groups and genders to identify common malignancies and any risk factors to facilitate cancer control initiative and prioritisation by the government and private sector.

Study design: Observational study. Place and Duration of the Study: Hyderabad Cancer Registry (HCR) Secretariat, Liaquat University of Health Sciences (LUMHS), Jamshoro, in collaboration with Karachi Cancer Registry, Health Research Institute, NICH, JPMC, Karachi, Pakistan, from January 2020 to December 2023.

Methodology: Cancer data of HCR collected from across Sindh province were analysed using SPSS. Parameters included age, gender, first contact date, primary site, and ICD coding. Data were cleaned, merged, and analysed. As per the standard guidelines, patients aged 0-14 years were classified as children, 15-19 years as adolescents, and aged 20 years and above as adults. Age-standardised incidence rates (ASIR) were also determined.

Results: During these four years, i.e., from January 2020 to December 2023, a total of 7,169 malignant cases were received. This included 3,310 (46.2%) males and 3,859 (53.8%) females, respectively. Out of a total of 7,169 cases, 6,967 (97.18%) tumours were seen in adults (≥20 years), 104 (1.45%) in adolescents, and 98 (1.37%) in children. In male adults, the oral, prostate, and urinary bladder, while in females, the breast, oral, and ovary constituted the three most common sites. The overall ASIR in males was 188.96 for adults, 2.25 for adolescents, and 2.41 for children. The overall ASIR in females was 236.68 for adults, 2.17 for adolescents, and 1.62 for children.

Conclusion: Both genders combined, breast cancer was the most common malignancy in Sindh. Oral cancer (OC) topped the list in males as the most common cancer, while it was 2nd most common in females after breast. OC, though largely a preventable cancer, has shown an upward trend mostly due to highly prevalent chewing habits, while breast cancer, largely a non- preventable one, not only shows an upward trend but more and more cases are occurring in young and pre-menopausal women. In adolescents and children, the orbital, oral, brain, colorectal, and bone malignancies were predominant.

Key words: Hyderabad, Sindh, Cancer registry, Oral cancer, Breast cancer.