Institution-based cancer incidence in a local population in Pakistan: nine year data analysis.

At present no national level of cancer registry program exists in Pakistan and the data available from different sources, necessary for incidence, prevalence, morbidity/mortality, and etiological assessment of cancer and cancer control programs, are from hospital or institutional databases. Karachi Institute of Radiotherapy and Nuclear Medicine (KIRAN) is a comprehensive healthcare facility for diagnosis, treatment and research of all cancers. This is a retrospective analysis of the cancer patients of both genders of all age groups to determine frequencies of different cancers presented to this Institute from 1st January 2000 to 31 December 2008. A total of 16,351 cancer patients were registered at KIRAN during the nine year period. Male cancers accounted for 48.1% and female cancers 51.8%. Some 558 (3.4%) were in children (0-15 years). The mean ages at presentation for males and females were 50-/+9.6 and 47-/+7.4 years respectively. In males the five most frequent malignancies were head and neck (32.6%), lung (15%), gastrointestinal tract (GIT) (6.9%), lymphoma (6.1%), and bone and soft tissue (4.9%). In females breast cancer was the most common cancer accounting for 38.2% followed by head and neck (15.1%), cervical (5.5%), ovarian (4.9%) and GIT cancer (4.9%) respectively. Cancer prevalence in different age groups with respect to gender and the epidemiologies of most common cancers with reference to our cultural and environmental factors and dietary habits are also discussed. Overall cancer incidence in nine years in this tertiary care cancer institution showed that head and neck cancers in males and breast cancers in females are most common, at rates almost highest in Asia. Mean age and male to female ratio in all other cancers are essentially comparable to other developing countries.

Significance of prostate specific antigen in prostate cancer patients and in non cancerous prostatic disease patients.

OBJECTIVE: To evaluate the significance of prostate specific antigent (PSA) and scan in prostate cancer patients and in non cancerous prostatic disease patients. METHODS: The study was carried out in Radioimmunoassay (RIA) lab, KIRAN Hospital, Karachi during 2002 to 2006. A total of 149 serum samples were collected in which 93 samples were biopsy positive prostate cancer patients referred to KIRAN hospital for treatment. The other 56 samples were collected from patients having other prostatic diseases and advised PSA tests by physicians and urologists from 'The Lab' Karachi. The PSA (total) was measured by immunoradiometric assay (IRMA) in which two monoclonal antibodies against two different epitopes of PSA molecules were used. The results were correlated with bone scan and age of the patients. RESULTS: A total of 149 patient samples were analyzed in which 93 were from biopsy positive prostate cancer patients and 56 from patients having other prostatic diseases. Out of 93 prostate cancer patients sample, 74 (79.6%) had elevated PSA level (>4 ng/ml) and 19 (20.4%) had PSA within normal range (<4 ng/ml). Among 74 elevated PSA level cases, 48 (64.8%) had a positive bone scan and 26 (35.2%) had negative bone scan. Minimum age recorded was 40 years (Mean age 66.4 +/- 9.1 years). In fifty six (56) serum samples which were collected from 'The Lab' and having other prostatic diseases, 49 (87.5%) had PSA within normal range (< or =4 ng/ml). CONCLUSION: Prostate specific antigen has a significant role for the diagnosis of prostate cancer (and has a significant correlation with bone scan). Immunoradiometric assay has a sensitivity of 79.5% and specificity of 87.5% for prostate cancer.