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ORIGINAL ARTICLE
Year : 2018  |  Volume : 31  |  Issue : 2  |  Page : 582-587

Cancer statistics in Menofia University Hospital 2012–2013: a trial of cancer registry in Menofia University Hospital


Department of Clinical Oncology, Faculty of Medicine, Menofia University, Menofia, Egypt

Date of Submission10-Dec-2016
Date of Acceptance17-Feb-2017
Date of Web Publication27-Aug-2018

Correspondence Address:
Mohamed S El-Senbawy
Clinical Oncology Department, Faculty of Medicine, Menofia University, Yassin Abdel Ghafar Street, Shebin El-Kom, Menofia
Egypt
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/mmj.mmj_649_16

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  Abstract 


Background
The purposes of a hospital-based cancer registry are by definition different from those of a population-based registry. The purpose of the hospital-based registry is to serve the needs of the hospital administration and the hospital's cancer program, guide planning and evaluation of cancer control programs, and provide information for the national database of cancer incidence.
Objective
The aim of this work is to describe cancer statistics in Menoufia University Hospital among cases who had presented to the clinical oncology department in 2012–2013.
Patients and methods
A retrospective descriptive study was carried out at Menoufia University Hospital, Clinical Oncology Department, describing cancer registry among all cases who had presented in 2012–2013. Data were collected from patients' records, paper file. This study described the total number of cases in 2012 and 2013 and, in each year, the number of patients of both sexes, cancer site frequency, and the most common cancers for both sexes and for each sex. Cases with incomplete data were excluded.
Results
In 2012, 1413 patients presented versus 1475 patients in 2013, with a total of 2888 patients; ~52% of the cases were women and ~48% of cases were men. Breast cancer was the most frequent cancer, followed by lymphohematopoietic malignancies, gastrointestinal tract tumors, urinary tract tumors, lung and pleura cancers, metastasis of unknown origin, gynecological tumors, head and neck cancers, sarcomas, central nervous system tumors, male genital system tumors, skin tumors, endocrinal tumors, and miscellaneous, respectively.
Conclusion
In our study, the male to female ratio was less than 1. The most frequent tumor sites are breasts, lymphohematopoietic system, gastrointestinal tract, urinary tract, and lung and pleura, respectively.

Keywords: Cancer statistics, hospital-based cancer registry, menoufia university hospital


How to cite this article:
El-Senbawy MS, Abd El Bary NM, Shehata MA, Shaltout EA. Cancer statistics in Menofia University Hospital 2012–2013: a trial of cancer registry in Menofia University Hospital. Menoufia Med J 2018;31:582-7

How to cite this URL:
El-Senbawy MS, Abd El Bary NM, Shehata MA, Shaltout EA. Cancer statistics in Menofia University Hospital 2012–2013: a trial of cancer registry in Menofia University Hospital. Menoufia Med J [serial online] 2018 [cited 2018 Nov 20];31:582-7. Available from: http://www.mmj.eg.net/text.asp?2018/31/2/582/239760




  Introduction Top


The cancer registry is an organization for the systematic collection, storage, analysis, interpretation, and reporting of data on patients with cancer. There are two main types of cancer registries: hospital based and population based [1].

Hospital-based cancer registries record information on the cancer patients seen in a particular hospital. The main purpose of such registries is to contribute toward patient care by providing readily accessible information on the patients with cancer and the treatment they received. The data are used mainly for administrative purposes and for reviewing clinical performance. Although these data may be used, to a certain extent, for epidemiological purposes, these registries cannot provide measures of the occurrence of cancer in a defined population [2].

Population-based cancer registries seek to collect data on all new cases of cancer occurring in a well-defined population. Usually, the population is that which is resident in a particular geographical region. As a result, and in contrast to hospital-based registries, the main objective of this type of cancer registry is to produce statistics on the occurrence of cancer in a defined population and to provide a framework for assessing and controlling the impact of cancer in the community. Thus, the emphasis is on epidemiology and public health [3],[4],[5].

One of the main advantages of hospital registries is that they have ready and instant access to medical records, the primary source of cases. The data items collected by a hospital registry tend to be more extensive than those collected by a population registry. There are, however, several limitations to the data from hospital registries:

  1. They are institution based and not population based. This means that an attempt is made to register all cancer cases occurring in any defined population; thus, incidence rates cannot be determined. Patients who are hospitalized in more than one hospital are counted more than once in an area's hospital tumor registries. Information may not be shared among hospitals caring for the patient at different times. Changes over time in the numbers of any type of cancer or patient characteristics may only reflect shifts by patients (or doctors) from one institution to another. The cancer cases in any one hospital (or group of hospitals) may not be representative of all cancer cases that are occurring in the area
  2. Ascertainment of death is likely to be more incomplete in hospital-based registries than population-based registries [6],[7],[8].


The aim of this study is to describe cancer statistics in Menoufia Hospital among patients who had presented to the Clinical Oncology Department in 2012–2013.


  Patients and Methods Top


The study was approved by the Ethical Committee of the Menoufi a Faculty of Medicine. This retrospective descriptive study was carried out at Menoufia University Hospital, Clinical Oncology Department. This study described the cancer registry of all patients who had presented in 2012–2013. The study was approved by the Ethical Committee of the Menoufia Faculty of Medicine.

The generally accepted definitions of classes of patients are as follows:

  1. Diagnosed at this hospital since the reference (starting) date of the hospital registry and the entire first course of therapy provided elsewhere
  2. Diagnosed and treated at this hospital (note: if the patient is considered to be untreatable, he or she is still included in this category)
  3. Diagnosed elsewhere, but received all or part of the first course of therapy at this hospital; the previously mentioned categories are eligible
  4. Diagnosed and the entire first course of therapy received elsewhere (this would include patients admitted only for supportive care)
  5. Diagnosed and treated at this hospital before the reference (starting) date of the hospital registry
  6. Diagnosed only at autopsy.


Cases included in categories 1, 2, and 3 are generally referred to as analytical cases. Cases included in categories 4–6 are considered to be nonanalytical cases and are specifically excluded from most tabulations [9].

This hospital-based cancer registry trial included patients who presented to Menoufia University Hospital, Clinical Oncology Department, from January 2012 till December 2013; data were collected from patients' records, paper files. Full data patient files were only included for the first 'four' categories of patients.

Patients with lost file records or with incomplete basic data were excluded from the study. There were 107 of these cases (3.7% of all cases).

Data were collected, tabulated, and statistically analyzed using an IBM personal computer with the statistical package for the social science version 17 (SPSS; SPSS Inc., Chicago, Illinois, USA) and (Epi Info 2000, CDC, Atlanta, Georgia, USA) programs. Data were presented in the form of mean, SD, and range, and qualitative data were presented in the form of numbers and percentages.

This study focused on the following factors: the total number of cases in 2012 and 2013 and in each year, the number of male and female patients, the rank of tumor categories from the most frequent to the least frequent in the entire population and in each sex, and the most frequent individual tumor sites in the entire population.


  Results Top


In 2012, 1413 patients presented with cancer versus 1475 patients in 2013, with a total of 2888 patients. Patients with lost file records or with incomplete basic data were excluded from the study: 107 patients (3.7% of all cases).

It was found that ~52% of patients were women and ~48% of patients were men [Figure 1].
Figure 1: Percentage of cases among patients of both sexes.

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Breast cancer was the most common cancer among in the entire population (22.1%), followed by lymphohematopoietic system malignancies (16.3%), gastrointestinal tract (GIT) tumors (16.1%), urinary tract tumors (8.5%), lung and pleural cancers (7%), unknown origin (MUO) (6.5%), gynecological tumors (5.2%), head and neck cancers (3.9%), sarcomas (3.4%), central nervous system (CNS) tumors (3%), male genital system tumors (2.9%), skin tumors (0.9%), endocrinal tumors (0.7%), and miscellaneous (thymoma, thymic carcinoma, and wilms tumors) (0.3%), respectively [Table 1] and [Figure 2].
Table 1: Ranking of the most frequent tumor category among patients of both sexes

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Figure 2: Ranking of the most frequent tumor categories among patients of both sexes.

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Women

Approximately 1463 female patients presented to our department in 2012–2013. Breast cancer was the most common cancer among the female patients, prevalent in ~41% of all female cancer patients, followed by lymphohematopoietic malignancies (13.3%), GIT malignancies (11.2%), gynecological tumors (9.6%), MUO (5.6%), urinary tract tumors (3.5%), sarcomas (3.4%), lung and pleural tumors (3%), head and neck cancers (2%), and CNS tumors (2%), endocrinal tumors (0.7%), skin tumors (0.6%), and miscellaneous (thymoma, thymic carcinoma, and wilms tumors) (0.3%), respectively [Table 2].
Table 2: Ranking of cancer categories among patients of both sexes

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Men

Approximately 1331 male patients presented to our department in 2012–2013. GIT malignancies were the most common cancers among the male patients, prevalent in approximately one-fifth of all male cancers, followed by lymphohematopoietic malignancies (19.7%), urinary tract tumors (13.8%), lung and pleural tumors (11.2%), MUO (7.5%), male genital tract tumors (5.9%), CNS tumors (4.1%), sarcomas (3.3%), skin tumors (1.2%), endocrinal tumors (0.6%), male breast cancers (0.45%), and miscellaneous tumors (0.4%), respectively [Table 2].

The most frequent individual tumor sites in the entire population were breast cancer, followed by non-Hodgkin lymphoma (NHL), urinary bladder cancer, MUO, nonsmall cell lung cancer, and colorectal cancer [Table 3] and [Table 4].
Table 3: Number and percentage of frequent individual cancer sites among patients of both sexes

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Table 4: The rank of the most frequent individual cancer sites for men and women separately and among patients of both sexes

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  Discussion Top


This is the first trial of a hospital-based cancer registry at Menoufia Governorate; we carried out this study at a university hospital among patients who presented to the Oncology Department in two consecutive years: 2012 and 2013.

The male to female ratio was less than 1; it may be explained by the large bulk of female breast cancer with 41% between women and 22% in both sexes being the most common malignancy in this series, this high prevalence of female patients may also be explained by the employment status of the patients as most of female patients are house wives and not insured while male patient more insured and more of them may receive their treatment totally at health insurance hospitals including 'Alhelal' Hospital at Menoufia Governorate.

Our hospital-based results are similar to these of pathology-based series by Mokhtar and colleagues at the National Cancer Institute in 2007 on the ranking of the most four frequent tumor categories (breast cancer, lymphohematopoietic malignancies, GIT tumors, and urinary system tumors, but there is a difference in the percentage, being ~ 15% in the pathology series in both GIT and the urinary system, but in our series, it is 16 and 8.5%, respectively [10].

This difference in the percentage of urinary system malignancies in our hospital-based cancer registry and Mokhtar et al.'s [10] pathology-based cancer registry may be explained by the lower occurrences of urinary system tumors in our trial, which may be related to decreased incidence of urinary system tumors over time with increased awareness and treatment of bilharziasis with time compared with that in 2007 [11].

In Egypt, the National Population-Based Cancer Registry Program has shown that the two most common cancers in patients of both sexes were liver and breast cancer, whereas in our hospital-based study, there was a decrease incidence of liver cancer. This may be attributed to the main presentation of early hepatocellular carcinoma (HCC) cases in Menoufia National Liver Institute, where they receive their main local ablative therapy. However, in our center, the main presentation is advanced and metastatic HCC cases, when local therapy is contraindicated or nonbeneficial [12],[13].

On the basis of the results of the National Population-Based Registry Program of Egypt, 2008–2011, the most frequent cancers among male patients were liver cancer, bladder cancer, lung cancer, NHL, nervous system tumors, and prostate cancer. In women, the most frequent cancers were breast cancer, liver cancer, nervous system tumors, ovarian cancers, NHL, and thyroid cancers [12].

HCC, in our hospital-based registry, was the fifth most common cancer among men, but not in women or among patients of both sexes, whereas HCC was the most common tumor among men, the second frequent cancer among women, and the most frequent cancer among patients of both sexes according to the results of the National Population-Based Registry Program of Egypt [12]. This can explained by the fact that the Menoufia National Liver Institute is nearby; it treats early HCC cases and refers only the advanced HCC cases to us. HCC was not one of the frequent cancers among women because of lower incidences of chronic liver disease; men are at a higher risk of HCC as they are exposed more to bilharziasis, blood transfusion, and hepatitis C virus infection, placing them at a higher risk of developing chronic liver disease and therefore HCC.

In our hospital-based registry, thyroid cancers were not among the most frequent cancers, whereas according to the results of the National Population-Based Registry Program of Egypt (2008–2011), thyroid cancers was the fifth frequent most common cancer among women. This may be because of lack of radioactive iodine in our center, which is the cornerstone of adjuvant therapy in most thyroid cancer cases rather than anaplastic cancer. Therefore, almost all cases of thyroid cancers were referred to other centers [12].

Nervous system tumors were the fifth most frequent tumors among men, the third most frequent tumors among women, and the fourth most frequent tumors among patients of both sexes according to the results of the National Population-Based Registry Program of Egypt [12], whereas according to our results, nervous system tumors are not among the most frequent tumors. This can be attributed to the fact that our study focused on a hospital-based registry, which includes only cases presenting to us for adjuvant radiotherapy and/or chemotherapy not including nervous system tumors treated only by surgery and then under follow-up without any adjuvant therapy such as low-grade meningeoma, low-grade gliomas, pituitary adenomas, and so on.


  Conclusion Top


During the years 2012–2013, the Clinical Oncology Department diagnosed and treated a total of 2888 patients; a total of 107 patients were excluded from our study because of incomplete data and lost medical records. The male to female ratio was less than 1.

The most frequent individual tumor sites among patients of both sexes were breast cancer, followed by NHL, urinary bladder cancer, MUO, nonsmall cell lung cancer, and colorectal cancer.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

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WHO. G lobal action plan for the prevention and control of NCDs. 2013–2020. Geneva: World Health Organization; 2013. Available at: http://www.who.int/nmh/publications/ncdaction-plan/en. Last accesed on 2016 Nov 20.  Back to cited text no. 1
    
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Bray F, Znaor A, Cueva P, Korir A, Swaminathan R, Ullrich A, et al. Planning and developing population-based cancer registration in low- and middle-income settings. Lyon, France: IARC; 2014.  Back to cited text no. 2
    
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Surveillance, Epidemiology, and End Results (SEER) Program. SEER*Stat Database: Mortality-All COD, Aggregated With State, Total US (1969-2012) (Katrina/Rita Population Adjustment). Bethesda, MD: National Cancer Institute, Division of Cancer Control and Population Sciences, Surveillance Research Program, Cancer Statistics Branch, National Center for Health Statistics 2015. 2015.  Back to cited text no. 3
    
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Bray F, Parkin DM. Evaluation of data quality in the cancer registry: principles and methods. Part I: comparability, validity and timeliness. Eur J Cancer 2009; 45:747–755.  Back to cited text no. 4
    
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World Health Organization (WHO). Manual of the international statistical classification of diseases, injuries, and causes of death. Geneva: WHO; 2008.  Back to cited text no. 5
    
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Zheng YL, Amr S, Saleh DA, Dash C, Ezzat S, Mikhail NN, et al. Urinary bladder cancer risk factors in Egypt: a multicenter case-control study. Cancer Epidemiol Biomarkers Prev 2012; 21:537–546.  Back to cited text no. 11
    
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Ibrahim AS, Mikhail NNH. The evolution of cancer registration in Egypt: from proportions to population-based incidence rates. SECI Oncol; 2015; 4:1–21.  Back to cited text no. 12
    
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    Figures

  [Figure 1], [Figure 2]
 
 
    Tables

  [Table 1], [Table 2], [Table 3], [Table 4]



 

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