ObjectivesTo estimate the cancer incidence by age group for the Lahore district population within the Punjab Cancer Registry (PCR), Pakistan. The average annual population of Lahore was 9.8 million in 2010–2012. This is a sequel to a study published earlier.DesignA cross-sectional study.SettingThe registry has 19 centres in Lahore reporting their data to the coordinating office located within the Shaukat Khanum Memorial Cancer Hospital and Research Center (SKMCH&RC), Lahore, Pakistan.ParticipantsData existing in the PCR database, based on a confirmed diagnosis of cancer from 1 January 2010 to 31 December 2012, among the Lahore residents, were reviewed.Outcome measuresCancer counts and the age-standardised incidence rates (ASIR) per 100 000 population were computed by gender, cancer site/type and age group (0–14, 15–19 and ≥20 years).ResultsBetween 2010 and 2012, of the 15 840 new cancers diagnosed, 57% were in females. The ASIRs in age groups 0–14, 15–19 and ≥20 years, among females, were: 6.1, 8.4 and 170.7, respectively, and among males, 9.3, 12.2 and 104.5, respectively. The common diagnoses in children, adolescents and adults were: (1) among females: leukaemia: 2.2; bone tumour: 1.4 and breast cancer: 79.2, respectively, and (2) among males: leukaemia: 3.6; bone tumour: 2.4 and prostate cancer: 10.7, respectively.ConclusionsThe ASIR was higher in adult women than in men, but it was lower in girls and young women than their corresponding male counterparts. Leukaemia was the most common diagnosis in children and bone tumour in adolescents, regardless of gender. Among women, breast cancer and, in men, prostate cancer, were the leading cancer types, in adults. These estimates could be used for the expansion of health coverage in the region including setting-up low cost, diagnostic tests for early detection of cancers.

ObjectivesTo estimate the population-level cancer estimates for the Lahore district, which is part of the Punjab Cancer Registry (PCR), Pakistan. The average population per year of Lahore was estimated at 9.8 million in 2010–2012.DesignA cross-sectional study.SettingThe Registry has 19 collaborating centres in Lahore that report their data to the Central Office located within a tertiary care cancer treatment facility in Lahore, Pakistan.ParticipantsPatients belonging to Lahore, of any age-group, and diagnosed with cancer in 2010–2012, were included in the study. They were followed up between July and October 2015 to determine their vital status.Outcome measuresSummaries were generated for gender, the basis of diagnosis, diagnoses and deaths. The Age-Standardized Incidence Rates (ASIR) were computed per 100 000 population, by gender and cancer site. Five-year age categories were created from 0–4 until 70–74, followed by 75+ years. Death counts were reported by site.ResultsBetween 2010 and 2012, in Lahore, a total of 15 840 new cancers were diagnosed in 43% male patients and 57% female patients; 93.5% were microscopically confirmed and 6.5% non-microscopically. In females, the ASIR was 105.1 and in males, it was 66.7. ASIRs of leading cancers among women were breast 47.6, ovary 4.9 and corpus uteri 3.6, whereas among men they were prostate 6.4, bladder 5.0, and trachea, bronchus and lung 4.6. A total of 5134 deaths were recorded.ConclusionsIn Lahore, the ASIR was higher in women than in men. Among women and men, breast cancer and prostate cancer, respectively, were the leading cancer types. These estimates can be used for health promotion and policymaking in the region.

ObjectivesTo study the cancer incidence rates over 10 years (2010–2019), in Lahore, Pakistan.DesignAn incidence study.SettingThe population-based Punjab Cancer Registry was established in 2005 in Lahore, which is the provincial metropolis of the province of Punjab (five rivers), and is located in the northeast region of Pakistan. The coordinating office of the Registry is located within Shaukat Khanum Memorial Cancer Hospital and Research Center. Both the active and passive forms of data collection are used.ParticipantsResidents of the district of Lahore diagnosed with cancer. The average annual population of Lahore was estimated at 11.1 million.Outcome measuresCancer counts and incidence rates per 100 000 population, by age-group, sex and cancer site/type, over 10 years.ResultsIn Lahore, from 2010 to 2019, 58 394 incident cases were reported, with the majority seen in females (57.1%). Adults accounted for 92.2%, adolescents 2.2% and children 5.6% of the total cases. Per 100 000 population, the age-standardised incidence rate was 103.4 for females and 65.6 for males. Among females, the highest incidence rates were recorded for breast cancer (76.7) in adults, bone tumour (1.2) in adolescents and lymphoid leukaemia (1.6) in children, and among males, prostate cancer (10.7) in adults, bone tumour (2.2) in young adults and lymphoid leukaemia (2.4) in children. The age-specific incidence rates peaked in the 60–70 year group, reaching a high of 420 per 100 000 in women and 330 per 1 00 000 men.ConclusionsIn Lahore, the incidence rates for cancers of the breast, prostate, lymphoid leukaemia and bone were among the highest documented. More cases were recorded in females than in males. The results reported could be used as a reference point for assessing the effectiveness of future interventions.

Pakistan is categorised as a lower-middle-income country, with population estimated at 197 million in 2017 by the World Bank. 1 Although Pakistan is a populous country, there is a dearth of oncologists or dedicated facilities that deal specifically with cancer diagnosis or management. 2 This is compounded by the fact that cancer registration has never been taken seriously in the country in more than 70 years of existence, and enough efforts have not been made to establish populationbased cancer registries in the region. Except for the population-based data from the Karachi Cancer Registry (KCR), 3 which was published by the International Agency for Research on Cancer (IARC) in 2007, the data reported from few other centres is institutional and does not represent the population of the region. Even the KCR data represented merely 1.7 million population of the Karachi South district, accounting for nearly 1% of the population of the country. The government's total expenditure on health is 2.6% of the GDP, and healthcare delivery is quite complex, with a large part of the population being served through a mixed health system via multiple health providers. 4 The Punjab Cancer Registry was established in 2005 and the reporting of cancer cases was initiated under a mutual agreement between various centres. 5 During the early phase of the Registry, enough information could not be collected. Later, reports on its 3-year data (2010-2012) were published. 6,7 The current study is a comprehensive, retrospective study over an extended six-year period (2010)(2011)(2012)(2013)(2014)(2015) reporting the cancer incidence rates within the population of Lahore.

Late presentation with advanced disease, poor nutritional status and high risk of exposure to infective agents all contribute to the high mortality in patients treated with intensive protocols in resource-poor countries.