Keywords
hepatocellular carcinoma
hepatitis C
late-stage presentation
cancer registry
retrospective study
Rawalpindi
How to Cite
Abstract
Objective: To assess the magnitude and distribution of malignant cases attending the Oncology Care Clinic of a tertiary care hospital in Rawalpindi, and to perform a comparative sub-analysis of hepatobiliary malignancies with respect to tumour type, stage, and viral hepatitis burden by sex and geographic origin.
Methods: A retrospective observational study examined all confirmed malignancy registrations at the Rawalpindi Medical University (RMU) Oncology Care Clinic between August 2022 and July 2024. A hepatobiliary sub-cohort (n = 99) was analysed separately using Chi-square, Fisher exact, and Mann–Whitney U tests to compare tumour characteristics by sex and area of residence. Statistical significance was set at p < 0.05.
Results: Five hundred patients were included in the main cohort (mean age 50.1 years; 61.8% female). Gynaecological cancers predominated (29.0%), followed by hepatobiliary (19.6%) and haematological (19.0%) malignancies. In the hepatobiliary sub-cohort (n = 99), hepatocellular carcinoma (HCC) accounted for 73 cases (73.7%), CA pancreas for 18 (18.2%), and other tumours for 8 (8.1%). Males constituted 71.7% of this group. Hepatitis C virus (HCV) was the predominant underlying chronic liver disease, present in 65 patients (65.7%). Late-stage presentation (stage III or IV) was recorded in 70 patients (70.7%). No statistically significant differences were found in tumour type (p = 0.431), late-stage presentation (p = 0.260), or HCV burden (p = 0.221) when compared by sex, nor in late-stage presentation by area of residence (p = 0.475). Stage distribution across tumour types was also comparable (p = 0.953).
Conclusion: Gynaecological malignancies are the most frequent cancers in this tertiary care setting. Hepatobiliary tumours carry a heavy HCV burden and a strikingly high rate of late-stage presentation; however, tumour patterns do not differ significantly by sex or geographic origin within this cohort, suggesting uniformly delayed diagnosis across all subgroups. These findings argue for system-wide early detection initiatives rather than targeted subgroup interventions alone.
Keywords: malignancy; hepatocellular carcinoma; hepatitis C; late-stage presentation; cancer registry; retrospective study; Rawalpindi
References
Global Burden of Disease Cancer Collaboration. Cancer incidence, mortality, years of life lost, years lived with disability, and disability-adjusted life years for 29 cancer groups from 2010 to 2019: a systematic analysis for the Global Burden of Disease Study 2019. JAMA Oncol. 2022;8(3):420–444.
Parkin DM, Bray F, Ferlay J, Pisani P. Global cancer statistics, 2002. CA Cancer J Clin. 2005;55(2):74–108.
Siegel RL, Giaquinto AN, Jemal A. Cancer statistics, 2024. CA Cancer J Clin. 2024;74(1):12–49.
Tufail M, Wu C. Cancer statistics in Pakistan from 1994 to 2021: data from the cancer registry. JCO Clin Cancer Inform. 2023;7:e2200142.
Ikram A, Pervez S, Khadim MT, et al. National Cancer Registry of Pakistan: first comprehensive report of cancer statistics 2015–2019. J Coll Physicians Surg Pak. 2023;33(6):625–632.
Khokhar MA, Ali MM, Liaqat S, et al. A review of access to cancer facilities in Punjab, Pakistan. Cancer Rep (Hoboken). 2020;3(3):e1245.
Ashraf T, Ghafoor T, Tanveer S. Pattern of paediatric malignancies in a tertiary care hospital in northern Pakistan. Pak J Physiol. 2018;14(4):21–24.
Badar F, Mahmood S, Mahmood MT, et al. Cancer epidemiology in Lahore, Pakistan, 2010–2015. J Coll Physicians Surg Pak. 2020;30(2):113–122.
Badar F, Sohaib M, Mahmood S, et al. Cancer incidence in Khyber Pakhtunkhwa, Pakistan, 2020. BMC Public Health. 2023;23(1):1785.
Abbas G, Shah S, Hanif M, et al. Cancer prevalence, incidence and mortality rates in Pakistan in 2018. Bull Cancer. 2020;107(4):517–518.
Siegel RL, Miller KD, Wagle NS, Jemal A. Cancer statistics, 2023. CA Cancer J Clin. 2023;73(1):17–48.
Sharmin T, Nikhat N, Rayna SE, et al. Types and distribution of cancer patients attending a tertiary care hospital of Bangladesh. Bangabandhu Sheikh Mujib Med Univ J. 2022;15(1):43–49.
Zeng Q, Yang J, Wang Z, et al. Epidemiological characteristics of non-communicable diseases and malignant tumours in Guiyang, China: cross-sectional study. JMIR Public Health Surveill. 2022;8(10):e36523.
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