Cancer Incidence Report Saudi Arabia 2008

Kingdom of Saudi Arabia Ministry of Health Saudi Cancer Registry

P01.indd 1 26-05-2012 7:21:53 PM Report prepared by: Haya S. Al-Eid, BDS, DFE, CTR Marielen S. Manalo, Secretary

Reviewed by: Shouki Bazarbashi, MD Ali Al-Zahrani, MD, PhD

P01.indd 2 26-05-2012 7:21:53 PM Foreword Acknowledgment

The 2008 cancer incidence report represents the The Saudi Cancer Registry is a program funded by twelfth publication for the cancer registry since its The Ministry of Health and its main office located establishment in 1992. Our Mission is to provide at King Faisal Specialist Hospital and Research comprehensive cancer data about incidence of Center. This publication is a part of our efforts cancer in Saudi Arabia. Cancer data undergo an to make cancer data available to oncologists, extensive quality control performed continuously researchers, strategic health planners, community which includes IARC edit checks and through visual care providers, and administrators. review of abstracted cases. The production of this report reflects the efforts of It is clear from this report that the number and our valuable cancer registrars, main office staff and the incidence of cancer are a little bit lower than in members of the board of directors. Special warm 2007. Despite of our continuous efforts to ascertain thanks to our registrar who maintain patients’ comprehensive case finding, we faced many confidentiality and travel to every part of the obstacles manifested in resignation, unavoidable kingdom to collect the cancer cases from different maternity issues, and for sadness death of two of and numerous health facilities. our dedicated registrars. Nevertheless, we believe there is considerable room for improvement Special thanks to the support provided by the manifested in the newly recruited tumor registrars Ministry of Health represented by his Excellency that have joined us in 2012. the Minister of Health Dr. Abdullah Al Rabeeah and the deputy Minister of Health Dr. Mansour Also, one of our main obstacles is medical record Al Hawasi. In addition we continue to be in unavailability in many hospitals. This leads to debt for the continuous support of King Faisal under-reporting of clinically diagnosed cases in our Specialist Hospital and Research Center leadership population. We continue to struggle and face many represented by His Excellency Dr. Qasem Al challenges, of most importance is the finding of well Qasabi, the chief operating officers. qualified tumor registrars.

On November, 2011, we conducted a high quality education and training workshop for our registrar, registrars from the research unit at KFSH&RC and the Gulf Cooperation Council States.

In this report, we have maintained the same standard format as in the previous reports especially the section of the collective data variables since the start of the Saudi Cancer Registry in January 1994 beside the Arabic summary of cancer statistics.

Cancer data from 1994-2008 is available in our website www.scr.org.sa. Moreover, the cancer registry provides aggregate data upon request through electronic data request and we encourage everyone to make use of it.

Shouki Bazarbashi, MD Chairman

P01.indd 3 26-05-2012 7:21:53 PM P01.indd 4 26-05-2012 7:21:53 PM Introduction

This is the twelfth incidence report published by Part IV Cancer Incidence among Non-Saudis the Saudi Cancer Registry. Previous publications include the 1994 Summary Report, 1994-1996 This part presents the incidence of cancer cases Incidence Report, 1997-1998 Incidence Report, among Non-Saudis including the most common 1999-2000 Incidence Report, 2001, 2002, 2003, types of cancer. The analysis of the Non-Saudis 2004, 2005, 2006 & 2007 Incidence Reports. is performed separately due to the nature of the expatriate population in Saudi Arabia in which a The structure of this report can be outlined as large part of the population, particularly among follows: males, falls in the labor work force age group (25-44) and some of patients come for treatment Part I Materials and Methods purposes only.

This part of the report contains information about the background of the Saudi Cancer Registry and Part V Incidence Tables methods used in collecting and analyzing the data. We present the basics of coding and classification Part V contains the following detailed tables for all of tumor topography, morphology and extent of newly diagnosed cancer types among Saudis and disease at the time of diagnosis. Also we describe Non-Saudis for 2008: the software programs we have used to analyze the data. • Distribution of cancer cases among Saudis by age group and sex Part II Overview of Cancer Incidence • Distribution of cancer cases among Non- Saudis by age group and sex Part II contains figures and tables that show overall cancer incidence in Saudi Arabia for the year 2008. • Cancer Incidence (per 100,000 population) We present these figures and tables mainly by sex among Saudis by age group and sex and in certain areas we have it analyzed by different age groups. There are bar charts representing the • Cancer Incidence (per 100,000 population) age distribution of cancer incidence for the year among Non-Saudis by age group and sex 2008 among Saudis by sex and age groups. We • Age-standardized incidence rate and relative present incidence and morphology tables for the frequencies among Saudis by cancer site, sex most common types of cancers among adults and and administrative regions children. In addition, tables list the total number of cases, the Age-Standardized Incidence Rate (ASR) • Distribution of cancer and cancer incidene per 100,000 population, Crude Incidence Rate (per 100,000 population) among Saudis by (CIR) and Cumulative rates by primary site and sex. year and sex. Separate bar charts depict the most common types of cancer, by sex, in each of the 13 administrative regions of Saudi Arabia. Part VI Appendices

Part III Incidence of Selected-Sites Appendix A: Regional listing of all health care facilities from which cancer cases have been In this part the incidence of the most common reported. The objective is to receive feedback from cancers among Saudi males and females are outlined. facilities that have not been included in order to A standardized layout presents data for all patients improve our case-finding and reporting processes. and for both sexes where applicable. For each selected site the number and the percentage of all Appendix B: Names of the members of the Board newly diagnosed cases for the year 2008, the ASR, of Directors. morphological differentiation and staging for each sex and the specific cancer rank for both sexes is Appendix C: Cancer Registration Abstract Form. presented. In addition, ASR for the specified cancer among Saudis is compared with ASR among other Appendix D: Summary of Cancer Statistics in populations from selected countries. Saudi Arabia for the year 2008.

P01.indd 5 26-05-2012 7:21:54 PM Table of Contents

Foreword...... 3 Acknowledgement...... 3 Introduction...... 5

PART I...... 9

Background on Saudi Arabia...... 10 Saudi Cancer Registry...... 10 Definitions of Statistical Terms...... 13

PART II...... 15

Cancer in Saudi Arabia 2008...... 16 Adult Cancers in Saudi Arabia, 2008 (above 14 years)...... 21 Childhood Cancers in Saudi Arabia 2008 (14 years and below)...... 24 Cancer in the 13 Administrative Regions of the Kingdom...... 27 International Comparison of Age-Standardized Incidence Rates ...... 32

PART III...... 33

Cancer Incidence for Most Common Sites, 2008...... 34 Female Breast (C 50)...... 35 Colo-rectal (C18-C20)...... 37 Non-Hodgkin Lymphoma (C82-C85; C96)...... 39 Thyroid (C73)...... 41 Leukemia (C91-C95)...... 43 Liver (C22)...... 45 Lung (C33-C34)...... 47 Hodgkin disease (C81)...... 49 Skin (C44)...... 51 Prostate (C61)...... 53 Corpus Uteri (C55)...... 55 Bladder (C67)...... 57 Stomach (C16)...... 59 Ovary (C56)...... 61 Sources...... 64

PART IV...... 65

Cancer Among Non-Saudi Population 2008...... 67

P01.indd 6 26-05-2012 7:21:54 PM PART V...... 69

Table 5.1.1 Age Distribution of Cancer Cases among Saudi Males, 2008...... 70 Table 5.1.2 Age Distribution of Cancer Cases among Saudi Females, 2008...... 71 Table 5.1.3 Cancer Incidence Cases among Saudi Males by Age Group (per 100,000), 2008...... 72 Table 5.1.4 Cancer Incidence Cases among Saudi Females by Age Group (per 100,000), 2008...... 73 Table 5.2.1 Number, Relative Frequencies, Age Standardized Rates and Crude Rates for all Cancer Cases among Saudi Males by Cancer Site and Administrative Region (Asir, Baha, Jazan), 2008...... 74 Table 5.2.2 Number, Relative Frequencies, Age Standardized Rates and Crude Rates for all Cancer Cases among Saudi Males by Cancer Site and Administrative Region (Madinah, Hail, Qassim), 2008...... 75 Table 5.2.3 Number, Relative Frequencies, Age Standardized Rates and Crude Rates for all Cancer Cases among Saudi Males by Cancer Site and Administrative Region (Najran, Jouf, Tabuk, Northern Region), 2008...... 76 Table 5.2.4 Number, Relative Frequencies, Age Standardized Rates and Crude Rates for all Cancer Cases among Saudi Males by Cancer Site and Administrative Region (Riyadh, Makkah, Eastern Province), 2008...... 77 Table 5.3.1 Number, Relative Frequencies, Age Standardized Rates and Crude Rates for all Cancer Cases among Saudi Females by Cancer Site and Administrative Region (Asir, Baha, Jazan), 2008...... 78 Table 5.3.2 Number, Relative Frequencies, Age Standardized Rates and Crude Rates for all Cancer Cases among Saudi Females by Cancer Site and Administrative Region (Madinah, Hail, Qassim), 2008...... 79 Table 5.3.3 Number, Relative Frequencies, Age Standardized Rates and Crude Rates for all Cancer Cases among Saudi Females by Cancer Site and Administrative Region (Najran, Tabuk, Jouf, Northern Region), 2008...... 80 Table 5.3.4 Number, Relative Frequencies, Age Standardized Rates and Crude Rates for all Cancer Cases among Saudi Females by Cancer Site and Administrative Region (Riyadh, Makkah, Eastern Province), 2008...... 81 Table 5.4.1 Age Distribution of Cancer among non-Saudi Males, 2008...... 82 Table 5.4.2 Age Distribution of Cancer among non-Saudi Females, 2008...... 83 Table 5.4.3 Incidence Rates for Cancer Cases among non-Saudi Males by Age Group (per 100,000), 2008...... 84 Table 5.4.4 Incidence Rates for Cancer Cases among non-Saudi Females by Age Group (per 100,000), 2008...... 85 Table 5.5.1 Number of Cases by Primary Site and Years among Saudi Males, 1994-2008...... 86 Table 5.5.2 Number of Cases by Primary Site and Years among Saudi Females, 1994-2008...... 87 Table 5.5.3 Age Adjusted Incidence Rate by Primary Site and Years among Saudi Males, 1994-2008...... 88 Table 5.5.4 Age Adjusted Incidence Rate by Primary Site and Years among Saudi Females, 1994-2008...... 89

PART VI...... 90

APPENDIX A: Reporting Health Care Facilities...... 91-94 APPENDIX B: Members of SCR Board of Directors...... 95-96 APPENDIX C: Cancer Registration Abstract Form...... 97-98 APPENDIX D: Summary of Cancer Statistics in Saudi Arabia for the Year 2008...... 99-100

P01.indd 7 26-05-2012 7:21:54 PM P01.indd 8 26-05-2012 7:21:54 PM PART I MATERIALS AND METHODS

P01.indd 9 26-05-2012 7:21:54 PM Background on Saudi Arabia

Saudi Arabia is a vast country extending over four- 12,877 0.3075+ .4 8,039 fifths of the Arabian Peninsula. It stretches from the 11,115 0.2 70-74 0.4 8,734 Arabian Gulf in the east to the Red Sea in the west. 17,946 0.4 65-69 0.5 9,290 43,912 1.0 60-64 0.7 14,965 It is approximately 2,149,700* square kilometers in 111,260 2.4 55-59 1.3 27,005 area and is divided into 13 administrative regions 230,177 5.0 50-54 2.3 47,892 (Figure 1.1). 386,405 8.4 45-49 3.7 75,824 580,891 12.7 40-44 6.7 137,851 808,908 17.6 35-39 12.3 252,475 798,612 17.4 30-34 15.0 308,648 566,698 12.3 25-29 11.3 232,543 213,260 4.6 20-24 7.5 153,717 145,293 3.2 15-19 6.9 142,647 189,705 4.1 10-14 8.9 182,572 231,866 5.0 5-9 10.5 216,391 242,960 5.3 0-4 11.6 238,638

20 18 16 14 12 10 8 6 4 2 0 0246810 12 14 16 18 20 Male Female 4,591,885 2,057,772 Figure 1.3 Population Pyramid of non-Saudis (%) by Sex and Age Group, 2008

Saudi Cancer Registry The Saudi Cancer Registry (SCR) of Saudi Arabia Figure 1.1 Administrative Regions of Saudi Arabia is a population-based registry established in 1992 under the jurisdiction of the Ministry of Health The estimated Saudi national population for (MOH) by the order of His Excellency the Minister year 2008 was 18,045,027**. Of these 9,100,119 of Health. The SCR commenced reporting cancer (50.4%)were males and 8,944,908 (49.6%)were cases from 01 January 1994. females. The Non-Saudi population in 2008 was 6,649,657**; of these 4,591,885 (69.1%) were males and 2,057,772 (30.9%) females. Objectives:

Figures 1.2 and 1.3 show the Saudi and Non- The primary goal of the SCR is to define the Saudi population pyramids by sex and age group population-based incidence of cancer in Saudi respectively. Arabia. Additional objectives include programs for early detection and cancer screening, as well

119,656 1.3 75+ 1.3 119,169 as cancer research projects. 91,620 1.0 70-74 0.9 80,055 106,420 1.2 65-69 1.2 111,138 Organizational Structure: 155,139 1.7 60-64 1.7 152,047 208,221 2.3 55-59 2.2 196,803 283,086 3.1 50-54 3.1 275,304 A Board of Directors was appointed to include 362,886 4.0 45-49 3.9 345,026 representatives from the MOH, King Faisal Specialist 452,718 5.0 40-44 4.9 439,836 Hospital and Research Center (KFSH&RC), and 545,529 6.0 6.1 548,429 35-39 the Medical Services Departments of the Ministry 668,223 7.3 30-34 7.4 666,390 788,267 8.7 25-29 8.8 785,629 of Defense and Aviation, Ministry of Interior, 934,163 10.3 20-24 10.0 907,735 the National Guard, King Saud University, King 1,002,435 11.0 15-19 11.0 982,222 Faisal University, King Abdul-Aziz University and 1,069,359 11.8 10-14 12.0 1,070,030 King Khalid University. The Board is charged 1,119,133 12.3 5-9 12.4 1,106,359 1,193,264 13.1 0-4 13.0 1,158,736 with the responsibility of overseeing the SCR’s 20 18 16 14 12 10 8 6 4 2 0 0 2468101214161820 establishment, defining demographic and cancer- Male Female related data to be collected, approving research 9,100,119 8,944,908 requests, and reporting findings, as well as Figure 1.2 Population Pyramid of Saudis (%) by Sex disseminating information collected while ensuring and Age Group, 2008 the confidentiality of all data reported to the SCR.

* Source: Demographic and Health Indicators for Countries of the East Mediterranean, WHO, Regional Office for the EM, 1999 ** Source: 2008 SCR Estimation with 3.2% Growth Rate among saudis and 2.5% among non-Saudis based on 2010 Census, Central Department for Statistics (CDS) data, Ministry of Planning (web site http:\\www.planning.gov.sa).

P01.indd 10 26-05-2012 7:21:57 PM The SCR Main Office, including administrative and technical staff, is located in the premises of Ministry of Health the KFSH&RC in Riyadh. Additionally, five regional Saudi Arabia branches and four hospital-based offices were set up to ensure comprehensive data collection from all over the Kingdom (Figure 1.4).

Regional Offices: Saudi Cancer Registry 1 Central Region: King Fahad Medical City in Main Office Riyadh, covering Riyadh, Qassim, and Hail Health Regions. 2 Eastern Region: King Fahad Hospital of the Central Region University, Al Khobar, covering Dammam, Al (Riyadh, Qassim & Hail) Ahsa, and Hafr Al-Batin Health Regions. 3 Western Region: King Abdulaziz Hospital and Cancer Center, Jeddah, covering Jeddah, Eastern Region (Dammam, Ahsa & Hafr Al Batin) Makkah, Taif and Qunfudah Health Regions. 4 Southern Region: Asir Central Hospital, Abha, covering Asir, Baha, Najran, Jazan and Western Region Bisha Health Regions. (Jeddah, Makkah, Taif & Qunfudah) 5 Madinah/Northern Region: Maternity and Children Hospital, Madinah, covering Madinah, Southern Region Tabuk, Jouf and Northern Health Regions. (Asir, Baha, Jazan & Najran)

Offices at the Medical Service Division or Oncology Department of the following establishments: Madinah Region (Madinah, Tabuk, Jouf & Northern Region) 6 King Faisal Specialist Hospital & Research Centre, Riyadh King Faisal Specialist Hospital 7 Ministry of Defense amd Aviation, Armed & Research Centre, Riyadh Forces Hospitals, Riyadh 8 National Guard Hospitals, King Abdulaziz Medical City, Princess Norah Oncology Armed Forces Hospitals Center, Jeddah (Riyadh, Western, South & Northern) 9 King Abdul Aziz University Hospital, Jeddah 10 Ministry of Interior, Security Forces Hospital, National Guard Hospitals Riyadh (Riyadh, Jeddah, Dammam & Ahsa) 11 King Khalid University Hospital, Riyadh Each of the SCR offices operates under the supervision of a member of the Board of Directors King Abdulaziz University Hospital who is responsible for the daily management of Jeddah that office. Staffing consists of tumor registrars and secretarial staff. Security Forces Hospital The SCR Main Office indirectly supervises the regional offices and is responsible for ensuring the accuracy and quality of data collected in all of the regions. King Khalid University Hospital Riyadh Quality control processes include verification of site, morphology, and staging information as well as Figure 1.4 Organizational Chart of the Saudi Cancer case linkage (tumor and patient), and consolidation Registry of Saudi Arabia of data. The Main Office also prepares periodic Format reports for dissemination of information to the medical community, government establishments, The format of the current report is similar to the international organizations and the media. previous reports.

P01.indd 11 26-05-2012 7:21:57 PM Data management

A ministerial decree has categorized cancer as counted as malignant. Also small number of cancers a mandatory notifiable disease. This ensures the that were previously coded as borderline tumors opportunity for comprehensive data collection. are now considered benign. Counts of ovarian The SCR strives for full access to cancer data cancers, lymphomas and leukemias as well as some from all Ministry of Health, governmental and hematopoietic diseases will change due to changes private hospitals, as well as clinics and laboratories in either reportability or definition. However, throughout the Kingdom. Cancer data are abstracted as with the new staging guidelines, the ICD-O from patients’ medical records, based on clinical changes reflect advances in the understanding of and/or histopathological diagnosis, by SCR-trained the pathology and behavior of cancers. cancer registrars. It should be noted that ICD-O-3 codes are The data abstract (see appendix D) includes converted to ICD-10 for analysis purposes. Since personal identification (name, ID Number, sex, the WHO has not yet converted the ICD-10 age), demographic information (address, telephone hematopoietic disease behavior changes, our number, nationality), and tumor details (diagnosis software, CanReg 4.33, cannot include these cases date, primary site, histology, behavior, grade, stage, for analysis and they have been excluded. Every basis of diagnosis). The primary site (topography) effort is made to accurately code patient and and histology (morphology) of the malignancies tumor information, to ensure that all data can be are identified and coded according to the reviewed, linked, and consolidated, as appropriate, International Classification of Diseases for Oncology so that each malignancy is counted only once for 3rd Edition (ICD-O-3), published by the World Health statistical analysis. Organization (WHO), 2000.

Effective from year 2001, changes were made in The computer software programs used for data coding of cancer types and behaviors as well as entry and incidence tables output are CanReg 4.33, staging according to International guidelines. The developed by the International Agency for Research new SEER Summary Stage 2000 guidelines should on Cancer, (IARC) Lyon, France. result in increased accuracy and consistency in the coding of stage. There are some differences in the The second part of the report includes the overall timing rules for determining stage and some sites are cancer incidence in Saudi Arabia and the relevant coded differently using the new guidelines. However, epidemiological and clinicopathological details for the new criteria and guidelines should improve the the 14 most common cancers among Saudi nationals usefulness of staging as a predictor of prognosis and for the year 2008. For each cancer site, the number survival as the changes reflect a new understanding and percentage of all newly diagnosed cases for the of the natural history of cancer. The new guidelines, year 2008, age-standardized incidence rate (ASR) SEER Summary Stage Manual 2000, is available on per 100,000 population for each sex, and specific the web at: http:/seer.cancer.gov/tools/ssm/. Cases cancer rank in comparison to all cancers for both diagnosed on or after 01 January 2008 are classified sexes are presented. according to the updated ICD-O-3. Improvements in the understanding of cancer pathology over the Useful international statistics for specified cancer last decade are reflected in the changes to ICD-O-3. include the ranking of cancer worldwide. The While there have not been any changes in the references for this information is summarized on primary site codes, there are significant changes page 64. regarding histology (cell types). Leukemias and lymphomas, particularly are affected. Some cases that were previously considered benign are now

P01.indd 12 26-05-2012 7:21:57 PM The relevant data incorporate details for all patients Notification presented over the year 2008. For each cancer there are five figures: The data included in this report were abstracted up to June 2010. 2008 incident cases which are identified after this date (late reporting) will be noted 1. An Arithmetic line graph represents the in subsequent incidence reports. It is anticipated age-specific incidence rate (AIR) for all age that the number of late-reported cases will decrease groups at five-year intervals. The graph is as case ascertainment processes are improved. plotted by sex, where applicable.

2. A Table lists the percentages of the most Definitions of Statistical Terms common histology sub-types for each specific cancer. Age-Specific Incidence Rate (AIR) 3. A Pie chart shows the distribution of the clinical stages of each cancer such as The number of cancer cases occurring during a localized, regional, distant metastasis and specific period in a population of a specific age unknown. and sex group, divided by the number of midyear population of that age and sex group. 4. A Bar chart shows regional distribution of ASR for particular cancer across the Age-Standardized Rate (ASR) administrative regions by males and females. The Age-standardized rate is a summary measure 5. A Bar chart shows comparison of age- of a rate that a population would have if it had a standardized incidence rate (ASR) for each standard age structure. Standardization is necessary cancer type in Saudi Arabia with ASR in when comparing several populations that differ selected countries. with respect to age structure. The most frequently used standard population is the World Standard Population (see below). The calculated incidence is known as the World Standardized Incidence Rate. In reviewing the data, its collection and analysis, two The rate is expressed per 100,000 populations. qualifying statements can be made: Age Class Population 0-4 12,000 a. The number of patients presenting with 5-9 10,000 malignant disease from Riyadh region exceeds the expected number per 10-14 9,000 population. The reason for this is that 15-19 9,000 Riyadh has many referral centers providing 20-24 8,000 patients from outside the region with 25-29 8,000 cancer-related care. Some of these patients 30-34 6,000 don’t provide their permanent address, but instead, provide a temporary Riyadh 35-39 6,000 address. This situation is partially resolved 40-44 6,000 through tumor and patient linkage of cases 45-49 6,000 from all regions based on identifiers such 50-54 5,000 as national ID. 55-59 4,000 60-64 4,000 b. As previously noted, the software used in analyzing this report, CanReg 4.33, does not 65-69 3,000 include in situ cases in the incidence tables. 70-74 2,000 These cases were added to the total cancer 75+ 2,000 cases in the overview. Total 100,000

* Doll R. Payne P. Waterhouse J. Cancer incidence in Five Continents Vol. I. International Union Against Cancer. 1966

P01.indd 13 26-05-2012 7:21:57 PM Crude Incidence Rate Incidence Rate

The crude incidence rate for a cancer site is the An incidence rate is defined as the rate at which a total number of cases registered as a proportion new event occurs in a population. It is calculated of the total population. It denotes the approximate as the number of new cases of disease arising in a number of cases occurring in each 100,000 population over a defined time period, divided by the population at risk of developing that disease. individuals. All rates are thus, expressed as per 100,000 population. Mean Cancer rates vary greatly with age and the crude rate is strongly influenced by the demographic The simple mathematical average of two or more structure of the population. Hence, if the numbers. population structure changes over time the crude rate over that period may be artificially altered. It is not appropriate to compare crude rates across Median geographical areas of cancer registries with different The midpoint of the range numbers that are population age structures. Therefore, in order to arranged in order of value. assess time trends in registration data or compare incidence across geographical areas or between registries it is necessary to first standardize the Metastasis rates with respect to age. Metastasis is the distant spread of cancer from its original site to other organs of the body, including lymph nodes, skeletal and or visceral organs. Cumulative Incidence rate

Cumulative incidence is the probability or risk of Range individuals developing the disease during a specified period. For cancer, it is expressed as the number Is the difference between the maximum and of new born children (out of 100, or 1000) who minimum values in a set of observations. would be expected to develop a particular cancer before the age of 65 (or 70, or 75) if they had the rates of cancers currently observed. Like the age Rank standardized rate, it permits comparison between This measure reflects the importance of a specific populations of different age structures. In this cancer site relative to other sites, in terms of the report the age ranges 0-64 and 0-74 years are used. number of registrations. Ranking illustrates the The cumulative rate is the summation of the cancer most and least frequent cancer sites in a population age-specific rates; which are computed for five-year according to their frequency. age intervals. The cumulative rate is five times the sum of the age-specific rates calculated over the five-year age groups. Ratio The relation between two quantities. The ICD-10 first quantity as numerator and the second as denominator The World Health Organization’s International Classification of Diseases, tenth edition. Relative Frequency ICD-O-3 This statistic is defined as the number of specific The World Health Organization’s International cancer cases registered relative to the total number of all cancer. It is expressed as a percentage. Classification of Diseases for Oncology, 3rd Edition has been the standard coding system for neoplasms for over 25 years. The coding system includes a four Summary Stage character code for primary site, a four-digit numeric code for cell type, one-digit code for behavior and Staging is the grouping of cancer cases into broad a one-digit code for tumor aggressiveness (grade). categories based on the extent of disease.

P01.indd 14 26-05-2012 7:21:57 PM PART II OVERVIEW OF CANCER INCIDENCE 2008

P02.indd 15 26-05-2012 6:14:10 PM Reported Cancer Incidence Cases in Saudi Arabia, 2008

Between January 01 and December 31, 2008, the As shown on Table 2.1, 11,456 cases were analyzed, total number of cancer incident cases reported to of which 8,848 (77.2%) were Saudis and 2,608 the SCR was 11,946. Overall cancer was slightly (22.8%) were Non-Saudis. Among the saudis more among women than men. Cancers affected 4,231 (47.8%) were male and 4,617 (52.2%) were 5,908 (49.5%) males and 6,038 (50.5%) females, with female. The male to female ratio was 92:100. The a male to female ratio of 98:100. 9,054 cases were crude incidence rate (CIR) of all cancers among reported among Saudis, 2,701 among Non-Saudis. Saudi Population was 49% 100,000 (46.4/100,000 among males and 51.5% 100,000 among females). The total number of cases excluded from analysis The overall age-standardized incidence rate (ASR) includ 191 cases of unknown nationalities. Other for all Saudis with a world standard population exclusions were 249 in situ cases, the current reference was 76.8/100,000 (74.1/100,000 in males software program CanReg-4 version 4.33, does and 79.4/100,000 in females). not include in situ cases in the statistical analysis. Also, 52 were ICD-O-3 coded cases that failed to For all sites, the age-specific incidence rate (AIR) convert to ICD-10 codes as described in the Data increased with age for both males and females. Management (see page 12). This puts the total After the age of 64 years, the increase was nearly number of exclusions from the analysis as 490 cases. one and one half fold for males compared to Table 2.1 illustrates the distribution of the cases by females. The median age at diagnosis is was 58 sex and nationality. Range (0-120) years for men and 50 Range (0-104) years for women. Diagnosis of malignancy was confirmed histologically in 85.6% of the cases, and haematological and The five geographic regions with the highest ASR cytologically in 8.4% of cases, clinically confirmed were Eastern Region at 104/100,000, Riyadh Region cases were 0.3%, radiologically confirmed cases at 102.3/100,000, Tabuk Region at 86.8/100,000, were 2.2%, cases confirmed by Death Certificate Makkah Region at 78.3/100,000 and Northern Only were 2.8% and the method of diagnosis was Region at 77.3/100,000. unknown for 0.7% of the cases.

SaudisNon-Saudis Unknown Nationality All

Male Female TotalMaleFemale Total Male Female TotalTotal

Analyzed * 4231 4617 8848 1422 1186 2608 81 108189 11456 Invasive 4255 4633 8888 1429 1191 2620 81 108189 11697 In Situ 89 77 1665328811 12249 ICD 10 ** 24 16 40 7512 00052 Total 4344 4710 9054 1482 1219 2701 82 109191 11946

Table 2.1 Distribution of Cancer Cases in Saudi Arabia by Nationality and Sex, 2008

* Unknown nationalities, in situ cases and ICD-10 conversion failures are excluded from analysis ** ICD-10 conversion failure

P02.indd 16 26-05-2012 6:14:10 PM Cancer among Saudis 2008

As explained earlier the total number of cancer cases 30-44 Years

analyzed among Saudis during the year 2008 were Colo-rectal 13.8 40.2 Breast 8,848. Following are figures presenting the percentage NHL 13.2 18.8 Thyroid Thyroid 8.1 7.1 Colo-rectal distributions of cancer incidence and most frequent NHL Leukemia 7.9 4.5 Leukemia types of cancers among Saudis by sex and age-group. Brain, CNS 6.5 3.5 2.8 Cervix uteri 18 Nasopharynx 6.1 Male 2.1 Ovary Hodgkin Disease 5.9 16 Female 15.3 1.9 Kidney 14.3 Kidney 4.7 1.8 Stomach 14 Testis 4.5 12.2 1.5 Nasopharynx 11.7 Skin 12 10.7 3.7 1.5 Skin Lung 3.0 1.5 Corpus uteri 10 8.4 Other sites 22.6 12.6 Other sites 8 50 40 30 20 10 0 10 20 30 40 50

Percentage 5.7 6 5.1 5.0 4.2 4.5 Male (508) Female (1033) 4 3.0 2 45-59 Years

0 Colo-rectal 16.2 33.5 Breast 0-14 15-29 30-44 45-59 60-7475+ Age Group Lung 8.6 11.4 Colo-rectal NHL 8.4 8.1 Thyroid Figure 2.1 Percentage Distribution of Cancer Incidence Liver 6.7 5.8 NHL among Saudis by Sex according to Age Group, 2008 Nasopharynx 5.9 5.8 Corpus uteri All Ages Stomach 5.1 3.8 Ovary Kidney 4.9 2.4 Liver Colo-rectal 11.3 25.0 Breast Bladder 4.1 2.1 Skin NHL 8.7 10.3 Thyroid Leukemia 4.0 2.1 Cervix uteri Leukemia 7.9 9.2 Colo-rectal Skin 3.6 1.9 Leukemia Liver 7.2 6.6 NHL Other sites 32.5 23.0 Other sites Lung 6.7 5.3 Leukemia 50 40 30 20 10 0 10 20 30 40 50 Prostate 6.3 4.2 Corpus uteri Hodgkin disease 4.1 3.5 Ovary Male (944) Female (1354) Bladder 4.1 2.8 Hodgkin disease Stomach 3.9 2.7 Skin 60-74 Years 3.8 2.5 Skin Liver Colo-rectal 12.2 16.3 Breast Other sites 35.9 27.9 Other sites Prostate 10.9 12.5 Colo-rectal 50 40 30 20 10 0 10 20 30 40 50 Liver 10.4 7.9 NHL Male (4231)* Female (4617) Lung 9.6 7.1 Corpus uteri NHL 7.3 4.7 Thyroid 0-14 Years Bladder 6.3 4.6 Ovary Leukemia 32.4 38.7 Leukemia Stomach 4.2 4.0 Skin Brain, CNS 14.4 11.1 Brain, CNS Skin 4.2 3.9 Liver NHL 12.3 Kidney 7.3 Leukemia 4.2 3.4 Lung Hodgkin Disease 10.2 6.9 Bone Pancreas 3.2 2.9 Gallbladder, etc Bone 7.0 6.9 Hodgkin Disease 2.8 Eye 5.1 6.1 NHL Kidney 2.9 Pancreas Kidney 4.8 4.6 Connective, Soft Tissue Other sites 24.7 29.9 Other sites Connective, Soft Tissue Eye 4.3 4.6 50 40 30 20 10 0 10 20 30 40 50 Adrenal Gland 2.4 4.2 Adrenal Gland Liver 1.6 2.3 Ovary Male (1265) Female (1081) Other sites 5.6 7.3 Other sites 50 40 30 20 10 0 10 20 30 40 50 75+ Years

Male (374) Female (261) Prostate 12.9 11.8 Breast Liver 12.1 15-29 Years 11.1 Colo-rectal Colo-rectal 10.3 8.4 NHL Hodgkin disease 19.0 21.9 Thyroid Lung 8.9 6.8 Skin Leukemia 14.7 17.0 Hodgkin disease Stomach 6.2 6.1 Liver NHL 10.6 12.5 Breast Bladder 5.9 5.9 Stomach Testis 8.9 10.3 Leukemia NHL 5.9 4.3 Corpus uteri Bone 8.9 NHL 7.8 Skin 5.5 4.3 Thyroid Thyroid 6.3 3.8 Ovary Leukemia 3.4 3.6 Gallbladder, etc Colo-rectal 6.1 3.3 Bone Pancreas 2.7 3.2 Oesophagus Brain, CNS 4.6 3.3 Connective, Soft tissue Oesophagus 2.6 Lung Connective, Soft tissue 3.3 3.1 Colo-rectal 3.2 Skin 2.3 2.5 Brain, CNS Kidney 2.4 3.2 Ovary Other sites 16.5 13.4 Other sites Other sites 21.2 28.0 Other sites 50 40 30 20 10 0 10 20 30 40 50 50 40 30 20 10 0 10 20 30 40 50 Male (395) Female (448) Male (744) Female (440) Figure 2.2 Percentage Distribution of Most Frequent Types of Cancer by Sex among Saudis, 2008 * 1 male case is included only in the total as he may not be added to any age group

P02.indd 17 26-05-2012 6:14:14 PM Cancer No. %

Breast 1169 13.2

Colo-rectal 904 10.2

NHL 674 7.6

Thyroid 606 6.8

Leukemia 582 6.6

Liver 418 4.7

Lung 367 4.1

Hodgkin disease 306 3.5

Skin 284 3.2

Prostate 267 3.0

Table 2.2 Ten Most Common Cancers among Saudis, 2008 (All Ages)

Male 4231 Female 4617

Colo-rectal 478 11.3% Breast 1152 25.0% NHL 370 8.7% Thyroid 475 10.3% Leukemia 335 7.9% Colo-rectal 426 9.2% Liver 303 7.2% NHL 304 6.6% Lung 285 6.7% Leukemia 247 5.4% Prostate 267 6.3% Corpus uteri 194 4.2% Hodgkin disease 175 4.1% Ovary 160 3.5% Bladder 173 4.1% Hodgkin disease 131 2.8% Stomach 166 3.9% Skin 125 2.7% Skin 159 3.8% Liver 115 2.5%

Figure 2.3 Ten Most Common Cancers among Saudis by Sex, 2008

P02.indd 18 26-05-2012 6:14:15 PM 700

600 male female

500

400

300

AIR (per 100,000) 200

100

0 0- 5- 10- 15- 20- 25- 30- 35-40- 45-50- 55-60- 65-70- 75+ Age Groups

Figure 2.4 Age-Specific Incidence Rates (AIR) for All Cancers among Saudis, 2008

Eastern 104.0 104.0 Riyadh 106.3 98.2 78.8 Tabuk 94.8 82.4 Makkah 74.1 81.7 Northern 72.9 66.0 Madinah 68.9 66.8 Jouf 65.0 63.9 Qassim 56.8 56.8 Asir 51.9 57.6 Najran 50.9 46.3 Hail 47.1 48.5 Baha 40.4 43.4 Jazan 34.7

020406080100 120

Figure 2.5 Age Standardized Rate (ASR) Regional Distribution (per 100,000) of All Sites of Cancer among Saudis, 2008

P02.indd 19 26-05-2012 6:14:15 PM Male Female ICD-10 Site No. % Crude ASR Cumulative Rate No.%Crude ASR Cumulative Rate Rate World 0-64 0-74 RateWorld 0-64 0-74 AllAll sites Total 4231 100.0% 46.474.139.982.54617100.0%51.579.452.468.7 Not C44 All sites but C44 4072 96.2% 44.771.139.979.3449297.3% 50.1 77 51.1 66.8 C00 Lip 90.2%0.1 0.20.0 0.150.1% 0.10.1 0.10.1 C01-C02 Tongue 30 0.7% 0.30.6 0.30.7 29 0.6% 0.30.6 0.50.5 C03-C06 Mouth 39 0.9% 0.40.7 0.30.9 46 1.0% 0.50.9 0.50.8 C07-C08 Salivary glands 17 0.4% 0.20.3 0.10.4 18 0.4% 0.20.2 0.20.2 C09 Tonsil 20.0%0 00.0 0.030.1% 00.1 0.10.1 C10 Other Oropharynx 20.0%0 00.0 0.000.0% 000.00.0 C11 Nasopharynx 122 2.9% 1.321.52.3 45 1.0% 0.50.7 0.50.6 C12-C13 Hypopharynx 50.1%0.1 0.10.1 0.1160.3%0.2 0.30.1 0.2 C14 Pharynx unspecified 30.1%0 0.10.0 0.110.0% 000.00.0 C15 Oesophagus 51 1.2% 0.610.41.0 54 1.2% 0.61.1 0.70.9 C16 Stomach 166 3.9% 1.83.2 1.83.4 1002.2%1.1 1.91.0 1.5 C17 Small intestine 31 0.7% 0.30.6 0.30.8 14 0.3% 0.20.3 0.20.2 C18 Colon 286 6.8% 3.15.3 3.35.9 2745.9%3.1 5.23.4 4.4 C19-C20 Rectum 192 4.5% 2.13.7 2.14.7 1523.3%1.7 32.1 2.8 C21 Anus 10 0.2% 0.10.2 0.10.2 70.2%0.1 0.10.1 0.1 C22 Liver 303 7.2% 3.36.2 2.67.3 1152.5%1.3 2.31.2 1.9 C23-C24 Gallbladder etc. 54 1.3% 0.610.61.0 77 1.7% 0.91.6 0.81.3 C25 Pancreas 100 2.4% 1.121.12.3 67 1.5% 0.71.4 0.91.6 C30-C31 Nose, sinuses etc. 14 0.3% 0.20.2 0.20.3 60.1%0.1 0.10.1 0.1 C32 Larynx 57 1.3% 0.61.2 0.71.4 50.1%0.1 0.10.1 0.1 C33-C34 Trachea, Bronchus, Lung 285 6.7% 3.15.8 3.07.1 82 1.8% 0.91.7 1.01.5 C37-C38 Other Thoracic organs 11 0.3% 0.10.2 0.10.2 11 0.2% 0.10.1 0.10.1 C40-C41 Bone 73 1.7% 0.80.8 0.40.6 47 1.0% 0.50.5 0.40.4 C43 Melanoma of Skin 12 0.3% 0.10.2 0.10.3 10 0.2% 0.10.2 0.10.1 C44 Other Skin 159 3.8% 1.731.53.2 1252.7%1.4 2.41.3 1.8 C45 Mesothelioma 17 0.4% 0.20.3 0.10.4 20.0%0 00.0 0.0 C46 Kaposi sarcoma 16 0.4% 0.20.3 0.20.3 50.1%0.1 0.10.0 0.0 C47;C49 Connective, Soft tissue 66 1.6% 0.70.9 0.61.0 54 1.2% 0.60.8 0.50.7 C50 Breast 17 0.4% 0.20.3 0.20.3 1152 25.0%12.919.214.917.7 C51 Vulva −−−−−−50.1%0.1 0.10.1 0.1 C52 Vagina −−−−−−00.0%0 00.0 0.0 C53 Cervix Uteri −−−−−−93 2.0% 11.7 1.21.5 C54 Corpus Uteri −−−−−−1944.2%2.2 42.7 3.9 C55 Uterus unspecified −−−−−−22 0.5% 0.20.4 0.30.4 C56 Ovary −−−−−−1603.5%1.8 32.0 2.6 C57 Other Female Genital −−−−−−50.1%0.1 0.10.1 0.1 C58 Placenta −−−−−−12 0.3% 0.10.1 0.10.1 C60 Penis 30.1%0 0.10.0 0.2− −−−−− C61 Prostate 267 6.3% 2.95.7 1.96.9 −−−−−− C62 Testis 74 1.7% 0.80.8 0.60.6 −−−−−− C63 Other male genital 00.0%0 00.0 0.0− −−−−− C64 Kidney 144 3.4% 1.62.5 1.72.6 93 2.0% 11.5 1.11.2 C65 Renal Pelvis 50.1%0.1 0.10.0 0.010.0% 000.00.0 C66 Ureter 30.1%0 0.10.0 0.200.0% 000.00.0 C67 Bladder 173 4.1% 1.93.6 1.74.4 38 0.8% 0.40.8 0.30.6 C68 Other Urinary organs 10.0%0 00.0 0.110.0% 000.00.0 C69 Eye 27 0.6% 0.30.3 0.10.2 17 0.4% 0.20.2 0.10.1 C70-C72 Brain, Nervous system 158 3.7% 1.72.1 1.32.0 92 2.0% 11.3 0.91.1 C73 Thyroid 131 3.1% 1.421.42.1 47510.3% 5.36.8 5.05.7 C74 Adrenal gland 14 0.3% 0.20.1 0.10.1 13 0.3% 0.10.1 0.10.1 C75 Other Endocrine 90.2%0.1 0.10.1 0.120.0% 000.10.1 C81 Hodgkin disease 175 4.1% 1.91.9 1.41.6 1312.8%1.5 1.50.9 1.2 C82-C85;C96 Non-Hodgkin lymphoma 370 8.7% 4.163.46.7 3046.6%3.4 5.43.4 4.6 C88 Immunoproliferative dis. 00.0%0 00.0 0.000.0% 000.00.0 C90 Multiple Myeloma 37 0.9% 0.40.7 0.40.8 25 0.5% 0.30.5 0.20.5 C91 Lymphoid Leukemia 157 3.7% 1.720.91.7 1122.4%1.2 1.40.7 0.9 C92-C94 Myeloid Leukemia 139 3.3% 1.51.9 1.22.0 1042.3%1.2 1.40.9 1.0 C95 Leukemia unspecified 39 0.9% 0.40.6 0.30.6 31 0.7% 0.30.4 0.30.3 Other Other & unspecified 156 3.7% 1.73.1 1.73.5 1653.6%1.8 3.31.4 2.7

Table 2.3 Number, Percentage, ASR,CIR, and Cumulative Rates (per 1000) of New Cases by Primary Site and Sex among Saudis, 2008

P02.indd 20 26-05-2012 6:14:15 PM Adult Cancers in Saudi Arabia, 2008 (>14 years)

Between January and December 2008, the total 95:100. Of all cases, there were 8,412 Saudis, 2,577 number of adult cancer incidence cases reported of Non-Saudis and 175 of unknown nationalities. As was 11,164. Overall cancer was slightly more shown on table 2.4, the total number of analyzed in females than in males. Cancer affected 5,449 cases are 10,697. (48.8%) males and 5,715 (51.2%) females with a

SaudisNon-Saudis Unknown Nationality All

Male Female TotalMaleFemale Total Male Female TotalTotal

Analyzed * 3856 4356 8212 1352 1133 2485 72 101173 10697 Invasive 3876 4371 8247 1359 1138 2497 72 101173 10917 In Situ 89 76 1655228801 12247 ICD 10 ** 20 15 35 7512 00047 Total 3965 4447 8412 1411 1166 2577 73 102175 11164

Table 2.4.1 Distribution of Reported Adult Cancer Cases in Saudi Arabia by Nationality and Sex, 2008

Cancer No. % Breast 1169 14.2 Colo-rectal 904 11.0 NHL 612 7.5 Thyroid 601 7.3 Liver 410 5.0 Lung 367 4.5 Leukemia 360 4.4 Skin 280 3.4 Prostate 267 3.3 Stomach 266 3.2

Table 2.4.2 Ten Most Common Cancers among Saudi Adults, 2008

Male 3856 Female 4356

Colo-rectal 478 12.4% Breast 1152 26.4% NHL 324 8.4% Thyroid 471 10.8% Liver 297 7.7% Colo-rectal 426 9.8% Lung 285 7.4% NHL 288 6.6% Prostate 267 6.9% Corpus uteri 194 4.5% Leukemia 214 5.5% Ovary 154 3.5% Bladder 172 4.5% Leukemia 146 3.4% Stomach 166 4.3% Skin 124 2.8% Skin 156 4.0% Liver 113 2.6% Hodgkin disease 137 3.6% Hodgkin Disease 113 2.6%

Figure 2.6 Ten Most Common Cancers among Saudi Adults by sex, 2008

* Unknown nationalities, in situ cases and ICD-10 conversion failures are excluded from analysis ** ICD-10 conversion failure

P02.indd 21 26-05-2012 6:14:15 PM Primary Site Code Morphology Male %%Female

Breast 8500 Infiltrating duct carcinoma, NOS 12 70.6 897 77.9 8520 Lobular carcinoma, NOS 0 0.0 57 4.9 8010 Carcinoma, NOS 0 0.0 35 3.0 8523 Infiltrating duct mixed with other types of carcinoma 1 5.9 28 2.4 8000 Neoplasm, malignant 1 5.9 27 2.3 8510 Medullary carcinoma, NOS 1 5.9 22 1.9 8522 Infiltrating duct and lobular carcinoma 0 0.0 13 1.1 8140 Adenocarcinoma, NOS 0 0.0 12 1.0 Other 2 11.8 61 5.3

Colo-rectal 8140 Adenocarcinoma, NOS 350 73.2 312 73.2 8480 Mucinous adenocarcinoma 31 6.5 42 9.9 8490 Signet ring cell carcinoma 17 3.6 9 2.1 8263 Adenocarcinoma in tubulovillous adenoma 10 2.1 11 2.6 8000 Neoplasm, malignant 14 2.9 6 1.4 8481 Mucin-producing adenocarcinoma 10 2.1 8 1.9 8261 Adenocarcinoma in villous adenoma 8 1.7 9 2.1 8010 Carcinoma, NOS 9 1.9 6 1.4 8144 Adenocarcinoma, intestinal type 7 1.5 7 1.6 8210 Adenocarcinoma in adenomatous polyp 6 1.3 8 1.9 Others16 3.3 8 1.9

NHL 9680 Malignant lymphoma, large B-cell, diffuse, NOS 155 47.8 156 54.2 9590 Malignant lymphoma, NOS 19 5.9 22 7.6 9591 Malignant lymphoma, non-Hodgkin, NOS 15 4.6 21 7.3 9699 Marginal zone B-cell lymphoma, NOS 12 3.7 15 5.2 9687 Burkitt lymphoma, NOS 14 4.3 7 2.4 9700 Mycosis fungoides 13 4.0 7 2.4 9670 Malignant lymphoma, small B lymphocytic, NOS 10 3.1 8 2.8 9695 Follicular lymphoma, grade 1 9 2.8 8 2.8 9702 Mature T-cell lymphoma, NOS 10 3.1 6 2.1 9690 Follicular lymphoma, NOS 9 2.8 6 2.1 9691 Follicular lymphoma, grade 2 6 1.9 8 2.8 9698 Follicular lymphoma, grade 3 11 3.4 3 1.0 9714 Anaplastic large cell lymphoma, T cell and Null cell type 8 2.5 4 1.4 9671 Malignant lymphoma, lymphoplasmacytic 5 1.5 4 1.4 9673 Mantle cell lymphoma 5 1.5 3 1.0 9684 Malignant lymphoma, large B-cell, diffuse, immunoblastic, NOS 4 1.2 2 0.7 Others19 5.9 8 2.8

Thyroid 8260 Papillary adenocarcinoma, NOS 75 57.7 273 58.0 8340 Papillary carcinoma, follicular variant 15 11.5 79 16.8 8341 Papillary micro carcinoma 10 7.7 39 8.3 8343 Papillary carcinoma, encapsulated 4 3.1 20 4.2 8510 Medullary carcinoma, NOS 3 2.3 11 2.3 8330 Follicular adenocarcinoma, NOS 6 4.6 7 1.5 8021 Carcinoma, anaplastic, NOS 4 3.1 8 1.7 8290 Oxyphilic adenocarcinoma 1 0.8 7 1.5 8335 Follicular carcinoma, minimally invasive 1 0.8 6 1.3 8344 Papillary carcinoma, columnar cell 3 2.3 3 0.6 Others86.2 18 3.8

Liver 8170 Hepatocellular carcinoma, NOS 250 84.2 81 71.7 8000 Neoplasm, malignant 17 5.7 14 12.4 8140 Adenocarcinoma, NOS 7 2.4 7 6.2 8160 Cholangiocarcinoma 7 2.4 5 4.4 8010 Carcinoma, NOS 5 1.7 0 0.0 8180 Combined hepatocellular carcinoma and cholangiocarcinoma 3 1.0 2 1.8 Others82.7 4 3.5

Lung 8140 Adenocarcinoma, NOS 69 24.2 27 32.9 8070 Squamous cell carcinoma, NOS 62 21.8 8 9.8 8046 Non-small cell carcinoma 34 11.9 9 11.0 8000 Neoplasm, malignant 26 9.1 7 8.5 8041 Small cell carcinoma, NOS 29 10.2 4 4.9 8010 Carcinoma, NOS 19 6.7 5 6.1 8250 Bronchiolo-alveolar adenocarcinoma, NOS 14 4.9 8 9.8 8240 Carcinoid tumor, NOS 4 1.4 2 2.4 8480 Mucinous adenocarcinoma 4 1.4 2 2.4 8071 Squamous cell carcinoma, keratinizing, NOS 4 1.4 0 0.0 Others20 7.0 10 12.2

Leukemia 9863 Chronic myeloid leukemia, NOS 35 16.4 32 21.9 9861 Acute myeloid leukemia, NOS 35 16.4 18 12.3 9823 B-cell chronic lymphocytic leukemia/small lymphocytic lymphoma 26 12.1 20 13.7 9835 Precursor cell lymphoblastic leukemia, NOS 18 8.4 9 6.2 9836 Precursor B-cell lymphoblastic leukemia 14 6.5 10 6.8 9800 Leukemia, NOS 11 5.1 8 5.5 9801 Acute leukemia, NOS 10 4.7 7 4.8 9866 Acute promyelocytic leukemia, t(15;17) (q22; q11-12) 10 4.7 5 3.4 9837 Precursor T-cell lymphoblastic leukemia 10 4.7 1 0.7 9873 Acute myeloid leukemia without maturation 3 1.4 7 4.8 9805 Acute biphenotypic leukemia 6 2.8 3 2.1 9874 Acute myeloid leukemia with maturation 4 1.9 4 2.7 9867 Acute myelomonocytic leukemia 3 1.4 3 2.1 9875 Chronic myelogenous leukemia, BCR/ABL positive 5 2.3 1 0.7 9891 Acute monocytic leukemia 4 1.9 2 1.4 9872 Acute myeloid leukemia, minimal differentiation 2 0.9 3 2.1 9896 Acute myeloid leukemia, t(8;21)(q22;q22) 3 1.4 2 1.4 9820 Lymphoid leukemia, NOS 4 1.9 0 0.0 Others11 5.1 11 7.5

Table 2.5 Number and Proportion of Morphological Types for the Most Common Types of Cancer among Saudi Adults, 2008

P02.indd 22 26-05-2012 6:14:16 PM Table 2.5 continued .....

Primary Site CodeMorphology Male%Female %

Skin 8090 Basal cell carcinoma, NOS 58 37.264 51.6 8070 Squamous cell carcinoma, NOS 41 26.325 20.2 8832 Dermatofibrosarcoma, NOS 17 10.986.5 8071 Squamous cell carcinoma, keratinizing, NOS 63.8 43.2 8094 Basosquamous carcinoma 53.2 43.2 8097 Basal cell carcinoma, nodular 53.2 43.2 8410 Sebaceous adenocarcinoma 42.6 21.6 8091 Multifocal superficial basal cell carcinoma21.332.4 8051 Verrucous carcinoma, NOS 42.6 00.0 8000 Neoplasm, malignant 10.6 21.6 8076 Squamous cell carcinoma, micro invasive 21.3 10.8 8092 Infiltrating basal cell carcinoma, NOS 21.3 10.8 Others95.864.8

Prostate 8140 Adenocarcinoma, NOS 236 88.4− − 8010 Carcinoma, NOS 11 4.1−− 8000 Neoplasm, malignant 93.4 −− 8550 Acinar cell carcinoma 62.2 −− 8041 Small cell carcinoma, NOS 31.1 −− 8020 Carcinoma, undifferentiated, NOS10.4−− 8120 Transitional cell carcinoma, NOS10.4−−

Stomach 8140 Adenocarcinoma, NOS 86 51.830 30.0 8490 Signet ring cell carcinoma 37 22.335 35.0 8144 Adenocarcinoma, intestinal type 15 9.077.0 8145 Carcinoma, diffuse type 53.0 33.0 8936 Gastrointestinal stromal sarcoma 21.2 66.0 8000 Neoplasm, malignant 31.8 44.0 8480 Mucinous adenocarcinoma 21.2 55.0 8481 Mucin-producing adenocarcinoma 10.6 33.0 8070 Squamous cell carcinoma, NOS 21.2 11.0 8240 Carcinoid tumor, NOS 21.2 11.0 Others116.6 55.0

Hodgkin Disease 9663 Hodgkin lymphoma, nodular sclerosis, NOS 59 43.164 56.6 9652 Hodgkin lymphoma, mixed cellularity, NOS 30 21.916 14.2 9650 Hodgkin lymphoma, NOS 14 10.212 10.6 9659 Hodgkin lymphoma, nodular lymphocyte predominance 12 8.832.7 9665 Hodgkin lymphoma, nodular sclerosis, grade 1 53.6 87.1 9653 Hodgkin lymphoma, lymphocyte depletion, NOS 42.9 54.4 9651 Hodgkin lymphoma, lymphocyte-rich 75.1 10.9 9667 Hodgkin lymphoma, nodular sclerosis, grade 2 32.2 43.5 Others32.200.0

Bladder 8120 Transitional cell carcinoma, NOS 74 43.017 44.7 8130 Papillary transitional cell carcinoma 73 42.415 39.5 8000 Neoplasm, malignant 63.5 12.6 8070 Squamous cell carcinoma, NOS 42.3 25.3 8010 Carcinoma, NOS 42.3 00.0 8071 Squamous cell carcinoma, keratinizing, NOS31.712.6 8041 Small cell carcinoma, NOS 31.7 00.0 8140 Adenocarcinoma, NOS 00.0 25.3 8480 Mucinous adenocarcinoma 21.2 00.0 8490 Signet ring cell carcinoma 21.2 00.0 9130 Hemangioendothelioma, malignant 10.6 00.0

Corpus Uteri 8380 Endometrioid adenocarcinoma, NOS −−119 61.3 8140 Adenocarcinoma, NOS −−26 13.4 8950 Mullerian mixed tumor −−63.1 8980 Carcinosarcoma, NOS −−63.1 8010 Carcinoma, NOS −−52.6 8460 Papillary serous cyst adenocarcinoma −−52.6 8890 Leiomyosarcoma, NOS −−52.6 8310 Clear cell adenocarcinoma, NOS −−42.1 8441 Serous cyst adenocarcinoma, NOS −−42.1 8931 Endometrial stromal sarcoma, low grade −−31.5 Others−−115.7

Ovary 8441 Serous cyst adenocarcinoma, NOS −−32 20.8 8460 Papillary serous cyst adenocarcinoma −−23 14.9 8010 Carcinoma, NOS −−15 9.7 8140 Adenocarcinoma, NOS −−15 9.7 8480 Mucinous adenocarcinoma −−11 7.1 8461 Serous surface papillary carcinoma −−10 6.5 8470 Mucinous cyst adenocarcinoma, NOS −−85.2 8000 Neoplasm, malignant −−63.9 8380 Endometrioid adenocarcinoma, NOS −−53.2 9071 Yolk sac tumor −−53.2 8310 Clear cell adenocarcinoma, NOS −−42.6 9060 Dysgerminoma −−31.9 9080 Teratoma, malignant, NOS −−31.9 8260 Papillary adenocarcinoma, NOS −−21.3 8620 Granulosa cell tumor, malignant −−21.3 8980 Carcinosarcoma, NOS −−21.3 Others −−85.2

P02.indd 23 26-05-2012 6:14:16 PM Childhood Cancers in Saudi Arabia, 2008 (≤ 14 years)

The total incident cases reported among children The male to female ratio among Saudis was 143:100. (0-14 years) between January and December 2008 Childhood cancer is very important, not only were 770. This represents 6.4 % of the total because of the age of occurrence, but also because number of cancers in Saudi Arabia. The reported 41.7% of the Saudi population is under 15 years of incidents show that cancer was more common age. In addition to this, recent years have shown among boys than girls. 452 (58.7%) cases were a breakthrough for the cure of many childhood reported among boys and 318 (41.3%) among cancers. Childhood cancers accounted for 7.1% of girls, with a male to female ratio of 142:100. Of all cancer among Saudis. The leading cancer among all the cases reported there were 640 Saudis, Saudi children was leukemia, which accounted for 122 non-Saudis and 8 of “unknown nationality”. 35%, followed by Brain, CNS 13.1% then NHL 9.8% Based on table 2.6, the total number of cases and Hodgkin disease 8.8%. Figure 2.7 shows the top analyzed was 756 including 635 (84%) Saudis ten sites by sex and frequency, and table 2.7 shows and 121 (14%) non-Saudis. Among Saudis, 374 the number and proportion of the morphological (58.9%) were male and 261 (41.1%) were female. types for the most common types of cancer.

SaudisNon-Saudis Unknown Nationality All

Male Female TotalMaleFemale TotalMale Female TotalTotal

Analyzed * 374261 6356952121 0 0 0756 Invasive 378262 6406952121 0 0 0761 In Situ 0001010 0 01 ICD 10 ** 4150000 0 05 Total 378262 6407052122 448770

Table 2.6.1 Distribution of Reported Childhood Cancer Cases in Saudi Arabia by Nationality and Sex, 2008

Cancer No. % Leukemia 222 35.0 Brain, CNS 83 13.1 NHL 62 9.8 Hodgkin disease 56 8.8 Bone 44 6.9 Kidney 37 5.8 Eye 31 4.9 Connective, Soft tissue 28 4.4 Adrenal gland 20 3.1 Liver 81.3

Table 2.6.2 Ten Most Common Cancers among Saudi Children, 2008

* Unknown nationalities, in situ cases and ICD-10 conversion failures are excluded from analysis ** ICD-10 conversion failure

P02.indd 24 26-05-2012 6:14:16 PM Male 374 Female 261

Leukemia 121 32.4% Leukemia 101 38.7% Brain, CNS 54 14.4% Brain, CNS 29 11.1% NHL 46 12.3% Kidney 19 7.3% Hodgkin Disease 38 10.2% Bone 18 6.9% Bone 26 7.0% Hodgkin disease 18 6.9% Eye 19 5.1% NHL 16 6.1% Kidney 18 4.8% Connective, Soft tissue 12 4.6% Connective, Soft tissue 16 4.3% Eye 12 4.6% Adrenal gland 9 2.4% Adrenal gland 11 4.2% Liver 6 1.6% Ovary 6 2.3%

Figure 2.7 Ten Most Common Cancers among Saudi Children by Sex, 2008

Primary SiteCode MorphologyMale%Female %

Leukemia 9836 Precursor B-cell lymphoblastic leukemia 50 41.3 40 39.6 9835 Precursor cell lymphoblastic leukemia, NOS 20 16.5 26 25.7 9861 Acute myeloid leukemia, NOS 11 9.1109.9 9837 Precursor T-cell lymphoblastic leukemia 86.6 33.0 9801 Acute leukemia, NOS 32.5 76.9 9805 Acute biphenotypic leukemia 65.0 33.0 9800 Leukemia, NOS 32.5 33.0 9946 Juvenile myelomonocytic leukemia 21.7 44.0 9863 Chronic myeloid leukemia, NOS 43.3 11.0 9866 Acute promyelocytic leukemia, t(15;17)(q22;q11-12) 32.5 22.0 9874 Acute myeloid leukemia with maturation 21.7 11.0 Others 97.4 11.0

Brain, CNS 9470 Medulloblastoma, NOS 20 37.0 14 48.3 9380 Glioma, malignant 916.7517.2 9400 Astrocytoma, NOS 47.4 310.3 9473 Primitive neuroectodermal tumor, NOS47.413.4 9391 Ependymoma, NOS 35.6 13.4 9392 Ependymoma, anaplastic 35.6 00.0 9080 Teratoma, malignant, NOS 23.7 00.0 9440 Glioblastoma, NOS 23.7 00.0 9471 Desmoplastic nodular medulloblastoma 00.0 26.9 9508 Atypical teratoid/rhabdoid tumor 23.7 00.0 8963 Malignant rhabdoid tumor 00.0 13.4 9085 Mixed germ cell tumor 00.0 13.4 9382 Mixed glioma 11.9 00.0 9401 Astrocytoma, anaplastic 11.9 00.0 9420 Fibrillary astrocytoma 00.0 13.4 Others 35.6 00.0

Table 2.7 Number and Proportion of Morphological Types for the Most Common Types of Cancer among Saudi Children, 2008

P02.indd 25 26-05-2012 6:14:17 PM Table 2.7 continued .....

Primary SiteCode Morphology Male%Female %

NHL 9687 Burkitt lymphoma, NOS 21 45.7 425.0 9729 Precursor T-cell lymphoblastic lymphoma 510.9212.5 9680 Malignant lymphoma, large B-cell, diffuse, NOS 510.916.3 9714 Anaplastic large cell lymphoma, T cell and Null cell type 24.3 212.5 9590 Malignant lymphoma, NOS 36.5 00.0 9702 Mature T-cell lymphoma, NOS 36.5 00.0 9691 Follicular lymphoma, grade 2 12.2 16.3 9699 Marginal zone B-cell lymphoma, NOS 12.2 16.3 9727 Precursor cell lymphoblastic lymphoma, NOS 24.3 00.0 9728 Precursor B-cell lymphoblastic lymphoma 12.2 16.3 9754 Langerhans cell histiocytosis, disseminated 24.3 00.0 9591 Malignant lymphoma, non-Hodgkin, NOS 00.0 16.3 9675 Malignant lymphoma, mixed small and large cell, diffuse 00.0 16.3 9700 Mycosis fungoides 00.0 16.3 9740 Mast cell sarcoma 00.0 16.3

Hodgkin Disease 9663 Hodgkin lymphoma, nodular sclerosis, NOS 21 55.3 950.0 9652 Hodgkin lymphoma, mixed cellularity, NOS 513.2316.7 9650 Hodgkin lymphoma, NOS 410.515.6 9665 Hodgkin lymphoma, nodular sclerosis, grade 1 410.515.6 9651 Hodgkin lymphoma, lymphocyte-rich 12.6 316.7 9659 Hodgkin lymphoma, nodular lymphocyte predominance 25.3 00.0 9664 Hodgkin lymphoma, nodular sclerosis, cellular phase12.615.6

Connective Tissue 9500 Neuroblastoma, NOS 425.0216.7 8900 Rhabdomyosarcoma, NOS 425.018.3 8910 Embryonal rhabdomyosarcoma, NOS 318.818.3 9071 Yolk sac tumor 16.3 18.3 9080 Teratoma, malignant, NOS 00.0 216.7 9364 Peripheral neuroectodermal tumor16.318.3 8804 Epithelioid sarcoma 00.0 18.3 8830 Malignant ﬁbrous histiocytoma 16.3 00.0 8920 Alveolar rhabdomyosarcoma 00.0 18.3 9040 Synovial sarcoma, NOS 00.0 18.3 9043 Synovial sarcoma, biphasic 16.3 00.0 9085 Mixed germ cell tumor 00.0 18.3 9490 Ganglioneuroblastoma 16.3 00.0

Bone 9260 Ewing sarcoma 13 50.0 11 61.1 9180 Osteosarcoma, NOS 10 38.5 316.7 8910 Embryonal rhabdomyosarcoma, NOS13.815.6 9181 Chondroblastic osteosarcoma 13.8 15.6 9043 Synovial sarcoma, biphasic 13.8 00.0 9310 Ameloblastoma, malignant 00.0 15.6 9370 Chordoma, NOS 00.0 15.6

Kidney 8960 Nephroblastoma, NOS 12 66.7 17 89.5 8963 Malignant rhabdoid tumor 15.6 210.5 8964 Clear cell sarcoma of kidney316.7 00.0 9500 Neuroblastoma, NOS 211.100.0

Eye 9510 Retinoblastoma, NOS 11 57.9 975.0 9512 Retinoblastoma, undifferentiated 315.818.3 9511 Retinoblastoma, differentiated 15.3 18.3 8004 Malignant tumor, spindle cell type 15.3 00.0 8070 Squamous cell carcinoma, NOS 00.0 18.3 8072 Squamous cell carcinoma, large cell, nonkeratinizing, NOS15.300.0 8910 Embryonal rhabdomyosarcoma, NOS 15.3 00.0 9581 Alveolar soft part sarcoma 15.3 00.0

Adrenal Gland 9500 Neuroblastoma, NOS 888.9763.6 9490 Ganglioneuroblastoma111.1 436.4

Liver 8970 Hepatoblastoma 466.7150.0 8170 Hepatocellular carcinoma, NOS116.7 150.0 9500 Neuroblastoma, NOS 116.700.0

Ovary 9080 Teratoma, malignant, NOS−−233.3 9060 Dysgerminoma −−116.7 9064 Germinoma −−116.7 9071 Yolk sac tumor −−116.7 9085 Mixed germ cell tumor −−116.7

P02.indd 26 26-05-2012 6:14:17 PM Cancer in the 13 Administrative Regions of the Kingdom, 2008

The following bar charts list the most common It is worth noting that the major regions such as cancer sites in the 13 administrative regions of Saudi Riyadh, Makkah and Eastern Province represent Arabia by sex. These sites are listed on the basis of the majority of cases. This can be attributed to the total number of cases for each site reported the increasing number of people seeking medical by permanent address (region) of the patient at the attention in these urbanized cities with modern time of diagnosis. In most regions breast cancer was hospital facilities where permanent addresses may the leading cancer among women, while among men not be documented in source records. NHL, Colo-rectal, Leukemia and Liver interchange.

Colo-rectal 11.4 Breast 23.9 Breast 12.7 Liver 9.4 Colo-rectal 10.9 Colo-rectal 11.2 NHL 9.1 Thyroid 10.5 NHL 8.3 Leukemia 7.1 NHL 7.6 Thyroid 7.1 Prostate 7.0 Ovary 4.0 Liver 6.2 Brain, CNS 5.8 Corpus uteri 3.4 Leukemia 5.0 Hodgkin disease 5.0 Liver 3.2 Brain, CNS 4.2 Lung 4.8 Leukemia 3.1 Hodgkin disease 3.9 Bladder 4.3 Hodgkin disease 3.0 Lung 3.4 Nasopharynx 3.9 Kidney 2.7 Prostate 3.4 Kidney 3.8 Brain, CNS 2.7 Kidney 3.2 Other Sites 28.6 Other Sites 25.0 Other Sites 31.6 010203040 010203040 010203040

Males (1191) Females (1283) All (2474)

Figure 2.8.1 Riyadh Region, 2008 (Percentage Distribution)

Colo-rectal 14.4 Breast 27.4 Breast 14.6 Lung 9.2 Colo-rectal 9.7 Colo-rectal 11.9 NHL 8.1 Thyroid 9.0 NHL 7.1 Leukemia 7.1 NHL 6.2 Leukemia 6.2 Liver 6.5 Leukemia 5.4 Thyroid 5.9 Prostate 5.7 Corpus uteri 5.2 Lung 5.1 Stomach 5.2 Ovary 3.8 Liver 4.0 Bladder 3.9 Skin 2.9 Stomach 3.6 Brain, CNS 3.4 Stomach 2.2 Skin 3.1 Skin 3.2 Cervix uteri 2.2 Corpus uteri 2.8 Kidney 3.2 Hodgkin disease 2.0 Prostate 2.7 Hodgkin disease 3.2 Liver 1.8 Hodgkin disease 2.6 Other Sites 26.8 Other Sites 22.1 Other Sites 30.4 010203040 010203040 010203040

Males (964) Females (1089) All (2053)

Figure 2.8.2 Makkah Region, 2008 (Percentage Distribution)

P02.indd 27 26-05-2012 6:14:17 PM Cancer in the 13 Administrative Regions of the Kingdom, 2008

Colo-rectal 11.0 Breast 32.4 Breast 17.5 Lung 10.6 Thyroid 10.9 Colo-rectal 9.9 Leukemia 8.0 Colo-rectal 8.8 Thyroid 7.2 Prostate 7.4 NHL 5.3 Lung 6.2 NHL 7.2 Leukemia 4.2 NHL 6.2 Kidney 4.4 Corpus uteri 4.0 Leukemia 6.0 Bladder 4.4 Hodgkin disease 3.1 Hodgkin disease 3.5 Skin 4.0 2.5 3.5 Hodgkin disease 4.0 Stomach Prostate 3.2 Stomach 3.4 Cervix uteri 2.4 Kidney Liver 3.4 Lung 2.3 Stomach 3.0 Other Sites 32.1 Other Sites 23.8 Other Sites 34.0 010203040 010203040 010203040

Males (726) Females (826) All (1552)

Figure 2.8.3 Eastern Region, 2008 (Percentage Distribution)

Leukemia 11.1 Breast 20.4 Breast 10.3 NHL 9.3 Colo-rectal 9.1 Colo-rectal 9.1 Colo-rectal 9.0 Thyroid 8.4 Leukemia 9.1 Lung 8.0 NHL 8.4 NHL 8.9 Liver 6.6 Leukemia 6.9 Thyroid 6.2 Prostate 5.2 Oesophagus 4.0 Liver 4.8 Thyroid 4.2 Corpus uteri 4.0 Lung 4.8 Brain, CNS 3.8 Ovary 3.6 Oesophagus 3.0 Stomach 3.5 Liver 2.9 Hodgkin disease 3.0 Skin 3.5 Bone 2.6 Skin 2.8 Hodgkin disease 3.5 Hodgkin disease 2.6 Brain, CNS 2.8 Other Sites 32.5 Other Sites 27.0 Other Sites 35.2 010203040 010203040 010203040 Males (289) Females (274) All (563) Figure 2.8.4 Madinah Region, 2008 (Percentage Distribution)

Lung 14.0 Breast 13.0 Leukemia 10.6 Thyroid 11.1 Lung 9.6 Leukemia 12.0 NHL 9.3 NHL 7.7 Prostate 8.0 Leukemia 9.3 Breast 6.7 Bladder 8.0 Colo-rectal 5.6 Thyroid 6.7 Liver 6.0 Lung 5.6 Kidney 4.8 Brain, CNS 5.6 Colo-rectal 3.8 Kidney 6.0 Stomach 3.7 Prostate 3.8 NHL 6.0 Melanoma of Skin 3.7 Bladder 3.8 Oesophagus 4.0 Skin 3.7 Stomach 2.9 Cervix uteri 3.7 Liver 2.9 Connective,Soft tissue 4.0 Corpus uteri 3.7 Brain, CNS 2.9 Multiple Myeloma 4.0 Kidney 3.7 Multiple Myeloma 2.9 Other Sites 28.0 Other Sites 18.5 Other Sites 30.8 010203040 010203040 010203040 Males (50) Females (54) All (104) Figure 2.8.5 Northern Region, 2008 (Percentage Distribution)

P02.indd 28 26-05-2012 6:14:18 PM Cancer in the 13 Administrative Regions of the Kingdom, 2008

Colo-rectal 11.7 Breast 21.7 Breast 11.4 Liver 10.5 Thyroid 19.0 Thyroid 11.4 NHL 9.4 Colo-rectal 7.9 Colo-rectal 9.7 Leukemia 6.4 NHL 6.3 NHL 7.8 Nasopharynx 5.3 Leukemia 5.8 Liver 6.1 Hodgkin disease 5.3 Gallbladder, etc. 4.8 Leukemia 6.1 Stomach 4.7 Hodgkin disease 4.8 Hodgkin disease 5.0 Skin 4.7 Skin 3.2 Gallbladder, etc. 4.4 Gallbladder, etc. 4.1 Lung 2.6 Skin 3.9

Prostate 4.1 Ovary 2.6 Nasopharynx 3.3

Other Sites 33.9 Other Sites 21.2 Other Sites 30.8 010203040 010203040 010203040 Males (171) Females (189) All (360)

Figure 2.8.6 Qassim Region, 2008 (Percentage Distribution)

Colo-rectal 11.0 Breast 14.1 Mouth 8.7 Stomach 7.9 Mouth 12.1 Colo-rectal 8.3 NHL 7.9 Leukemia 7.4 Breast 7.6 Leukemia 6.3 Colo-rectal 6.0 NHL 6.9 Tongue 5.5 Leukemia 6.9 Bladder 5.5 NHL 6.0 Stomach 5.1 Mouth 4.7 Corpus uteri 5.4 Tongue 4.3 Nasopharynx 3.9 Thyroid 4.7 Skin 4.0 Skin 3.9 Oesophagus 4.0 3.6 Pancreas 3.1 Bladder Liver 4.0 3.6 Bone 3.1 Thyroid Skin 4.0 Connective,Soft tissue 3.1 Liver 3.3 Prostate 3.1 Hodgkin disease 4.0 Hodgkin disease 3.3 Other Sites 30.7 Other Sites 28.2 Other Sites 34.4 010203040 010203040 010203040 Males (127) Females (149) All (276) Figure 2.8.7 Jazan Region, 2008 (Percentage Distribution)

NHL 14.1 Breast 12.1 Breast 24.4 Colo-rectal 8.7 Leukemia 10.4 Liver Thyroid 12.2 8.7 NHL 8.8 Leukemia 8.7 Leukemia 12.2 Thyroid 8.2 Skin 7.6 Colo-rectal 6.0 Lung 4.3 Corpus uteri 7.8 Skin 6.0 Prostate 4.3 Skin 4.4 Liver 5.5 Kidney 4.3 Corpus uteri 3.8 Thyroid 4.3 Colo-rectal 3.3 Oesophagus 3.3 Kidney 3.3 3.3 Bone 3.3 Connective,Soft tissue Lung 2.7 Bladder 3.3 Connective,Soft tissue 2.7 NHL 3.3 Hodgkin disease 3.3 Hodgkin disease 2.7 28.9 Other Sites 21.7 Other Sites Other Sites 27.5 010203040 010203040 010203040

Males (92) Females (90) All (182) Figure 2.8.8 Hail Region, 2008 (Percentage Distribution)

P02.indd 29 26-05-2012 6:14:18 PM Cancer in the 13 Administrative Regions of the Kingdom, 2008

Liver 13.8 Breast 20.9 Breast 11.2 Colo-rectal 12.1 Thyroid 10.4 Leukemia 10.4 Leukemia 12.1 Leukemia 9.0 Colo-rectal 9.6 Stomach 6.9 Liver 8.8 Colo-rectal 7.5 Bone 5.2 Thyroid 6.4 Skin 7.5 Kidney 5.2 Stomach 5.6 Hodgkin disease 5.2 NHL 6.0 Skin 5.6 Pancreas 3.4 Stomach 4.5 NHL 4.8 Lung 3.4 Liver 4.5 Bone 3.2 Skin 3.4 Corpus uteri 4.5 Kidney 3.2 Prostate 3.4 Pancreas 2.4 Bladder 4.5 Testis 3.4 Corpus uteri 2.4 Nasopharynx 3.0 NHL 3.4 Bladder 2.4 3.0 Multiple Myeloma 3.4 Connective,Soft tissue Hodgkin disease 2.4 Other Sites 15.5 Other Sites 14.9 Other Sites 21.6 010203040 010203040 010203040

Males (58) Females (67) All (125)

Figure 2.8.9 Najran Region, 2008 (Percentage Distribution)

Prostate 16.1 Breast 19.1 Breast 10.5 Liver 10.7 Thyroid 11.8 Prostate 7.3 Colo-rectal 7.1 Leukemia 10.3 Leukemia 7.3 6.5 Bladder 7.1 Ovary 8.8 Thyroid NHL 6.5 NHL 7.1 Corpus uteri 5.9 Liver 5.6 Stomach 5.4 NHL 5.9 Colo-rectal 4.8 Lung 3.6 Pancreas 4.4 Ovary 4.8 Skin 3.6 Vulva 4.4 Stomach 3.2 3.6 2.9 Connective,Soft tissue Colo-rectal Pancreas 3.2 3.6 2.9 Eye Skin Skin 3.2 3.6 2.9 Brain, CNS Kidney Corpus uteri 3.2 Leukemia 3.6 Hodgkin disease 2.9 Bladder 3.2 Other Sites 25.0 Other Sites 17.6 Other Sites 30.6 010203040 010203040 010203040

Males (56) Females (68) All (124) Figure 2.8.10 Baha Region, 2008 (Percentage Distribution)

NHL 13.4 Breast 15.5 NHL 10.2 Colo-rectal 9.7 Thyroid 11.4 Colo-rectal 10.1

Leukemia 9.7 Colo-rectal 10.4 Leukemia 9.2 Liver 8.6 Leukemia 8.9 Breast 8.4

Skin 6.9 NHL 7.3 Thyroid 7.3

Prostate 6.9 Skin 6.3 Skin 6.6

Stomach 5.9 Ovary 4.7 Liver 5.3

Bladder 4.5 Hodgkin disease 4.4 Hodgkin disease 4.5

Hodgkin disease 4.5 Corpus uteri 3.8 Stomach 4.3

Brain, CNS 3.1 Stomach 2.8 Prostate 3.3

Other Sites 26.9 Other Sites 24.4 Other Sites 30.9 010203040 010203040 010203040 Males (290) Females (316) All (606) Figure 2.8.11 Asir Region, 2008 (Percentage Distribution)

P02.indd 30 26-05-2012 6:14:19 PM Cancer in the 13 Administrative Regions of the Kingdom, 2008

Leukemia 10.2 Breast 22.0 Breast 11.4 Lung 7.9 Thyroid 11.0 Leukemia 10.2 Colo-rectal 7.1 Leukemia 10.2 Thyroid 8.3 6.3 Liver Colo-rectal 6.3 Colo-rectal 6.7 Skin 6.3 NHL 6.3 NHL 5.9 Thyroid 5.5 Corpus uteri 4.7 Liver 4.7 NHL 5.5 Oesophagus 3.9 Lung 4.3 Stomach 3.9 Liver 3.1 Skin 3.9 Pancreas 3.9 Connective, Soft tissue 3.1 Bladder 3.5 Prostate 3.9 3.1 Bladder 3.9 Bladder 3.1 Brain, CNS Brain, CNS 3.9 Ovary 2.4 Stomach 2.8 2.4 Hodgkin disease 3.9 Brain, CNS Connective, Soft tissue 2.8 Other Sites 27.6 Other Sites 21.3 Other Sites 32.3 010203040 010203040 010203040 Males (127) Females (127) All (254)

Figure 2.8.12 Tabuk Region, 2008 (Percentage Distribution)

Leukemia 15.2 Breast 33.3 Breast 16.3 6.3 NHL 13.6 Colo-rectal NHL 9.3 Thyroid 6.3 Hodgkin disease 10.6 Leukemia 9.3 Nasopharynx 4.8 Nasopharynx 6.1 Hodgkin disease 6.2 Pancreas 4.8 Liver 6.1 Cervix uteri 4.8 Nasopharynx 5.4 Skin 6.1 NHL 4.8 Colo-rectal 5.4 3.2 Stomach 4.5 Stomach Thyroid 4.7 Gallbladder, etc. 3.2 Colo-rectal 4.5 Stomach 3.9 Ovary 3.2 Prostate 4.5 Liver 3.9 Multiple Myeloma 3.2 4.5 3.9 Brain, CNS Leukemia 3.2 Skin 31.8 Other Sites 24.2 Other Sites 19.0 Other Sites 010203040 010203040 010203040 Males (66) Females (63) All (129)

Figure 2.8.13 Jouf Region, 2008 (Percentage Distribution)

P02.indd 31 26-05-2012 6:14:19 PM International Comparison of Age-Standardized Incidence Rates

Worldwide, it is estimated that 12,662,554 people followed by stomach, liver, colo-rectal and developed cancer in 2008. Of these, 56.1% oesophagus cancers. In women, the most common were in developing countries and 43.9% were in cancer site was breast followed by colo-rectal then developed countries. According to 2008 estimates, cervix uteri then lung cancers. Among women, the most common cancer site worldwide among breast cancer was the most common followed men was lung cancer, followed by prostate then by colo-rectal, lung and corpus uteri cancers in colo-rectal then stomach. However; in developed developed countries. While in the developing countries prostate was the leading cancer in men countries breast cancer was the leading cancer followed by lung, colo-rectal, and bladder, while followed by cancers of the cervix, lung then in developing countries, lung cancer was first stomach.

Norway 363.4

Wales 305.5

Egypt, Gharbiah 162.9

Bahrain 159.0

Qatar 153.4

Jordan 134.7

Kuwait 131.0

Algeria, Setif 94.0

Oman 92.5

United Arab Emirates 82.3

Saudi Arabia 74.1

050 100 150 200 250300 350400

Figure 2.9.A Comparison of ASR* for Saudi Males with Selected Countries**

Norway 288.7

Wales 279.0

Qatar 172.2

Bahrain 154.6

Kuwait 142.0

Jordan 136.0

Egypt, Gharbiah 121.8

United Arab Emirates 95.1

Algeria, Setif 84.7

Oman 82.6

India, Karunagappally 80.0

Saudi Arabia 79.4

050 100 150 200 250 300350 400

Figure 2.9.B Comparison of ASR* for Saudi Females with Selected Countries**

* ASR Per 100,000 ** Source for this information is summarized on page 64

P02.indd 32 26-05-2012 6:14:19 PM PART III CANCER INCIDENCE FOR MOST COMMON SITES 2008

P03.indd 33 26-05-2012 6:26:33 PM P03.indd 34 26-05-2012 6:26:34 PM Cancer Incidence for Most Common Sites, 2008

In this section, the incidence of the most frequencies. The relevant data incorporate details common cancers among Saudi males and females for all patients presented over the period of January are outlined in accordance to their relative through December 2008.

Cancer Male Female All %

Breast 17 1152 116913.2 Colo-rectal 478 426 904 10.2 NHL 370 304 674 7.6 Thyroid 131 475 606 6.8 Leukemia 335 247 582 6.6 Liver 303 115 418 4.7 Lung 285 82 367 4.1 Hodgkin disease 175 131 306 3.5 Skin 159 125 284 3.2 Prostate 267 − 267 3.0 Corpus Uteri − 194 194 2.2 Bladder 173 38 211 2.4 Stomach 166 100 266 3.0 Ovary − 160 160 1.8

Table 3.1 Most Common Cancers among Saudis by sex, 2008

P03.indd 35 26-05-2012 6:26:34 PM Female Breast (C 50)

There were 1152 female breast cancer cases for with the highest ASR were Eastern region at year 2008. Breast cancer ranked first among 31.8/100,000, Riyadh region at 24.2/100,000, Makkah females accounting for 25% of all newly diagnosed region at 21.6/100,000, Jouf region at 19.4/100,000 female cancers (4,617) in year 2008. The ASR was and Tabuk region at 17.2/100,000. The median age 19.2/100,000 for female population. The five regions at diagnosis was 47 years (Range 17-96 years).

20 AIR (per 100,000)

0 0- 5- 10- 15- 20- 25- 30- 35-40- 45-50- 55-60- 65-70- 75+ Age Groups

Figure 3.1.1 Age-Specific Incidence Rate (AIR) for Female Breast Cancer in Saudi Arabia, 2008

ICD-O-3 Morphology Female %

8500 Infiltrating duct carcinoma, NOS 897 77.9 8520 Lobular carcinoma, NOS 57 4.9 8010 Carcinoma, NOS 35 3.0 8523 Infiltrating duct mixed with other types of carcinoma 28 2.4 8000 Neoplasm, malignant 27 2.3 8510 Medullary carcinoma, NOS 22 1.9 8522 Infiltrating duct and lobular carcinoma 13 1.1 8140 Adenocarcinoma, NOS 12 1.0 Others 61 5.3

Table 3.1.1 Morphological Distribution of Female Breast Cancer in Saudi Arabia, 2008

9.5% 16.2% Distant Localised Regional Unknown 42.7% 31.6%

Female

Figure 3.1.2 Stage Distribution of Female Breast Cancer, 2008

P03.indd 36 26-05-2012 6:26:34 PM Eastern 31.8

Riyadh 24.2

Makkah 21.6

Jouf 19.4

Tabuk 17.2

Qassim 13.3

Madinah 12.2

Hail 11.9

Najran 10.8 Baha 10.8

Najran 10.8

Northern 10.5 Asir 9.0

Jazan 6.0

0510 15 20 25 30 35

Figure 3.1.3 ASR* Regional Distribution of Female Breast Cancer in Saudi Arabia, 2008

Wales 93.0

Norway 72.8

Bahrain 54.4

Singapore 54.1

Jordan 50.4

Kuwait 48.0

Qatar 45.6

United Arab Emirates 25.1

Korea 23.3

Saudi Arabia 19.2

Algeria, Setif 18.8

Oman 15.7

020406080100 120

Figure 3.1.4 Comparison of ASR* for Female Breast Cancer among Saudi Females with ASR in Selected Countries**

* ASR Per 100,000 ** Source for this information is summarized on page 64

P03.indd 37 26-05-2012 6:26:34 PM Colo-rectal (C18-C20)

There were 904 cases of colo-rectal cancer The five regions with the highest ASR were accounting for 10.2% of all newly diagnosed cases Riyadh region at 13/100,000, Eastern region at in year 2008. This cancer ranked first among male 10.7/100,000, Makkah region at 10.2/100,000, population and third among female population. Qassim region at 7/100,000 and Madinah region It affected 478 (52.9%) males and 426 (47.1%) at 7/100,000. The median age at diagnosis was 59 females with a male to female ratio of 112:100. years among males (range 18-103 years) and 57 The overall ASR was 8.6/100,000. ASR for males years among females (range 18-98 years). was 9/100,000 and for females 8.2/100,000.

60 male female

AIR (per 100,000) 20

0 0- 5- 10- 15- 20- 25- 30- 35-40- 45-50- 55-60- 65-70- 75+ Age Groups

Figure 3.2.1 Age-Specific Incidence Rate (AIR) for Colo-rectal Cancer in Saudi Arabia, 2008

ICD-O-3 Morphology Male % Female %

8140 Adenocarcinoma, NOS 350 73.2 312 73.2 8480 Mucinous adenocarcinoma 31 6.5429.9 8490 Signet ring cell carcinoma 17 3.692.1 8263 Adenocarcinoma in tubulovillous adenoma 10 2.1112.6 8000 Neoplasm, malignant 14 2.961.4 8481 Mucin-producing adenocarcinoma 10 2.181.9 8261 Adenocarcinoma in villous adenoma 81.7 92.1 8010 Carcinoma, NOS 91.9 61.4 8144 Adenocarcinoma, intestinal type 71.5 71.6 8210 Adenocarcinoma in adenomatous polyp 61.3 81.9 Others 16 3.381.9

Table 3.2.1 Morphological Distribution of Colo-rectal Cancer in Saudi Arabia, 2008

8.8% 8.2% 8.5% 29.1% 29.3% 29.2% Distant Localised Regional Unknown 38.1% 39.7% 38.8% 24.1% 22.8% 23.5% Male Female All

Figure 3.2.2 Stage Distribution of Colo-rectal Cancer in Saudi Arabia, 2008

P03.indd 38 26-05-2012 6:26:35 PM Riyadh 13.1 12.9 Eastern 10.1 11.2 Makkah 9.0 11.3 6.3 Qassim 7.7 6.9 Madinah 7.0 Asir 6.8 5.4 Tabuk 6.7 5.2 4.7 Najran 7.0 4.5 Jouf 3.8 2.8 Jazan 4.2 4.8 Northern 1.7 1.9 Hail 4.5 1.2 Baha 2.9

0 2468 10 12 14 16

Figure 3.2.3 ASR* Regional Distribution of Colo-rectal Cancer in Saudi Arabia, 2008

Wales 25.1 41.3

Sweden 22.5 29.6

Korea 17.4 29.1

Jordan 13.9 20.9

Qatar 16.6 15.0 13.3 Kuwait 15.5

7.4 Bahrain 14.3

8.2 Saudi Arabia 9.0 7.3 United Arab Emirates 8.0

4.1 Oman 5.5

010203040 50

Figure 3.2.4 Comparison of ASR* for Colo-rectal Cancer among Saudis with ASR in Selected Countries**

* ASR Per 100,000 ** Source for this information is summarized on page 64

P03.indd 39 26-05-2012 6:26:35 PM Non-Hodgkin Lymphoma (C82-C85; C96)

There were 674 cases of Non-Hodgkin Lymphoma and 5.4/100,000 for females. The five regions with accounting for 7.6 % of all newly diagnosed cancers in the highest ASR were Riyadh region at 8.2/100,000, year 2008. This cancer ranked second among male Madinah region at 6.1/100,000, Eastern region at population and fourth among female population. It 5.7/100,000, Jouf region at 5.7/100,000 and Makkah affected 370 (54.9%) males and 304 (45.1%) females regions at 5.6/100,000. The median age at diagnosis with a male to female ratio of 122:100. The overall was 50 years among males (range 0-92 years) and ASR was 5.7/100,000. ASR for males was 6/100,000 56 years among females (range 0-97 years).

40 male female

15 AIR (per 100,000) 10

5 0 0- 5- 10- 15- 20- 25- 30- 35-40- 45-50- 55-60- 65-70- 75+ Age Groups Figure 3.3.1 Age-Specific Incidence Rate (AIR) for NHL in Saudi Arabia, 2008 ICD-O-3 Morphology Male %%Female

9680 Malignant lymphoma, large B-cell, diffuse, NOS 16043.2157 51.6 9687 Burkitt lymphoma, NOS 35 9.5113.6 9590 Malignant lymphoma, NOS 22 5.9227.2 9591 Malignant lymphoma, non-Hodgkin, NOS 15 4.1227.2 9699 Marginal zone B-cell lymphoma, NOS 13 3.5165.3 9700 Mycosis fungoides 13 3.582.6 9702 Mature T-cell lymphoma, NOS 13 3.562.0 9670 Malignant lymphoma, small B lymphocytic, NOS 10 2.782.6 9695 Follicular lymphoma, grade 1 92.4 82.6 9691 Follicular lymphoma, grade 2 71.9 93.0 9714 Anaplastic large cell lymphoma, T cell and Null cell type 10 2.762.0 9690 Follicular lymphoma, NOS 92.4 62.0 9698 Follicular lymphoma, grade 3 11 3.031.0 9729 Precursor T-cell lymphoblastic lymphoma 92.4 20.7 9671 Malignant lymphoma, lymphoplasmacytic 51.4 41.3 9673 Mantle cell lymphoma 51.4 31.0 Others 24 6.5134.3 Table 3.3.1 Morphological Distribution of NHL in Saudi Arabia, 2008 14.6% 18.8% 16.5% 44.3% 42.1% 43.3% Distant 14.6% Localised 14.7% 14.8% Regional Unknown 26.5% 24.3% 25.5% Male Female All Figure 3.3.2 Stage Distribution of NHL Cancer, 2008

P03.indd 40 26-05-2012 6:26:36 PM Riyadh 8.4 7.9 Madinah 6.0 6.1 Eastern 5.3 6.0 2.5 Jouf 8.8 5.6 Makkah 5.6 4.9 Qassim 5.5 3.9 Asir 6.1 Northern 5.9 3.2 1.7 Hail 7.1 3.4 Tabuk 5.2 3.1 Baha 2.7 3.4 Najran 2.1 2.4 Jazan 2.5

0246810

Figure 3.3.3 ASR* Regional Distribution of NHL Cancer in Saudi Arabia, 2008

Egypt, Gharbiah 9.9 16.9

Wales 9.5 13.3

Norway 8.5 12.3

Qatar 9.1 9.4

6.4 Kuwait 11.1

5.6 Bahrain 7.1

4.6 Oman 7.6

5.4 Saudi Arabia 6.0

4.6 United Arab Emirates 6.6

0 246810 12 14 16 18 20

Figure 3.3.4 Comparison of ASR* for NHL Cancer among Saudis with ASR in Selected Countries**

* ASR Per 100,000 ** Source for this information is summarized on page 64

P03.indd 41 26-05-2012 6:26:36 PM Thyroid (C 73)

There were 606 cases of thyroid cancer accounting males and 6.8/100,000 for females. The five for 6.8% of all newly diagnosed cases for the year regions with the highest ASR were Tabuk region at 2008. This cancer ranked second among female 6/100,000, Eastern region at 5.9/100,000, Riyadh population and thirteenth among male population. region at 5.8/100,000, Qassim region at 5.7 /100,000 It affected 131 (21.6%) males and 475 (78.4%) and Northern region at 4.9/100,000. The median age females with a male to female ratio of 28:100. The at diagnosis was 44 years among males (range 9-92 overall ASR was 4.4/100,000. ASR was 2/100,000 for years) and 40 years among females (range 9-91 years).

20 18 male female 16 14

10 8

AIR (per 100,000) 6 4 2

0 0- 5- 10- 15- 20- 25- 30- 35-40- 45-50- 55-60- 65-70- 75+ Age Groups

Figure 3.4.1 Age-Specific Incidence Rate (AIR) for Thyroid Cancer in Saudi Arabia, 2008

ICD-O-3 Morphology Male %%Female

8260 Papillary adenocarcinoma, NOS 76 58.0 27658.1 8340 Papillary carcinoma, follicular variant 15 11.5 79 16.6 8341 Papillary microcarcinoma 10 7.6398.2 8343 Papillary carcinoma, encapsulated 43.1 20 4.2 8510 Medullary carcinoma, NOS 32.3 11 2.3 8330 Follicular adenocarcinoma, NOS 64.6 71.5 8021 Carcinoma, anaplastic, NOS 43.1 81.7 8290 Oxyphilic adenocarcinoma 10.8 71.5 8335 Follicular carcinoma, minimally invasive 10.8 61.3 8344Papillary carcinoma, columnar cell 32.3 30.6 Others86.1194.0

Table 3.4.1 Morphological Distribution of Thyroid Cancer in Saudi Arabia, 2008

11.5% 10.7% 9.1% 5.9% 9.6% 6.9%

Distant 26.5% 30.0% Localised Regional 35.1% Unknown 58.5% 53.5% 42.7% Male Female All

Figure 3.4.2 Stage Distribution of Thyroid Cancer, 2008

P03.indd 42 17-06-2012 10:38:12 AM 7.4 Tabuk 4.5 9.6 Eastern 2.1 9.1 Riyadh 2.5 9.8 Qassim 1.6 8.4 Northern 1.3 4.7 Madinah 2.8 5.0 Hail 2.5 5.8 Makkah 1.6 6.0 Asir 1.3 4.8 Najran 0.5 2.8 Jouf 2.4 4.8 Baha 0.0 1.5 Jazan 0.9

0246810 12

Figure 3.4.3 ASR* Regional Distribution of Thyroid Cancer in Saudi Arabia, 2008

Korea 12.2 2.3

Qatar 10.9 3.2

Kuwait 8.5 3.2

Bahrain 7.7 2.0

7.2 Hong Kong 2.2

6.8 Saudi Arabia 2.0

7.1 United Arab Emirates 1.7 5.6 Oman 1.7 5.3 Norway 1.7

2.6 Egypt, Gharbiah 1.1

0246810121416

Figure 3.4.4 Comparison of ASR* for Thyroid Cancer among Saudis with ASR in Selected Countries**

* ASR Per 100,000 ** Source for this information is summarized on page 64

P03.indd 43 26-05-2012 6:26:37 PM Leukemia (C91-C95)

There were 582 cases of leukemia accounting 3.2/1000,000 for females. The five regions with the for 6.6% of all newly diagnosed cancers in year highest ASR were Northern region at 5.9/100,000, 2008. This cancer ranked third for males Tabuk region at 5.3/100,000, Madinah region at and fifth for females and affected 335 (57.6%) 4.9/100,000, Eastern region at 4.6/100,000 and males and 247 (42.4%) females with a male to Hail region at 4.3/100,000. The median age at female ratio of 136:100. The overall ASR was diagnosis is 26 years among males (range 0-92years) 3.9/100,000. ASR for males was 4.5/100,000 and and 22 years among females (range 0-93 years).

35 male female

15 AIR (per 100,000) 10

0 0- 5- 10- 15- 20- 25- 30- 35-40- 45-50- 55-60- 65-70- 75+ Age Groups

Figure 3.5.1 Age-Specific Incidence Rate (AIR) for Leukemia in Saudi Arabia, 2008

ICD-O-3 Morphology Male %%Female

9836 Precursor B-cell lymphoblastic leukemia 64 19.150 20.2 9861 Acute myeloid leukemia, NOS 46 13.728 11.3 9835 Precursor cell lymphoblastic leukemia, NOS 38 11.335 14.2 9863 Chronic myeloid leukemia, NOS 39 11.633 13.4 9823 B-cell chronic lymphocytic leukemia/small lymphocytic lymphom 26 7.8208.1 9801 Acute leukemia, NOS 13 3.9145.7 9800 Leukemia, NOS 14 4.2114.5 9837 Precursor T-cell lymphoblastic leukemia 18 5.441.6 9866 Acute promyelocytic leukemia, t(15;17)(q22;q11-12) 13 3.972.8 9805 Acute biphenotypic leukemia 12 3.662.4 9873 Acute myeloid leukemia without maturation 41.2 83.2 9874 Acute myeloid leukemia with maturation 61.8 52.0 9867 Acute myelomonocytic leukemia 51.5 31.2 9891 Acute monocytic leukemia 61.8 20.8 9875 Chronic myelogenous leukemia, BCR/ABL positive 51.5 10.4 9946 Juvenile myelomonocytic leukemia 20.6 41.6 Others 24 7.2166.5

Table 3.5.1 Morphological Distribution of Leukemia in Saudi Arabia, 2008

P03.indd 44 26-05-2012 6:26:37 PM 4.6 Northern 7.2 4.2 Tabuk 6.4 Madinah 3.3 6.4 3.2 Eastern 6.0 5.0 Hail 3.5 1.1 Jouf 7.3 3.9 Asir 4.3 3.6 Makkah 4.5 4.0 Najran 3.5 2.2 Riyadh 4.6 4.9 Baha 1.6 3.6 Qassim 2.6 2.1 Jazan 1.7

01 2345678 910

Figure 3.5.2 ASR* Regional Distribution of Leukemia in Saudi Arabia, 2008

Norway 9.7 12.2

Wales 6.7 10.4 4.8 Qatar 8.5 4.4 Bahrain 8.3 4.9 Kuwait 7.0 4.6 Jordan 6.8

4.8 Egypt, Gharbiah 6.5 4.4 Hong Kong 5.8 3.8 Oman 5.4 3.2 Saudi Arabia 4.5 4.1 United Arab Emirates 3.5

02468101214

Figure 3.5.3 Comparison of ASR* for Leukemia among Saudis with ASR in Selected Countries**

* ASR Per 100,000 ** Source for this information is summarized on page 64

P03.indd 45 26-05-2012 6:26:37 PM Liver (C 22)

There were 418 cases of liver cancer accounting 2.3/100,000 for females. The five regions with the for 4.7% of all newly diagnosed cases in year highest ASR were Riyadh region at 7.9/100,000, 2008. This cancer ranked fourth in males, Najran region at 6/100,000, Tabuk region at and tenth in females and affected 303 (72.5%) 5/100,000, Qassim region at 4.7/100,000 and males and 115 (27.5%) females with a male to Madinah region at 3.9/100,000. The median age at female ratio of 263:100. The overall ASR was diagnosis was 68 years in males (range 0-100 years) 4.3/100,000. ASR was 6.2/100,000 for males and and 64 years in female (range 0-90 years).

70 male female

30 AIR (per 100,000) 20

0 0- 5- 10- 15- 20- 25- 30- 35-40- 45-50- 55-60- 65-70- 75+ Age Groups

Figure 3.6.1 Age-Specific Incidence Rate (AIR) for Liver Cancer in Saudi Arabia, 2008

ICD-O-3Morphology Male %%Female

8170 Hepatocellular carcinoma, NOS 251 82.8 82 71.3 8000 Neoplasm, malignant 17 5.614 12.2 8140 Adenocarcinoma, NOS 72.3 76.1 8160 Cholangiocarcinoma 72.3 54.3 8010 Carcinoma, NOS 51.7 00.0 8180 Combined hepatocellular carcinoma and cholangiocarcinoma 31.0 21.7 8970 Hepatoblastoma 41.3 10.9 Others 93.0 43.5

Table 3.6.1 Morphological Distribution of Liver Cancer in Saudi Arabia, 2008

19.1% 20.0% 19.4% 32.0% 34.8% 32.8% Distant Localised Regional Unknown 36.0% 39.1% 36.8% 12.9% 6.1% 11.0% Male Female All

Figure 3.6.2 Stage Distribution of Liver Cancer, 2008

P03.indd 46 26-05-2012 6:26:38 PM 4.1 Riyadh 11.7 3.3 Najran 8.7 3.3 Tabuk 6.6 2.0 Qassim 7.3 2.4 Madinah 5.4 1.2 Jouf 6.3 3.0 Eastern 4.1 1.7 Makkah 5.0 1.0 Baha 5.5 1.4 Asir 4.8 0.0 Northern 6.1 0.9 Hail 4.0 2.8 Jazan 0.8

02468 10 12 14

Figure 3.6.3 ASR* Regional Distribution of Liver Cancer in Saudi Arabia, 2008

Hong Kong 7.3 29.5

Egypt, Gharbiah 4.4 21.9

Qatar 7.6 13.9

3.0 Kuwait 7.2

3.6 Bahrain 5.3

2.3 Saudi Arabia 6.2

2.2 Oman 5.7

1.9 United Arab Emirates 3.0 1.2 Norway 2.6

0.8 Algeria, Setif 1.1

0510 15 20 25 30 35

Figure 3.6.4 Comparison of ASR* for Liver Cancer among Saudis with ASR in Selected Countries**

* ASR Per 100,000 ** Source for this information is summarized on page 64

P03.indd 47 26-05-2012 6:26:38 PM Lung (C33-C34)

There were 367 cases of lung cancer accounting The five regions with the highest ASR were for 4.1% of all diagnosed cases in year 2008. Northern region at 9.8/100,000, Eastern region Lung cancer ranked fifth among male population at 8.7/100,000, Tabuk region at 5.5/100,000, and fifteenth among female population. It Makkah region at 4.5/100,000, and Riyadh region affected 285 (77.7%) males and 82 (22.3%) at 4.4/100,000. The median age at diagnosis was females with a male to female ratio of 348:100. 65 years among males (range 26-109 years) and 61 The overall ASR was 3.8/100,000. ASR was years among females (range 20-100 years). 5.8/100,000 for males and 1.7/100,000 for females.

70 male female

30 AIR (per 100,000) 20

0 0- 5- 10- 15- 20- 25- 30- 35-40- 45-50- 55-60- 65-70- 75+ Age Groups

Figure 3.7.1 Age-Specific Incidence Rate (AIR) for Lung Cancer in Saudi Arabia, 2008

ICD-O-3 Morphology Male %%Female

8140 Adenocarcinoma, NOS 69 24.227 32.9 8070 Squamous cell carcinoma, NOS 62 21.889.8 8046 Non-small cell carcinoma 34 11.9911.0 8000 Neoplasm, malignant 26 9.178.5 8041 Small cell carcinoma, NOS 29 10.244.9 8010 Carcinoma, NOS 19 6.756.1 8250 Bronchiolo-alveolar adenocarcinoma, NOS 14 4.989.8 8240 Carcinoid tumor, NOS 41.4 22.4 8480 Mucinous adenocarcinoma 41.4 22.4 8071 Squamous cell carcinoma, keratinizing, NOS 41.4 00.0 Others 20 7.010 12.2

Table 3.7.1 Morphological Distribution of Lung Cancer in Saudi Arabia, 2008

19.3% 19.5% 19.3%

Distant

13.4% 14.2% Localised Regional 14.4% 62.2% Unknown 56.5% 57.8% 9.8% 4.9% 8.7% Male Female All

Figure 3.7.2 Stage Distribution of Lung Cancer, 2008

P03.indd 48 26-05-2012 6:26:38 PM 7.7 Northern 11.8 3.0 Eastern 14.3 0.9 Tabuk 10.0 1.3 Makkah 7.7 2.9 Riyadh 5.8 1.1 Madinah 5.8 2.2 Qassim 2.1 0.6 Hail 2.6 0.0 Najran 2.5 0.0 Jouf 2.5 0.4 Baha 1.6 0.7 Asir 1.2 0.7 Jazan 0.3

02468 10 12 14 16

Figure 3.7.3 ASR* Regional Distribution of Lung Cancer in Saudi Arabia, 2008

23.4 Hong Kong 57.9 28.5 Wales 42.0 12.5 Korea 51.1 25.1 Norway 35.0 10.7 Bahrain 31.1 3.9 Jordan 19.6 4.5 Qatar 18.0 5.0 Kuwait 15.1 3.6 Egypt, Gharbiah 14.0 3.3 United Arab Emirates 9.3 2.0 Oman 7.9 1.7 Saudi Arabia 5.8

01020304050607080

Figure 3.7.4 Comparison of ASR* for Lung Cancer among Saudis with ASR in Selected Countries**

* ASR Per 100,000 ** Source for this information is summarized on page 64

P03.indd 49 26-05-2012 6:26:39 PM Hodgkin disease (C 81)

There were 306 cases of hodgkin disease cancer and 1.5/100,000 for females. The five regions with accounting for 3.5% of all newly diagnosed cases highest ASR were Riyadh region at 2.3/100,000, Asir in year 2008. This cancer ranked seventh among region at 2.2/100,000, Eastern region at 2/100,000, male and eighth in female population. It affected Jouf at 1.9/100,000 and Tabuk region at 1.7/100,000 175 (57.2%) males and 131 (42.8%) females with a for each. The median age at diagnosis was 23 years male to female ratio of 134:100. The overall ASR (range 3-86 years) in males and 23 year in females was 1.7/100,000. ASR was 1.9/100,000 for males (range 3-80).

7 male female

3 AIR (per 100,000) 2

0 0- 5- 10- 15- 20- 25- 30- 35-40- 45-50- 55-60- 65-70- 75+ Age Groups

Figure 3.8.1 Age-Specific Incidence Rate (AIR) for Hodgkins disease in Saudi Arabia, 2008

ICD-O-3MorphologyMale%Female %

9663 Hodgkin lymphoma, nodular sclerosis, NOS 80 45.773 55.7 9652 Hodgkin lymphoma, mixed cellularity, NOS 35 20.019 14.5 9650 Hodgkin lymphoma, NOS 18 10.3139.9 9665 Hodgkin lymphoma, nodular sclerosis, grade 1 95.1 96.9 9659 Hodgkin lymphoma, nodular lymphocyte predominance 14 8.032.3 9651 Hodgkin lymphoma, lymphocyte-rich 84.6 43.1 9653 Hodgkin lymphoma, lymphocyte depletion, NOS 42.3 53.8 9667 Hodgkin lymphoma, nodular sclerosis, grade 2 31.7 43.1 9664 Hodgkin lymphoma, nodular sclerosis, cellular phase 31.7 10.8 9662 Hodgkin sarcoma 10.6 00.0

Table 3.8.1 Morphological Distribution of Hodgkins disease in Saudi Arabia, 2008

7.4% 19.1% 12.4% 34.4% 38.2% 41.1% Distant Localised 26.5% Regional 26.0% 26.9% Unknown 20.6% 22.9% 24.6% Male Female All

Figure 3.8.2 Stage Distribution of Hodgkins disease, 2008

P03.indd 50 26-05-2012 6:26:39 PM 1.9 Riyadh 2.7 2.7 Asir 1.7 1.9 Eastern 2.0 0.5 Jouf 3.2 0.9 Tabuk 2.5 1.6 Qassim 1.7 1.1 Makkah 1.8 1.3 Madinah 1.6 0.8 Hail 1.2 0.0 Najran 1.9 1.0 Jazan 0.5 1.0 Baha 0.4 0.7 Northern 0.7

01234

Figure 3.8.3 ASR* Regional Distribution of Hodgkins disease in Saudi Arabia, 2008

Qatar 1.8 3.9

Kuwait 2.0 3.3

Norway 1.5 2.9

Bahrain 1.8 2.0

Egypt, Gharbiah 1.2 2.5 1.2 Oman 2.4

1.5 Saudi Arabia 1.9

1.4 United Arab Emirates 1.8

0.6 Singapore 0.9

0.2 Korea 0.4

01234 5

Figure 3.8.4 Comparison of ASR* for Hodgkins disease among Saudis with ASR in Selected Countries**

* ASR Per 100,000 ** Source for this information is summarized on page 64

P03.indd 51 26-05-2012 6:26:39 PM Skin (Non-Melanoma) (C 44)

There were 284 cases of skin cancer accounting The five regions with the highest ASR were Tabuk for 3.2% of all newly diagnosed cases in year 2008. region at 4.1/100,000, Asir region at 3.7/100,000, This cancer ranked tenth for males and ninth for Jouf region at 3.3/100,000, Najran region at females. It affected 159 (56%) males and 125 (44%) 3/100,000 and Riyadh region at 3/100,000. The females with a male to female ratio of 127:100. median age at diagnosis was 64 years among males The overall ASR was 2.7/100,000. ASR was (range 10-102 years) and 66 years among female 3/100,000 for male and 2.4/100,000 for females. (range 11-91 years).

40 male female

15 AIR (per 100,000) 10

0 0- 5- 10- 15- 20- 25- 30- 35-40- 45-50- 55-60- 65-70- 75+ Age Groups

Figure 3.9.1 Age-Specific Incidence Rate (AIR) for Skin Cancer in Saudi Arabia, 2008

ICD-O-3 Morphology Male %%Female

8090 Basal cell carcinoma, NOS 58 36.564 51.2 8070 Squamous cell carcinoma, NOS 42 26.426 20.8 8832 Dermatofibrosarcoma, NOS 18 11.386.4 8071 Squamous cell carcinoma, keratinizing, NOS 63.8 43.2 8094 Basosquamous carcinoma 53.1 43.2 8097 Basal cell carcinoma, nodular 53.1 43.2 8410 Sebaceous adenocarcinoma 42.5 21.6 8051 Verrucous carcinoma, NOS 53.1 00.0 8091 Multifocal superficial basal cell carcinoma 21.3 32.4 8000 Neoplasm, malignant 10.6 21.6 8076 Squamous cell carcinoma, microinvasive 21.3 10.8 8092 Infiltrating basal cell carcinoma, NOS 21.3 10.8 Others 95.7 64.8 Table 3.9.1 Morphological Distribution of Skin Cancer in Saudi Arabia, 2008

0.6% 3.2% 1.8% 13.6% 15.1% 17.0% 7.2% Distant 8.8% 8.1% Localised Regional Unknown 73.6% 76.0% 74.6% Male Female All

Figure 3.9.2 Stage Distribution of Skin Cancer, 2008

P03.indd 52 26-05-2012 6:26:40 PM 1.1 Tabuk 7.0 3.3 Asir 4.0 1.3 Jouf 5.2 3.5 Najran 2.5 3.1 Riyadh 2.9 2.1 Hail 3.3 1.4 Eastern 3.9 2.7 Makkah 2.4 Northern 5.1 0.0 1.7 Qassim 2.8 1.7 Madinah 2.2 Jazan 2.0 1.4 Baha 1.3 1.2

012345678910

Figure 3.9.3 ASR* Regional Distribution of Skin Cancer in Saudi Arabia, 2008

Austria 16.3 24.2

Norway 10.9 15.5 4.5 Algeria, Setif 7.7 5.0 Qatar 6.4

2.5 Egypt, Gharbiah 6.8 3.0 Oman 4.0 2.5 United Arab Emirates 4.0 2.0 Bahrain 3.6 2.4 Saudi Arabia 3.0 1.9 Korea 2.6 1.4 Kuwait 1.4

0510 15 20 25 30

Figure 3.9.4 Comparison of ASR* for Skin Cancer among Saudis with ASR in Selected Countries**

* ASR Per 100,000 ** Source for this information is summarized on page 64

P03.indd 53 26-05-2012 6:26:40 PM Prostate (C 61)

There were 267 cases of prostate cancer accounting were Eastern region at 10.5/100,000, Riyadh for 6.3% of all newly diagnosed cases among males region at 9.4/100,000, Baha region at 6.3/100,000, in year 2008. This cancer ranked sixth among Northern region at 5.7/100,000 and Makkah males. The ASR was 5.7/100,000 among male region at 5/100,000. The median age at population. The five regions with the highest ASR diagnosis was 70 years (range 41-107 years).

30 AIR (per 100,000) 20

0 0- 5- 10- 15- 20- 25- 30- 35-40- 45-50- 55-60- 65-70- 75+ Age Groups

Figure 3.10.1 Age-Specific Incidence Rate (AIR) for Prostate Cancer in Saudi Arabia, 2008

ICD-O-3MorphologyMale%

8140 Adenocarcinoma, NOS 236 88.4 8010 Carcinoma, NOS 11 4.1 8000 Neoplasm, malignant 93.4 8550 Acinar cell carcinoma 62.2 8041 Small cell carcinoma, NOS 31.1 8020 Carcinoma, undifferentiated, NOS 10.4 8120 Transitional cell carcinoma, NOS 10.4

Table 3.10.1 Morphological Distribution of Prostate Cancer in Saudi Arabia, 2008

12.4% 27.7% 8.6% Distant Localised Regional Unknown

51.3% Male

Figure 3.10.2 Stage Distribution of Prostate Cancer in Saudi Arabia, 2008

P03.indd 54 26-05-2012 6:26:41 PM Eastern 10.5

Riyadh 9.4

Baha 6.3

Northern 5.7

Makkah 5.0

Tabuk 4.9

Jouf 4.6

Madinah 4.1

Asir 3.6

Qassim 2.6

Najran 2.2

Hail 1.9

Jazan 1.1

02468 10 12

Figure 3.10.3 ASR* Regional Distribution of Prostate Cancer in Saudi Arabia, 2008

Norway 16.8

Hong Kong 15.0

Bahrain 14.6

13.3 Kuwait 11.5 Jordan 10.0 Qatar 8.5 Egypt, Gharbiah 8.5 Oman 8.4 United Arab Emirates 7.5

Saudi Arabia 5.7

China, Jiashan 1.4

02468101214161820

Figure 3.10.4 Comparison of ASR* for Prostate Cancer among Saudi males with ASR in Selected Countries**

* ASR Per 100,000 ** Source for this information is summarized on page 64

P03.indd 55 26-05-2012 6:26:41 PM Corpus uteri (C 54)

There were 194 cases of corpus uteri cancer region at 6.3/100,000, Eastern region at among females accounting for 4.2 % of all newly 5.4/100,000, Makkah region at 5.2/100,000, diagnosed cases for females (4,617) in year 2008. Northern region at 5.1/100,000 and Riyadh This cancer ranked sixth among female population. region at 4.3/100,000. The median age at The ASR was 4/100,000 for female population. diagnosis was 59 years (range 21-90 years). The five regions with the highest ASR were Tabuk

15 AIR (per 100,000) 10

0 0- 5- 10- 15- 20- 25- 30- 35-40- 45-50- 55-60- 65-70- 75+ Age Groups

Figure 3.11.1 Age-Specific Incidence Rate (AIR) for Corpus uteri Cancer in Saudi Arabia, 2008

ICD-O-3 Morphology Female %

8380 Endometrioid adenocarcinoma, NOS 119 61.3 8140 Adenocarcinoma, NOS 26 13.4 8950 Mullerian mixed tumor 63.1 8980 Carcinosarcoma, NOS 63.1 8010 Carcinoma, NOS 52.6 8460 Papillary serous cystadenocarcinoma 52.6 8890 Leiomyosarcoma, NOS 52.6 8310 Clear cell adenocarcinoma, NOS 42.1 8441 Serous cystadenocarcinoma, NOS 42.1 8931 Endometrial stromal sarcoma, low grade 31.5 Others 11 5.7

Table 3.11.1 Morphological Distribution of Corpus uteri Cancer in Saudi Arabia, 2008

8.2% 17.0% Distant 18.6% Localised Regional Unknown

56.2% Female

Figure 3.11.2 Stage Distribution of Corpus uteri Cancer, 2008

P03.indd 56 26-05-2012 6:26:41 PM Tabuk 6.3

Eastern 5.4

Makkah 5.2

Northern 5.1

Riyadh 4.3

Hail 3.8

Baha 3.0

Madinah 3.0

Jazan 2.8

Najran 2.7

Asir 2.4

Jouf 1.1

Qassim 1.1

01234 5678

Figure 3.11.3 ASR* Regional Distribution of Corpus uteri Cancer in Saudi Arabia, 2008

Norway 17.4

Wales 15.6

Qatar 9.6

Kuwait 6.2

Bahrain 6.1

Saudi Arabia 4.0

United Arab Emirates 3.3

Korea 2.9

Egypt, Gharbiah 2.6

Oman 1.5

Algeria, Setif 1.1

02468101214161820

Figure 3.11.4 Comparison of ASR* for Corpus uteri Cancer among Saudi females with ASR in Selected Countries**

* ASR Per 100,000 ** Source for this information is summarized on page 64

P03.indd 57 26-05-2012 6:26:41 PM Bladder (C 67)

There were 211 cases of bladder cancer accounting and 0.8/100,000 for females. The five regions with for 2.4% of all newly diagnosed cases in year 2008. the highest ASR were Tabuk region at 3.9/100,000, This cancer ranked eighth among male population Eastern region at 3.6/100,000, Northern region and 23rd among female population. It affected 173 at 3.5/100,000, Riyadh region at 3/100,000 and (82%) males and 38 (18%) females with a male Makkah region at 2.1/100,000. The median age at to female ratio of 455:100. The overall ASR was diagnosis was 65 among males (range 6-108 years) 2.2/100,000. ASR was 3.6/100,000 for males and 69 among females (range 21-90 years).

35 male female

15 AIR (per 100,000) 10

0 0- 5- 10- 15- 20- 25- 30- 35-40- 45-50- 55-60- 65-70- 75+ Age Groups

Figure 3.12.1 Age-Specific Incidence Rate (AIR) for Bladder Cancer in Saudi Arabia, 2008

ICD-O-3 Morphology Male %%Female

8120 Transitional cell carcinoma, NOS 74 42.817 44.7 8130 Papillary transitional cell carcinoma 73 42.215 39.5 8000 Neoplasm, malignant 63.5 12.6 8070 Squamous cell carcinoma, NOS 42.3 25.3 8010 Carcinoma, NOS 42.3 00.0 8071 Squamous cell carcinoma, keratinizing, NOS 31.7 12.6 8041 Small cell carcinoma, NOS 31.7 00.0 Others 63.5 25.3

Table 3.12.1 Morphological Distribution of Bladder Cancer in Saudi Arabia, 2008

12.7% 18.5% 21.1% 18.4% 14.2% 18.5%

Distant 14.5% 16.6% Localised Regional

26.3% 34.2% Unknown 54.3% 50.7% Male Female All

Figure 3.12.2 Stage Distribution of Bladder Cancer, 2008

P03.indd 58 26-05-2012 6:26:42 PM 2.5 Tabuk 5.3 1.1 Eastern 6.1 0.0 Northern 7.0 0.8 Riyadh 5.1 0.6 Makkah 3.5 3.8 Najran 0.0 0.6 Madinah 2.5 0.5 Asir 2.5 0.8 Jazan 2.1 0.0 Baha 2.8 0.7 Qassim 1.7 0.0 Hail 1.2 0.0 Jouf 1.1

012345678

Figure 3.12.3 ASR* Regional Distribution of Bladder Cancer in Saudi Arabia, 2008

Egypt, Gharbiah 5.4 27.9

Scotland 7.5 23.4

Bahrain 3.2 13.8

Wales 3.7 12.9 1.9 Qatar 11.6

1.6 Korea 9.1

3.0 Kuwait 7.2

1.9 United Arab Emirates 5.4

2.2 Oman 4.8

0.8 Saudi Arabia 3.6

0510 15 20 25 30 35

Figure 3.12.4 Comparison of ASR* for Bladder Cancer among Saudis with ASR in Selected Countries**

* ASR Per 100,000 ** Source for this information is summarized on page 64

P03.indd 59 26-05-2012 6:26:42 PM Stomach (C 16)

There were 266 cases of stomach cancer accounting 1.9/100,000 for females. The five regions with the for 3% of all newly diagnosed cases in year 2008. highest ASR were Eastern region at 3.7/100,000, This cancer ranked ninth among male population Najran region at 3.3/100,000, Northern region at and eleventh among female population. It affected 3.1/100,000, Makkah regions at 2.9/100,000 and 166 (62.4%) males and 100 (37.6%) females with a Tabuk region at 2.8/100,000. The median age at male to female ratio of 166:100. The overall ASR was diagnosis was 63 years among males (range 18-97 2.6/100,000. ASR was 3.2/100,000 for male and years) and 62 years among female (range 24-93 years).

40 male female

20 15 AIR (per 100,000) 10

0 0- 5- 10- 15- 20- 25- 30- 35-40- 45-50- 55-60- 65-70- 75+ Age Groups

Figure 3.13.1 Age-Specific Incidence Rate (AIR) for Stomach Cancer in Saudi Arabia, 2008

ICD-O-3 Morphology Male %%Female

8140 Adenocarcinoma, NOS 86 51.830 30.0 8490 Signet ring cell carcinoma 37 22.335 35.0 8144 Adenocarcinoma, intestinal type 15 9.077.0 8145 Carcinoma, diffuse type 53.0 33.0 8936 Gastrointestinal stromal sarcoma 21.2 66.0 8000 Neoplasm, malignant 31.8 44.0 8480 Mucinous adenocarcinoma 21.2 55.0 8481 Mucin-producing adenocarcinoma 10.6 33.0 8070 Squamous cell carcinoma, NOS 21.2 11.0 8240 Carcinoid tumor, NOS 21.2 11.0 Others 11 6.655.0

Table 3.13.1 Morphological Distribution of Stomach Cancer in Saudi Arabia, 2008

7.8% 9.0% 8.3% 28.3% 32.3% Distant 39.0% 30.0% Localised 36.1% Regional 39.8% Unknown 24.1% 22.0% 23.3% Male Female All

Figure 3.13.2 Stage Distribution of Stomach Cancer, 2008

P03.indd 60 26-05-2012 6:26:43 PM 2.7 Eastern 4.7 2.8 Najran 3.7 4.7 Northern 1.4 1.9 Makkah 3.9 1.0 Tabuk 4.5 1.9 Asir 3.5 2.1 Jouf 3.0 2.2 Riyadh 2.7 1.6 Jazan 3.0 1.0 Qassim 2.7 1.2 Madinah 2.4 0.4 Baha 2.3 1.1 Hail 1.0

012 3456

Figure 3.13.3 ASR* Regional Distribution of Stomach Cancer in Saudi Arabia, 2008

7.3 Hong Kong 14.7 5.8 Oman 10.5

Wales 4.1 9.6 4.7 Bahrain 6.8 5.5 Qatar 5.9 3.5 Norway 7.0 4.4 Jordan 5.9 3.1 Algeria, Setif 7.1 3.5 United Arab Emirates 6.5 2.1 Kuwait 4.0 1.7 India, New Delhi 3.4 1.9 Saudi Arabia 3.2

0246810121416

Figure 3.13.4 Comparison of ASR* for Stomach Cancer among Saudis with ASR in Selected Countries**

* ASR Per 100,000 ** Source for this information is summarized on page 64

P03.indd 61 26-05-2012 6:26:44 PM Ovarian Cancer (C 56)

There were 160 cases of ovarian cancer among regions with the highest ASR were Riyadh region females accounting for 3.5% of all newly diagnosed at 4.5/100,000, Baha region at 4.2/100,000, Makkah cases among females (4,617) in year 2008. This region at 3.5/100,000, Asir region at 3/100,000, cancer ranked seventh among female population. and Jouf region at 2.8/100,000. The median age at The ASR was 3/100,000 for females. The five diagnosis was 55 years (range 0-86 years).

AIR (per 100,000) 10

0 0- 5- 10- 15- 20- 25- 30- 35-40- 45-50- 55-60- 65-70- 75+ Age Groups

Figure 3.14.1 Age-Specific Incidence Rate (AIR) for Ovarian Cancer in Saudi Arabia, 2008

ICD-O-3 Morphology Female %

8441 Serous cystadenocarcinoma, NOS 32 20.0 8460 Papillary serous cystadenocarcinoma 23 14.4 8010 Carcinoma, NOS 15 9.4 8140 Adenocarcinoma, NOS 15 9.4 8480 Mucinous adenocarcinoma 11 6.9 8461 Serous surface papillary carcinoma 10 6.3 8470 Mucinous cystadenocarcinoma, NOS 85.0 8000 Neoplasm, malignant 63.8 9071 Yolk sac tumor 63.8 8380 Endometrioid adenocarcinoma, NOS 53.1 9080 Teratoma, malignant, NOS 53.1 8310 Clear cell adenocarcinoma, NOS 42.5 9060 Dysgerminoma 42.5 8260 Papillary adenocarcinoma, NOS 21.3 8620 Granulosa cell tumor, malignant 21.3 8980 Carcinosarcoma, NOS 21.3 Others 10 6.3

Table 3.14.1 Morphological Distribution of Ovarian Cancer in Saudi Arabia, 2008

8.1%

15.0% Distant Localised 59.4% Regional

17.5% Unknown

Female

Figure 3.14.2 Stage Distribution of Ovarian Cancer, 2008

P03.indd 62 26-05-2012 6:26:44 PM Riyadh 4.5

Baha 4.2

Makkah 3.5

Asir 3.0

Jouf 2.8

Madinah 2.6

Eastern 2.1

Qassim 2.0

Tabuk 1.9

Northern 1.3

Hail 1.2

Jazan 1.1

Najran 1.1

01 23456

Figure 3.14.3 ASR* Regional Distribution of Ovarian Cancer in Saudi Arabia, 2008

Wales 14.2

Denmark 12.3

Austria 11.3

Norway 10.9

Bahrain 7.4

Qatar 7.2

Hong Kong 5.5

Kuwait 5.1

Oman 4.5

United Arab Emirates 4.2

Saudi Arabia 3.0

Algeria, Setif 2.1

0246810121416

Figure 3.14.4 Comparison of ASR* for Ovarian Cancer among Saudi Females with ASR in Selected Countries**

* ASR Per 100,000 ** Source for this information is summarized on page 64

P03.indd 63 26-05-2012 6:26:44 PM ** Sources:

1 Welsh Cancer and Intelligence and Surveillance Unit (WCISU). Trends in Incidence, 1985-2009. Available from: http://www.wales.nhs.uk/sites3/page.cfm?orgid=242&pid=27758

2 Cancer Incidence, Mortality, Survival and Prevalence in Norway. Cancer in Norway, 2009.

3 Cancer Incidence in Jordan, 2008

4 Ten-Year Cancer Incidence among Nationals of the GCC States 1998-2007.

5 Descriptive Epidemiology Group, IARC. GLOBOCAN 2002. Available from.: http://www-dep.iarc.fr/

6 Cancer Incidence in Five Continents Vol. IX, IARC Scientiﬁc Publication. Lyon, France, 2007

P03.indd 64 26-05-2012 6:26:45 PM PART IV CANCER AMONG NON-SAUDIS 2008

P04.indd 65 26-05-2012 6:28:02 PM P04.indd 66 26-05-2012 6:28:02 PM Cancer Among Non- Saudi Population 2008

Between January and December 2008, a total that cancer is primarily a disease of the elderly, the of 2,701 cancer cases were reported among the pattern of cancer had some significant differences. Non-Saudi population. Eighty one in situ cases Those over 60 years represented 20% and the 20 and 12 were ICD-O-3 coded cases that failed to to 54 age-group represented 60% of non-Saudi convert to ICD-10 codes as described in the data population. During 2008, approximately 5% of Management (see page 12). This puts the total all cancers occurred before the age of 15, 23.2% number of exclusions from the analysis as 93 cases. occurred between the ages 15 to 39 years, 57.6% As a result, the total number of cases analyzed were were between the ages 40-64, and 14.2% occured 2,608 out of this 1422 (54.5%) were males and after the age of 64. The median age at diagnosis 1,186 (45.5%) were females. The male to female was 51 years in males (range 0-90 years) and 46 ratio was 120:100. Taking into consideration the years in females (range 0-95 years). population structure of non-Saudis and the fact

Cancer No. % Breast 44016.9 Colo-rectal 28510.9 NHL 166 6.4 Leukemia 157 6.0 Skin 127 4.9 Thyroid 121 4.6 Lung 102 3.9 Prostate 92 3.5 Stomach 89 3.4 Liver 72 2.8

Table 4.1 Ten Most common Cancers among non-Saudis, 2008 Nationality Male %Female% All% Yemen 258 17.4181 14.8 43916.3 Egypt 176 11.9123 10.1 29911.1 Sudan 1288.6 1159.4 2439.0 Philippines 1057.1 13711.2242 9.0 Pakistan 1087.3 64 5.3172 6.4 India 92 6.2352.9 1274.7 Syrian Arab Republic 72 4.9473.9 1194.4 Bangladesh 81 5.5171.4 98 3.6 Palestine533.6 56 4.6109 4.0 Indonesia 15 1.0645.3 79 2.9 Jordan 40 2.7312.5 71 2.6 Bahrain 22 1.5463.8 68 2.5 United States of America342.3 15 1.2491.8 Eritrea 16 1.1322.6 48 1.8 Ethiopia 17 1.1312.5 48 1.8 Somalia 21 1.4231.9 44 1.6 Afghanistan 25 1.7151.2 40 1.5 Nigeria 21 1.4161.3 37 1.4 Lebanon 24 1.6100.8 34 1.3 United Kingdom 19 1.3100.8 29 1.1 Chad 12 0.8161.3 28 1.0 Kuwait 90.6 18 1.5271.0 Qatar 40.3 60.5 10 0.4 United Arab Emirates 10.1 20.2 30.1 Oman 10.1 10.1 20.1 Iraq 50.3 40.3 90.3 Other Nationalities123 8.3104 8.5227 8.4

Table 4.2 Distribution of Cancer Cases among Different Nationalities in Order of Relative Frequency, 2008

P04.indd 67 26-05-2012 6:28:03 PM Male 1422 Female 1186

Colo-rectal 206 14.5% Breast 427 36.0% NHL 108 7.6% Colo-rectal 79 6.7% Leukemia 93 6.5% Thyroid 71 6.0% Prostate 92 6.5% Leukemia 64 5.4% Skin 89 6.3% NHL 58 4.9% Lung 85 6.0% Cervix Uteri 54 4.6% Stomach 71 5.0% Ovary 43 3.6% Bladder 56 3.9% Corpus uteri 42 3.5% Liver 53 3.7% Skin 38 3.2% Thyroid 50 3.5% Brain, CNS 23 1.9%

Figure 4.1 Ten Most Common Cancer among non-Saudis by sex, 2008

800

700 male female

600

500

400

300 AIR (per 100,000) 200

100

0 0- 5- 10- 15- 20- 25- 30- 35-40- 45-50- 55-60- 65-70- 75+ Age Groups

Figure 4.2 Age-Specific Incidence Rate (AIR) for All Cancers among non-Saudis in Saudi Arabia, 2008

P04.indd 68 26-05-2012 6:28:03 PM PART V TABLES

P05.indd 69 26-05-2012 6:30:32 PM ---- - .7 % .9 % .4 % .0 % .9 % .1 % .1 % .8 % .5 % .2 % .2 % .4 % .3 % .3 % .7 % .8 % .4 % .1 % .0 % .1 % .1 % .7 % .7 % 3.4% 0.1% 0.1% 0.0% 1.2% 3.9% 0.7% 1.3% 1.3% 6.7% 0.3% 0.4% 1.6% 0.4% 6.3% 1.7% 0.0% 0.6% 3.7% 0.3% 0.2% 8.7% 0.0% 0.9% 3.3% 0.9% 0.2% 4.1% 6.2% 00.0 % % of Total 50 60 40 00 42 00 00 10 00 00 31 40 00 00 83 16 64 07 02 13 44 23 03 39 18 19 46 15 12 66 96 10 44 5+ ---- 70 74 41 31 64 35 19 34 24 42 07 22 10 15 36 50 35 10 93 06 ------70-7 47 41 82 02 14 11 42 72 05 21 17 44 50 30 13 ---- 41 53 43 64 5-6 9 66 62 13 05 92 78 61 92 01 71 21 41 38 27 04 23 ------0-6 46 6967 71 71 42 03 64 21 31 52 11 0977 10 26 29 15 27 ---- 32 04 33 24 5-5 96 31 71 04 52 01 91 01 32 10 11 17 13 10 35 10 27 29 39 ------0-5 45 81 13 22 21 41 31 82 2887 13 29 17 25 ---- 26 13 27 33 5-4 95 31 81 71 51 45983133 71 62 05 51 10 13 11 25 74 82 ------40-4 44 91 91 71 13 16 14 15 23 10 ---- 17 71 18 01 35-3 9 9956410001 11 15 14 11 19 13 38 46 ------0-3 4 11 12 12 18 12 ---- 13 11 13 61 5-2 93 41 15 10 28 14 30 33 ------20-2 42 876111320023 5767303117 29 16 12 51 12 61 ----- 5-19 8459 81 2599 11 21 13 02 05 ----- 15-1 91 400214 21 61 61 11 21 12 19 5-9 ----- 0001000001000003 0000000000000210 0000001000000001 0002222569 0001100001544636 0001 50111124 0000113287 0000100035 00000231 0000100010311221 00313583 0000000201202325 6464455531516263 0000001102212305 0000000035 3108 0000000000000010 0103 8101110010000001 0016100100000000 0000000000000000 0000110141346349 4442320000503246 40011113 0000001000000116 7112000110100102 72 14 25 16 14 0-4 17 39 17 39 ----- 0010021033 1000016002422384 0001001111010214 0000000000011000 0000000120110000 0000000100001010 0000001101255548 0000000010113111 0000001232635944 0012000121202111 0001211101100120 05 31 0000101101111311 0000000000000021 0000000000000000 01 0000100000645153 00021514 00000262 05 04 ----- ge Unk 50 30 20 10 90 00 90 10 70 20 70 60 70 40 40 70 90 39 17 51 10 54 14 11 73 16 27 30 73 22 92 75 57 16 60 28 60 30 10 00 28 50 15 90 26 70 14 40 15 80 13 10 13 90 15 60 37 00 07 21 23 11 ----- ll Age sA d3 d3 a1 l0 n1 a3 e1 e3 a1 d1 x1 x5 r1 outh elanoma of Ski esotheliom ultiple Myelom yeloid Leukemia ther Oropharyn x2 esophagus allbladder etc. ther Thoracic organs ther Skin ther male genita ther Urinary organs ther Endocrine enal Pelvis reter asopharyn ypopharyn olon ectu m1 ose, sinuses etc. odgkin diseas on-Hodgkin lymphoma ll sites but C4 44 it eA ladde ll sites Tota l4 alivary glands harynx unspecifie tomach nus ancreas one aposi sarcoma reas t1 eni s3 rostate idney ye rain, Nervous system drenal glan onsil rachea, Bronchus, Lung esti s7 hyroid ongue iver aryn x5 ymphoid Leukemi eukemia unspecifie ip mmunoproliferative dis. Small intestin Connective, Soft tissu e6 Other & unspecified 6N 6M 8S 3H 0R 4G 1N 4T 8O 1B 2B 4M 2T Not C4 4A ICD (10th )S C6 5R C6 6U C6 7B Al lA C03-C0 C07-C0 C0 9T C1 0O C1 1N C12-C1 C1 4P C1 5O C1 6S C17 C1 8C C19-C2 C2 1A C2 2L C23-C2 C2 5P C30-C3 C3 2L C33-C3 C37-C3 C40-C4 C4 3M C4 4O C4 5M C4 6K C47;C49 C5 0B C6 0P C6 1P C6 2T C6 3O C6 4K C6 8O C6 9E C70-C7 C7 3T C7 4A C7 5O C8 1H C8 8I C9 0M C9 1L C92-C9 C9 5L Other C0 0L C01-C0 C82-C85;C9 Table 5.1.1 Age Distribution of Cancer Cases among Saudi Males, 2008 Distribution of Cancer Cases among Saudi Males, Age 5.1.1 Table

P05.indd 70 26-05-2012 6:30:32 PM ----- .2 % .2 % .9 % .5 % .8 % .7 % .5 % .0 % .8 % .0 % .6 % 5.0% 7.3% 0.3% 0.0% 1.0% 0.0% 0.1% 0.4% 1.7% 0.2% 1.0% 2.5% 0.1% 1.0% 1.2% 0.0% 0.7% 3.6% 0.0% 0.6% 0.3% 0.2% 0.1% 0.2% 0.1% 0.3% 0.0% 0.0% 0.4% 0.5% 2.4% 2.3% 0.1% 0.5% 0.1% 3.3% 0.0% 0.1% 2.8% 0.0% 2.0% 4.2% 0.0% 0.3% 00.0 % 10.3 % % of Total 09 41 62 15 41 02 22 43 00 76 71 32 32 16 27 43 18 19 19 5+ 44 01 41 ----- 53 11 55 53 61 63 41 81 62 95 25 10 10 15 19 10 12 20 14 ----- 70-7 47 54 21 11 14 23 31 72 54 12 15 29 12 16 27 15 36 23 35 03 ----- 5-69 21 61 51 06 82 04 11 16 22 94 78 12 17 11 22 30 22 ----- 60-6 46 01 01 32 02 82 63 91 79 91 15 14 20 25 17 10 17 41 33 40 43 ----- 5-59 13 03 61 41 81 91 57 50 38 12 10 13 20 11 29 38 ----- 50-5 45 19 33 32 65 91 24 18 24 54 19 51 49 14 48 34 ----- 5-49 93 29 02 91 96545246 84 45 36 12 11 10 10 64 ----- 40-4 44 62 32 61 331314724 11 70 14 71 33 84 33 14 ----- 35-3 9 41 71 50 50 84 11 60 ----- 0-34 08 21 39 46 52 21 42 21 22 ----- 25-2 93 02 22 411122331010 27 132 130 ----- 20-24 13 22346 0001000000211 4436446 81 8331221623435 0002000000000 10 19 102 100 ----- 15-19 4 12 0 1 46 91 0 62 61 ----- 15-19 34 71 67 67 5-9 ----- 72 10 21 81 05 10 0000010130210242 0000000000000000 0000000001001010 1000124211211002 00001001230346 0000000011011100 5436181126432512 0000000000000000 0000000000000000 000004 0000000100211011 0000010011002001 0000000211000010 0001212321000000 0000000000000100 0000000000000010 0000000010020110 0000000000020111 0000000000011000 0-4 132 132 ----- 000000011268774 00010000000000000 00011224845433323 00000001255 00012220798 00000001156 00000212138 00000101110002103 000019 060111122 00000011124682876 0000207 01101202065 0396 01 01 01 03 01 07244211110024101 012337755 00000001122673133 0000014568678 00000010002122114 000003237 02002200101110001 0013 0565 00000000103331653 0 000002251 00000020121442222 00000000001000001 00000010000102100 02 51 00000000000000000 01 0 ----- Age Unk 60 80 80 40 30 20 00 30 50 00 00 70 60 50 10 10 50 50 20 54 45 67 77 82 10 46 47 93 17 92 31 29 14 11 25 22 13 125 165 274 115 112 104 160 100 152 475 304 194 131 ----- 1152 4617 4492 All Ages .0 e5 d1 s1 a2 x1 i9 r3 ll sites Total Pharynx unspecifie Oesophagus Hypopharyn Nasopharynx Other Oropharynx Tonsil Pancreas Other Skin Salivary gland Gallbladder etc. Trachea, Bronchus, Lung Melanoma of Skin Breast Bladde Other & unspecified Cervix Uter Mouth Colon Liver Larynx Bone Connective,Soft tissu Kidney Ureter Eye Brain, Nervous system Lymphoid Leukemia Myeloid Leukemia Leukemia unspecified Vagina Ovary Tongue Stomach Small intestine Rectum Anus Nose, sinuses etc. Other Thoracic organs Mesotheliom Kaposi sarcoma Other Female Genita l5 Placent a1 Renal Pelvis Other Urinary organs Thyroid Non-Hodgkin lymphoma Immunoproliferative dis Multiple Myeloma Vulva Corpus Uteri Uterus unspecified Lip Hodgkin disease Site Adrenal gland Other Endocrine All sites but C44 C14 C15 C12-C13 C11 C10 C09 C25 C44 C07-C08 C23-C24 C33-C34 C43 C50 C67 Other C53 C03-C06 C18 C22 C32 C40-C41 C47;C49 C64 C66 C69 C70-C72 C91 C92-C94 C95 C52 C56 C01-C02 C16 C17 C19-C20 C21 C30-C31 C37-C38 C45 C46 C57 C58 C65 C68 C73 C82-C85;C96 C88 C90 Al lA C51 C54 C55 C00 C81 ICD (10th) C74 C75 Not C44 Table 5.1.2 Age Distribution of Cancer Cases among Saudi Females, 2008 Distribution of Cancer Cases among Saudi Females, Age 5.1.2 Table

P05.indd 71 26-05-2012 6:30:32 PM 1 2 3 2 1 6 0 .1 .2 .2 .3 .3 .3 .3 .9 .9 .6 5. 3 3. 7 0. 1 0. 6 0. 2 0. 1 3. 2 6. 2 0. 2 0. 8 0. 2 0. 9 2. 5 0. 1 3. 6 2. 1 3. 1 0. 1 5. 8 0. 8 0. 1 0. 7 0. 3 0. 1 5. 7 0. 2 0. 6 0. 7 ---- - 71. 1 74. 1 SR World 00 32 10 10 61 20 20 20 30 91 72 51 40 .1 .1 .1 .3 .2 .2 .8 .6 .1 .7 .4 .6 .3 .1 .8 .1 .7 .6 .1 .9 .7 .1 .7 .1 .8 .4 .2 .9 .1 .3 .4 1. 0. 0. 0. 1. 0. 0. 0. 0. 1. 1. 0. ----- 44.7 46.4 Crude Rat eA 00 50 00 00 00 00 0 00 00 0 00 0 00 50 50 51 53 .5 .8 .2 .3 .2 .7 .3 .8 10 10 ---- 0. 80 6. 71 2. 50 0. 80 2. 50 2. 50 8. 31 0. 80 7. 50 3. 30 4. 20 0. 80 586 621 75+ 42. 53 21. 72 38. 41 12. 50 16. 71 34. 21 15. 80 75. 13 36. 71 36. 74 33. 41 80. 12 04 01 4 .3 .1 .6 .4 .3 .2 .5 .6 .3 .1 .1 .4 .4 .1 .1 .3 .4 3. 32 1. 10 2. 24 4.4 1. 13 4. 45 8.7 428 442 ------25.1 26.1 16.3 13.1 14.2 44.7 10. 91 28.3 38.1 10. 93 10. 95 39. 25 54.5 70-74 00 01 .9 .9 .8 .8 .9 .8 .5 .9 .9 .8 .8 ---- 5. 63 0. 91 6. 67 9. 45 1. 90 1. 93 1. 92 1. 96 5. 67 5.6 0. 90 1. 91 2. 84 0. 94 1. 91 0. 91 4. 73 7. 54 389 409 28.1 25.3 15.9 11.3 19.7 47.8 26.3 28.1 12. 23 13. 12 41.3 46.9 65-69 00 0000 0000 .6 .6 .8 .4 .6 .6 .9 .8 .5 .9 .9 .3 .6 .9 1. 90 0. 60 1. 32 5. 83 1. 90 1. 32 1. 91 4. 53 3. 23 260 272 ------19.9 12.2 13.5 10.9 12.2 25.7 10. 97 16.7 17.4 16.7 26.4 24.4 60-64 10 00 00 0000 01 11 .8 .4 .4 .5 .5 .8 .4 .2 .5 ---- 1. 92 4. 85 3.4 5.8 3. 46 0. 50 0. 53 6.2 6.7 2. 95 0. 54 7.2 4. 83 0. 50 0. 50 1. 93 2. 40 153 159 19.2 10.1 12.5 12.5 12.9 13.9 55-59 .1 .8 .1 .6 .5 .7 .5 .9 .8 .1 .8 .7 .5 .5 .4 .5 .4 .1 .4 .4 .7 3. 23 0. 41 0. 70 1. 12 0. 40 0. 70 0. 40 1. 80 2. 83 1. 82 0. 40 3. 57 0. 40 116 120 ------10.6 12.3 50-54 58 000000 01 86 00 .4 .3 .3 .7 .3 .6 .3 .6 .7 .3 .4 72 75 5.8 0. 31 0. 60 1. 41 2. 54 1. 93 0. 80 3. 33 3. 63 3. 38 0. 30 0. 31 3. 96 0. 30 2. 26 1. 43 6. 99 0. 80 3. 63 1. 71 0. 31 1. 71 1. 10 ----- 45-49 00 0000000 00 00 00 .5 .3 .2 .7 .2 .3 .8 .2 .8 .2 .7 .2 .2 .7 .5 .7 .2 .5 .1 .9 .1 .9 .2 .4 38 40 ---- 0. 91 0. 41 0. 20 0. 20 1. 53 0. 20 2. 44 0. 71 40-44 00 00 00 00 0000 000000 00000000 00 .7 .2 .4 .5 .2 .2 .8 .2 .4 32 33 3. 13 1. 63 0.2 0. 40 0. 91 0. 41 0. 20 0. 51 2. 92 0. 70 0. 90 2. 41 0. 50 1. 62 4. 25 0. 50 0. 51 2. 62 1. 61 0. 20 0. 20 ------35-39 00 000 00 0000000 0000000 00 0000 000000000 000000000 0000 .6 .3 .1 .3 .4 .1 .2 .2 .3 .1 .7 .6 .1 .8 .1 .6 .3 .1 21 22 ---- 1. 62 0. 30 0. 10 0. 10 1. 91 0.1 0. 10 0. 40 0.1 0.1 0. 10 30-34 00 0 00 00 .3 .1 .1 .1 .1 .3 17 17 1. 41 0. 80 0. 10 0. 30 0. 10 0. 80 0. 61 1. 52 0. 10 0. 10 0. 60 0. 10 0. 10 1. 12 1. 52 0. 81 0.3 0. 10 0. 10 1. 51 0. 10 0. 10 0. 80 ------25-29 32 00000 00 00 00 11 00 00 00000 14 14 0.4 0.2 0.1 0.1 0.1 0.1 0.2 0.1 0.7 0.3 1.1 0.1 0.1 0.1 0.4 0.2 0.2 0.5 1.5 0.7 0.3 0.1 0.5 1.6 0.1 0.1 ----- 20-24 00 00 12 13 2.9 0.1 0.6 0.1 0.1 0.2 1.8 0.1 0.1 0.3 0.1 0.2 0.1 0.4 0.2 0.4 1.6 1.5 0.2 0.1 0.1 0.5 0.8 0.1 ----- 15-19 2 0 0 00 00 1 0 10 10 0.1 0.2 1.7 0.3 0.1 0.1 0.6 0.1 0.7 1.2 0.4 0.2 1.1 0.1 ----- 15-19 0 00 1.1 0.1 0.1 0.3 0.1 0.4 0.4 0.1 0.1 1.9 1.7 1.9 0.4 0.2 0.1 5-9 ----- 49 49 0.4 0.7 0.4 0.4 0.5 1.2 1.4 2.1 1.2 3.9 0.3 0.3 1.3 0.3 0-4 ----- 00000 0000000 0 0000 00000 000 11 0000 00000 00 0000000 11 0000 00000 00000 000 0000000 0000 0000000 0000000 00 0000000 00000 0 00000 000 0000 0 00000000000000 0000000 0 00 0 0 0 0000000 00000 0 0 0 0000000 0000000 000 0000000 0 000000000 0 0000 10000 000 0000000 ----- Age Unk 9 5 3 1 3 3 0 9 2 2 0 7 40 4 30 2 7 1 57 31 14 11 16 66 27 37 39 74 30 39 17 192 175 286 100 166 159 131 303 285 144 173 158 370 157 156 122 139 267 ----- 4072 4231 All Ages .0 Site n1 .5 a1 d1 x5 s5 Rectum Anu s1 Hodgkin disease Colon Larynx Other Endocrine All sites but C44 Small intestine Pancreas Nose, sinuses etc. Mesotheliom Adrenal glan All sites Total Stomach Gallbladder etc Bon e7 Melanoma of Ski Other Skin Breas t1 Renal Pelvis Ureter Other Urinary organs Thyroid Immunoproliferative dis Pharynx unspecified Oesophagu Liver Trachea, Bronchus, Lung Other Thoracic organs Kaposi sarcoma Connective, Soft tissue Penis Other male genital Kidney Bladder Eye Brain, Nervous system Non-Hodgkin lymphoma Multiple Myeloma Lymphoid Leukemia Leukemia unspecified Other & unspecified Lip Tonsil Nasopharynx Hypopharyn Myeloid Leukemia Prostate Testis Tongue Mouth Salivary glands Other Oropharynx ICD (10th) C19-C20 C21 C81 C18 C32 C75 Not C44 C17 C25 C30-C31 C45 C74 All C16 C23-C24 C40-C41 C43 C44 C50 C65 C66 C68 C73 C88 C14 C15 C22 C33-C34 C37-C38 C46 C47;C49 C60 C63 C64 C67 C69 C70-C72 C82-C85;C96 C90 C91 C95 Other C00 C09 C11 C12-C13 C92-C94 C61 C62 C01-C02 C03-C06 C07-C08 C10 Table 5.1.3 Cancer Incidence Cases among Saudi Males by Age Group (per 100,000), 2008 (per 100,000), Group Age 5.1.3 Cancer Incidence Cases among Saudi Males by Table

P05.indd 72 26-05-2012 6:30:33 PM 0 0 0 0 0 0 4 3 3 0 77 ---- 0.1 0.6 0.1 0.9 0.2 2.4 0.1 0.8 0.8 0.2 0.7 0.1 1.3 0.3 1.1 0.1 1.9 0.3 1.7 6.8 5.2 0.4 1.5 0.1 5.4 2.3 0.1 0.1 1.6 1.4 0.1 0.1 1.5 0.5 1.7 0.1 1.4 1.4 0.5 0.2 0.4 3.3 79.4 19.2 SR Worl d -- 00 00 1 1 1 0.1 0.3 0.1 0.5 0.2 1.4 0.6 0.4 0.2 0.5 0.1 0.2 0.6 0.1 1.1 0.2 5.3 3.1 2.2 1.7 0.2 1.5 0.1 1.8 3.4 1.3 0.1 0.1 0.9 0.7 0.1 0.1 0.3 0.9 0.1 1.2 1.2 0.5 0.1 0.3 1.8 ---- 51.5 12.9 50.1 Crude Rat eA 0 5 00 00 00 00 0 00 00 00 00 0 26 31 36 ---- 0.8 2.5 1.7 0.8 1.7 8.4 0.8 2.5 2.5 1.7 3.3 4.2 1.7 3.3 0.8 5.9 0.8 2.5 2.5 0.8 4.2 2.5 0.8 368 343 75+ 25.1 43.5 11.7 21.8 15.9 15.9 15.1 11.7 22.6 13.4 11.7 5 5 5 00 5 00 00 55 0 0 10 15 1.2 3.7 1.2 8.7 1.2 1.2 1.2 1.2 2.5 1.2 7.5 1.2 2.5 2.5 1.2 6.2 3.7 1.2 405 386 ------18.7 56.1 11.2 17.5 43.6 24.9 19.9 32.4 18.7 12.5 12.5 13.7 23.7 70-74 00 0 00 0 00 0 26 ---- 0.9 0.9 7.2 4.5 5.4 1.8 2.7 0.9 4.5 1.8 3.6 0.9 5.4 1.8 6.3 0.9 0.9 3.6 0.9 5.4 9.9 3.6 1.8 0.9 0.9 325 314 10.8 54.8 10.8 13.5 19.8 24.2 14.4 11.7 24.2 13.5 10.8 13.5 65-69 2 2 0 000 21 1.3 0.7 0.7 1.3 2.6 1.3 4.6 7.2 1.3 7.2 0.7 1.3 2.6 0.7 7.9 1.3 5.9 7.9 1.3 0.7 6.6 0.7 9.8 3.3 0.7 1.3 2.6 259 248 ------10.5 45.9 14.4 18.4 19.7 14.4 13.8 11.2 60-64 1 2 0 12 2 ---- 3.5 4.1 4.6 0.5 1.5 1.5 1.5 5.1 0.5 3.5 4.1 4.6 8.6 0.5 0.5 0.5 9.1 7.6 3.5 5.1 0.5 4.6 1.5 5.1 0.5 1.5 7.1 209 205 51.2 16.7 12.7 10.1 18.3 55-59 0000 00 0 00000 4 000000 00 0 2.2 2.2 4.3 0.7 1.4 1.4 2.9 0.7 2.9 2.5 0.4 7.2 1.4 1.1 0.7 3.3 7.2 4.7 0.4 3.6 2.2 1.8 1.1 1.4 2.2 0.4 1.8 1.1 3.3 163 159 ------56.9 13.8 11.2 10.5 50-54 0 0010 000 001 0.6 1.2 0.3 2.3 0.3 0.3 1.7 0.9 0.3 1.4 1.7 1.7 1.7 0.6 2.6 9.5 6.9 5.2 0.3 0.3 6.9 6.7 1.4 1.7 1.4 0.3 0.3 0.3 1.7 0.9 2.3 0.3 0.3 1.7 0.6 3.2 142 140 ----- 56.4 15.6 45-49 9 2 00 0 0 2 0.5 0.5 0.2 0.2 0.5 0.5 0.9 0.9 0.7 0.5 0.2 1.8 2.7 6.6 2.3 2.5 0.5 0.7 2.7 4.5 1.4 1.1 1.1 0.5 0.2 0.2 2.3 0.7 0.5 0.5 0.2 0.2 101 ----- 41.7 14.5 40-44 2 09 000000 000000000 0 22 0.2 0.2 0.4 1.3 0.4 0.2 0.2 1.5 0.7 0.2 0.2 1.1 1.1 2.9 0.2 1.3 0.2 0.5 0.2 0.9 2.4 0.2 0.4 0.5 1.1 0.2 0.2 0.4 0.2 0.2 0.2 0.2 0.4 ----- 26.7 12.7 35-39 76 76 000000000 000000000 00000000 0 000000000 9 000 00000 1 0 0000 000000000 00 0000000 0 0.1 0.1 0.6 0.1 0.1 0.6 0.9 0.1 0.7 1.6 0.3 0.7 0.4 1.3 0.7 2.1 0.3 0.1 0.1 0.3 0.6 0.3 0.1 0.1 1.2 0.1 0.1 0.3 ----- 12.6 30-34 73 73 1 00 0 00 0 0.1 0.3 5.8 0.3 0.4 0.1 0.5 0.5 6.6 0.1 0.9 0.3 0.3 0.3 2.9 0.9 2.8 0.1 0.1 0.4 0.1 0.1 0.4 0.1 1.3 0.3 0.1 0.1 ----- 25-29 52 42 1 3 0 1 0.1 0.1 0.1 0.2 0.4 0.1 0.2 0.3 3.5 0.8 1.1 0.2 0.2 0.2 0.2 0.3 0.2 0.4 0.1 0.2 0.2 0.1 ----- 20-24 01 01 000 000000000000 1 0.6 0.1 0.1 0.4 1.9 0.2 2.1 0.3 0.8 0.1 0.1 0.2 0.8 0.2 0.6 0.2 0.4 0.1 ----- 15-19 61 61 1 0 0 0.3 0.1 0.1 0.4 0.3 0.1 0.3 0.5 1.3 0.6 0.4 0.1 0.4 0.1 ----- 15-19 000 0 00000 00 0 0.4 1.2 0.1 0.5 0.2 0.5 0.1 0.2 1.5 0.8 0.5 0.2 5-9 ----- 16 16 0.4 0.1 0.9 0.9 0.2 0.1 0.4 0.1 1.5 3.3 0.2 0.3 0.9 0.6 0.5 0-4 ----- 0000000 000000 0 01 00000000000010 0 00000000 0000000 00000 0000000000 0000 0 01 01 0000000000 0000000 000 0000000 000000 00 0000000 00000 000000000 0000000 000000 000 000000 0 0000000 0000 00000 0 00000 000000 0 0 00000000 0 000000 0000 0 0000000 0000000 0000000 000000 000000000 00000 00000000 0 0 0000000 0 0 0 00000 000 0 ----- Age Unk 7 5 5 5 0 3 0 0 1 2 7 5 6 5 1 29 46 54 18 38 17 92 45 16 54 93 14 13 22 12 93 67 82 11 47 31 10 475 100 274 194 131 152 160 304 115 112 104 125 165 ----- 4617 1152 4492 All Ages .0 s1 a2 .7 esotheliom a2 ultiple Myelom elanoma of Skin ther Oropharynx ther Urinary organ esophagus ther Endocrine vary ther Female Genital ther Skin reter asopharynx ervix Uteri olon orpus Uteri odgkin disease terus unspecified enal Pelvis aposi sarcoma ll sites Total ladder ulv a5 agina harynx unspecified tomach mall intestine drenal gland nus lacenta idney ancreas mmunoproliferative dis Lip Tongue Mouth Connective, Soft tissue Salivary glands Tonsil Breast Eye Brain, Nervous system All sites but C44 Hypopharynx Thyroid Site Rectum Non-Hodgkin lymphoma Liver Gallbladder etc Nose, sinuses etc. Larynx Trachea, Bronchus, Lung Lymphoid Leukemia Other Thoracic organs Bone Myeloid Leukemia Leukemia unspecified Other & unspecified C00 C01-C02 C03-C06 C4 6K C47;C49 C6 6U Al lA C07-C08 C09 C6 7B C4 5M C1 0O C50 C6 8O C69 C70-C72 Not C44 C1 1N C12-C13 C5 1V C5 2V C73 ICD (10th) C1 4P C1 5O C1 6S C5 3C C7 5O C1 7S C1 8C C5 4C C7 4A C8 1H C19-C20 C5 5U C2 1A C5 6O C82-C85;C96 C22 C5 7O C8 8I C23-C24 C5 8P C6 4K C9 0M C2 5P C30-C31 C32 C33-C34 C6 5R C91 C37-C38 C40-C41 C92-C94 C95 C4 3M C4 4O Other Table 5.1.4 Cancer Incidence Cases among Saudi Females by Age Group (per 100,000), 2008 (per 100,000), Group Age by 5.1.4 Cancer Incidence Cases among Saudi Females Table

P05.indd 73 26-05-2012 6:30:33 PM 3 .5 .1 .8 .3 .3 .3 .6 .6 .6 .1 .8 .3 .9 .4 .3 .7 .8 .1 .6 .9 .5 .4 .3 .3 ---- 0. 8 1. 1 1. 1 2. 5 1. 7 1. 4 0. 2 0. 3 0. 1 33.3 34.7 ASR Worl d -- 00 11 11 00 00 00 40 32 11 20 20 40 72 81 60 20 80 20 81 20 60 60 32 40 60 60 20 40 20 .6 .8 .9 .9 .1 .2 .2 .2 0. 0. 0. 0. 1. 0. 0. 1. 0. 0. 0. 1. 0. 0. 0. 0. 0. 0. 0. 1. 0. 0. 0. ---- 23.3 24.2 Crude Rat e Jaza n ---- .4 %0 .1 %0 .9 %1 .0 %0 0 .9 %1 .9 %1 .7 %1 .0 %0 0 .0 %0 0 .8 %0 .0 %0 0 .0 %0 0 .0 %0 0 .8 %0 .9 %1 .0 %0 0 .0 %0 0 .0 %0 0 .0 %0 0 .8 %0 .0 %0 0 .0 %0 0 6.1% 1.6% 0.0% 2.4% 1.6% 0.8% 5.5% 0.8% 0.8% 7.1% 3.9% 0.0% 0.8% 3.1% 2.4% 5.5% 2.4% 0.8% 1.6% 1.6% 3.1% 2.4% 0.0% 0.8% 4.7% 0.0% 3.1% 3.9% 0.8% 2.4% 100.0% % of Total 07 07 32 43 00 53 64 00 00 10 00 00 00 10 53 00 00 00 00 10 00 00 27 12 29 ------All Age s 29 .5 .3 .5 .7 .3 .2 ---- 0. 41 0. 52 1. 52 0. 77 0. 81 2. 31 0. 95 0. 40 1. 61 0. 63 2. 87 2. 71 0. 92 0. 94 1. 14 0. 55 0. 43 39.2 ASR Worl d 00 00 00 00 00 00 00 00 00 00 00 00 00 00 .6 .2 .6 .6 .9 .6 .6 .2 .6 .5 .5 .6 .6 .9 .2 .6 .6 4. 64 3. 75 5. 66 1. 21 0. 60 3. 74 1. 21 ------33.4 Crude Rat e Baha ---- .8 %0 .0 %000 .0 %003 .6 %1 .0 %001 .8 %0 .8 %0 .0 %001 .4 %1 .8 %0 .8 %0 .6 %1 .0 %004 .8 %0 .1 %2 .0 %003 .1 %2 .0 %001 .8 %0 .0 %002 .8 %0 .0 %003 .0 %000 .0 %001 .0 %006 .0 %000 .4 %1 .6 %1 .8 %0 .0 %001 .8 %0 0.7% 6.1% 0.7% 6.4% 0.0% 0.0% 3.6% 0.0% 0.0% 1.8% 0.0% 0.0% 0.0% 0.0% 0.0% 0.0% 0.0% 0.0% 0.0% 3.6% 0.0% 00.0 %3 % of Total 61 49 11 00 00 23 00 11 11 00 35 11 61 11 23 00 91 11 47 00 47 00 11 00 11 00 00 00 00 00 35 23 61 11 00 11 ------All Age s 85 21 42 0.4 1.3 0.8 1.5 0.4 0.2 0.1 0.4 3.5 2.2 4.8 0.5 1.2 0.6 3.6 1.5 2.5 1.3 6.1 0.2 1.9 0.1 1.4 0.4 0.5 0.2 0.3 0.2 3.2 0.4 1.1 1.1 0.2 1.7 ----- 51. 95 ASR Worl d 0.3 0.9 0.7 1.2 0.4 0.1 0.1 0.3 2.2 1.5 3.3 0.3 0.8 0.7 2.6 1.1 1.7 1.1 5.2 0.1 1.7 1.6 0.1 0.8 0.3 0.3 0.1 0.3 0.1 2.2 0.3 0.8 0.8 2.6 0.1 1.7 ----- 38.3 35. 74 Crude Rate Asir ----- 0.7% 2.4% 1.7% 3.1% 1.0% 0.3% 0.3% 0.0 %000 0.7% 5.9% 3.8% 8.6% 0.7% 2.1% 0.0 %000 1.7% 6.9% 2.8% 4.5% 0.0 %002 2.8% 0.0 %000 0.0 %000 0.3% 4.5% 4.1% 0.3% 0.0 %000 2.1% 0.7% 0.7% 0.3% 0.7% 0.3% 5.9% 0.0 %000 0.0 %000 0.7% 0.0 %000 0.0 %000 0.0 %000 0.0 %000 0.0 %000 2.1% 0.0 %000 2.1% 6.9% 0.0 %000 0.3% 4.5% 13.4% 93.1% 100.0% % of Total 9 2 7 5 9 1 1 0 2 2 6 0 8 0 8 0 1 1 0 6 2 2 1 2 0 0 0 0 0 6 17 11 25 20 13 13 12 17 20 13 290 270 ----- All Ages .0 a3 d3 n0 s1 a0 ultiple Myeloma elanoma of Ski esotheliom esophagus ther Oropharyn x0 ther male genital ther Urinary organs ther Endocrine ther Skin olon onnective, Soft tissue enal Pelvis reter asopharynx odgkin disease tomach mmunoproliferative dis Small intestine Gallbladder etc. Testis Brain, Nervous system Leukemia unspecifie Bon e5 Site Tongue Mout h2 Salivary gland Hypopharynx Pharynx unspecified Rectum Anu s0 Liver Nose, sinuses etc. Trachea, Bronchus, Lung Other Thoracic organs Prostate Kidney Bladder Eye Thyroid Adrenal gland Non-Hodgkin lymphom Lymphoid Leukemia Myeloid Leukemia Other & unspecifie d6 All sites Total All sites but C44 Lip Tonsil Pancreas Larynx Breast Penis Kaposi sarcom a1 C17 C23-C24 C62 C70-C72 C95 C1 5O C40-C41 C8 8I C9 0M ICD (10th) C1 0O C01-C02 C03-C06 C07-C08 C12-C13 C14 C1 6S C1 8C C19-C20 C21 C22 C30-C31 C33-C34 C37-C38 C4 3M C4 5M C47;C4 9C C61 C6 3O C64 C6 5R C6 6U C67 C6 8O C69 C73 C74 C7 5O C82-C85;C96 C91 C92-C94 Other All Not C44 C00 C09 C1 1N C25 C32 C50 C60 C4 4O C46 C8 1H Table 5.2.1 Number, Relative Frequencies, Age Standardized and Crude Rates for All Cancer Cases Among Saudi Males by Site and Region, 2008 Site and Region, Among Saudi Males by All Cancer Cases and Crude Rates for Standardized Age Frequencies, Relative 5.2.1 Number, Table

P05.indd 74 26-05-2012 6:30:33 PM 5 .4 .8 .7 .5 .7 .3 .5 .3 .2 .5 .1 .9 .8 .6 .6 .1 .7 .2 .6 .3 .7 .5 .9 .5 54 ---- 1. 7 5. 5 0. 2 0. 2 56.8 ASR Worl d -- 00 00 23 00 00 47 00 00 00 00 00 21 00 20 11 82 20 52 52 32 20 20 12 10 82 11 52 70 71 11 20 11 20 20 90 52 .9 .5 .5 .2 .2 36 1. 1. 1. 1. 0. 1. 0. 0. 1. 0. 0. 1. 0. 0. 0. 1. 0. 0. 1. 1. 1. 1. 1. ---- 37.8 Crude Rat e assi m ---- .6 %2 .1 %1 .4 %3 .0 %0 0 .6 %0 .0 %0 0 .0 %0 0 .0 %0 0 .0 %0 0 .0 %0 0 .0 %0 0 .0 %0 0 .0 %0 0 .0 %0 0 .6 %0 0.5% 5.3% 4.1% 4.7% 3.5% 4.1% 0.6% 4.1% 0.6% 0.6% 2.9% 0.0% 1.8% 1.8% 0.0% 2.9% 0.6% 2.3% 0.0% 0.0% 0.6% 0.0% 0.0% 2.9% 0.6% 0.0% 0.0% 0.0% 0.0% 5.3% 0.6% 5.3% 2.9% 2.9% 4.7% 4.1% 2.9% 100.0% of Total 81 37 69 74 00 10 00 00 00 00 00 00 00 00 00 10 71 16 39 ------All Age s% 18 16 41 31 .2 ---- 7. 11 1. 57 1. 97 0. 41 0. 61 2. 65 0. 50 0. 73 2. 33 2. 55 2. 34 0. 40 1. 21 1. 25 0. 60 1. 29 7. 11 1. 25 1. 35 3. 38 2. 87 1. 35 43.7 ASR Worl d 00 00 00 00 00 00 00 00 00 00 00 00 .3 .7 .8 .4 .8 .4 .7 .4 .8 .7 .7 .1 .4 .8 .4 .3 .4 .1 .3 .5 .3 .3 .9 .1 .8 8. 74 1. 31 ------35.8 lQ Crude Rat e ai ---- .3 %1 .3 %1 .2 %0 .1 %0 .0 %007 .2 %0 .0 %001 .1 %0 .3 %1 .1 %0 .2 %0 .3 %1 .0 %000 .3 %1 .0 %001 .4 %2 .0 %000 .1 %0 .2 %0 .0 %000 .7 %3 .0 %000 .3 %1 .0 %001 .1 %0 .4 %2 .0 %000 .0 %000 .0 %000 .3 %1 .0 %001 .0 %009 .3 %1 .3 %1 .6 %2 .4 %2 .2 %0 2.4% 3.3% 0.0% 0.0% 0.0% 0.0% 0.0% 0.0% 0.0% 0.0% 0.0% 0.0% 0.0% 0.0% 00.0 %3 14.1 %5 % of Total 21 59 33 44 22 11 00 22 00 11 44 11 22 44 00 44 00 55 00 11 22 00 88 00 33 00 11 55 00 00 00 33 00 00 33 33 77 55 22 13 ------All Age s 23 1.5 4.1 2.4 0.2 0.3 1.2 0.1 2.2 5.8 0.5 0.5 1.4 0.1 2.8 0.1 1.5 2.9 0.3 0.2 0.3 5.4 0.7 2.5 2.1 0.9 5.5 0.2 0.3 0.3 1.6 6.1 0.5 1.7 1.6 1.2 2.2 3.9 1.4 ----- 68. 99 66. 78 ASR Worl d 0.8 2.4 1.6 0.2 0.2 0.6 0.2 1.3 3.6 0.5 0.5 1.1 0.2 1.9 0.2 1.6 1.6 1.9 0.2 0.2 0.2 0.3 1.4 1.7 0.6 3.3 0.2 0.2 0.2 1.6 4.2 0.3 1.1 0.9 1.1 1.6 2.4 0.9 ----- 45.5 43.9 Crude Rate ----- Madina hH 1.7% 5.2% 3.5% 0.3% 0.3% 1.4% 0.3% 2.8% 8.0% 1.0% 1.0% 2.4% 0.3% 4.2% 0.3% 3.5% 3.5% 4.2% 0.3% 0.3% 0.0 %000 0.0 %000 0.3% 6.6 %3 0.7% 0.0 %000 3.1% 3.8% 1.4% 7.3% 0.3% 0.3% 0.0 %000 0.0 %000 0.3% 0.0 %000 0.0 %000 3.5% 9.3% 0.0 %000 0.7% 0.0 %000 0.0 %000 2.4% 2.1% 2.4% 3.5% 5.2% 0.0 %000 0.0 %000 2.1% 96.5% 100.0% % of Total 2 7 5 5 1 1 4 1 8 3 3 7 1 1 1 1 0 0 1 2 0 9 0 0 1 0 0 2 7 6 6 15 10 23 12 10 10 19 11 21 10 10 289 279 ----- All Ages .0 a2 d1 n1 s0 a0 elanoma of Ski esotheliom ultiple Myeloma ther Oropharyn x0 ther male genital ther Urinary organs ther Endocrine esophagus ther Skin olon enal Pelvis reter odgkin disease asopharynx onnective, Soft tissue tomach mmunoproliferative dis Rectum Leukemia unspecifie Prostate Mout h4 Small intestine Anu s1 Gallbladder etc. Pancreas Nose, sinuses etc. Larynx Trachea, Bronchus, Lung Other Thoracic organs Testis Kidney Eye Thyroid Adrenal gland Non-Hodgkin lymphom Lymphoid Leukemia Myeloid Leukemia All sites Total All sites but C44 Lip Tongue Salivary gland Tonsil Hypopharynx Pharynx unspecified Liver Bon e7 Breast Penis Bladder Brain, Nervous system Other & unspecifie d1 Site Kaposi sarcom a0 C19-C20 C95 C1 0O C61 C03-C06 C1 6S C17 C1 8C C21 C23-C24 C25 C30-C31 C32 C33-C34 C37-C38 C4 3M C4 5M C62 C6 3O C64 C6 5R C6 6U C6 8O C69 C73 C74 C7 5O C8 1H C82-C85;C96 C8 8I C9 0M C91 C92-C94 All Not C44 C00 C01-C02 C07-C08 C09 C1 1N C12-C13 C14 C1 5O C22 C40-C41 C4 4O C50 C60 C67 C70-C72 Other ICD (10th) C46 C47;C4 9C Table 5.2.2 Number, Relative Frequencies, Age Standardized and Crude Rates for All Cancer Cases among Saudi Males by Site and Region, 2008 Site and Region, All Cancer Cases among Saudi Males by and Crude Rates for Standardized Age Frequencies, Relative 5.2.2 Number, Table

P05.indd 75 26-05-2012 6:30:33 PM .1 .4 .3 .5 .4 .7 .1 .7 .2 .6 .1 .7 .5 .3 .6 .1 2. 9 2. 9 6. 9 4. 1 0. 7 3. 2 ---- - 11.8 ASR Worl d 47 47 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 83 81 81 52 81 81 36 81 82 80 51 15 33 17 81 52 83 .4 .1 .8 .8 .3 ---- 8. 8. 0. 2. 0. 2. 0. 0. 0. 1. 0. 0. 0. 1. 3. 3. 0. 1. 0. Rate Crude ------.0 %3 .0 %0 .0 %2 % of 0.0% 0.0% 0.0% 0.0% 2.0% 6.0% 2.0% 0.0% 0.0% 0.0% 6.0% 0.0% 0.0% 0.0% 2.0% 0.0% 0.0% 2.0% 0.0% 0.0% 0.0% 0.0% 0.0% 0.0% 0.0% 2.0% 0.0% 4.0% 0.0% 2.0% 2.0% 2.0% 0.0% 0.0% 4.0% 8.0% 8.0% 0.0% 0.0% 2.0% 4.0% 0.0% 0.0% 2.0% 0.0% 0.0% Total 00.0 %3 00.0 %3 14.0 %5 10.0 %3 Northern Regio n 01 01 48 12 36 ---- All Ages 07 00 00 00 00 01 70 00 00 13 00 00 00 01 00 00 00 00 10 00 00 .5 .2 4. 85 7. 85 6. 63 4. 71 4. 51 0. 30 0. 60 2. 15 1. 10 1. 51 0. 20 0. 82 3. 10 2. 11 1. 11 0. 21 0. 30 0. 20 1. 92 4. 94 5. 34 0. 40 2. 40 4. 51 0. 82 0. 70 0. 20 2. 21 2. 10 ------13.2 ASR Worl d 89 31 .4 .5 .5 .3 .3 .5 .3 .9 .3 .3 .5 .2 .3 .3 .4 .3 .3 .9 .5 .3 .5 .3 .5 .1 .3 .2 .3 .3 .3 .8 .6 ---- 5. 68 1. 52 2. 15 Rate Crude Tabuk ------.3 %2 .9 %1 .9 %1 .0 %0 .0 %0 .8 %0 .8 %0 .9 %1 .0 %0 .0 %0 .8 %0 .0 %0 .4 %0 .8 %0 .8 %0 .9 %1 .1 %1 .8 %0 .8 %0 .3 %2 .8 %0 .8 %0 .4 %0 .0 %0 .9 %1 .0 %0 .8 %0 .0 %0 .9 %1 .0 %0 .8 %0 .9 %1 .5 %2 .0 %0 .8 %0 .0 %0 .0 %0 .0 %0 .0 %0 .0 %0 .8 %0 .8 %0 .0 %0 .8 %0 .7 %1 .6 %0 .0 %0 % of 7.9% 3.9% 5.5% Total 00.0 %3 11.0 %4 93.7 %3 86 53 53 00 00 10 10 53 00 00 10 00 32 10 10 53 43 10 10 86 10 10 32 00 53 00 10 00 53 00 10 53 75 00 10 00 00 00 00 00 10 10 00 10 64 21 00 19 10 14 12 71 ----- All Ages .3 .7 .1 .5 .5 .1 .5 .6 .6 .9 .2 .6 .1 .2 .6 .1 .1 .3 .4 .1 .6 .3 .5 65 9. 91 3. 25 8. 87 ----- ASR Worl d 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 .1 .3 6. 35 2. 36 0. 61 1. 83 0. 61 0. 60 1. 22 0. 61 2. 33 0. 60 0. 61 2. 33 1. 22 0. 61 0. 61 2. 35 1. 84 0. 61 0. 61 1. 81 1. 22 0. 61 1. 21 1. 81 1. 82 ----- 38.6 Rate Crude Jouf ----- % of 0.0% 6.1% 1.5% 0.0% 0.0% 0.0% 4.5% 1.5% 0.0% 1.5% 0.0% 3.0% 0.0% 0.0% 1.5% 0.0% 0.0% 6.1% 0.0% 0.0% 1.5% 1.5% 6.1% 0.0% 0.0% 3.0% 1.5% 0.0% 1.5% 6.1% 0.0% 0.0% 0.0% 0.0% 4.5% 0.0% 1.5% 0.0% 1.5% 0.0% 0.0% 4.5% 3.0% 0.0% 1.5% 3.0% 4.5% 4.5% 0.0% Total 93.9 %3 10.6 %4 13.6 %5 100.0% 0 4 1 0 0 0 3 1 0 1 0 2 0 0 1 0 0 4 0 0 1 1 4 0 0 2 1 0 1 4 0 0 0 0 3 0 1 0 1 0 0 3 2 0 7 1 2 3 9 0 66 62 ----- All Age s 23 8.7 2.1 3.7 1.2 1.1 2.5 0.9 0.4 1.5 0.5 0.7 4.3 2.7 1.9 2.5 2.2 2.1 0.4 0.5 1.9 2.5 2.5 2.1 ----- 50.9 48.4 ASR Worl d 9 00 1 00 00 00 00 00 1 00 00 1 00 1 00 00 00 00 00 00 1 00 00 00 00 1 00 00 00 00 00 00 1 1 00 1 00 30 4.1 2.1 0.5 0.5 0.5 2.6 0.5 0.5 2.1 1.6 1.6 1.6 0.5 0.5 1.6 ----- Rate Crude Najran ----- % of 0.0% 3.4% 0.0% 0.0% 0.0% 6.9% 1.7% 0.0% 1.7% 0.0% 3.4% 0.0% 0.0% 3.4% 1.7% 0.0% 8.6% 3.4% 0.0% 0.0% 1.7% 1.7% 0.0% 0.0% 0.0% 6.9% 5.2% 0.0% 5.2% 3.4% 0.0% 0.0% 0.0% 0.0% 3.4% 0.0% 5.2% 0.0% 0.0% 0.0% 0.0% 1.7% 1.7% 0.0% 5.2% 3.4% 3.4% 0.0% 3.4% 0.0% Total 96.6 %2 13.8% 100.0% 8 6 0 0 0 4 1 0 1 0 2 0 0 2 1 0 5 2 0 0 1 1 0 4 8 3 2 0 0 0 2 0 3 0 0 1 1 0 2 2 0 2 ----- All Age s .0 e3 45 x0 s0 s2 r0 allbladder etc. esophagu ose, sinuses etc. enal Pelvis asopharyn olon ectu m3 rete r0 odgkin diseas rachea, Bronchus, Lung All sites Tota l5 Other Thoracic organs Site All sites but C4 Tonsi l0 Other Oropharynx Hypopharynx Stomach Small intestine Anus Melanoma of Skin Breast Testis Adrenal gland Lymphoid Leukemia Myeloid Leukemia Lip Tongue Mouth Salivary glands Pharynx unspecified Liver Pancrea Laryn x0 Bone Other Skin Mesothelioma Kaposi sarcoma Connective, Soft tissu e0 Penis Prostate Other male genital Kidney Bladde Other Urinary organs Eye Brain, Nervous system Thyroid Other Endocrine Multiple Myeloma Other & unspecified Leukemia unspecified Non-Hodgkin lymphoma Immunoproliferative dis 4G 1N 4T 0R All C37-C38 ICD (10th) Not C44 C09 C10 C12-C13 C16 C17 C21 C23-C2 C30-C3 C33-C3 C43 C50 C62 C6 5R C74 C91 C92-C94 C00 C01-C02 C03-C06 C07-C08 C1 1N C14 C1 5O C1 8C C19-C2 C22 C25 C32 C40-C41 C44 C45 C46 C47;C49 C60 C61 C63 C64 C6 6U C67 C68 C69 C70-C72 C73 C75 C8 1H C90 Other C95 C82-C85;C96 C88 Table 5.2.3 Number, Relative Frequencies, Age Standardized and Crude Rates for All Cancer Cases among Saudi Males by Site and Region, 2008 Site and Region, All Cancer Cases among Saudi Males by and Crude Rates for Standardized Age Frequencies, Relative 5.2.3 Number, Table

P05.indd 76 26-05-2012 6:30:34 PM .1 .1 .5 .4 .7 .3 .6 .6 .3 .2 .6 .3 .6 .6 .6 .9 .2 .5 .9 .4 .1 .8 .2 .1 .6 .9 .1 .1 .2 .8 .6 .6 04 ---- 0. 5 0. 8 1. 2 0. 6 4. 1 0. 3 0. 2 0. 7 0. 2 3. 8 00.1 14.3 ASR Worl d -- 91 91 00 11 23 22 10 41 30 74 41 15 45 10 53 20 13 10 70 30 51 30 80 30 71 11 24 10 26 30 41 42 10 20 66 92 72 40 .4 .5 .2 .7 .3 .1 .1 .4 .1 .5 1. 1. 9. 7. 0. 0. 2. 1. 3. 1. 2. 2. 1. 1. 0. 1. 0. 3. 0. 0. 0. 0. 3. 1. 0. 0. 0. 0. 0. 0. 0. 0. 0. 0. ---- Crude Rat e ---- .8 %0 .0 %0 .4 %0 .0 %0 0 .4 %1 .0 %0 0 .0 %0 0 .1 %0 .1 %0 .8 %0 .0 %0 0 .1 %0 .0 %1 .0 %0 0 3.4% 3.0% 0.3% 2.2% 0.8% 4.8% 2.2% 7.4% 4.4% 4.4% 2.9% 2.9% 0.1% 3.3% 0.8% 6.2% 0.4% 4.0% 0.6% 4.0% 0.8% 0.1% 1.9% 7.2% 3.9% 0.6% 0.0% 0.3% 1.4% 0.6% 0.6% 1.7% 0.3% 0.7% 0.4% 1.0% 00.0 %4 10.6 %5 96.0 %4 Eastern Province of Total 53 60 23 71 30 00 00 00 10 10 60 00 10 00 25 22 97 35 16 77 54 16 32 32 21 21 24 45 29 29 14 52 28 10 12 72 61 ------All Age s% 52 01 .9 .7 .2 .6 .8 .1 .8 .7 .3 .5 .6 .7 .5 .4 .8 .6 .5 .4 .2 .1 ---- 1. 76 0. 12 0. 46 0. 56 0. 13 0. 14 0. 36 0. 54 0. 10 0. 52 0. 34 0. 24 0. 25 0. 67 2. 72 74.1 ASR Worl d 11 45 22 00 00 11 00 00 00 00 .1 .3 .3 .2 .1 .1 .1 .3 .3 .1 .3 .2 .2 .3 .4 .7 2. 63 7. 77 0. 71 0. 81 0. 70 0. 50 0. 10 2. 53 0. 61 4. 67 2. 85 1. 62 1. 93 1. 72 1. 21 1. 21 4. 77 1. 62 1. 61 1. 32 0. 61 0. 50 0. 10 ------49.3 Crude Rat e ---- Makkah .1 %0 .5 %0 .6 %0 .5 %3 .2 %0 .2 %0 .1 %0 .5 %0 .0 %001 .6 %0 .1 %0 .6 %0 .4 %0 .3 %0 .0 %002 .5 %0 .0 %003 .7 %0 .5 %1 2.1% 5.2% 1.3% 1.7% 1.0% 0.1% 5.0% 1.2% 9.2% 5.7% 1.3% 3.2% 3.9% 3.4% 2.4% 2.4% 8.1% 4.1% 0.0% 0.0% 9.4% 3.2% 2.0% 0.0% 3.2% 2.7% 1.2% 0.9% 0.0% 0.1% 0.0% 0.0% 96.8 %4 100.0% % of Total 36 43 10 50 60 20 20 10 50 00 60 10 60 40 30 00 50 00 70 20 50 13 16 64 33 10 48 12 89 55 13 31 38 33 23 23 78 40 91 31 19 31 26 12 ------All Age s 33 2.2 2.7 1.1 1.4 0.1 1.1 0.4 0.9 6.7 0.3 1.1 5.8 0.6 9.4 1.1 3.7 5.1 4.2 2.5 0.4 2.1 0.4 0.3 7.9 2.1 0.2 0.1 6.2 0.2 0.1 2.9 0.6 0.6 0.2 0.6 0.2 2.7 3.4 0.6 0.2 ----- 11. 76 98. 29 95. 39 ASR Worl d 1.1 1.3 0.5 0.7 0.1 0.6 1.1 0.2 0.4 3.2 5.3 0.2 0.6 2.7 0.3 3.9 2.1 2.4 3.3 1.9 0.4 1.8 0.3 0.1 5.1 1.8 0.1 3.2 1.5 0.2 0.4 0.1 0.6 0.2 2.8 1.6 2.2 0.3 0.1 ----- 56.4 54.9 Crude Rate Riyadh ----- 2.0% 2.4% 0.9% 1.3% 0.3% 1.0% 0.0 %001 0.3% 0.1 %000 0.1 %000 0.8% 5.7% 9.4% 0.3% 1.0% 4.8% 0.5% 0.0 %000 7.0% 2.0% 3.8% 4.3% 5.8% 3.4% 0.7% 3.2% 0.6% 0.3% 9.1% 3.3% 0.3% 0.1 %0 5.7% 0.1 %0 1.8 %119 0.1 %0 2.6% 0.4% 0.8% 0.0 %000 0.2% 0.0 %001 0.0 %000 1.1% 0.4% 5.0% 2.8% 3.9% 0.0 %000 0.6% 0.2% 97.4% 100.0% % of Total 2 2 3 3 0 4 1 1 9 4 6 0 8 3 9 0 2 0 0 5 7 24 28 11 15 68 12 57 83 24 45 51 69 41 38 39 68 31 13 59 46 112 108 ----- 1191 1160 All Ages .0 d7 n1 s3 a2 elanoma of Ski esotheliom ultiple Myeloma esophagus ther Oropharyn x1 ther Skin ther male genital ther Urinary organs ther Endocrine olon onnective, Soft tissue enal Pelvis reter odgkin disease asopharynx tomach mmunoproliferative dis Pancreas Mout h1 Gallbladder etc. Other Thoracic organs Pharynx unspecified Testis Tongue Salivary gland Tonsil Hypopharynx Small intestine Rectum Anu s1 Liver Nose, sinuses etc. Larynx Trachea, Bronchus, Lung Bon e2 Kaposi sarcom a5 Breast Penis Prostate Kidney Bladder Brain, Nervous system Thyroid Adrenal gland Myeloid Leukemia Leukemia unspecifie Other & unspecifie d3 All sites Total Lip Non-Hodgkin lymphoma Lymphoid Leukemia All sites but C44 Site Eye C25 C1 5O C1 6S C03-C06 C23-C24 C37-C38 C1 0O C14 C62 C01-C02 C07-C08 C09 C12-C13 C17 C1 8C C19-C20 C21 C22 C30-C31 C32 C33-C34 C40-C41 C4 3M C4 4O C4 5M C46 C47;C4 9C C50 C60 C61 C6 3O C64 C6 5R C6 6U C67 C6 8O C70-C72 C73 C74 C7 5O C8 1H C92-C94 C95 Other All C00 C1 1N C82-C85;C96 C8 8I C9 0M C91 Not C44 ICD (10th) C69 Table 5.2.4 Number, Relative Frequencies, Age Standardized and Crude Rates for All Cancer Cases among Saudi Males by Site and Region, 2008 Site and Region, All Cancer Cases among Saudi Males by and Crude Rates for Standardized Age Frequencies, Relative 5.2.4 Number, Table

P05.indd 77 26-05-2012 6:30:34 PM 0 0 .4 .5 .2 .2 .5 .1 .8 .6 .7 .7 .1 .8 .7 .7 .2 .4 .2 .8 .4 .7 .8 .2 .6 .5 .2 .4 .1 .9 ---- 3. 4 1. 1 41.5 ASR Worl d -- 14 91 35 20 20 40 20 11 71 40 11 51 12 20 20 20 40 12 20 86 52 40 50 50 20 50 31 20 11 62 91 91 20 71 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 .5 26 7. 1. 1. 0. 1. 1. 0. 1. 1. 0. 3. 1. 0. 1. 0. 3. 0. 0. 0. 0. 0. 0. 0. 0. 0. 0. 0. 0. 0. 0. 0. 0. 0. 0. ---- Crude Rat e azan ---- .0 %0 .0 %0 .0 %0 6.0% 2.1% 4.1% 4.7% 4.0% 0.0% 0.7% 4.0% 5.4% 2.0% 4.0% 6.0% 3.4% 4.0% 2.7% 4.0% 2.0% 0.0% 0.0% 0.7% 2.7% 0.0% 3.4% 0.0% 0.7% 0.7% 0.0% 0.7% 0.0% 0.0% 2.0% 0.0% 0.7% 0.0% 3.4% 0.7% 0.7% 0.0% 1.3% 0.7% 1.3% 0.0% 0.0% 0.0% 0.7% 1.3% 1.3% 0.0% 0.0% 2.0% 0.0% 0.0% 0.0% 00.0 %2 % of Tota l 81 11 32 00 00 14 91 14 39 ------All Ages 16 38 16 .2 .9 .3 ---- 0. 82 4. 87 0. 41 1. 36 3. 19 3. 35 0. 91 0. 44 0. 86 0. 43 2. 84 2. 51 1. 23 1. 65 0. 90 0. 42 0. 53 48.5 47.2 ASR Worl d 000 003 006 000 000 001 000 005 000 001 000 001 000 000 000 001 000 001 001 000 002 001 002 000 000 001 002 000 000 000 000 000 .4 .6 .6 .1 .2 .1 .2 .8 .6 .6 .6 .6 .2 .7 .1 .1 .6 .6 .6 7. 21 3. 34 0. 60 1. 72 ------37.6 36.5 Crude Rate Bah aJ ---- .5 %0 .5 %0 .9 %1 .9 %2 .0% .9 %1 .9 %2 .4 %2 .5 %0 .0% .5 %0 .5 %0 .5 %0 .0% .9 %2 .0% .0% .4 %1 .0% .0% .9 %1 .0% .0% .9 %1 .0% .0% .0% .0% .5 %0 .0% .0% .5 %0 .0% .5 %0 9.1% 7.1% 0.0% 8.8% 0.0% 0.0% 0.0% 0.0% 0.0% 1.5% 4.4% 0.0% 0.0% 0.0% 0.0% 0.0% 0.0% 0.0% 0.0% 0.0% 0.0% 11.8 %4 100.0% % of Tota l 31 69 11 11 22 45 00 22 45 57 11 00 11 11 11 00 45 00 00 34 00 00 22 00 00 22 00 00 00 00 11 00 00 11 00 11 68 ------All Ages 91 68 36 3. 46 1.4 0.7 3.3 2.4 0.5 2.7 3.9 1.7 0.4 0.5 1.9 4.5 2.3 0.4 1.6 0.7 0.4 0.7 0.7 0.5 1.2 0.1 0.4 1.3 0.9 0.3 0.2 0.2 1.3 0.1 0.3 0.2 0.1 0.8 ----- 56.8 ASR Worl d 000 3 000 000 000 000 000 001 003 000 000 000 000 000 000 000 000 000 000 8. 55 6.4 4.7 0.9 0.5 2.6 1.6 0.4 1.8 1.6 0.3 0.4 1.2 2.9 1.4 0.3 1.9 0.9 0.4 0.3 0.5 0.8 0.3 0.9 0.1 0.3 1.2 0.9 0.3 0.1 0.3 0.9 0.1 0.3 0.3 0.1 0.5 ----- 41.1 Crude Rate Asir ----- 5.5% 2.2% 0.0% 1.3% 6.3% 3.8% 0.9% 4.4% 7.3% 3.8% 0.6% 0.9% 2.8% 7.0% 3.5% 0.6% 4.7% 0.0% 0.0% 2.2% 0.0% 0.9% 0.0% 0.6% 1.3% 0.0% 0.0% 1.9% 0.0% 0.6% 0.0% 2.2% 0.0% 0.3% 0.6% 2.8% 2.2% 0.6% 0.0% 0.3% 0.0% 0.6% 0.0% 2.2% 0.3% 0.6% 0.6% 0.0% 0.3% 0.0% 1.3% 0.0% 0.0% 0.0% 11.4% 93.7 %3 100.0% % of Total 1 91 0 3 0 2 4 0 0 0 0 7 0 1 2 9 7 0 1 0 2 0 7 1 2 2 0 0 4 0 0 0 96 16 20 12 14 23 12 22 15 36 ----- All Ages g4 s0 d7 n2 s2 d0 s3 i2 r3 ll sites Tota l3 All sites but C4 42 Site Lip Tongue Other Oropharynx Nasopharynx Live r7 Pancreas Laryn x0 Trachea, Bronchus, Lun Other Skin Mesothelioma Kaposi sarcoma Vulva Cervix Uter Corpus Uteri Placenta Kidney Ureter Bladde Eye Hodgkin disease Non-Hodgkin lymphoma Multiple Myeloma Lymphoid Leukemia Myeloid Leukemia Leukemia unspecified Mout h2 Salivary gland Tonsil Hypopharynx Pharynx unspecified Oesophagu Stomac h9 Small intestine Colon Rectu m1 Anus Gallbladder etc. Nose, sinuses etc. Other Thoracic organs Bone Melanoma of Ski Breas t4 Uterus unspecified Ovary Renal Pelvis Other Urinary organ Brain, Nervous system Thyroid Adrenal glan Other Endocrine Immunoproliferative dis. Other & unspecifie Connective, Soft tissu e6 Vagina Other Female Genita l1 Not C44 ICD (10th) C00 C01-C02 C10 C11 C22 C25 C32 C33-C34 C44 C45 C46 C51 C53 C54 C58 C64 C66 C67 C69 C81 C82-C85;C96 C90 C91 C92-C94 C95 C03-C06 C07-C08 C09 C12-C13 C14 C15 C16 C17 C18 C19-C20 C21 C23-C24 C30-C31 C37-C38 C40-C41 C43 C50 C55 C56 C65 C68 C70-C72 C73 C74 C75 C88 Other Al lA C47;C49 C52 C57 Table 5.3.1 Number, Relative Frequencies, Age Standardized and Crude Rates for All Cancer Cases Among Saudi Females by Site and Region, 2008 Site and Region, by Among Saudi Females All Cancer Cases and Crude Rates for Standardized Age Frequencies, Relative 5.3.1 Number, Table

P05.indd 78 26-05-2012 6:30:34 PM 0 0 0 0 0 0 0 0 0 0 2 0 0 0 4 0 0 0 1 0 0 .8 .9 .6 .1 .8 .2 ---- 3. 3 3. 4 0. 2 1. 2 0. 4 2. 2 0. 2 0. 4 0. 7 1. 6 0. 9 0. 7 0. 4 1. 7 4. 9 0. 5 1. 2 1. 7 1. 2 0. 7 63.9 62.2 SR World A -- 50 62 50 31 71 12 19 20 92 00 00 00 00 00 00 .8 .2 .7 .2 .9 .1 .2 .2 .5 .7 .5 .5 .4 .7 .7 .2 .9 .1 .9 .5 1. 0. 0. 1. 9. 0. 0. 8. 0. ---- 42.8 41.4 Crude Rat e ---- Qassim ota l .0 %0 .0 %0 .2 %1 .0 %0 .0 %0 .5 %0 .0 %0 .6 %0 .0 %0 .0 %0 .0 %0 .0 %0 .5 %0 .0 %0 .1 %0 .6 %1 .5 %0 .5 %0 .1 %0 .0 %0 .8 %2 .0 %0 .0 %0 .6 %0 .1 %0 .8 %2 .1 %0 .0 %0 .2 %1 .0 %0 .3 %2 .0 %0 .6 %0 .5 %0 .0 %0 .1 %0 .0 %0 .6 %1 .1 %0 .1 %0 1.7% 6.8% 9.0% 0.0% 0.0% 0.0% 2.6% 0.5% 0.0% 1.1% 3.7% 1.6% 0.0% 0.0% 1.1% 2.1% 100.0% % of T 12 26 61 00 00 84 00 00 10 00 31 00 00 00 00 10 00 42 52 10 10 21 00 94 00 00 31 21 94 21 00 63 00 00 31 10 00 42 00 52 42 21 es 89 ------18 39 ll Ag A 00 00 00 01 00 02 00 00 53 .6 .5 .9 .6 .2 .8 .4 .5 .1 .1 .2 .7 .6 .2 .3 .5 ---- 6. 31 1. 94 1. 25 1. 97 3. 83 1. 71 1. 42 1. 14 44.2 SR World 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 22 22 .8 .2 .8 .2 .2 .4 .8 6. 24 0. 40 0. 40 8. 91 0. 40 0. 81 0. 81 0. 80 0. 80 1. 62 0. 40 0. 40 0. 81 0. 80 0. 81 0. 81 0. 40 0. 40 ------34.6 Crude Rat eA Hail ---- ota l .0 %0 .0 %0 .0 %0 .2 %0 .0 %0 .0 %0 .0 %0 .3 %1 .8 %2 .3 %1 .0 %0 .0 %0 .3 %1 .2 %0 4.4% 5.6% 1.1% 1.1% 0.0% 0.0% 0.0% 0.0% 0.0% 1.1% 2.2% 2.2% 0.0% 0.0% 0.0% 2.2% 0.0% 0.0% 0.0% 2.2% 0.0% 4.4% 0.0% 0.0% 0.0% 0.0% 1.1% 1.1% 2.2% 0.0% 0.0% 0.0% 2.2% 0.0% 2.2% 2.2% 0.0% 1.1% 5.6% 5.6% 1.1% 00.0 %3 12.2 %4 % of T 22 01 69 00 00 00 22 00 00 00 33 77 33 00 00 33 22 es 11 ------l Ag Al 69 01 00 00 00 00 00 00 00 00 00 00 00 00 .6 .3 .3 .1 .5 .7 .2 1. 21 4. 80 0. 30 1. 11 1. 32 0. 82 1. 32 0. 90 2. 42 1. 74 0. 60 0. 10 0. 30 0. 31 3. 31 1. 52 1. 20 0. 20 1. 12 1. 22 0. 62 0. 30 0. 31 1. 35 1. 15 0. 91 ----- 12. 22 64. 48 SR World A 00 00 00 00 00 00 .9 .2 .6 .8 .5 .1 .6 .3 .3 .2 .2 .2 .8 .8 .1 .2 .8 .8 .3 .2 .2 .3 .8 9.1 1. 62 0. 20 0. 20 1. 12 1. 83 0. 30 3. 76 3. 74 2. 64 ----- 44. 46 43.4 Crude Rate ----- otal .6 %2 .0 %0 .4 %0 .2 %1 .0 %0 .0 %0 .5 %0 .8 %0 .0 %0 .1 %0 .6 %1 .5 %0 .9 %1 .0 %0 .0 %0 .7 %0 .0 %0 .4 %0 .4 %0 .4 %0 .0 %0 .0 %0 .0 %1 .8 %0 .0 %0 .6 %1 .4 %0 .2 %1 .8 %0 .0 %0 .8 %0 .7 %0 .4 %0 .0 %0 .0 %0 .4 %0 .9 %1 .2 %1 .8 %0 Madinah 0.0% 0.0% 3.6% 0.4% 0.0% 0.4% 2.6% 0.0% 4.0% 0.7% 8.4% 0.0% 0.0% 8.4% 5.8% 20.4% 97.8% 100.0% % of T 86 6 14 00 10 62 00 00 41 51 00 31 72 41 82 00 00 20 00 10 10 10 00 00 51 00 72 10 62 51 00 51 20 10 00 00 10 82 62 51 10 11 23 23 16 ges ----- 274 268 l A Al ng s. e2 oma ed tal , Lu ssu ed ve di ed ed hus e0 orga ns system ymph kem ia Ge ni e0 oma l ds spec ifi d0 ary nx ferati kem ia i s1 in t C44 is spec ifi sease an ary orga ns an Leu un oma i gu docr in ve, Soft ti orac ic un spec ifi di nu ses etc .0 test in id Myel Leu gl ary nx ary nx el Uteri sarcoma ta oprol un spec ifi in Uteri in oma of Sk in le id al adder etc. m7 a0 ea, Bro nc n l Pe lv , Nervo us ue h1 il n tes Total tes bu n1 ey a1 ip -Hodgk bl creas vary gl kem ia er En er Fema le er Th er Ur in er Oroph er Sk in er & un si lt us lv ary nx yro id acen dn adder l si p0 ver ll Sa li An Breas t5 Uter us Ovary Adren Oth Vu Site Li To ng Mo ut Co lo Rectu Lary nx Trach Vag in Cerv ix Oth Pl Ki Hodgk Li Re na Ureter Bl Eye Al To ns Ph Oesop ha Ga ll Oth Bo ne Corp us Oth Bra in Non Oth Nasoph Hypoph Stomach Pan Me la Oth Mesoth Co nn ecti Immu Mu Sma ll Nose, si Kaposi Th Lymp ho Mye lo Leu Oth r lA C07-C08 C21 C50 C55 C56 C74 C75 C51 ICD (10th) C00 C01-C02 C03-C06 C18 C19-C20 C32 C33-C34 C52 C53 C57 C58 C64 C81 Al C22 C65 C66 C67 C69 Not C44 C09 C14 C15 C23-C24 C37-C38 C40-C41 C54 C68 C70-C72 C82-C85;C96 C10 C11 C12-C13 C16 C25 C43 C44 C45 C47;C49 C88 C90 C17 C30-C31 C46 C73 C91 C92-C94 C95 Ot he Table 5.3.2 Number, Relative Frequencies, Age Standardized and Crude Rates for All Cancer Cases Among Saudi Females by Site and Region, 2008 Site and Region, by Among Saudi Females All Cancer Cases and Crude Rates for Standardized Age Frequencies, Relative 5.3.2 Number, Table

P05.indd 79 26-05-2012 6:30:35 PM d 3 1 1 7 7 8 5 4 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 R .7 .6 .1 .7 .2 .1 .3 .4 .9 .6 .9 1. 1. 5. 0. 1. 4. 0. 3. 2. ----- 81.7 76.6 10.5 AS Worl

54 81 83 37 51 55 81 33 68 95 94 52 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 .8 .8 .5 .8 .8 .3 .8 .5 .4 .5 2. 1. 3. 2. 3. 0. 0. 1. 0. 1. 1. 4. ----- 41.7 40.1 Rate Crude

%5 %0 %0 %0 %0 %0 %0 %0 %0 %0 %0 %0 %1 %0 %0 %0 %2 %0 %0 %0 %1 %0 %0 %1 %0 ----- .0 .0 .0 .0 .9 .0 .0 .0 .0 .0 .9 .7 .9 .9 .0 .6 .0 .0 .9 .7 .0 .0 .7 .0 % of 6.3% 1.1% 0.0% 0.0% 0.0% 5.6% 3.7% 0.0% 9.3% 0.0% 5.6% 9.3% 0.0% 0.0% 0.0% 0.0% 0.0% 1.9% 1.9% 0.0% 3.7% 1.9% 0.0% 3.7% 0.0% 3.7% 0.0% 0.0% 0.0% 0.0% 0.0% Total 13.0 orthern Region 100.0% 29 00 00 00 00 11 00 00 00 00 00 11 23 11 11 00 35 00 00 11 23 00 00 23 61 00 es 54 ----- Ag l Al 75 27 d 30 50 93 45 50 73 75 50 80 30 61 91 92 31 12 00 02 00 00 00 00 00 00 12 00 00 00 00 00 R .4 .9 .3 .3 .9 .7 .3 .8 .2 .8 .4 7. 7. 3. 2. 0. 3. 0. 0. 1. 0. 0. 3. 0. 1. 5. 1. 1. ----- 78.8 AS Worl

37 31 30 22 81 61 96 30 56 30 61 31 30 61 47 00 00 00 00 00 00 00 00 00 00 00 00 .3 .3 .3 .5 .3 .9 .3 .6 .3 .6 .6 .3 .9 .2 .3 .6 9. 1. 0. 2. 8. 0. 1. 0. 2. 0. 0. 0. 0. 0. 4. ----- 39.9 Rate Crude kN

%3 %1 %0 %1 %0 %0 %0 %2 %0 %0 %0 %1 %0 %0 %0 %0 %0 %0 %1 %0 %0 %0 %0 %0 %2 %0 %0 %0 %0 %0 Tabu ----- .1 .0 .1 .0 .0 .8 .3 .8 .0 .4 .1 .6 .0 .0 .0 .0 .8 .9 .6 .8 .0 .4 .0 .5 .8 .0 .6 .0 .0 % of 2.0% 1.0% 0.0% 0.0% 0.0% 3.1% 0.8% 0.0% 5.5% 0.0% 1.6% 0.0% 0.0% 0.0% 4.7% 0.8% 0.0% 6.3% 0.0% 0.0% 0.8% 1.6% 0.0% 0.8% 0.8% 1.6% Total 98.4 100.0% 82 41 43 00 43 00 00 10 86 10 00 32 43 21 00 00 00 00 10 53 21 10 00 32 00 75 10 00 21 00 00 es 25 27 ----- Ag l Al 42 51 81 d 10 52 20 16 51 40 48 12 52 81 00 00 04 01 00 07 00 00 00 00 00 01 00 01 01 R .2 .5 .2 .5 .1 .1 .1 .4 .8 .7 .1 .3 .8 1. 1. 2. 1. 0. 4. 3. 3. 0. 2. ----- 19. 65. 66. AS Worl

61 82 82 60 21 61 22 24 22 22 84 61 60 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 .6 .6 .6 .6 .6 .2 .8 .8 .6 .4 0. 1. 1. 0. 1. 0. 1. 1. 1. 1. 1. 0. 0. ----- 12.5 36.9 37.5 Rate Crude

Jouf %0 %0 %0 %0 %0 %0 %0 %0 %0 %0 %0 %0 %0 %0 %1 %1 %0 %0 %0 %1 %0 %0 %0 %0 %2 ----- .0 .0 .6 .0 .0 .0 .0 .0 .6 .0 .0 .6 .6 .6 .2 .8 .0 .0 .0 .8 .0 .0 .0 .6 .3 % of 1.6% 0.0% 0.0% 0.0% 0.0% 0.0% 4.8% 4.8% 0.0% 1.6% 3.2% 0.0% 0.0% 0.0% 0.0% 0.0% 0.0% 1.6% 3.2% 3.2% 0.0% 3.2% 0.0% 3.2% 4.8% 0.0% 1.6% 1.6% 0.0% Total 00.0% 33.3% 98.4% 1 31 2 00 00 11 00 00 00 00 00 11 00 00 11 11 11 23 34 00 00 00 34 00 00 00 11 46 es ----- l Ag Al 82 66 16 d 31 80 43 43 32 30 10 82 72 12 62 43 51 00 00 00 00 00 01 00 00 00 00 01 00 00 00 01 00 R .8 .5 .1 .4 .7 .9 .8 .7 .8 3. 3. 3. 2. 2. 1. 1. 2. 0. 1. 3. 0. 3. ----- 10. 57. 54. AS Worl 52 51 50 52 50 50 64 00 00 11 00 11 00 00 00 00 00 00 00 00 00 00 00 00 00 .5 .5 .5 .5 .5 .5 .5 .5 .5 .6 1. 7.2 0. 0. 1. 0. 0. 3. ----- 34.3 31.7 Rate Crude

l %1 %0 %1 %0 %0 %2 %1 %0 %2 %0 %0 %0 %0 %0 %0 %0 %0 %0 %1 %0 %0 %0 %0 %1 %0 %0 %2 %0 %0 Najran ----- .5 .0 .5 .0 .0 .0 .0 .0 .0 .0 .0 .5 .5 .0 .0 .0 .0 .0 .5 .5 .0 .5 .0 .5 .5 .0 .5 .0 .0 % of 0.0% 4.5% 0.0% 3.0% 1.5% 1.5% 4.5% 0.0% 3.0% 0.0% 0.0% 0.0% 0.0% 0.0% 1.5% 0.0% 0.0% 0.0% 0.0% 0.0% 1.5% 0.0% 0.0% 0.0% Tota 00.0% 20.9% 92.5% 10.4% 4 71 34 00 34 00 00 46 23 00 46 00 00 11 11 00 00 00 00 00 34 11 00 11 00 7 34 11 00 57 00 00 es 62 ----- l Ag Al e2 l0 a1 ho ma stem x0 mi ia in a0 e0 mp a0 yn ke e0 organs em l6 a0 d0 lom i3 le Genita x0 in ly s0 i0 nx yn a of Sk in ma Mye unspecified y glands in diseas e0 mia unspecified m3 t1 nx y1 x0 r0 x Uter h1 ll intestin n2 phoid Leu loid Leuk ophar roid yn te out elanom ye ultiple esotheliom ther Orophar ther Endocrine esophagus allbladder etc. vary ther Urinary ther & unspecified ther Thoracic organs ther Sk ther Fe terus unspecified rete on-Hodgk ectu onnective, Soft tissu asophary orpus Uter enal Pelvi olo yp ervi odgk ose, sinuses etc. alivar ladder nu s0 reas ll sites Tota ll sites but C44 hary aposi sarcom on e1 rain, Nervous sy ulva tomach agina idne ye ma ancreas lacenta drenal glan rachea, Bronchus, Lung ongu onsi l0 hy iver ym ip ar eu ke mm unoproliferative dis. Si 8S 4T 0R 6M 4M 2T 3H 4G 1B 2B 1N 8O 9C 4A rO lA C6 7B C2 2L C07-C0 C2 1A C5 0B Al Not C4 C33-C3 C5 5U C6 6U C82-C85;C9 6N C9 1L C19-C2 C47;C4 C03-C0 C1 1N C1 4P C4 3M C5 4C C92-C9 C4 6K C1 0O C6 5R C1 8C C5 1V C7 5O ICD (10th) C0 0L C01-C0 C0 9T C12-C1 C1 5O C1 6S C23-C2 C3 2L C40-C4 C5 2V C5 3C C5 6O C6 4K C6 8O C6 9E C70-C7 C7 3T C8 1H C9 0M Othe C1 7S C2 5P C30-C3 C37-C3 C4 4O C4 5M C5 7O C5 8P C7 4A C8 8I C9 5L Table 5.3.3 Number, Relative Frequencies, Age Standardized and Crude Rates for All Cancer Cases Among Saudi Females by Site and Region, 2008 Site and Region, by Among Saudi Females All Cancer Cases and Crude Rates for Standardized Age Frequencies, Relative 5.3.3 Number, Table

P05.indd 80 26-05-2012 6:30:35 PM .6 .4 .8 .2 .7 .6 .8 .3 .1 .1 .2 .7 .4 .2 .7 .4 .4 .1 .2 .1 .3 .1 .5 .6 .1 .9 .3 .3 .6 .4 .2 .7 04 0. 2 1. 3 1. 8 1. 4 0. 8 9. 6 ----- 02.6 31.8 ASR Worl d 71 11 30 30 50 10 52 30 66 83 10 33 10 43 10 50 10 10 52 45 20 32 10 10 22 41 40 10 91 25 61 31 11 10 63 00 00 00 00 12 00 00 00 00 00 00 00 11 00 00 .1 .5 .7 .6 .6 .6 0. 0. 0. 0. 0. 3. 1. 0. 2. 0. 1. 0. 0. 0. 1. 1. 1. 1. 0. 0. 1. 0. 0. 0. 0. 1. 0. 0. 1. 0. 0. 3. 0. 1. 1. ----- 19.7 Crude Rate ----- .1 %0 .8 %0 .1 %0 .0 %0 .0 %0 2.4% 0.5% 0.1% 0.5% 0.8% 0.2% 2.5% 5.9% 2.9% 0.0% 2.3% 0.8% 0.0% 2.4% 4.0% 0.0% 0.2% 3.1% 2.2% 0.2% 0.0% 0.0% 0.0% 0.0% 0.5% 0.1% 2.2% 1.6% 0.2% 0.2% 0.0% 0.1% 0.0% 0.4% 2.2% 0.1% 0.2% 2.1% 0.0% 0.7% 0.0% 0.6% 1.7% 0.0% 5.3% 0.0% 1.0% 1.8% 2.7% 00.0 %6 10.9 %6 99.0 %6 astern Province % of Total 10 70 91 81 81 18 21 49 24 19 20 33 26 18 18 13 18 17 14 90 44 15 22 ----- 82 61 26 83 All Ages 04 00 00 00 00 00 01 00 00 00 00 00 .9 .8 .2 .3 .6 .2 .1 .9 .8 .8 .7 .4 .6 .7 .1 .5 .1 .2 .8 .6 .2 .8 9. 78 0. 21 0. 54 0. 67 0. 62 0. 10 0. 57 0. 12 0. 52 0. 30 0. 10 0. 34 0. 21 0. 22 0. 12 0. 53 0. 21 0. 12 0. 66 0. 35 0. 78 ----- 82.4 21.6 ASR Worl d 11 .1 .2 .3 .4 .4 .1 .5 .2 .3 .2 .1 .2 .1 .2 .1 .1 .3 .1 .2 .3 .2 .4 4. 77 1. 21 3. 45 2. 13 0. 81 1. 21 2. 95 1. 11 1. 81 0. 50 0. 50 0. 81 0. 91 1. 72 0. 71 2. 13 0. 81 0. 91 5. 15 3. 55 0. 91 2. 43 ----- 56.4 15.4 hE Crude Rate Makka ----- .1 %0 .3 %0 .6 %0 .7 %0 .7 %0 .1 %0 .8 %0 .0 %0 .0 %0 .3 %0 .6 %0 .3 %0 .1 %0 .0 %0 .0 %0 .3 %0 .2 %0 .3 %0 .1 %0 .1 %0 .0 %0 .0 %0 .5 %0 .2 %0 .3 %0 .0 %0 .6 %0 .0 %0 .4 %0 .0 %0 .0 %0 .6 %0 7.4% 2.2% 6.1% 3.7% 1.5% 2.2% 5.2% 2.0% 3.2% 0.8% 0.9% 1.8% 1.4% 1.6% 2.9% 1.3% 3.8% 1.5% 1.7% 9.0% 6.2% 1.7% 4.2% 97.1 %5 100.0% % of Total 10 30 60 80 80 10 90 00 00 30 60 30 10 00 00 30 20 30 10 10 00 00 50 20 30 00 60 00 40 00 00 70 66 40 57 35 24 16 24 22 10 20 15 17 32 14 41 16 18 98 67 18 46 ----- 29 82 1089 1057 All Ages 19 0.3 0.1 0.8 1.1 0.1 2.2 7.8 5.3 0.2 2.9 0.7 0.1 2.7 4.3 0.2 0.2 1.9 0.9 0.2 0.1 0.1 0.7 0.2 0.3 4.1 1.9 2.3 0.1 0.1 3.1 0.2 0.8 0.6 4.5 0.2 2.6 0.8 0.1 0.3 2.2 9.1 0.1 8.4 0.2 1.1 4.9 ----- 06.3 03.2 24.2 ASR Worl d 0 0 0 0 0 0 00 00 2 00 00 00 00 0 0 00 15 2. 61 1. 11 0.3 0.4 0.4 0.8 1.1 4.3 2.5 0.1 1.3 0.7 1.5 2.1 0.2 1.9 0.8 0.2 0.4 0.1 0.1 0.9 1.1 0.1 0.1 1.5 0.1 0.6 0.2 2.5 0.2 1.7 0.4 0.2 1.7 6.6 4.8 0.1 0.9 2.1 ----- Crude Rate l Riyadh ----- 3.9% 0.5% 0.5% 0.1% 0.6% 0.7% 1.2% 0.1% 1.7% 6.9% 4.1% 0.2% 2.0% 1.1% 0.1% 2.3% 3.4% 0.1% 0.4% 3.0% 1.3% 0.3% 0.1% 0.1% 0.0% 0.0% 0.6% 0.2% 0.2% 3.2% 1.5% 1.7% 0.2% 0.2% 2.4% 0.2% 0.9% 0.0% 0.0% 0.4% 4.0% 0.0% 0.3% 2.7% 0.0% 0.7% 0.1% 0.4% 2.7% 0.1% 7.6% 0.0% 0.2% 1.5% 3.4% 00.0 %6 97.6 %6 % of Tota 6 2 8 2 4 0 4 8 1 2 8 6 1 9 1 1 4 1 1 0 8 3 2 3 0 4 9 1 5 1 0 3 26 17 41 19 22 51 34 34 19 44 28 31 ----- 30 72 13 51 1252 All Ages a9 d5 n2 e3 d5 x1 x1 e8 a0 outh esothelioma elanoma of Ski ultiple Myeloma esophagus allbladder etc. vary ose, sinuses etc. asopharyn ypopharyn olo n8 ectu m5 ervix Uter i3 orpus Uter i4 enal Pelvis odgkin diseas alivary glands on e1 drenal glan harynx unspecified nu s3 ancreas aposi sarcoma ulva agin ongu rachea, Bronchus, Lung onsil hyroid aryn x2 ymphoid Leukemia eukemia unspecified mmunoproliferative dis. All sites Tota l1 Stomac h2 Breast Site Lip Other Oropharyn x0 Small intestine Liver Other Thoracic organs Other Ski n3 Connective, Soft tissu e1 Uterus unspecifie Other Female Genita l0 Placenta Kidney Urete r0 Bladder Other Urinary organs Eye Brain, Nervous system Other Endocrine Non-Hodgkin lymphom Myeloid Leukemia Other & unspecified All sites but C44 8S 1N 2T 6M 3H 0R 4G 4T 1B All C07-C0 C16 C30-C3 C4 5M C50 C7 4A ICD (10th) C00 C01-C0 C03-C0 C0 9T C10 C1 1N C12-C1 C1 4P C1 5O C17 C1 8C C19-C2 C2 1A C22 C23-C2 C2 5P C3 2L C33-C3 C37-C38 C40-C4 C4 3M C44 C4 6K C47;C49 C5 1V C5 2V C5 3C C5 4C C55 C5 6O C57 C58 C64 C6 5R C66 C67 C68 C69 C70-C72 C7 3T C75 C8 1H C82-C85;C96 C8 8I C9 0M C9 1L C92-C94 C9 5L Other Not C44 Table 5.3.4 Number, Relative Frequencies, Age Standardized and Crude Rates for All Cancer Cases Among Saudi Females by Site and Region, 2008 Site and Region, by Among Saudi Females All Cancer Cases and Crude Rates for Standardized Age Frequencies, Relative 5.3.4 Number, Table

P05.indd 81 26-05-2012 6:30:35 PM l ----- .5 % 0.3% 0.1% 0.0% 2.4% 0.3% 0.1% 1.1% 1.2% 0.4% 1.9% 0.1% 3.2% 0.1% 0.1% 3.9% 0.0% 0.4% 3.2% 3.5% 0.1% 0.1% 0.1% 1.7% 1.2% 5.0% 0.6% 8.2% 0.6% 2.7% 7.6% 0.0% 1.2% 2.4% 3.1% 1.1% 6.3% 0.8% 3.7% 1.0% 1.4% 0.3% 1.3% 6.0% 6.3% 0.4% 0.4% 2.0% 0.9% 0.1% 4.9% 93.7 % 00.0 % of Tota 36 21 48 ----- 75 +% 64 82 91 65 64 ----- 0-74 573 336 333 801 724 821 66 12 10 14 89 ----- 5-69 8 3 2 12 16 13 10 15 22 59 17 19 ----- 60-6 46 87771 11 61 14 16 17 12 20 86 17 01 ----- 5-59 71 855321 11 22 20 13 10 18 11 96 20 71 ----- 50-5 45 01 11 18 17 15 72 16 21 ----- 5-49 6594 51 90 10 51 ----- 40-4 44 71 14 17 10 ----- 35-3 9 11 11 47 ----- 30-3 78 68 ----- 5-29 44 24 ----- 20-2 42 83 73 ----- 15-19 01103104320010 41 31 ----- 15-19 31 31 11 5-9 ----- 22 22 0-4 ----- 00000001101100000 00000000000200000 00000000000000000 00001011248455210 00000000200000200 00000000001001000 00000010010425011 00000105877 02020202221400000 00000010020111000 00011210 00001249423101000 00000000000000010 0300001114 00000000000010000 00000000001000000 0100000026389 00000000000000000 03000000001010000 04643124224363110 00002368537652120 00100000000100000 00001000000000000 00000000001010000 00000012261531120 00000010213431110 00000010112110110 0000005587 0000002363 00001000120220001 00133352916110220 0323292988 00000000000000000 00000001204231301 07 02210365746311102 02001004101201012 01000234 00000010031311101 10000301116 00000010232212001 00000003011643002 00000000100201000 00000000014343021 00000003566 00000000201011000 00000001101011000 04001124515212000 00000100121231011 00000000100000000 00000000003 13 13 ----- Age Unk 2 4 1 1 1 0 5 2 1 2 9 9 0 4 5 1 1 7 9 5 9 7 9 8 3 2 34 15 27 56 46 50 24 17 89 34 44 15 12 53 14 20 18 85 117 108 ----- 1422 1333 All Ages d2 d6 n6 a1 e3 s4 a5 y4 ther Thoracic organs alivary gland on e1 ll sites Total Tonsil Other Oropharyn x0 Nasopharynx Hypopharynx Pharynx unspecifie Oesophagus Stomac h7 Melanoma of Ski Other Ski n8 Testis Other male genital Kidne Renal Pelvis Ureter Bladder Other Urinary organs Eye Brain, Nervous system Thyroid Adrenal gland Other Endocrine Hodgkin diseas Lip Tongue Mouth Small intestine Colon Rectum Non-Hodgkin lymphoma Immunoproliferative dis. Multiple Myelom Lymphoid Leukemia Myeloid Leukemia Leukemia unspecified Other & unspecifie Anus Liver Gallbladder etc. Pancreas Nose, sinuses etc. Larynx Trachea, Bronchus, Lung Mesotheliom Kaposi sarcoma Connective, Soft tissu e2 Breas t1 Penis Prostat e9 All sites but C44 Site 8S 1B 8O C09 C10 C11 C12-C13 C14 C15 C16 C43 C44 C62 C63 C64 C65 C66 C67 C68 C69 C70-C72 C73 C74 C75 C81 C00 C01-C02 C03-C06 C07-C0 C17 C18 C19-C20 C40-C4 C82-C85;C96 C88 C90 C91 C92-C94 C95 Other C21 C22 C23-C24 C25 C30-C31 C32 C33-C34 C37-C3 C45 C46 C47;C49 C50 C60 C61 Al lA Not C44 ICD (10th) Table 5.4.1 Age Distribution of Cancer Cases among non-Saudi Males, 2008 Distribution of Cancer Cases among non-Saudi Males, Age 5.4.1 Table

P05.indd 82 26-05-2012 6:30:36 PM ----- 4.7% 0.6% 2.2% 2.6% 0.7% 0.0% 1.5% 4.9% 0.0% 0.1% 6.0% 1.9% 0.0% 0.2% 0.4% 0.1% 0.1% 1.4% 0.2% 0.3% 3.6% 0.8% 0.3% 3.5% 1.2% 0.3% 4.6% 0.1% 0.2% 3.2% 0.3% 0.9% 0.1% 1.4% 0.3% 0.0% 0.8% 0.9% 1.6% 0.1% 2.7% 4.0% 0.5% 1.5% 0.5% 0.0% 0.0% 0.7% 0.3% 0.1% 0.8% 0.5% 0.0% 0.2% 36.0 % 96.8 % 100.0% % of Total 40 39 ----- 75+ 21 69 41 36 ----- 70-74 63 10 16 62 ----- 65-69 70 21 64 ----- 60-64 85223 46 117 ----- 113 55-59 533431 870411 10 49 129 ----- 124 50-54 0 3 7640002 5313 84 163 ----- 159 45-49 31 6 31 81 14 155 ----- 151 40-44 12 66 144 ----- 141 35-39 20 36 115 ----- 113 30-34 54 11 53 ----- 25-29 25 23 ----- 0-24 17 17 ----- 15-1 92 00111467976625 00031000000000 13224310002030 00000021121010 022487 00000000000000 34121111201000 00000000000000 00000000000010 00000000000000 00001000100201 00000000000010 00000100000000 00001010000000 00000111001000 01148372343421 00001100101000 000068 01001253 02120220120010 00000001011100 00000001010000 00212344546151 01000000000000 00100002000000 00000001420110 00000221222403 00000010000000 00036633411032 00000120120000 00010020002001 00000000000000 10100310120100 00000000000000 12 12 ----- 5-19 0 1 2 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 14 14 5- 91 ----- 04 11131103031100 000086 03 12131210132010 0000000000000100 0000011113232001 00 00010003210102 00002 0000000000000001 0000002011000000 0150001201100000 0000011011311314 0000000000000000 00 00011010012131 00 001333 0000003422331000 0000000000000000 00 00004300100000 0000010000010010 00 00000001000000 00 00000200021010 0000000001001000 ----- Age Unk 60 60 80 80 30 41 20 40 80 70 80 00 90 00 10 20 00 50 10 10 00 20 40 40 40 20 10 40 90 10 60 60 00 00 27 31 71 23 17 10 11 17 11 47 18 18 61 14 81 ----- All Ages a5 d1 a2 n4 e1 a1 s6 i4 x8 x3 i5 ther & unspecifie d5 ll sites Tota l1 ll sites but C4 41 Leukemia unspecified Myeloid Leukemi Lymphoid Leukemia Multiple Myeloma Non-Hodgkin lymphom Immunoproliferative dis. Hodgkin diseas Other Endocrine Adrenal gland Thyroid Ey e2 Brain, Nervous system Other Urinary organs Bladder Ureter Renal Pelvis Kidney Placenta Other Female Genital Ovar y4 Cervix Uter Uterus unspecified Breas t4 Vagina Corpus Uter Connective, Soft tissu e1 Vulva Kaposi sarcom Mesothelioma Other Ski n3 Melanoma of Ski Bone Other Thoracic organs Laryn x0 Trachea, Bronchus, Lung Nose, sinuses etc. Pancreas Gallbladder etc. Live r1 Anus Rectu m3 Colon Small intestine Stomach Other Oropharyn x0 Nasopharyn Hypopharyn Pharynx unspecifie Oesophagus Salivary gland Tonsil Tongu e2 Mout h1 Lip Site Othe rO C95 C92-C94 Al lA C91 C90 Not C4 4A C82-C85;C96 C88 C81 C75 C74 C73 C69 C70-C72 C68 C67 C66 C65 C64 C58 C57 C56 C53 C55 C50 C52 C54 C47;C49 C51 C46 C45 C44 C43 C40-C41 C37-C38 C32 C33-C34 C30-C31 C25 C23-C24 C22 C21 C19-C20 C18 C17 C16 C10 C11 C12-C13 C14 C15 C07-C08 C09 C01-C02 C03-C06 C00 ICD (10th) Table 5.4.2 Age Distribution of Cancer Cases among non-Saudi Females, 2008 Distribution of Cancer Cases among non-Saudi Females, Age 5.4.2 Table

P05.indd 83 26-05-2012 6:30:36 PM 1 4 1 .7 .1 .5 .6 .5 .1 .4 .2 .2 .2 .2 .6 .1 .5 .5 0. 8 1. 3 1. 5 0. 3 0. 1 0. 5 0. 2 0. 9 0. 4 4. 6 0. 7 0. 7 0. 1 4. 4 1. 3 0. 1 6. 7 4. 1 1. 1 5. 8 1. 9 4. 3 0. 2 ---- - 74. 2 69. 6 SR World 00 29 12 00 40 10 31 20 30 24 30 10 20 10 10 10 11 81 53 .3 .7 .1 .6 .4 .4 .9 .6 .3 .3 .7 .5 .5 .5 .9 .4 .8 .4 .2 .1 29 1. 1. 0. 0. 0. 0. 0. 0. 0. 0. 0. 0. 0. 1. 0. ----- 30.9 Crude Rat eA 00 00 00 00 00 00 00 00 0 00 00 00 00 00 0 01 00 0 00 0 00 0 00 0 00 11 12 .7 .7 .7 .7 .7 .7 .7 ---- 7. 70 7. 71 7. 70 7. 70 101 403 372 75+ 15. 50 15. 51 15. 50 23. 22 46. 51 15. 51 23. 21 9 00 00 00 90 97 90 07 07 0 00 87 87 80 80 83 18 18 593 575 ------80.8 26.9 26.9 53. 93 62. 87 71.8 62.8 70-74 00 00 00 09 09 00 00 00 .6 .6 .6 .6 ---- 5. 60 5. 61 5. 69 534 495 44. 51 16. 71 11. 11 11. 19 11. 10 38. 91 77.9 16.7 16.7 66.7 44. 50 38.9 55.6 16. 70 27.8 65-69 00 07 05 0000 0000 0000 0 .3 .3 .3 .5 .3 .5 .8 2. 30 2. 30 2. 30 2. 30 2. 35 2. 35 4. 50 2. 35 6. 80 6. 80 2. 30 2.3 389 361 ------22.7 11.4 11.4 11. 40 27.3 18.2 29.5 36.4 29.5 15.9 34.1 27.3 60-64 02 02 0000 0000 .5 .8 .8 .9 .9 .7 .7 .9 .9 .9 .6 .6 .9 .7 ---- 3.6 4.5 0. 90 0. 92 0. 94 2. 72 4. 54 1. 80 0. 90 9.9 7.2 5. 46 0. 90 8.1 0. 90 167 152 14.4 17. 95 15.2 12.6 14.4 10.8 55-59 00 00 0 5 .9 .5 .4 .3 .4 .7 .8 .9 .9 .8 .6 .6 .3 .3 .3 .5 0. 90 1. 74 1. 71 0. 90 0. 91 0. 40 2. 22 1. 72 0. 40 0. 90 0. 40 0. 90 9.5 8.7 1. 30 2. 63 1. 33 7.8 0. 40 0. 92 ------50-54 11 11 49 28 .3 .1 .3 .3 .8 .5 .5 .3 .6 .4 .3 .3 .5 .3 1. 33 2. 83 1. 50 1. 51 0. 30 0. 80 0. 31 2. 64 1. 30 0. 30 0. 84 1. 82 3. 95 0. 30 1. 83 1. 54 0. 30 0. 83 0. 30 ----- 45-49 00 00000 00 00 0000000 10 00 11 00 01 84 54 .7 .2 .7 .3 .3 .6 .2 .3 .5 .4 .2 .2 .3 ---- 0. 72 0. 20 0. 30 0. 30 0. 20 0. 20 0. 50 1. 24 0. 54 0. 50 0. 20 0. 21 40-44 11 11 41 41 .1 .2 .2 .1 .1 .2 .1 .2 .2 .1 .2 .1 .7 .6 .1 .2 1. 71 0. 10 1. 10 0. 90 0. 50 0. 20 0. 92 0. 60 0. 10 0. 60 0. 10 0. 10 0. 20 0. 21 ------35-39 00 00 000000009 00 00 00 00 00 000000000 00 000000000 00 00 0000 00 00000 0000 000000000 000000000 01 01 .5 .1 .2 .6 .1 .2 .5 .1 .4 .6 .1 .5 ---- 0. 50 0. 10 0. 20 0. 10 0. 61 0. 40 0. 40 0. 40 0. 10 0. 10 30-34 00 00 00 81 81 00 00 .2 .2 .2 .2 .2 .2 .2 .9 .4 .2 0. 50 0. 20 0. 90 1. 10 0. 71 0. 20 0. 40 1. 11 0. 41 0. 40 ------25-29 00 00 00 00 00 00 00 00 00 00 00 00 00 16 15 0.9 1.4 1.4 0.9 0.9 0.9 0.5 0.5 1.4 4.2 0.5 0.5 1.4 0.5 ----- 20-24 0 0 12 12 0.7 2.1 0.7 0.7 0.7 0.7 0.7 1.4 0.7 1.4 0.7 2.1 ----- 15-19 0 0000 1.6 0.5 1.1 0.5 1.6 2.1 ----- 15-19 000 00 0000 0 00 000000 00000000 07 07 0.4 0.9 0.9 4.7 2.6 0.4 5-9 ----- 31 31 0.4 0.8 1.2 0.8 0.8 1.6 1.2 2.9 0.4 1.2 1.6 0-4 ----- 0 0 0000000 0000000000 00000 0000000 0 0000000 00000 0000000 00000 0000000 0000000000 00 0 11 11 0000000000 00000 00000 0000000 0000 00000 00000 00000 0000 0000000 0000000 00000 00000 00000 10000 0000000 000000000 0000000 0000 000 0000000 0 0000000 0000 0000 0 0000000 0000000 0 0000000000 0 0000000 0 00 ----- Age Unk 2 1 4 1 2 0 9 4 2 9 5 1 1 1 0 50 5 3 1 4 2 70 69 15 45 92 39 44 24 17 34 27 89 53 20 18 85 89 28 50 17 34 56 46 117 108 ----- 1422 1333 All Ages .0 n6 .1 a5 d2 x4 s1 Other & unspecified Leukemia unspecified Hypopharyn Pharynx unspecified Oesophagu Other male genital Kidney Site Nose, sinuses etc. Melanoma of Ski Mesotheliom Breas t1 Penis Prostate Hodgkin disease Immunoproliferative dis Myeloid Leukemia All sites Total All sites but C44 Lip Tongue Mouth Other Oropharynx Nasopharynx Stomac h7 Small intestine Gallbladder etc Testis Salivary glands Tonsil Colon Rectum Anu s1 Liver Pancreas Larynx Trachea, Bronchus, Lung Other Thoracic organs Bon e1 Other Skin Kaposi sarcoma Connective, Soft tissue Renal Pelvis Thyroid Adrenal glan Other Endocrine Non-Hodgkin lymphoma Multiple Myeloma Lymphoid Leukemia Ureter Bladder Other Urinary organs Eye Brain, Nervous system Other C95 C12-C13 C14 C15 C63 C64 ICD (10th) C30-C31 C43 C45 C50 C60 C61 C81 C88 C92-C94 All Not C44 C00 C01-C02 C03-C06 C10 C11 C16 C17 C23-C24 C62 C07-C08 C09 C18 C19-C20 C21 C22 C25 C32 C33-C34 C37-C38 C40-C41 C44 C46 C47;C49 C65 C73 C74 C75 C82-C85;C96 C90 C91 C66 C67 C68 C69 C70-C72 Table 5.4.3 Incidence Rates for Cancer Cases among non- Saudi Males by Age Group (per 100,000), 2008 (per 100,000), Group Age Cancer Cases among non- Saudi Males by 5.4.3 Incidence Rates for Table

P05.indd 84 26-05-2012 6:30:36 PM 0 0 1 0 0 0 2 0 0 2 0 0 ---- 1.4 0.4 6.6 0.3 4.6 0.9 0.8 0.4 0.1 1.9 0.2 0.4 0.9 1.4 0.3 0.4 0.1 0.5 3.8 0.2 5.1 2.7 3.3 1.2 0.3 1.3 5.7 3.1 0.1 1.1 0.5 0.2 5.2 2.3 0.2 2.1 0.3 0.2 8.3 1.1 0.8 116 39.2 121.1 SR Worl d -- 26 0 0 0.5 0.2 2.6 0.1 2.1 0.5 0.3 0.2 0.1 0.8 0.2 0.1 0.3 0.9 0.4 0.1 0.3 1.1 3.4 2.3 1.6 0.9 0.9 0.5 0.2 0.4 2.8 0.8 0.4 0.5 0.2 1.8 1.5 0.1 1.3 0.3 2.7 0.7 0.2 ---- 57.5 55.7 20.7 Crude Rat eA 00 0 00 00 00 00 00 0 0 00 00 00 0 00 00 00 0 0 0 ---- 497 484 112 75+ 24.8 12.4 12.4 37.2 12.4 12.4 12.4 24.8 12.4 24.8 37.2 12.4 12.4 49.7 12.4 12.4 62.1 0 00 0 00 0 00 00 468 411 ------22.9 22.9 22.9 11.4 11.4 11.4 11.4 11.4 11.4 34.3 34.3 11.4 34.3 11.4 11.4 57.1 34.3 22.9 11.4 68.6 70-74 3 000 000 0 000 00 000 00 0 0 000 0 0 43 43 43 ---- 107 677 666 172 10.7 21.5 10.7 21.5 10.7 10.7 10.7 32.2 10.7 10.7 64.5 10.7 65-69 0 0 0000 00 04 000 0 0000 00 20 20 20 40 40 6.7 6.7 6.7 6.7 6.7 6.7 6.7 6.7 6.7 6.7 6.7 467 427 140 ------33.3 13.3 13.3 13.3 13.3 13.3 13.3 60-64 0 00 00000 0 00000 ---- 3.7 3.7 7.4 7.4 7.4 3.7 3.7 7.4 3.7 7.4 3.7 7.4 3.7 7.4 3.7 432 418 170 14.8 29.6 11.1 11.1 11.1 25.9 14.8 11.1 14.8 11.1 25.9 55-59 00 00 000000 000000 000000 0 0 0 4.2 2.1 6.3 6.3 2.1 2.1 4.2 6.3 2.1 2.1 2.1 8.3 4.2 4.2 8.3 6.3 2.1 2.1 2.1 269 258 102 ------20.8 16.7 12.5 10.4 10.4 18.8 50-54 0 0000000 0 0 000 000000 00 000 0 3.9 6.6 1.3 2.6 3.9 1.3 3.9 2.6 1.3 9.2 3.9 1.3 1.3 1.3 2.6 1.3 1.3 1.3 1.3 5.3 3.9 1.3 9.2 1.3 215 209 111 ----- 17.1 13.2 45-49 000 0000000 00 0 0 00 5.1 3.6 0.7 0.7 0.7 0.7 1.4 1.4 0.7 1.4 2.2 4.3 2.2 0.7 1.4 0.7 0.7 2.2 0.7 1.4 0.7 2.9 0.7 4.3 1.4 112 109 ----- 10.1 58.6 40-44 7 6 0 000 0 0 0 000000000 3.2 1.2 0.8 1.2 0.4 0.8 0.4 0.4 1.6 1.2 0.4 0.8 1.2 4.7 2.4 0.8 0.4 2.8 0.8 1.2 0.4 1.2 1.6 0.8 0.4 ----- 26.1 35-39 75 75 000 000000000 00000000 000000000 000000000 1 00000 00 00000000 000000000 000 000000000 000000000 000000000 000000000 0 1.9 2.6 0.3 0.3 0.3 0.3 1.3 0.3 6.5 1.9 0.3 0.3 2.6 0.3 0.3 0.6 0.6 0.3 1.3 0.3 0.3 0.3 ----- 11.6 30-34 33 33 00 0 0.4 1.7 0.4 1.3 1.3 2.6 0.4 0.4 1.3 0.9 0.4 1.7 0.4 0.4 1.3 0.9 0.4 1.3 0.9 4.7 ----- 25-29 62 52 00 00 0.6 0.6 0.6 0.6 5.2 0.6 1.3 0.6 1.3 0.6 1.3 0.6 0.6 1.3 ----- 20-24 21 21 0 000 0.7 0.7 1.4 2.8 1.4 0.7 0.7 2.1 1.4 ----- 15-19 71 71 0 00 000 0.5 0.5 1.6 2.7 0.5 0.5 ----- 15-19 0000 000000000000 000000 000 00 1.4 0.5 0.5 0.5 0.5 1.8 0.9 0.5 5-9 ----- 16 16 0 0.8 0.8 0.4 0.4 0.8 4.6 1.3 0.4 0.4 0.8 0-4 ----- 000000 0000 11 1000000 0000 0000000000000000 0000000000 000 00000000 0 00000000 0000000 0000000 00000000 0000000 0000000 0000000 0 11 0000000 00000001 0000000 00000000 00000 00000 000000 0000000000 000000 000000 0000000 0000000 00 0 000000000 000000 0000000000 0000000 000000 0000000 0000 00 000000000 00000 0000000 0 0000000000 0 0000000 0 00000 0000000000 0000000 ----- Age Unk 1 80 10 0 2 4 6 0 2 1 1 5 0 20 8 6 3 1 6 1 0 1 9 0 40 1 4 1 70 4 10 43 54 42 10 17 23 18 47 71 32 18 19 17 11 38 26 56 14 427 ----- 1186 1148 All Ages .0 a5 s0 a3 a8 .1 ultiple Myelom elanoma of Skin esotheliom a2 vary ther Female Genital ther Urinary organ ther Oropharynx esophagus ther Endocrine ther Skin terus unspecified ervix Uteri orpus Uteri enal Pelvis reter asopharynx olon odgkin disease ll sites Total lacenta idney ladder tomach mall intestine harynx unspecified drenal gland nus ancreas aposi sarcoma ulv a4 agina mmunoproliferative dis Lip Tongue Mouth Salivary glands Tonsil Eye Brain, Nervous system All sites but C44 Hypopharynx Thyroid Rectum Liver Gallbladder etc Non-Hodgkin lymphom Site Larynx Nose, sinuses etc. Trachea, Bronchus, Lung Other Thoracic organs Bone Lymphoid Leukemi Myeloid Leukemia Leukemia unspecified Other & unspecified Connective, Soft tissue Breast C00 C01-C02 C5 5U C5 6O Al lA C5 3C C5 4C C03-C06 C5 7O C07-C08 C09 C5 8P C6 4K C6 5R C6 6U C6 7B C6 8O C1 0O C69 C70-C72 Not C44 C1 1N C1 6S C1 7S C12-C13 C1 4P C1 5O C1 8C C73 C7 4A C7 5O C19-C20 C8 1H C2 1A C22 C23-C24 C82-C85;C96 ICD (10th) C2 5P C32 C30-C31 C33-C34 C8 8I C37-C38 C9 0M C40-C41 C91 C4 3M C4 4O C4 5M C92-C94 C4 6K C95 Other C47;C49 C50 C5 1V C5 2V Table 5.4.4 Incidence Rates for Cancer Cases among non-Saudi Females by Age Group (per 100,000), 2008 (per 100,000), Group Age by Cancer Cases among non-Saudi Females 5.4.4 Incidence Rates for Table

P05.indd 85 26-05-2012 6:30:37 PM Table 5.5.1 Number of New Cases by Primary Site and Years among Saudi Males, 1994 - 2008

ICD-10 Site 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 C00 Lip 8245416155865129 C01-C02Tongue 32 15 21 24 13 26 29 14 24 29 33 38 37 40 30 C03-C06Mouth 24 23 30 25 24 27 24 27 26 26 39 29 30 38 39 C07-C08Salivary glands 410611 712816 14 11 14 15 17 21 17 C09Tonsil 492462146523042 C10 Other Oropharynx 233213033023022 C11Nasopharynx78608699 109 97 89 122 85 89 103 114 98 93 122 C12-C13Hypopharynx111018 7665867711914 5 C14Pharynx unspecified 020011022444323 C15Oesophagus777168617956686371685558587351 C16Stomach 131128 133109 124 103 124 125 147 182 150 160 170 171 166 C17 Small intestine 10 811101513151317152223212831 C18Colon 61 87 74 85 106 100 116 119 153 177 200 262 232 273 286 C19-C20Rectum83666666648983 108 123 143 173 190 182 206 192 C21Anus1096 86510 12 14 11 17 16 81210 C22 Liver 299298 277269 327 296 290 274 288 284 276 289 313 331 303 C23-C24Gallbladder etc. 24 31 25 22 28 25 27 39 42 39 26 36 48 54 54 C25Pancreas 50 49 53 45 60 59 68 53 75 84 82 99 101 131 100 C30-C31Nose, sinuses etc. 5610 410135914101015910 14 C32Larynx494844414643455232605352645657 C33-C34Trachea, Bronchus, Lung 189185 187163 223 204 197 190 195 203 251 282 236 325 285 C37-C38 Other Thoracic organs 7111213817 765121221151911 C40-C41Bone475034465155526750456755656773 C43Melanoma of Skin2188 86711 912101313121912 C44 Other Skin104 118113 10999 122 112 156 149 166 140 156 190 168 159 C45Mesothelioma 54557275366881117 C46Kaposi sarcoma 15 10 14 14 12 11 19 19 21 26 27 22 22 18 16 C47;C49Connective, Soft tissue846851605068554764696076647366 C50 Breast1115612 19 11 16 12 15 16 13 15 18 21 17 C60Penis 341801113135103 C61 Prostate150 147155 125 162 148 186 169 200 192 247 273 234 260 267 C62Testis322225293831353645384744396374 C63 Other male genital 120312333432400 C64Kidney69805763727974869084 124 104 117 146 144 C65Renal Pelvis 550010 2621784545 C66Ureter 131030410633123 C67Bladder 164154 127126 154 151 159 143 161 177 175 168 173 177 173 C68 Other Urinary organs 111011001110011 C69 Eye 21 12 18 34 16 24 25 22 24 21 21 17 26 22 27 C70-C72 Brain, Nervous system 13299127 123 103 121 140 120 121 148 155 141 153 137 158 C73Thyroid726158728485767493879593 119 123 131 C74Adrenal gland 89884910 7615 6920 16 14 C75 Other Endocrine 235122141536549 C81Hodgkin disease104 106105 98 135 121 126 136 121 145 178 167 180 183 175 C82-C85;C96Non-Hodgkin lymphoma 272215 232228 284 270 265 248 272 328 351 356 363 428 370 C88Immunoproliferative dis. 000101000120000 C90Multiple Myeloma 59 41 30 36 47 37 46 36 29 39 45 62 51 46 37 C91Lymphoid Leukemia 152118 146143 154 137 152 160 145 165 155 165 158 195 157 C92-C94 Myeloid Leukemia 95 90 84 10594 109 93 128 115 90 117 107 125 113 139 C95Leukemia unspecified 10 5558714 13 12 14 15 16 25 29 39 Other Other & unspecified 148122 98 132 143 140 126 136 152 143 150 179 183 172 156 ------AllAll sites Total2946270326502667 3026 2952 3031 3100 3256 3513 3769 3992 4017 4413 4231 Not C44All sites but C442842258525372558 2927 2830 2919 2944 3107 3347 3629 3836 3827 4245 4072

P05.indd 86 26-05-2012 6:30:37 PM Table 5.5.2 Number of New Cases by Primary Site and Years among Saudi Females, 1994-2008

ICD-10 Site 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 C00Lip 334215436586455 C01-C02Tongue212028282931231930302922243729 C03-C06Mouth 23 38 37 22 33 39 26 27 29 29 23 44 37 53 46 C07-C08Salivary glands 876311814 8610 12 13 14 19 18 C09Tonsil 033311315411133 C10Other Oropharynx 010010002022010 C11Nasopharynx382839313736234141394535445745 C12-C13Hypopharynx191015151916101212216 16 10 916 C14Pharynx unspecified 231111203130131 C15Oesophagus755468524649553758525165635554 C16Stomach 67 73 64 58 66 71 62 73 76 75 77 74 115127 100 C17 Small intestine911 91016810 14 8101313141414 C18Colon 65 80 85 75 73 106108 143135 145179 196222 246274 C19-C20Rectum4450525957867388104 107119 143141 154152 C21Anus 6323524259798127 C22Liver 11188101 87 12393121 101115 128120 114137 130115 C23-C24Gallbladder etc. 51 38 25 32 51 59 46 54 41 60 53 68 72 86 77 C25Pancreas 28 30 24 25 50 41 35 35 54 41 35 53 77 53 67 C30-C31Nose, sinuses etc. 695498658261012146 C32Larynx102710910 9374769105 C33-C34Trachea, Bronchus, Lung 51 55 48 53 51 49 52 57 52 64 71 87 80 92 82 C37-C38Other Thoracic organs 76565585310913 11 711 C40-C41Bone263838254437384235394041392947 C43Melanoma of Skin 11 77288687812 9141810 C44Other Skin78558759827780104 95 123134 132135 120125 C45Mesothelioma 101104113757532 C46Kaposi sarcoma 03087845365815 65 C47;C49 Connective, Soft tissue 42 55 42 46 61 50 48 43 39 53 75 51 41 64 54 C50 Breast430 435463 473523 517606 559673 716820 946982 1176 1152 C51Vulva 867333875611 1345 C52Vagina 562423155157140 C53Cervix Uteri79748375967984848692929676103 93 C54Corpus Uteri574739486058927989111 124151 148184 194 C55Uterus unspecified 4211 10 17 13 51514141317242622 C56Ovary 96 10097114 107100 105111 108123 120146 136148 160 C57Other Female Genital 110224354510 6985 C58Placenta1610117912914 16 5814 23 12 12 C64Kidney613750575364497068688565808493 C65Renal Pelvis 010233211215411 C66Ureter 011011011124200 C67Bladder 29 40 23 30 41 37 39 52 41 45 42 39 42 36 38 C68Other Urinary organs 000001100011001 C69 Eye 15 16 18 13 12 24 25 17 20 16 18 20 19 20 17 C70-C72 Brain, Nervous system 78 74 76 93 86 78 84 84 85 96 108103 107117 92 C73Thyroid 206218 199211 269280 263260 276366 347392 433460 475 C74Adrenal gland10610 11 91014810 13 17 910813 C75Other Endocrine 212123100125542 C81Hodgkin disease597059597575877876113 105104 120135 131 C82-C85;C96Non-Hodgkin lymphoma 143150 142147 184177 187201 202238 244258 246290 304 C88Immunoproliferative dis. 000101110100000 C90Multiple Myeloma203320132527251920162627344825 C91Lymphoid Leukemia 76 90 80 80 74 95 11286101 92 85 85 91 116112 C92-C94Myeloid Leukemia 78 81 74 90 82 91 93 103100 98 123101 118105 104 C95Leukemia unspecified 6615712 945111216919 31 OtherOther & unspecified 106959395140 128124 116120 162179 147173 151165 ------AllAll sites Total238723702364236427782804290029123108347537574003424046864617 Not C44 All sites but C44 2309 2315 2277 2305 2696 2727 2820 2808 3013 3352 3623 3871 4105 4566 4492

P05.indd 87 26-05-2012 6:30:37 PM Table 5.5.3 Age Standardized Incidence Rate by Primary Site and Years among Saudi Males, 1994-2008

ICD-10 Site 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 C00Lip 0.20.1 0.10.2 0.10.2 0.100.10.1 0.20.1 0.10.2 0.2 C01-C02Tongue0.9 0.50.6 0.60.3 0.90.8 0.30.6 0.60.8 0.90.8 0.80.6 C03-C06Mouth 0.70.7 0.90.6 0.60.7 0.50.7 0.60.6 0.80.7 0.80.8 0.7 C07-C08Salivary glands 0.10.3 0.20.3 0.10.1 0.20.3 0.30.2 0.20.2 0.30.4 0.3 C09Tonsil0.1 0.20.1 0.10.1 0.100.10.1 0.10.1 0.100.10 C10Other Oropharynx0.1 0.10.1 0.100.100.10.1 000.1000 C11Nasopharynx2.1 1.62.3 2.52.6 2.122.51.9 1.72.1 2.21.7 1.52 C12-C13Hypopharynx0.3 0.20.4 0.20.2 0.30.1 0.20.1 0.10.2 0.20.2 0.30.1 C14Pharynx unspecified 0000000000.1 0.10.1 0.100.1 C15Oesophagus2.2 1.91.7 1.51.9 2.21.6 1.61.6 1.61.2 1.31.4 1.51 C16Stomach 3.73.6 3.52.7 33.7 32.9 3.24.2 3.53.5 4.23.6 3.2 C17 Small intestine0.3 0.20.3 0.30.4 0.30.4 0.30.4 0.30.5 0.50.5 0.50.6 C18Colon 1.82.4 22.1 2.61.8 2.92.8 3.54.1 4.45.8 5.35.5 5.3 C19-C20Rectum2.4 1.91.6 1.71.6 2.422.52.7 3.344.34.4 4.13.7 C21Anus 0.30.2 0.20.2 0.20.3 0.30.3 0.30.3 0.40.3 0.20.2 0.2 C22Liver 8.78.5 7.57.1 8.38.7 7.37.3 77.1 6.66.8 8.27.2 6.2 C23-C24Gallbladder etc. 0.70.9 0.70.6 0.70.7 0.71110.60.8 1.31.2 1 C25Pancreas1.4 1.31.5 1.21.5 1.41.6 1.31.7 222.32.6 2.72 C30-C31Nose, sinuses etc. 0.10.2 0.30.1 0.20.1 0.10.3 0.30.2 0.20.3 0.20.2 0.2 C32Larynx1.5 1.41.2 1.11.2 1.51.1 1.40.8 1.51.3 1.31.6 1.21.2 C33-C34Trachea, Bronchus, Lung 5.65.4 54.4 5.85.6 54.9 55.2 5.96.6 6.26.9 5.8 C37-C38Other Thoracic organs 0.20.2 0.20.2 0.20.2 0.10.1 0.10.3 0.20.3 0.20.3 0.2 C40-C41Bone0.7 0.70.5 0.70.7 0.70.7 0.80.6 0.60.7 0.60.7 0.70.8 C43Melanoma of Skin0.6 0.20.2 0.20.2 0.60.3 0.20.3 0.20.3 0.30.3 0.40.2 C44Other Skin2.7 3.12.8 2.82.4 2.72.5 3.63.2 3.73.1 3.44.5 3.33 C45Mesothelioma0.1 0.10.2 0.10.2 0.10.2 0.10.1 0.10.1 0.20.2 0.20.3 C46Kaposi sarcoma 0.50.3 0.30.3 0.30.5 0.40.5 0.50.6 0.60.4 0.50.3 0.3 C47;C49Connective, Soft tissue1.7 1.411.20.8 1.710.81.1 1.20.9 1110.9 C50 Breast0.3 0.40.1 0.30.5 0.30.4 0.30.4 0.40.3 0.30.4 0.40.3 C60Penis 0.10.1 00.2 00.1 000.100.10.1 000.1 C61 Prostate43.83.8 33.9 44.1 4.34.4 4.65.8 6.46.3 5.75.7 C62Testis0.7 0.40.5 0.50.7 0.70.6 0.50.7 0.50.6 0.50.5 0.70.8 C63Other male genital 0000.1000.1 0.10.1 0.10.1 00.1 00 C64Kidney1.8 21.4 1.51.7 1.81.7 1.91.8 1.82.5 2.12.5 2.82.5 C65Renal Pelvis 0.10.1 000.30.1 0.1000.2 0.20.1 0.10.1 0.1 C66Ureter00.1000.1 00.1 000.20.1 0.1000.1 C67Bladder 4.64.3 3.43.2 3.94.6 43.4 3.54.1 4.13.6 4.13.6 3.6 C68Other Urinary organs 000000000000000 C69 Eye 0.50.2 0.30.5 0.20.5 0.30.5 0.40.3 0.40.3 0.30.3 0.3 C70-C72 Brain, Nervous system 2.91.8 2.42.2 1.72.9 2.32.1 22.5 2.52.2 2.622.1 C73Thyroid 1.91.5 1.51.8 1.91.9 1.51.6 1.91.7 1.71.6 2.11.9 2 C74Adrenal gland0.1 0.10.2 0.100.10.2 0.10.1 0.20.1 0.10.2 0.20.1 C75Other Endocrine 0.10.1 0.1000.1 0000.1 00.1 0.100.1 C81Hodgkin disease2.1 1.91.7 1.52.1 2.11.7 1.91.7 1.92.3 2.12.1 2.21.9 C82-C85;C96Non-Hodgkin lymphoma 6.75.1 5.556.26.7 5.455.26.4 6.26.6 6.77.1 6 C88Immunoproliferative dis. 00000000000.1 0000 C90Multiple Myeloma 1.81.1 0.811.31.8 1.10.9 0.60.9 1.11.4 1.310.7 C91Lymphoid Leukemia2.2 1.82.1 2.12.4 2.22.1 2.422.22.1 22.3 2.42 C92-C94 Myeloid Leukemia 1.91.7 1.7221.9 1.7221.6 1.81.6 1.91.6 1.9 C95Leukemia unspecified 0.20.1 0.10.1 0.20.2 0.30.2 0.20.3 0.20.2 0.40.4 0.6 OtherOther & unspecified 43.1 2.63.3 3.442.83.4 3.43.3 3.33.9 4.33.4 3.1 ------AllAll sites Total75.967.263.361.3 68.9 75.9 65.3 67.7 67.574 76.4 80.186 81.1 74.1 Not C44All sites but C4473.264.160.558.5 66.5 73.2 62.8 64.1 64.3 70.3 73.3 76.7 81.5 77.8 71.1

P05.indd 88 26-05-2012 6:30:38 PM Table 5.5.4 Age Standardized Incidence Rate by Primary Site and Years among Saudi Females, 1994-2008

ICD-10 Site 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 C00Lip 0.10.1 0.1000.1 0.10.1 0.20.1 0.20.1 0.10.1 0.1 C01-C02Tongue0.7 0.70.9 0.80.9 0.70.6 0.50.8 0.70.7 0.50.6 0.80.6 C03-C06Mouth 0.71.2 1.10.7 1.10.7 0.70.6 0.70.7 0.510.810.9 C07-C08Salivary glands 0.20.2 0.20.1 0.30.2 0.20.2 0.10.2 0.30.2 0.20.3 0.2 C09Tonsil00.10.1 0.1000.1 00.1 0.10000.10.1 C10Other Oropharynx 000000000.100.10.1 000 C11Nasopharynx0.9 0.610.70.9 0.90.4 0.70.8 0.70.9 0.70.8 0.90.7 C12-C13Hypopharynx0.6 0.30.5 0.50.6 0.60.3 0.30.2 00.4 0.40.2 0.20.3 C14Pharynx unspecified 00.1 0 0000.100.100.1 0000 C15Oesophagus2.7 1.82.2 1.71.4 2.71.5 11.5 1.31.2 1.51.6 1.21.1 C16Stomach 2.42.4 2.11.8 22.4 1.61.7 1.71.8 1.71.7 2.72.5 1.9 C17 Small intestine0.3 0.40.3 0.30.5 0.30.2 0.30.2 0.20.3 0.30.3 0.30.3 C18Colon 2.32.7 2.62.2 2.22.3 2.63.4 33.4 4.14.2 5.14.6 5.2 C19-C20Rectum1.6 1.71.6 1.91.7 1.61.8 22.3 2.52.7 3.13.2 33 C21Anus 0.20.1 0.10.1 0.20.2 0.10.1 0.10.2 0.10.2 0.20.2 0.1 C22Liver 3.933.32.9 3.83.9 3.22.7 2.83.3 2.92.6 3.32.8 2.3 C23-C24Gallbladder etc. 1.81.4 0.811.61.8 1.31.4 1.11.5 1.21.6 1.71.9 1.6 C25Pancreas 1.11.1 0.80.9 1.61.1 0.90.8 1.410.91.3 1.91.2 1.4 C30-C31Nose, sinuses etc. 0.20.2 0.10.1 0.20.2 0.10.1 0.200.10.2 0.30.2 0.1 C32Larynx0.3 0.10.2 0.30.3 0.30.2 0.10.2 0.10.2 0.10.2 0.20.1 C33-C34Trachea, Bronchus, Lung 1.921.51.6 1.61.9 1.51.5 1.21.6 1.71.9 1.91.9 1.7 C37-C38Other Thoracic organs 0.20.2 0.10.1 0.10.2 0.20.1 00.1 0.20.2 0.20.1 0.1 C40-C41Bone0.4 0.70.7 0.40.6 0.40.4 0.50.4 0.50.5 0.40.4 0.30.5 C43Melanoma of Skin 0.30.2 0.20.1 0.20.3 0.10.2 0.20.2 0.20.2 0.30.4 0.2 C44Other Skin2.7 1.72.7 1.92.4 2.722.52.2 2.93.1 2.932.52.4 C45Mesothelioma 000000000.10.2 0.10.2 0.10.1 0 C46Kaposi sarcoma 00.1 00.3 0.200.10.1 0.10.1 0.10.2 0.40.1 0.1 C47;C49 Connective, Soft tissue 0.91.3 111.10.9 0.80.6 0.60.8 1.30.7 0.60.8 0.8 C50 Breast13.31313.212.91413.313.6121414.616.218.318.120.519.2 C51Vulva 0.30.2 0.20.1 0.10.3 0.20.2 0.10.1 0.200.10.1 0.1 C52Vagina0.2 0.200.200.200.10.1 00.1 0.200.10 C53Cervix Uteri2.4 2.22.5 2.22.8 2.41.9 21.8 1.91.9 21.6 1.91.7 C54Corpus Uteri2.1 1.41.4 1.522.12.5 22.2 2.733.63.8 3.94 C55Uterus unspecified 0.10.1 0.30.3 0.50.1 0.10.4 0.30.3 0.30.4 0.60.6 0.4 C56Ovary 2.932.73.1 3.12.9 2.22.4 2.22.3 2.432.92.7 3 C57Other Female Genital 0000.10.1 00.1 0.10.1 0.10.2 0.10.2 0.20.1 C58Placenta0.4 0.20.2 0.10.2 0.40.2 0.20.2 0.10.1 0.20.3 0.20.1 C64Kidney1.5 11.1 1.31.4 1.50.9 1.41.4 1.41.8 1.21.5 1.41.5 C65Renal Pelvis 0000.10.1 00.1 000.100.10.1 00 C66Ureter 000000000000.1 000 C67Bladder 11.2 0.711.311.11.3 11.1 10.8 10.7 0.8 C68Other Urinary organs 000000000000000 C69 Eye 0.30.3 0.40.2 0.20.3 0.40.3 0.40.3 0.30.3 0.30.3 0.2 C70-C72 Brain, Nervous system 1.41.5 1.41.8 1.51.4 1.51.5 1.31.6 1.71.4 1.71.7 1.3 C73Thyroid 5.55.2 4.64.9 5.75.5 4.84.6 4.76.1 5.76.3 6.66.4 6.8 C74Adrenal gland0.2 0.10.1 0.10.1 0.20.2 0.10.1 0.20.2 0.10.1 0.10.1 C75Other Endocrine0.1 00000.1000000.10.1 0.10 C81Hodgkin disease1.4 1.311.11.3 1.41.2 1.111.51.4 1.31.6 1.61.5 C82-C85;C96Non-Hodgkin lymphoma 4.34.2 4.144.94.3 4.14.4 4.354.95.2 5.15.2 5.4 C88Immunoproliferative dis. 000000000000000 C90Multiple Myeloma0.8 1.20.7 0.40.8 0.80.7 0.50.5 0.40.6 0.60.8 10.5 C91Lymphoid Leukemia 11.6 1.2 1111.61.2 1.21.2 1.111.21.5 1.4 C92-C94Myeloid Leukemia 1.81.7 1.61.7 1.61.8 1.61.8 1.81.6 1.91.6 2.11.6 1.4 C95Leukemia unspecified 0.10.1 00.1 0.20.1 0.20.1 0.10.2 0.20.2 0.20.3 0.4 OtherOther & unspecified 3.53.1 2.82.8 4.13.5 3.12.9 2.83.8 4.13.2 4.13.1 3.3 ------AllAll sites Total70.967.264.462.572.470.963.462.3647175.177.884.382.979.4 Not C44 All sites but C44 68.2 65.5 61.7 60.7 70 68.2 61.5 59.8 61.8 68.1 72 74.9 81.3 80.4 77

P05.indd 89 26-05-2012 6:30:38 PM P05.indd 90 26-05-2012 6:30:38 PM PART VI APPENDICES

P06.indd 91 28-05-2012 11:56:05 AM APPENDIX: A Reporting Health care Facilities

Asir Region Abha General Hospital (Maternity) King Fahad Hospital, AFH Abha Private Hospital Maghrabi Hospital & Center AFS Military South Hospital Mahael General Hospital Ahli Hospital (Abha) Majaridah General Hospital Al-Borg Laboratory (Khamis Mushait) Namas General Hospital Asir Central Hospital (Abha) Prince Abd Bin Abd Aziz Hospital Balasmar General Hospital Rijal Al Maa Hospital Bashayer Hospital Sabt Alaya Hospital Ghassan Nagib Pharaon Sarat Obeidah General Hospital Hayat Hospital (Khamis Mushait) Saudi German Hospital (Abha) Khamis Mushayt Civil Hospital Tathleeth General Hospital Khamis Mushayt General Hospital Unknown Asir Hospital King Fahad Hospital (Bishah) Zafer Hospital Baha Region Baljurashi General Hospital Mikhwah Hospital King Fahd Hospital (Baha) Qilwah Hospital Eastern Province Abdullah Fouad Hospital King Khalid General Hospital Abqaiq Health Center King Khalid Military Med Comp (AFH) Ahsa Hospital (Hofuf) Mana General Hospital (DM) Amal Hospital (DM) Mana General Hospital (Hofuf) Anak General Hospital Mana General Hospital (Jubail) ARAMCO Clinic Mana General Hospital (Khobar) Armed Forces Hospital (Hafr Batin) Maternity & Children's (Dammam) Astoon Hospital (Thomairy) Maternity & Children's (Hofuf) Badr Rubaie Dispensary Medical DX & TX Center Dammam Central Hospital Mohd Dossary Hospital Dhukair Medical Center Mousa Hospital (Hofuf) Dossary Hospital (Khobar) Mouwasat Dispensary (DM) Dr Fakhry & Mouhawis Hospital Mouwasat Hospital (DM) Eastern Province Hospital Mouwasat Hospital (Jubail) Elaj Hospital (Ahsa) Mouwasat Hospital (Qatif) Fanateer Hospital Naim Clinic (Hofuf) Faraby Dispensary Obeid Hospital (Hofuf) Imam Abd Rahman Bin Faisal Prince Saud Bin Jalawi Med Comp (AFH) Jabir Eye & ENT Hospital Qaisymah Dispensary Jubail General Hospital Qatif Central Hospital Jufer Hospital (Hofuf) Rowdha Dispensary Khafji General Hospital Royal Commission Hospital Khafji Joint Operation Saad Specialist Medical Center (Khobar) King Abd Aziz Airbase Saddiq Hospital King Abdul Aziz Navy Base Safwa Hospital King Abdulaziz NGH Hospital Salama Hospital King Fahad Hospital (Hofuf) Saudi ARAMCO Medical Services King Fahad Hospital of the University Tadawy General Hospital King Fahad Military Tapline Qaisuma Hospital King Fahad Specialist Hospital Yousif Hospital Hail Region Ahli Polyclinic Salamat Private Hospital Baqa Hospital Salimi Hospital (Shanan) Hail General Hospital Shamli Hospital (Hail) King Khaled General Hospital Sumiraa Hospital (Shanan) Maternity & Children's Hospital Unknown Hail Hospital Rashid Hospital Zamzam Private Hospital

P06.indd 92 28-05-2012 11:56:05 AM APPENDIX: A (continued...)

Jazan Region Abu Arish General Hospital Emeis National Hospital Ahad Masarha Hospital Jazan General Hospital Aridah Hospital King Fahd Central Hospital Baysh General Hospital Sabia General Hospital Darb Hospital Samtah General Hospital Dental Center (Jazan) Unknown Jazan Hospital Jouf Region Dawamat Jandal Hospital Qurayat General Hospital King Faisal Qurayyat Hospital Qurayat Psychiatric Hospital Maternity & Children's Hospital Skaka General Hospital Prince Abd Rahman Sudairi Hospital Tabarjal General Hospital Madinah Region Al-Borg Laboratory Mahd General Hospital Ansar Hospital Meeqat Hospital Ansary Specialist Hospital Mouwasat Hospital Badr General Hospital (Yanboa) National Hospital (Yanboa) Dar Hospital Ohoud Hospital Dr Erfan Saadi Hospital (Yanboa) Prince Abd Mohsen Ola Hospital Ees General Hospital (Yanboa) Royal Commission Medical Center Hanakyah General Hospital Saudi German Hospital Ijlal Hospital Taiba Diagnostic Center King Fahad Hospital Yanboa General Hospital Madina National Hospital Yanboa National Hospital Madinah Maternity & Children's Hospital Zahra Private Hospital Magrabi Eye Hospital Makkah Region Abd Rahman Qari Center King Fahad General Hospital Abdulllah Saeim Daher King Fahad, AFH (Jeddah) Abeer Polyclinic (Jeddah) King Fahd Air Base Hospital Abuzinada Hospital King Faisal Hospital (Al Sheshah) Adhm Hospital (Leeth) King Faisal Hospital (Taif) Adwani General Hospital (Taif) King Faisal Specialist Hospital & RC, Jeddah Ahli Clinic King Saud Hospital (Jeddah) Ahmed Hassan Fetahi Hospital Leeth Hospital Alawi Tunsi & Bros Hospital Maghraby Eye Hospital (Jeddah) Al-Borg Laboratory (Jeddah) Maternity & Children's Hospital (Jeddah) Al-Borg Laboratory (Makkah) Mhammad Saleh Bashrahil Hospital Amal Hospital (Jeddah) Misan Blhareth Hospital (Taif) Amen Hospital (Taif) Mustaf Iqbal Hospital Ansar Hospital (Jeddah) Nahda National Hospital (Taif) Badrddin Medical Group New Jedaani Hospital (Qulail) Bugshan General Hospital New Jeddah Clinic Dr Abd Rahman Bakhsh Hospital Noor Specialist Hospital Dr Erfan & Bagedo Hospital Nourah Oncology Cen, King Abdulaziz Med. City Dr Ghassan Pharaon Hospital Pioneers Laboratory Dr Halla Bin Laden Hospital Qunfudah General Hospital Dr Khalid Idriss Hospital Raﬁe Hospital (Makkah) Dr Solaiman Fakeeh Hospital Ranyah Hospital Eye Hospital (Jeddah) Royal Commission Medical center Hada Military Hospital (Afh) Saedy Medical Clinic Hai Jamea Hospital Salam Hospital Hamra Hospital Saudi German Hospital (Jeddah) Hayat Hospital (Jeddah) Saudi Hospital Heda Sanatorium Hospital Saudia Airlines Med Services Hera General Hospital (Makkah) Sheffaa Hospital International Medical Taif Chest Hospital

P06.indd 93 28-05-2012 11:56:05 AM APPENDIX: A (continued...)

Makkah Region Continued…… Jedaani (Safa) Hospital Taif Children's Hospital Jeddah Clinic Hospital Thagher Hospital Jeddah National Hospital The Eye Consultant (Jeddah) Khadra Lab (Jeddah) Torbah Hospital Khalid Idriss Hospital (Jeddah) Umm Qura General Private King Abd Aziz Hospital & Oncology Center Umm Qura Poly Clinic King Abd Aziz Hospital (Al Zaher) United Doctors Hospital King Abd Aziz Hospital (Taif) Zahra Hospital (Jeddah) King Abd Aziz University Hospital Najran Region Dhafer Hospital (Najran) Najran General Hospital King Khaled Hospital (Najran) Sharourah Armed Forces Hospital Maternity & Children's Sharourah General Hospital Najran Armed Forces Hospital Unknown Najran Hospital Northern Region Arar Central Hospital Rafha General Hospital Arar Psychiatric Hospital Turayf General Hospital Owaiqaliah Hospital Unknown Northern Hospital Prince Abduaziz Bin Musaad Hospital (Arar) Qassim Region Bukairiya General Hospital Maternity & Children's Hospital Buraidah Central Hospital Midhnab General Hospital King Fahd Specialist Hospital Onaizah General Hospital King Saud University Hospital Rass General Hospital Riyadh Region Abdul Azeem Bassam Medical center King Abd Aziz Medical City Adama Hospital King Abdul Aziz University Advance Cell Laboratory King Fahad Medical City Advanced Medicine Center King Faisal Specialist Hospital & RC, Riyadh Adwa Sigal Dental Clinic King Khaled Eye Specialist Hospital AFH Military (RKH Program) King Khaled General Hospital Aﬁf General Hospital King Khaled International Hospital Aﬂaj General Hospital King Khaled University Hospital Alam Medical Center King Saudi Medical Complex Al-Borg Laboratory Maghraby Eye Hospital (RY) Amal Clinic (1) Mamlaka Hospital (Kingdom) Amal Psychiatric Hospital Maternity & Children's Hospital Ameed Polyclinic (Kharj) Medical World Clinic Anda Medical Laboratory Mobarak Hospital Armed Forces Wadi Dawaser Moewed Medical Center Ashbelia Medical Clinic Mohd Anazi Medical Center British Saudi Hospital Mouwasat Hospital Bustan Clinic Muzhamiyah General Hospital Chest Diseases Hospital (Kharj) Obeid Hospital College of Dentistry KSU Olaya Medical Center Consultative Medical Center Om Hammam Polyclinic Consulting Radiologist Osrah Clinic Dallah Hospital Prince Nasser Bin Saad Dar Hekma Clinic Prince Salman Bin Abdulaziz Dar Shifa Hospital Quwayiyah General Hospital Dawadmi General Hospital Rathawiah Medical Specialist Delta Medical Laboratory Riyadh Care Hospital (Social) Derma Hospital Riyadh Medical Center Dilem General Hospital (Kharj) Rowaidha General Hospital

P06.indd 94 28-05-2012 11:56:05 AM APPENDIX: A (continued....)

Riyadh Region continued….. Dr Abdl Rahman Mishari Hospital Sajir Hospital (Dawadmi) Dr Fahd Sheduokhy Polyclinic Saudi German Hospital Dr Moagel's Polyclinic Saudi Medical Services Dr Mofarreh Polyclinic Security Forces Hospital Dr Mohamed Anazi Med Center Shaqra General Hospital Dr Suleiman Habib Med Center Sharif Poly Clinic Elite Medical & Surgical Shifa Health Center Eman General Hospital Specialized Medical Centre ENT Medical Center Sports Medicine Hospital Faiha Medical Center Sulail Hospital Faleh International Hospital Sulemaniya Children's Finger Print Laboratory Taawin Polyclinic Green Crescent Hospital Taif Medical Center Hammadi Hospital Thadeq General Hospital Hammadi Hospital Thuriah Medical Center Hayat Polyclinic (Kharj) Transad Clinic Heraa Medical Clinic Tumayr (Majmaah) Hotta Bani Tammim Hospital United Medical Laboratory Howtat Sudair Hospital Unknown Riyadh Hospital Huraymila General Hospital Wadi Dawasser Hospital Huraymila General Hospital Watan Clinic Dr. Ismail Raslan Polyclinic Watani Hospital Jafel International Hospital Wroud Medical Clinic Jazeera Medical Clinic Yamamah Hospital Karama Polyclinic Zulﬁ General Hospital Khazan Clinic (2) Tabuk Region Dhuba General Hospital North West Armed Force King Abd Aziz Military Prince Fahad Bin Sultan King Fahad Hospital (Tabuk) Tabuk Hospital NOS King Fahad Hospital (Tabuk) Umlujj General Hospital King Khalid CivilUnknown Tabuk Hospital King Khalid GeneralWajh General Hospital King Khalid Military Hospital International Hospitals in the following Countries Austria Malaysia Bahrain Morocco Bangladesh Nigeria Barbados Pakistan Egypt Philippines Ethiopia Qatar France Senegal French Polynesia Sudan Germany Syrian Arab Republic Hong Kong (SARC) Taiwan Province of China India Thailand Iran, Islamic Republic United Arab Emirates Jordan United Kingdom Kuwait United States of America Lebanon Yemen

P06.indd 95 28-05-2012 11:56:06 AM APPENDIX: B SCR Board Member Contact Information

SCR Main Ofﬁce Chairman: Shouki Bazarbashi, MD MBC 64 PO Box 3354, Riyadh 11211 Admin. Director: Haya Al Eid, BDS, DFE, CTR Saudi Arabia Tumor Registrar : Mohamed Hayder, CTR Tel: 01-442-3929 Asst. Tumor Registrar: Maisoun Khaled Fax: 01-448-3924 Secretary: Marielen S. Manalo Email: [email protected] [email protected] Website: www.scr.org.sa

Armed Forces Hospitals Director: Col. Dr. Ali Matar Al Zahrani Riyadh Military Hospital PO Box 7897, Riyadh 11159 Tel: 01-477-7714 x6747 Fax: 01-477-6743 x6743 Email: [email protected]

Central Region Director: Abdulaziz Al Humaidi, MD King Fahad Medical City PO Box 59046, Riyadh 11525 Tel: 01-288-9999 x7086 Fax: 01-288-1965 Email: [email protected]

Eastern Region Director: Prof. Hassan Al Idrissi, MD King Fahd Hospital of the University PO Box 40004, Al Khobar 31952 Tel: 03-896-6741 Fax: 03-896-6741 Email: [email protected]

King Abdulaziz University Hospital Director: Prof. Mahmoud Shaheen Al Ahwal, MD Faculty of Medicine PO Box 80215, Jeddah 21589 Tel: 02-624-0000 x18244/18253 Fax: 02-617-1412 Email: [email protected]

King Faisal Specialist Hospital & Representative: Ali Al-Zahrani, MD, PhD Research Center MBC-64 PO Box 3354, Riyadh 11211 Tel: 01-442-4286 Fax: 01-442-4542 Email: [email protected]

P06.indd 96 28-05-2012 11:56:07 AM APPENDIX: B Continued....

Madinah & Northern Region Director: Ahmed Tarawa, MD King Fahad Hospital Madinah Al Monawarah Tel: 04-836-2000 x2465/2462 Fax: 04-836-0937 Email: [email protected]

National Guard Hospitals Director: Amer Naeem Radwi, MD King Abdulaziz Medical City (KKNGH) PO Box 9515, Jeddah 21423 Tel: 02-624-0000 x24087 Fax: 02-624-7242 Email: [email protected]

Security Forces Hospital Director: Abdulaziz Saleh Aba Hussein, MD PO Box 3643, Riyadh 11481 Tel: 01-476-5878 / 802-3113 Fax: 01-802-3814 Email: [email protected]

Southern Region Director: Amjad Rehman, MD Assir Central Hospital PO Box 61421, Abha Tel: 07-224-0711 / 224 -7800 x118 Fax: 07-224-0964 / 224 -7570 Email: [email protected]

Western Region Director: Hasnah Al Ghamdi, MD King Abdulaziz Hosp. & Oncology Center PO Box 31467, Jeddah 21497 Tel: 02-637-5555 x2276 Fax: 02-635-6410 Email: [email protected]

Ministry of Health Representative: Mohammad Y. Saeedi, MD Kingdom of Saudi Arabia Dep. Chairman PO Box 335157, Riyadh 11314 Tel: 01-475-0426 x201 Fax: 01-475-0428 Email: [email protected]

Nasser Al Hamdan, Chairman 1997 - 1998 Dep. Chairman 1999 - 2006 Edward De Vol, PhD Representative January 2001 - April 2006 Hadir Meir, MD Director January 2001 - August 2005 Hassan Trabulsi, MD Director November 2001 - June 2007 Dahish Ajarim, MD Director 1992 - December 2009 Susan E. Young, CCHRA©, CTR Admin. Director March 2003-May 2006 Rizq Allah Assiri, MD Director 2001 - 2010 Abdulwahab Andejani, MD Director 2001 - 2010

P06.indd 97 16-06-2012 4:48:21 PM APPENDIX C: Cancer Registration Abstract Form

SAUDI CANCER REGISTRY CANCER REGISTRATION ABSTRACT Ministry of Health Revised 03, 2010 Kingdom of Saudi Arabia

1. ACCESSION DATE 2. CanReg-4 No. (Accession Number)

d dm m y y y y (Computer Assigned) PATIENT

3. First (Must be filled ) 4. FATHER (Must be filled) 5. GRANDFATHER6. FAMILY (Must be filled)

Use SCR standardized name spellings 7. Saudi ID/Passport/ Iqama Number 8. Sex 9. Date of Birth 10. Age at Diagnosis --

1-Male d d m m y y y y 2-Female (if only year is known, use 01/07//_ _ _ _ ) 9-Unknown 11.Nationality Code 12. Nationality Text (Must be filled) 13. Marital Status 1. Single 4. Widowed 2. Married 9. Unknown 3. Divorced 14. Address Code (Must be filled) 15. Address Details (Must be filled) City: Suburb /District P.O. Box Zip Code:

16. Mobile Number (Must be ﬁlled)

17. Telephone Number 1 (Must be ﬁlled) 18. Extension 1 19. Telephone Number 2 20. Extension 2

TUMOR 21. Date of Diagnosis (Must be ﬁlled) (First time physician states that patient has a malignancy clinically or pathologically) (if only year is known, use 01/07/_ _ _ _ )

d d m m y y y y 22. Topography Code 23. Topography Text (Must be ﬁlled)

C0B

24. Morphology Code 25. Morphology Text (Must be ﬁlled) / (behavior)

26. Behavior 27. Grade28. SEER Summary Stage (Extent)

1. In situ 2. In situ 1. Well differentiated / Differentiated, NOS 3. Malignant/Invasive 2. Moderately / Moderately well differentiated 2. Localized 3. Poorly Differentiated 3. Regional by direct extent 4. Undifferentiated / Anaplastic 4. Regional by lymph node 5. T-Cell* 5. Regional (both 3 and 4) 6. B-Cell/Pre-B/B-cursor* 6. Regional, NOS 7. Null Cell/Non-T-Non-B* 8. Natural Killer cell* 7. Distant Metastasis / Systemic disease 9. Unknown* 9. Unknown * for leukemias & lymphomas only

29. Laterality 30. Basis of Diagnosis

0. Not paired (unknown, ill deﬁned) 0. DCO (death certiﬁcate only) 5. Cytology / Hematology 1. Right 1. Clinical 6. Histology of Metastasis 2. Left 2. Medical Imaging (Radiology) 7. Histology of Primary 3. One side, but unknown 3. Surgery (Visualization without Biopsy) 4. Bilateral involvement, laterality origin unknown 8.Autopsy 9. Paired site, laterally not stated 4. Lab test (tumor marker) 9. Unknown

P06.indd 98 28-05-2012 11:56:08 AM APPENDIX C: Cancer Registration Abstract Form

HOSPITAL

31. Date ﬁrst seen at Source1 for this cancer (Must be ﬁlled) d d m m y y y y

32. Source 1 33. Reporting Hospital Text 34. MRN 1 35. Path 1

36. Source 237. Referral Hospital Text 38. MRN 2 39. Path 2

40. Source 3 41. Referral Hospital Text 42. MRN 3 43. Path 3

44. Source 4 45. Referral Hospital Text 46. MRN 4 47. Path 4

48. Source 5 49. Referral Hospital Text 50. MRN 5 51. Path 5

52. Source 6 53. Referral Hospital Text 54. MRN 6 55. Path 6

FOLLOW-UP

56. Last Contact 57. Status 58. Cause of Death

1. Cancer 1. Dead 2. Other 2. Alive 3. Not Applicable d d m m y y y y 9. Unknown 9. Unknown

59. Coder ID # 60. Data Entry ID #

Signature: ______Signature: ______

QUESTIONS / QUERIES / PROBLEMS:

P06.indd 99 28-05-2012 11:56:09 AM APPENDIX D: Summary of Cancer Statistics in Saudi Arabia for the Year 2008

100

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