Cancer Incidence Report Saudi Arabia 2005

Kingdom of Saudi Arabia Ministry of Health Saudi Cancer Registry

SCRPart001.indd 1 31/05/2009 09:28:53 Report prepared by: Haya S. Al-Eid, BDS, DFE, CTR Suad Omer Arteh, MA

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

SCRPart001.indd 2 31/05/2009 09:28:53 Foreword Acknowledgment

Cancer incidence is a continuous variable. Hence, The Saudi Cancer Registry is funded by The since the establishment of the Saudi Cancer Ministry of Health. The work of the Saudi Cancer Registry (SCR) in 1992, we have attempted to Registry including the production of this report publish the annual incidence report, initially every is the result of teamwork by our valuable cancer 2 years but more recently on a yearly basis. We registrars, Main Office staff and members of the present in this report the cancer incidence in Saudi Board of Directors. Special warm thanks to our Arabia for the year 2005. registrars who travel to every part of the kingdom to collect the cases that are included in this report. The number of cancer cases and the incidence in cancer case diagnosed in 2005 have increased over Our gratitude to the support provided by the the proceeding years. This might be secondary Ministry of Health represented by his Excellency to true increase in cancer incidence, an increase the Minister of Health Dr. Abdullah Al Rabeeah, in the population but also possibly to a better and the Deputy Minister of Health Dr. Mansour case finding from the part of the SCR. From the Al Hawasi. Many thanks to The Council for operational viewpoint, we have an increase in the Health Services, represented by the Secretary number of cases reported by death certificate only General Dr. Othman Al Rabieah who spared (DCO), which represent 3.3% of all our method of no effort in helping us to overcome the many reporting. problems we faced, and supported the funding of the SCR. In addition, we continue to be in debt Many challenges continue to face the SCR. This for the support of King Faisal Specialist Hospital include but is not restricted to quality of medical and Research Center leadership represented record data available from reporting hospitals, by Dr. Qasim Al Qasabi and Dr. Adnan Ezzat. funding, manpower, availability of mortality data and availability of continuous medical education in Furthermore, we would like to record our cancer registration within Saudi Arabia. appreciations to many pharmaceutical companies who have supported the SCR with unrestricted The wealth of data published by the annual report grants. In particular, we would like to thank Sanofi- of the SCR on a yearly basis cannot be over- Aventis, and Pfizer for their generous support. emphasized. Epidemiologists and researchers are encouraged to analyze this data so that adequate preventive measures are put in place before it is too late.

Shouki Bazarbashi, MD Chairman Riyadh, June 2009

SCRPart001.indd 3 31/05/2009 09:28:53 SCRPart001.indd 4 31/05/2009 09:28:53 Introduction

This is the ninth incidence report published by the Part IV Cancer Incidence among Non- Saudi Cancer Registry. Previous publications include Saudis the 1994 Summary Report, 1994-1996 Incidence Report, 1997-1998 Incidence Report, 1999-2000 This part presents the incidence of cancer cases Incidence Report, 2001 Incidence Report, 2002, among Non-Saudis including the most common 2003, and 2004 Incidence Reports. types of cancer. The analysis of the Non-Saudis is performed separately due to the nature of the The structure of this report can be outlined as expatriate population in Saudi Arabia in which a follows: large part of the population, particularly among males, falls in the 25-44 age group. Part I Materials and Methods Part V Incidence Tables This part of the report contains information about the background of the Saudi Cancer Registry and Part V contains the following detailed tables for all methods used in collecting and analyzing the data. newly diagnosed cancer types among Saudis and We present the basics of coding and classification Non-Saudis for 2005: of tumor topography, morphology and extent of disease at the time of diagnosis. Also we describe • Distribution of cancer cases among Saudis by the software programs we have used to analyze age group and sex the data. • Distribution of cancer cases among Non- Part II Overview of Cancer Incidence Saudis by age group and sex

Part II contains figures and tables that show overall • Cancer Incidence (per 100,000 population) cancer incidence in Saudi Arabia for the year 2005. among Saudis by age group and sex We present these figures and tables mainly by sex and in certain areas we have it analyzed by different • Cancer Incidence (per 100,000 population) age groups. There are bar charts representing the among Non-Saudis by age group and sex age distribution of cancer incidence for the year 2005 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) Part VI Appendices per 100,000 population, Crude Incidence Rate (CIR) and Cumulative rates by primary site and sex. Appendix A: Regional listing of all health care Separate bar charts depict the most common types facilities from which cancer cases have been of cancer, by sex, in each of the 13 administrative reported. The objective is to receive feedback regions of Saudi Arabia. from facilities that have not been included in order to improve our case-finding and reporting Part III Incidence of Selected-Sites processes.

In this part the incidence of the most common Appendix B: Names of the members of the Board cancers among Saudi males and females are outlined. of Directors. A standardized layout presents data for all patients and for both sexes where applicable. For each Appendix C: Data request form which may selected site the number and the percentage of all be copied, filled and submitted to the SCR Main newly diagnosed cases for the year 2005, the ASR Office. for each sex and the specific cancer rank for both sexes is presented. In addition, ASR for the specified Appendix D: Copy of the cancer registration cancer among Saudis is compared with ASR among abstract form which is completed by cancer other populations from selected countries. registrars for each cancer case.

SCRPart001.indd 5 31/05/2009 09:28:53 Table of Contents

Acknowledgment...... 3 Foreword...... 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 2005...... 16 Adult Cancers in Saudi Arabia, 2005 (above 14 years)...... 21 Childhood Cancers in Saudi Arabia 2005 (14 years and below)...... 24 Cancer in the 13 Administrative Regions of the Kingdom...... 27 International Comparison of Age-Standardized Incidence Rates ...... 31

PART III...... 33

Cancer Incidence for Specific Sites, 2005...... 35 Female Breast (C 50)...... 36 Colo-rectal (C18-C20)...... 38 Non-Hodgkin Lymphoma (C82-C85;C96)...... 40 Thyroid (C 73)...... 42 Leukemia (C91-C95)...... 44 Lung (C33-C34)...... 46 Liver (C 22)...... 48 Skin (Non-Melanoma) (C 44)...... 50 Prostate (C 61)...... 52 Hodgkin disease (C 81)...... 54 Stomach (C 16)...... 56 Brain, Nervous System (C70-C72)...... 58 Bladder (C 67)...... 60 Corpus Uteri (C 55)...... 62 Ovary Cancer (C 56)...... 64

PART IV...... 67

Cancer Among Non-Saudi Population 2005...... 69

SCRPart001.indd 6 31/05/2009 09:28:53 PART V...... 71

Table 5-1-1 Age Distribution of Cancer Cases among Saudi Males, 2005...... 72 Table 5-1-2 Age Distribution of Cancer Cases among Saudi Females, 2005...... 73 Table 5-1-3 Cancer Incidence Cases among Saudi Males by Age Group (per 100,000), 2005...... 74 Table 5-1-4 Cancer Incidence Cases among Saudi Females by Age Group (per 100,000), 2005...... 75 Table 5-2-1 Age Standardized Rates and Relative Frequencies among Saudi Males by Cancer Site and Administrative Region, 2005...... 76-79 Table 5-2-2 Age Standardized Rates and Relative Frequencies among Saudi Females by Cancer Site and Administrative Region, 2005...... 80-83 Table 5-3-1 Age Distribution of Cancer Cases among non-Saudi Males, 2005...... 84 Table 5-3-2 Age Distribution of Cancer Cases among non-Saudi Females, 2005...... 85 Table 5-3-3 Incidence Rates for Cancer Cases among non-Saudi Males by Age Group (per 100,000), 2005...... 86 Table 5-3-4 Incidence Rates for Cancer Cases among non-Saudi Females by Age Group (per 100,000), 2005...... 87

PART VI...... 89

APPENDIX A: Reporting Health Care Facilities...... 90-93 APPENDIX B: Members of SCR Board of Directors...... 94-95 APPENDIX C: SCR Data Request Form...... 96 APPENDIX D: Cancer Registration Abstract Form...... 97

SCRPart001.indd 7 31/05/2009 09:28:53 SCRPart001.indd 8 31/05/2009 09:28:53 PART I MATERIALS AND METHODS

SCRPart001.indd 9 31/05/2009 09:28:53 Background on Saudi Arabia

Saudi Arabia is a vast country extending over four- 9,403 0.1 75+ 0.2 7,571 fifths of the Arabian Peninsula. It stretches from the 10,299 0.2 70-74 0.2 6,681 17,462 8,215 Arabian Gulf in the east to the Red Sea in the west. 0.3 65-69 0.2 41,414 0.6 60-64 0.4 15,677 It is approximately 2,149,700* square kilometers in 88,869 1.4 55-59 0.6 22,661 area and is divided into 13 administrative regions 202,210 3.1 50-54 1.2 45,561 (Figure 1-1). 354,041 5.5 45-49 1.9 76,195 536,046 8.3 40-44 3.2 127,637 706,446 11.0 35-39 5.1 199,038 743,087 11.5 30-34 7.2 283,834 656,161 10.2 25-29 6.4 251,443 312,269 4.8 20-24 4.3 167,436 157,362 2.4 15-19 3.8 148,883 184,867 2.9 10-14 4.5 175,539 216,736 3.4 5-9 5.3 207,202 233,880 3.6 0-4 5.7 225,887 024681012 024681012 Male Females 4,470,552 1,969,460 Figure 1.3 Population Pyramid of non-Saudis (%) by Sex and Age Group, 2005

Saudi Cancer Registry

Figure 1.1 Administrative Regions of Saudi Arabia The Saudi Cancer Registry (SCR) of Saudi Arabia is a population-based registry established in 1992 under The estimated Saudi national population for year the jurisdiction of the Ministry of Health (MOH) by 2005 was 16,945,484**. Of these, 8,497,042 were the order of His Excellency the Minister of Health. males and 8,448,442 were females. The Non-Saudi The SCR commenced reporting cancer cases from population in 2005 was 6,440,012**; of these 01 January 1994. 4,470,552 were males and 1,969,460 females. Objectives: Figures 1-2 and 1-3 show the Saudi and Non- Saudi population pyramids by sex and age group The primary goal of the SCR is to define the respectively. population-based incidence of cancer in Saudi Arabia. Additional objectives include programs for early detection and cancer screening, as well as 118,597 0.7 75+ 0.6 95,783 cancer research projects. 79,232 0.5 70-74 0.5 87,046 105,857 0.6 65-69 0.6 103,774 129,797 0.8 60-64 0.8 137,790 Organizational Structure: 149,775 0.9 55-59 0.9 157,070 227,787 1.3 50-54 1.2 204,460 A Board of Directors was appointed to include 321,268 1.9 45-49 1.7 284,532 representatives from the MOH, King Faisal Specialist 422,311 2.5 40-44 2.3 382,417 505,004 3.0 35-39 3.0 510,774 Hospital and Research Center (KFSH&RC), and 583,552 3.4 30-34 3.5 589,677 the Medical Services Departments of the Ministry 743,766 4.4 25-29 4.2 719,070 of Defense and Aviation, Ministry of Interior, 779,378 4.6 20-24 4.8 806,409 the National Guard, King Saud University, King 972,709 5.7 15-19 5.7 962,738 1,109,256 6.5 10-14 7.0 1,184,968 Faisal University, King Abdul-Aziz University and 1,155,773 6.8 5-9 6.7 1,140,730 King Khalid University. The Board is charged 1,092,980 6.4 0-4 6.4 1,081,204 with the responsibility of overseeing the SCR’s 0246810 0246810 establishment, defining demographic and cancer- Male Females 8,497,042 8,448,442 related data to be collected, approving research requests, and reporting findings, as well as Figure 1.2 Population Pyramid of Saudis (%) by Sex disseminating information collected while ensuring and Age Group, 2005 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: Based on 2004 Census, Central Department for Statistics (CDS) data, Ministry of Planning with a 2.5% growth rate for Saudis, and 2.3% growth rate for non-Saudis (web site http:\\www.planning.gov.sa).

SCRPart001.indd 10 31/05/2009 09:28:55 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 Main Office 1 Central Region: King Khalid University Hospital in Riyadh, covering Riyadh, Qassim, and Hail Health Regions. 2 Eastern Region: King Fahad Hospital of the University, Al Khobar, covering Dammam, Al Central Region Ahsa, and Hafr Al-Batin Health Regions. (Riyadh, Qassim & Hail) 3 Western Region: King Abdulaziz Hospital and Cancer Center, Jeddah, covering Jeddah, Makkah, Taif and Qunfudah Health Regions. King Faisal Specialist Hospital 4 Southern Region: Asir Central Hospital, Abha, & Research Centre (Riyadh) covering Asir, Baha, Najran, Jazan and Bisha Health Regions. 5 Madinah/Northern Region: Madinah Maternity National Guard Hospitals & Children’s Hospital, Madinah, covering Madinah, Tabuk, Jouf and Northern Health Regions. Armed Forces Hospitals Offices at the Medical Service Division or Oncology Department of the following establishment Security Forces Hospitals 1 Ministry of Defense and Aviation, Armed Forces Hospital, Riyadh 2 National Guard, King Fahad Hospital, Riyadh Madinah Region (Madinah, Tabuk, Jouf & Northern Region) 3 Ministry of Interior, Security Forces Hospital, Riyadh. 4 King Faisal Specialist Hospital and Research Southern Region Centre, Riyadh. (Asir, Baha, Jazan & Najran) 5 King Abdul Aziz University Hospital, Jeddah

Eastern Region Each of the SCR offices operates under the (Dammam, Ahsa & Hafr Al Batin) supervision of a member of the Board of Directors who is responsible for the daily management of Western Region that office. Staffing consists of tumor registrars and (Jeddah, Makkah, Taif & Qunfudah) secretarial staff.

The SCR Main Office indirectly supervises the regional Figure 1.4 Organizational Chart of the Saudi Cancer offices and is responsible for ensuring the accuracy Registry of Saudi Arabia and quality of data collected in all of the regions. Quality control processes include verification of Format site, morphology, and staging information as well as case linkage (tumor and patient), and consolidation The format of the current report is similar to the of data. The Main Office also prepares periodic previous reports. reports for dissemination of information to the medical community, government establishments, international organizations and the media.

SCRPart001.indd 11 31/05/2009 09:28:56 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 4.31, 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 are tumor information, to ensure that all data can be identified and coded according to the International reviewed, linked, and consolidated, as appropriate, Classification of Diseases for Oncology 3rd Edition (ICD- so that each malignancy is counted only once for O-3), published by the World Health Organization statistical analysis. (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 4.31, 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 2005. For each cancer site, the number survival as the changes reflect a new understanding and the percentage of all newly diagnosed cases for of the natural history of cancer. The new guidelines, the year 2005, the age-standardized incidence rate SEER Summary Stage Manual 2000, is available on (ASR) per 100,000 population for each sex, and the the web at: http:/seer.cancer.gov/tools/ssm/. Cases specific cancer rank in comparison to all cancers diagnosed on or after 01 January 2005 are classified for both sexes are presented. according to the updated ICD-O-3. Improvements in the understanding of cancer pathology over the Useful international statistics for the specified last decade are reflected in the changes to ICD- cancer include the ranking of the cancer worldwide. O-3. While there have not been any changes in the The source for this information is summarized on primary site codes, there are significant changes page 66. regarding histology (cell types). Leukemias and lymphomas, particularly are affected. Some cases that were previously considered benign are now

SCRPart001.indd 12 31/05/2009 09:28:56 The relevant data incorporate details for all patients Notification presented over the year 2005. For each cancer there are five figures: The data included in this report were abstracted up to June 2006. 2005 incident cases which are identified after this date (late reporting) will 1. An arithmetic line graph represents the be noted in subsequent incidence reports. It is age-specific incidence rate (AIR) for all age anticipated that the number of late-reported cases groups at five-year intervals. The graph is will decrease as case ascertainment processes are plotted by sex, where applicable. improved.

2. A table lists the percentages of the most common histology sub-types for each Definitions of Terms 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 of a rate that a population would have if it had a 5. A bar chart shows comparison of age- standard age structure. Standardization is necessary standardized incidence rate (ASR) for each when comparing several populations that differ cancer type in Saudi Arabia with ASR in with respect to age structure. The most frequently selected countries. 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 malignant disease from Riyadh region 5-9 10,000 exceeds the anticipated 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. Many of these patients 30-34 6,000 fail to provide their permanent address, 35-39 6,000 but instead, provide a temporary Riyadh 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 65-69 3,000 analyzing this report, CanReg 4.31, does not 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

SCRPart001.indd 13 31/05/2009 09:28:56 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 individuals. All rates are thus, expressed as per the population at risk of developing that disease. 100,000 population.

Cancer rates vary greatly with age and the Mean crude rate is strongly influenced by the demo graphic structure of the population. Hence, if the The simple mathematical average of two or population structure changes over time the crude more numbers. 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 population age structures. Therefore, in order to The midpoint of the range numbers that are assess time trends in registration data or compare arranged in order of value. incidence across geographical areas or between registries it is necessary to first standarize the rates Metastasis with respect to age. Metastasis is the distant spread of cancer from its original site to other organs of the body, including Cumulative Incidence rate lymph nodes, skeletal and or visceral organs. Cumulative incidence is the probability or risk of individuals developing the disease during a specified Range period. For cancer, it is expressed as the number of new born children (out of 100, or 1000) who Is the difference between the maximum and would be expected to develop a particular cancer minimum values in a set of observations. 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 populations of different age structures. In this This measure reflects the importance of a specific report the age ranges 0-64 and 0-74 years are used. cancer site relative to other sites, in terms of the The cumulative rate is the summation of the cancer number of registrations. Ranking illustrates the age-specific rates; which are computed for five-year most and least frequent cancer sites in a population age intervals. The cumulative rate is five times the according to their frequency. sum of the age-specific rates calculated over the five-year age groups. Ratio

ICD-10 The relation between two quantities. The first quantity as numerator and the second as The World Health Organization’s International denominator 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 Classification of Diseases for Oncology, 3rd Edition of all cancer. It is expressed as a percentage. 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 a Staging is the grouping of cancer cases into broad one-digit code for tumor aggressiveness (grade). categories based on the extent of disease.

SCRPart001.indd 14 31/05/2009 09:28:56 PART II OVERVIEW OF CANCER INCIDENCE 2005

SCRPart002.indd 15 27/05/2009 18:35:31 Reported Cancer Incidence Cases in Saudi Arabia, 2005

Between January 01 and December 31, 2005, the As shown on table 2-1, 9,927 cases were analyzed, total number of cancer incident cases reported to of which 7,563 (78%) were Saudis and 2,364 the SCR was 10,513. Overall, cancer was slightly (22.%) were Non-Saudis. Among the Saudis, 3,729 more among men than women. Cancers affected (49.3%) were male and 3,834 (50.7 %) were female. 5,308 (50.5%) males and 5,205 (49.5%) females, with The male to female ratio was 97:100. The crude a male to female ratio of 102:100. 7,761 cases were incidence rate (CIR) of all cancers among the reported among Saudis, 2,453 among Non-Saudis. Saudi population was 44.6/100,000 (43.9/100,000 The total number of cases excluded from analysis among males and 45.2/100,000 among females). included 287 cases of unknown nationalities. Other The overall age-standardized incidence rate (ASR) exclusions were 262 in situ cases. The current for all Saudis with a world standard population software program CanReg-4 version 4.31, does reference was 74.3/100,000 (74.1/100,000 in males not include in situ cases in the statistical analysis. and 74.4/100,000 in females). For all sites, the age- Also, 37 were ICD-O-3 coded cases that failed to specific incidence rate (AIR) increased with age for convert to ICD-10 codes as described in the Data both males and females. After the age of 64 years, the Management (see page 12). This puts the total increase was nearly two folds for males compared number of exclusions from the analysis as 586 to females. The median age at diagnosis was 59 years cases. Table 2-1 illustrates the distribution of the for men and 49 years for women. The five geographic cases by sex. regions with the highest ASR were Eastern region at 98.2/100,000, Riyadh region at 91.2/100,000, Diagnosis of malignancy was confirmed histologically Makkah region at 80.5/100,000, Tabuk region at and/or cytologically in 93.9% of the cases. Clinically 70.6/100,000, and Jouf region at 61.9/100,000 confirmed cases were 0.2%; radiologically confirmed cases were 1.4%; cases confirmed by Death Certificate Only were 3.3% and 1.2% of the cases were confirmed by other methods. The method of diagnosis was unknown for 1.1% of the cases.

Saudis Non-Saudis Unknown Nationality All

Male Female Total Male Female Total Male Female Total Total

Total 3834 3927 7761 1316 1137 2453 158 141 299 10513

Invasive 3747 3848 7595 1267 1102 2369 146 141 287 10251

In Situ 87 79 166 49 35 84 12 0 12 262

ICD 10 * 18 14 32 4 1 5 0 0 0 37

Analyzed ** 3729 3834 7563 1263 1101 2364 146 141 287 9927

Table 2.1 Distribution of Cancer Cases in Saudi Arabia by Nationality and Sex 2005

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

SCRPart002.indd 16 27/05/2009 18:35:32 Cancer among Saudis 2005

As explained earlier the total number of cancer 30-44 years

cases analyzed among Saudis during the year 2005 Colo-rectal 4.7 27.7 Breast were 7,563. Following are ﬁgures presenting the NHL 4.3 10.2 Thyroid percentage distributions of cancer incidence and Thyroid 2.4 5.1 Colo-rectal most frequent types of cancers among Saudis by sex. Nasopharynx 2.2 3.0 NHL Lung 2.0 2.4 Leukemia Leukemia 2.0 1.8 Cervix Uteri 18 Hodgkin disease 1.6 1.4 Corpus Uteri Male 15.8 16 Brain, Nervous system 1.5 1.4 Ovary Female 13.9 14 Connective, Soft tissue 1.2 1.2 Brain, Nervous system 11.7 11.8 12 Kidney 1.0 1.1 Lung 10.4 Other sites 10.3 11.5 Other sites 10 8.7 01020304050 10 20 30 40 50 8 Percentage Male (440) Female (886) 5.3 5.8 6 4.8 4.2 4.4 4 3.2 45-59 years 2 Colo-rectal 7.3 18.6 Breast 0 NHL 4.3 6.8 Colo-rectal 0-14 15-29 30-4445-59 60-7475+ Age Group Lung 3.1 4.1 Thyroid Liver 2.7 2.9 Corpus uteri Figure 2.1 Percentage Distribution of Cancer Incidence Bladder 2.3 2.9 NHL among Saudis by Sex according to Age Group, 2005 Nasopharynx 2.1 2.1 Ovary All Ages Kidney 1.7 2.0 Cervix uteri Leukemia 1.7 1.4 Lung Colo-rectal 5.8 12.3 Breast Pancreas 1.4 1.4 Skin NHL 4.6 5.0 Thyroid Stomach 1.3 1.2 Leukemia Lung 3.5 4.5 Colo-rectal Thyroid 1.3 1.1 Gall bladder, etc. Prostate 3.5 3.3 NHL Other sites 13.7 12.6 Other sites 3.4 2.4 Leukemia Leukemia 1020304050 01020304050 Liver 2.8 1.9 Corpus uteri Male (788) Female (1048) Hodgkin disease 2.1 1.8 Ovary Stomach 2.1 1.7 Skin Bladder 2.0 1.3 Hodgkin disease 60-74 years Skin 2.0 1.3 Brain, Nervous system Other sites 17.6 15.2 Other sites Colo-rectal 7.9 7.1 Breast 1020304050 0 10 20 30 40 50 Prostate 7.1 4.1 Colo-rectal Male (3729) Female (3834)* Lung 6.4 3.8 NHL Liver 4.3 2.7 Corpus uteri 0-14 years NHL 4.1 2.1 Skin

Leukemia 19.2 12.7 Leukemia Stomach 3.3 2.0 Thyroid Brain, Nervous system 7.4 6.3 Brain, Nervous system Skin 3.2 1.9 Ovary Hodgkin disease Hodgkin disease 6.8 3.4 Bladder 2.3 1.7 Liver NHL 6.3 3.1 NHL Pancreas 1.5 1.5 Stomach Bone 3.1 2.9 Eye Connective, soft tissue 3.1 2.3 Connective, Soft tissue Nasopharynx 1.4 1.3 Lung Kidney 2.3 2.2 Bone Other sites 15.8 14.4 Other sites Adrenal gland 1.6 2.2 Kidney 01020304050 10 20 30 40 50 Eye 1.1 1.4 Ovary Skin 0.9 1.4 Adrenal gland Male (1198) Female (891) Other sites 5.0 5.4 Other sites 0101020304050 020304050 Male (316) Female (241) 75+ years

15-29 years Prostate 8.5 4.4 Colo-rectal Colo-rectal 6.6 3.7 Breast Hodgkin disease 9.5 15.2 Thyroid 5.9 3.2 Leukemia 8.9 7.0 Hodgkin disease Liver Skin NHL 6.2 4.9 Breast Stomach 4.8 2.4 Oesophagus Testis 3.8 4.7 NHL Bladder 4.8 2.4 NHL Bone 2.7 4.0 Leukemia Lung 4.3 1.7 Liver Connective, Soft tissue 2.3 2.9 Brain, Nervous system NHL 4.3 1.6 Lung Brain, Nervous system 2.3 2.6 Bone Skin 4.1 1.4 Ovary Thyroid 1.9 2.3 Ovary Pancreas 1.7 1.2 Stomach Nasopharynx 1.4 2.2 Colo-rectal Oesophagus 1.6 1.2 Corpus uteri Colo-rectal 1.2 1.9 Connective, Soft tissue Other sites 4.8 7.0 Other sites Other sites 17.8 12.5 Other sites 1020304050 0 10 20 30 40 50 01020304050 10 20 30 40 50 Male (329) Female (399) Male (658) Female (365) Figure 2.2 Percentage Distribution of Most Frequent Types of Cancer by Sex among Saudis, 2005

* 4 female cases of unknown age are included only in the total as they may not be added to any age group

SCRPart002.indd 17 27/05/2009 18:35:33 Cancer No. % Breast 948 12.5

Colo-rectal 778 10.3

Non-Hodgkin lymphoma 596 7.9

Thyroid 473 6.3

Leukemia 441 5.8

Lung 347 4.6

Liver 292 3.9

Skin 281 3.7

Prostate 261 3.5

Hodgkin disease 259 3.4

Table 2.2 Ten Most Common Cancers among Saudis, 2005 (All Ages)

Male 3729 Female 3834

Colo-rectal 439 11.8% Breast 932 24.3% NHL 346 9.3% Thyroid 380 9.9%

Lung 261 7.0% Colo-rectal 339 8.8%

Prostate 261 7.0% NHL 250 6.5%

Leukemia 259 6.9% Leukemia 182 4.7%

Liver 211 5.7% Corpus uteri 143 3.7%

Hodgkin disease 160 4.3% Ovary 136 3.5%

Stomach 156 4.2% Skin 129 3.4%

Bladder 155 4.2% Hodgkin disease 99 2.6%

Skin 152 4.1% Brain, Nervous system 96 2.5%

Figure 2.3 Ten Most Common Cancers among Saudis by Sex, 2005

SCRPart002.indd 18 27/05/2009 18:35:33 600

male female 500

400

300

200 AIR (per 100,000) 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, 2005

Eastern 104.7 91.6 Riyadh 89.8 92.5 78.3 Makkah 82.7 Tabuk 68.8 72.3 63.0 Jouf 60.8 54.4 Northern 64.0 50.1 Asir 53.2 Najran 56.2 40.3 44.0 Madinah 46.0 38.9 Hail 44.0 35.8 Baha 42.4 35.5 Jazan 33.4 35.8 Qassim 30.7

020406080 100 120

Figure 2.5 Age Standardized Rate (ASR) Regional Distribution (per 100,000) of All Sites of Cancer among Saudis, 2005

SCRPart002.indd 19 27/05/2009 18:35:33 Male Female ICD-10 Site No.%Crude ASR Cumulative Rate No. %Crude ASR Cumulative Rate Rate World 0-64 0-74 Rate World0-640-74 All All sites Total 3729 10043.9 74.1 41.22 86.19 3834 100 45.2 74.4 52.28 79.42 Not C44 All sites but C44 3577 95.9 42.1 70.8 39.8 82.0 3705 96.5 43.7 71.6 50.745 76.50 C00Lip 60.2 0.10.1 0.06 0.15 60.2 0.10.1 0.07 0.07 C01-C02 Tongue 40 1.10.5 0.90.631.14210.5 0.20.5 0.37 0.51 C03-C06 Mouth 32 0.90.4 0.70.410.83441.1 0.510.60 1.01 C07-C08 Salivary glands 15 0.40.2 0.20.120.18130.3 0.20.2 0.16 0.16 C09 Tonsil 30.1 00.1 0.06 0.06 10.0 000.02 0.02 C10 Other Oropharynx 20.1 000.04 0.04 20.1 00.1 0.04 0.09 C11Nasopharynx 1143.1 1.32.2 1.60 2.72 32 0.80.4 0.60.400.65 C12-C13Hypopharynx 11 0.30.1 0.20.130.24170.4 0.20.4 0.34 0.50 C14 Pharynx unspecied40.10 0.10.080.1400.00 00.000.00 C15 Oesophagus 53 1.40.6 1.20.761.39661.7 0.81.5 0.70 1.48 C16 Stomach 1564.2 1.83.5 1.49 4.33 68 1.80.8 1.60.972.03 C17 Small intestine 22 0.60.3 0.50.210.54120.3 0.10.3 0.13 0.29 C18Colon 2506.7 2.95.5 3.53 6.62 197 5.12.3 4.23.184.34 C19-C20Rectum 1895.1 2.24.2 2.53 5.50 142 3.71.7 32.133.36 C21 Anus 17 0.50.2 0.40.220.4890.20.1 0.20.150.21 C22Liver 2115.7 2.54.9 2.61 5.88 81 2.11 1.81.062.14 C23-C24 Gallbladder etc. 36 1.00.4 0.80.650.96631.6 0.71.5 1.11 1.74 C25 Pancreas 82 2.21 1.91.062.39491.3 0.61.2 0.66 1.61 C30-C31Nose, sinuses etc. 13 0.30.2 0.20.130.20100.3 0.10.2 0.14 0.31 C32Larynx 48 1.30.6 1.20.651.7460.20.1 0.10.130.13 C33-C34 Trachea,Bronchus,Lung 2617.0 3.16.1 3.24 8.27 86 2.21 1.91.272.05 C37-C38 Other Thoracic organs 17 0.50.2 0.30.190.30120.3 0.10.2 0.19 0.25 C40-C41 Bone 51 1.40.6 0.60.370.48360.9 0.40.4 0.21 0.27 C43 Melanoma of Skin 11 0.30.1 0.20.050.21100.3 0.10.2 0.09 0.21 C44 Other Skin 1524.1 1.83.3 1.42 4.23 129 3.41.5 2.81.542.92 C45 Mesothelioma 80.2 0.10.2 0.17 0.30 60.2 0.10.1 0.10 0.15 C46Kaposi sarcoma 26 0.70.3 0.50.280.5570.20.1 0.20.150.20 C47;C49 Connective,Soft tissue 70 1.90.8 10.610.83491.3 0.60.7 0.46 0.57 C50 Breast 16 0.40.2 0.30.250.32 932 24.31118 14.53 18.96 C51 Vulva 10.0 000.04 0.04 C52Vagina 70.2 0.10.2 0.18 0.18 C53Cervix Uteri 95 2.51.1 21.462.27 C54Corpus Uteri 143 3.71.7 3.42.624.22 C55 Uterus unspecied 14 0.40.2 0.30.230.37 C56 Ovary 136 3.51.6 2.81.913.18 C57 Other Female Genital 60.2 0.10.1 0.12 0.12 C58 Placenta 10 0.30.1 0.10.110.11 C60 Penis 60.2 0.10.1 0.05 0.11 C61 Prostate 2617.0 3.16.2 1.89 6.47 C62 Testis451.2 0.50.5 0.48 0.48 C63 Other male genital 10.0 000.05 0.10 C64 Kidney 92 2.51.1 1.91.542.83601.6 0.71.2 0.83 1.26 C65Renal Pelvis 30.1 000.12 0.24 4 00.1 0.06 0.06 C66Ureter 30.1 00.1 0.02 0.07 40.1 00.1 0.04 0.16 C67 Bladder 1554.2 1.83.3 1.81 4.50 35 0.90.4 0.80.360.83 C68 Other Urinary organs 00.0 000.04 0.04 1 000.00 0.06 C69Eye150.4 0.20.2 0.21 0.37 20 0.50.2 0.30.080.18 C70-C72 Brain, Nervous system 1243.3 1.521.42 2.37 96 2.51.1 1.30.991.21 C73Thyroid 93 2.51.1 1.61.001.82 380 9.94.5 64.615.68 C74 Adrenal gland 10 0.30.1 0.10.030.0390.20.1 0.10.040.04 C75 Other Endocrine60.20.1 0.10.020.0250.10.1 0.10.020.07 C81Hodgkin disease 1604.3 1.921.44 1.79 99 2.61.2 1.30.841.04 C82-C85;C96Non-Hodgkin lymphoma 3469.3 4.16.4 3.57 6.39 250 6.53 53.115.74 C88 Immunoproliferative dis.00.00 00.040.0400 00.000.00 C90 Multiple Myeloma551.5 0.61.2 0.48 1.06 24 0.60.3 0.50.360.52 C91Lymphoid leukemia 1494.0 1.81.7 0.95 1.48 75 2.00.9 0.90.460.67 C92-C94Myeloid leukemia 96 2.61.1 1.40.751.45922.4 1.11.4 1.02 1.56 C95Leukemia unspecied 14 0.40.2 0.20.090.09150.4 0.20.2 0.15 0.15 Other Other & unspecied 1794.8 2.13.8 1.79 3.55 147 3.81.7 3.21.873.61

Table 2.3 Number, Percentage, ASR, CIR, and Cumulative Rates (per 1000) of New Cases by Primary Site and Sex among Saudis, 2005

SCRPart002.indd 20 27/05/2009 18:35:34 Adult Cancers in Saudi Arabia, 2005 (>14 years)

Between January and December 2005, the total 100.4:100. Of all cases, there were 7,199 Saudis, number of adult cancer incidence cases reported 2,323 of Non-Saudis and 211 of unknown was 9,733. Overall cancer was slightly more in males nationalities. As shown on table 2.4, the than in females. Cancer affected 4,872 (50.1.%) total number of analysed cases were 9,236. males and 4,861 (49.9%) females, with a ratio of

Saudis Non-Saudis Unknown Nationality All

Male Female Total Male Female Total Male Female Total Total

Total 3518 3681 7199 1247 1076 2323 107 104 211 9733

Invasive 3431 3603 7034 1198 1041 2239 97 104 201 9474

In-Situ 87 78 165 49 35 84 10 0 0 259

ICD 10* 18 14 32 4 1 5 0 0 0 37

Analyzed** 3413 3589 7002 1194 1040 2234 97 104 201 9236

Table 2.4 Distribution of Reported Adult Cancer Cases in Saudi Arabia by Nationality and Sex 2005

Male 3413 Female 3589

Colo-rectal 439 12.9% Breast 930 25.9% NHL 311 9.1% Thyroid 375 10.4%

Lung 261 7.6% Colo-rectal 338 9.4%

Prostate 260 7.6% NHL 233 6.5%

Liver 209 6.1% Corpus uteri 143 4.0%

Stomach 156 4.6% Ovary 128 3.6%

Bladder 154 4.5% Skin 124 3.5%

Leukemia 152 4.5% Leukemia 110 3.1%

Skin 147 4.3% Cervix uteri 95 2.6%

Hodgkin disease 122 3.6% Lung 86 2.4%

Figure 2.6 Ten Most Common Cancers among Saudi Adults, 2005

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

SCRPart002.indd 21 27/05/2009 18:35:34 Primary Site Code Morphology Male % Female%

Breast 85003 Inltratin g duct carcinoma, NOS 12 1.3 71775.8 80103 Carcinoma, NOS 2 0.2 37 3.9 85203 Lobular carcinoma, NOS 0 0.0 39 4.1 80003 Neoplasm, malignant 1 0.1 22 2.3 85223 Inltratin g duct and lobular carcinoma 0 0.0 23 2.4 85233 Inltratin g duct mixed with other types of carcinoma 0 0.0 17 1.8 85103 Medullary carcinoma, NOS 0 0.0 14 1.5 All Others 1 0.1 61 6.4

Colo-rectal 81403 Adenocarcinoma, NOS 337 43.4 25432.7 84803 Mucinous adenocarcinoma 32 4.1 29 3.7 80003 Neoplasm, malignant 9 1.2 10 1.3 80103 Carcinoma, NOS 8 1.0 8 1.0 84903 Signet ring cell carcinoma 9 1.2 7 0.9 82613 Adenocarcinoma in villous adenoma 6 0.8 9 1.2 82633 Adenocarcinoma in tubulovillous adenoma 9 1.2 6 0.8 82103 Adenocarcinoma in adenomatous polyp 9 1.2 2 0.3 All Others 20 2.6 13 1.7

NHL 96803 Malignant lymphoma, large B-cell, diffuse, NOS 153 28.1 11320.8 95913 Malignant lymphoma, non-Hodgkin, NOS 20 3.7 23 4.2 95903 Malignant lymphoma, NOS 21 3.9 16 2.9 96703 Malignant lymphoma, small B lymphocytic, NOS 21 3.9 7 1.3 96983 Follicular lymphoma, grade 3 6 1.1 10 1.8 97003 Mycosis fungoides 8 1.5 7 1.3 97143 Anaplastic large cell lymphoma, T cell and Null cell type 9 1.7 6 1.1 96873 Burkitt lymphoma, NOS 8 1.5 6 1.1 96903 Follicular lymphoma, NOS 8 1.5 5 0.9 96993 Marginal zone B-cell lymphoma, NOS 8 1.5 5 0.9 97023 Mature T-cell lymphoma, NOS 6 1.1 7 1.3 96913 Follicular lymphoma, grade 2 6 1.1 6 1.1 96953 Follicular lymphoma, grade 1 8 1.5 4 0.7 96843 Malignant lymphoma, large B-cell, diffuse, immunoblastic, NOS 6 1.1 3 0.6 96733 Mantle cell lymphoma 6 1.1 1 0.2 96753 Malignant lymphoma, mixed small and large cell, diffuse 4 0.7 2 0.4 All Others 13 2.4 12 2.2

Thyroid 82603 Papillary adenocarcinoma, NOS 59 12.7 22147.6 83403 Papillary carcinoma, follicular variant 10 2.2 61 13.1 83413 Papillary microcarcinoma 0 0.0 22 4.7 83303 Follicular adenocarcinoma, NOS 3 0.6 15 3.2 83433 Papillary carcinoma, encapsulated 3 0.6 10 2.2 80503 Papillary carcinoma, NOS 2 0.4 9 1.9 83353 Follicular carcinoma, minimally invasive 1 0.2 10 2.2 82903 Oxyphilic adenocarcinoma 3 0.6 6 1.3 85103 Medullary carcinoma, NOS 4 0.9 3 0.6 All Others 4 0.9 18 3.9

Lung 81403 Adenocarcinoma, NOS 60 17.3 33 9.5 80463 Non-small cell carcinoma 39 11.2 11 3.2 80703 Squamous cell carcinoma, NOS 37 10.7 10 2.9 80413 Small cell carcinoma, NOS 29 8.4 1 0.3 80003 Neoplasm, malignant 19 5.5 5 1.4 80103 Carcinoma, NOS 19 5.5 2 0.6 80123 Large cell carcinoma, NOS 13 3.7 2 0.6 82503 Bronchiolo-alveolar adenocarcinoma, NOS 5 1.4 9 2.6 80713 Squamous cell carcinoma, keratinizing, NOS 11 3.2 2 0.6 80203 Carcinoma, undifferentiated, NOS 7 2.0 0 0.0 82603 Papillary adenocarcinoma, NOS 2 0.6 2 0.6 All Others 20 5.8 9 2.6

Liver 81703 Hepatocellular carcinoma, NOS 163 57.2 49 17.2 80003 Neoplasm, malignant 25 8.8 7 2.5 81603 Cholangiocarcinoma 8 2.8 9 3.2 81403 Adenocarcinoma, NOS 3 1.1 3 1.1 80103 Carcinoma, NOS 3 1.1 2 0.7 81803 Combined hepatocellular carcinoma and cholangiocarcinoma 2 0.7 1 0.4 All Others 5 1.8 5 1.8

Skin 80903 Basal cell carcinoma, NOS 68 25.1 65 24.0 80703 Squamous cell carcinoma, NOS 37 13.7 19 7.0 88323 Dermatobrosarcoma, NOS 12 4.4 8 3.0 80713 Squamous cell carcinoma, keratinizing, NOS 8 3.0 7 2.6 80973 Basal cell carcinoma, nodular 4 1.5 4 1.5 80943 Basosquamous carcinoma 3 1.1 3 1.1 84103 Sebaceous adenocarcinoma 3 1.1 2 0.7 80003 Neoplasm, malignant 2 0.7 2 0.7 80753 Squamous cell carcinoma, adenoid 2 0.7 2 0.7 80913 Multifocal supercial basal cell carcinoma 1 0.4 2 0.7 80983 Adenoid basal carcinoma 0 0.0 3 1.1 All Others 7 2.6 7 2.6

Table 2.5 Number and Proportion of Morphological Types for the Most Common Types of Cancer among Saudi Adults, 2005

SCRPart002.indd 22 27/05/2009 18:35:34 Table 2.5 continued .....

Primary Site Code Morphology Male % Female% Leukemia 98633 Chronic myeloid leukemia, NOS 32 12.2 24 9.2 98353 Precursor cell lymphoblastic leukemia, NOS 24 9.2 5 1.9 98613 Acute myeloid leukemia, NOS 11 4.2 15 5.7 98363 Precursor B-cell lymphoblastic leukemia 18 6.9 4 1.5 98663 Acute promyelocytic leukemia, t(15;17) (q22;q11-12) 6 2.3 12 4.6 98233 B-cell chronic lymphocytic leukemia/small lymphocytic lymphoma 8 3.1 9 3.4 98913 Acute monocytic leukemia 9 3.4 5 1.9 98373 Precursor T-cell lymphoblastic leukemia 11 4.2 2 0.8 98013 Acute leukemia, NOS 5 1.9 6 2.3 98743 Acute myeloid leukemia with maturation 5 1.9 5 1.9 98673 Acute myelomonocytic leukemia 1 0.4 6 2.3 98003 Leukemia, NOS 2 0.8 4 1.5 99403 Hairy cell leukemia 5 1.9 0 0.0 98733 Acute myeloid leukemia without maturation 1 0.4 3 1.1 All Others 14 5.3 10 3.8 Prostate 81403 Adenocarcinoma, NOS 235 90.4 80003 Neoplasm, malignant 17 6.5 80103 Carcinoma, NOS 5 1.9 84813 Mucin-producing adenocarcinoma 2 0.8 80203 Carcinoma, undifferentiated, NOS 1 0.4 Stomach 81403 Adenocarcinoma, NOS 80 35.7 23 10.3 84903 Signet ring cell carcinoma 30 13.4 20 8.9 81443 Adenocarcinoma, intestinal type 11 4.9 6 2.7 80103 Carcinoma, NOS 4 1.8 3 1.3 80703 Squamous cell carcinoma, NOS 4 1.8 3 1.3 80003 Neoplasm, malignant 3 1.3 3 1.3 80203 Carcinoma, undifferentiated, NOS 4 1.8 1 0.4 84813 Mucin-producing adenocarcinoma 4 1.8 1 0.4 81453 Carcinoma, diffuse type 2 0.9 2 0.9 84803 Mucinous adenocarcinoma 3 1.3 1 0.4 89363 Gastrointestinal stromal sarcoma 3 1.3 1 0.4 82113 Tubular adenocarcinoma 3 1.3 0 0.0 All Others 5 2.2 4 1.8 Bladder 81303 Papillary transitional cell carcinoma 60 31.9 15 8.0 81203 Transitional cell carcinoma, NOS 64 34.0 10 5.3 80703 Squamous cell carcinoma, NOS 9 4.8 5 2.7 80103 Carcinoma, NOS 5 2.7 1 0.5 80003 Neoplasm, malignant 4 2.1 1 0.5 81403 Adenocarcinoma, NOS 3 1.6 1 0.5 80713 Squamous cell carcinoma, keratinizing, NOS 2 1.1 0 0.0 84803 Mucinous adenocarcinoma 2 1.1 0 0.0 All Others 5 2.7 1 0.5 Corpus Uteri 83803 Endometrioid adenocarcinoma, NOS 78 54.5 81403 Adenocarcinoma, NOS 20 14.0 82603 Papillary adenocarcinoma, NOS 6 4.2 80103 Carcinoma, NOS 5 3.5 83103 Clear cell adenocarcinoma, NOS 5 3.5 89803 Carcinosarcoma, NOS 5 3.5 84603 Papillary serous cystadenocarcinoma 4 2.8 88903 Leiomyosarcoma, NOS 4 2.8 89303 Endometrial stromal sarcoma, NOS 4 2.8 84613 Serous surface papillary carcinoma 2 1.4 89503 Mullerian mixed tumor 2 1.4 All Others 8 5.6 Ovary 84603 Papillary serous cystadenocarcinoma 30 23.4 81403 Adenocarcinoma, NOS 25 19.5 80003 Neoplasm, malignant 11 8.6 80103 Carcinoma, NOS 7 5.5 84613 Serous surface papillary carcinoma 6 4.7 84613 Serous cystadenocarcinoma, NOS 5 3.9 84703 Mucinous cystadenocarcinoma, NOS 5 3.9 83803 Endometrioid adenocarcinoma, NOS 4 3.1 90603 Dysgerminoma 4 3.1 82603 Papillary adenocarcinoma, NOS 3 2.3 83103 Clear cell adenocarcinoma, NOS 3 2.3 84403 Cystadenocarcinoma, NOS 3 2.3 84803 Mucinous adenocarcinoma 3 2.3 80033 Malignant tumor, giant cell type 2 1.6 84903 Signet ring cell carcinoma 2 1.6 86203 Granulosa cell tumor, malignant 2 1.6 90713 Yolk sac tumor 2 1.6 90853 Mixed germ cell tumor 2 1.6 All Others 9 7.0 Cervix Uteri 80703 Squamous cell carcinoma, NOS 26 27.4 80723 Squamous cell carcinoma, large cell, nonkeratinizing, NOS 26 27.4 81403 Adenocarcinoma, NOS 13 13.7 80713 Squamous cell carcinoma, keratinizing, NOS 12 12.6 80003 Neoplasm, malignant 4 4.2 85603 Adenosquamous carcinoma 3 3.2 80103 Carcinoma, NOS 2 2.1 80763 Squamous cell carcinoma, microinvasive 2 2.1 83103 Clear cell adenocarcinoma, NOS 2 2.1 89333 Adenosarcoma 2 2.1 80213 Carcinoma, anaplastic, NOS 1 1.1 82603 Papillary adenocarcinoma, NOS 1 1.1 89803 Carcinosarcoma, NOS 1 1.1

SCRPart002.indd 23 27/05/2009 18:35:35 Childhood Cancers in Saudi Arabia, 2005 (≤ 14 years)

The total incident cases reported among children cases reported there were 558 Saudis, 121 non- (0-14 years) between January and December Saudis and 18 of “unknown nationality”. Based 2005 were 697. This represents 6.6 % of the total on table 2-6, the total number of cases analyzed number of cancers in Saudi Arabia. The reported was 678 including 557 (82.2%) Saudis and 121 incidents show that cancer was more common (17.8%) non-Saudis. Among Saudis, 316(56.7%) among boys than girls. 390 (56.0%) cases were were male and 241 (43.3%) were female. The reported among boys and 307 (44.0%) among girls, male to female ratio amongs Saudis was 131:100. with a male to female ratio of 127:100. Of all the

Saudis Non-Saudis Unknown Nationality All

Male Female Total Male Female Total Male Female Total Total Total 316 242 558 62 59 121 12 6 18 697 Invasive 316 242 557 62 59 121 12 6 18 696 In-situ 0 1 1 0 0 0 0 0 0 1 ICD 10* 0 0 0 0 0 0 0 0 0 0 Analyzed** 316 241 557 62 59 121 12 6 18 678

Table 2.6 Distribution of Reported Childhood Cancer Cases in Saudi Arabia by Nationality and Sex, 2005

Childhood cancer is very important, not only among Saudi children was leukemia, which because of the age of occurrence, but also because accounted for 32.0 %, followed by Brain (CNS) 39.9% of the Saudi population is under 15 years of 13.6 % then Hodgkin disease 10.2 % and NHL age. In addition to this, recent years have shown 9.3 %. Figure 2-7 shows the top ten sites by a breakthrough for the cure of many childhood sex and frequency, and table 2-7 shows the cancers. Childhood cancers accounted for 7.2% number and proportion of the morphological of all cancer among Saudis. The leading cancer types for the most common types of cancer.

Boys 316 Girls 241

Leukemia 107 33.9% Leukemia 71 29.5% Brain, Nervous System 41 13.0% Brain, Nervous System 35 14.5%

Hodgkin disease 38 12.0% Hodgkin disease 19 7.9%

Non-Hodgkin disease 35 11.1% Non-Hodgkin disease 17 7.1%

Bone 17 5.4% Eye 16 6.6%

Connective, soft tissue 17 5.4% Connective, soft tissue 13 5.4%

Kidney 13 4.1% Bone 12 5.0%

Adrenal gland 9 2.8% Kidney 12 5.0%

Eye 6 1.9% Ovary 8 3.3%

Skin 5 1.6% Adrenal gland 8 3.3%

Figure 2.7 Ten Most Common Cancers among Saudi Children by Sex, 2005

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

SCRPart002.indd 24 27/05/2009 18:35:36 Primary Site Code MorphologyMale % Female %

Leukemia 98353 Precursor cell lymphoblastic leukemia, NOS 30 16.9 31 17.4 98363 Precursor B-cell lymphoblastic leukemia 36 20.2 21 11.8 98613 Acute myeloid leukemia, NOS 9 5.1 3 1.7 98373 Precursor T-cell lymphoblastic leukemia 10 5.6 1 0.6 98053 Acute biphenotypic leukemia 2 1.1 3 1.7 98913 Acute monocytic leukemia 1 0.6 4 2.2 99103 Acute megakaryoblastic leukemia 4 2.2 1 0.6 98263 Burkitt cell leukemia 3 1.7 1 0.6 98743 Acute myeloid leukemia with maturation 2 1.1 1 0.6 98003 Leukemia, NOS 2 1.1 0 0.0 98013 Acute leukemia, NOS 1 0.6 1 0.6 98403 Acute myeloid leukemia, M6 type 2 1.1 0 0.0 98673 Acute myelomonocytic leukemia 0 0.0 2 1.1 99463 Juvenile myelomonocytic leukemia 2 1.1 0 0.0 All others31.7 2 1.1

Brain, CNS 94703 Medulloblastoma, NOS 16 21.1 10 13.2 93913 Ependymoma, NOS 5 6.6 4 5.3 93803 Glioma, malignant 4 5.3 3 3.9 89633 Malignant rhabdoid tumor 4 5.3 0 0.0 94003 Astrocytoma, NOS 2 2.6 2 2.6 93903 Choroid plexus carcinoma 0 0.0 3 3.9 94403 Glioblastoma, NOS 1 1.3 2 2.6 94713 Desmoplastic nodular medulloblastoma11.3 2 2.6 94733 Primitive neuroectodermal tumor, NOS 2 2.6 1 1.3 80003 Neoplasm, malignant 0 0.0 2 2.6 95003 Neuroblastoma, NOS 0 0.0 2 2.6 88143 Infantile brosarcoma 1 1.3 0 0.0 90643 Germinoma 1 1.3 0 0.0 90713 Yolk sac tumor 1 1.3 0 0.0 90803 Teratoma, malignant, NOS 1 1.3 0 0.0 93813 Gliomatosis cerebri 0 0.0 1 1.3 94013 Astrocytoma, anaplastic 1 1.3 0 0.0 94203 Fibrillary astrocytoma 0 0.0 1 1.3 94243 Pleomorphic xanthoastrocytoma 1 1.3 0 0.0 95033 Neuroepithelioma, NOS 0 0.0 1 1.3 95383 Papillary meningioma 0 0.0 1 1.3

Hodgkin Disease 96633 Hodgkin lymphoma, nodular sclerosis, NOS 16 28.1 14 24.6 96523 Hodgkin lymphoma, mixed cellularity, NOS 4 7.0 4 7.0 96513 Hodgkin lymphoma, lymphocyte-rich 610.5 0 0.0 96503 Hodgkin lymphoma, NOS 5 8.8 0 0.0 96653 Hodgkin lymphoma, nodular sclerosis, grade 1 3 5.3 1 1.8 96593 Hodgkin lymphoma, nodular lymphocyte predominance 3 5.3 0 0.0 96643 Hodgkin lymphoma, nodular sclerosis, cellular phase 1 1.8 0 0.0

NHL 96873 Burkitt lymphoma, NOS 12 23.1 5 9.6 96803 Malignant lymphoma, large B-cell, diffuse, NOS 815.4 3 5.8 97293 Precursor T-cell lymphoblastic lymphoma 3 5.8 4 7.7 95913 Malignant lymphoma, non-Hodgkin, NOS 4 7.7 0 0.0 97003 Mycosis fungoides 3 5.8 1 1.9 97283 Precursor B-cell lymphoblastic lymphoma 3 5.8 0 0.0 97023 Mature T-cell lymphoma, NOS 0 0.0 2 3.8 95903 Malignant lymphoma, NOS 0 0.0 1 1.9 96843 Malignant lymphoma, large B-cell, diffuse, immunoblastic, NOS 0 0.0 1 1.9 97083 Subcutaneous panniculitis-like T-cell lymphoma 1 1.9 0 0.0 97183 Primary cutaneous CD30+ T-cell lymphoproliferative disorder 1 1.9 0 0.0

Table 2.7 Number and Proportion of Morphological Types for the Most Common Types of Cancer among Saudi Children, 2005

SCRPart002.indd 25 27/05/2009 18:35:36 Continued Table 2.7......

Primary Site Code MorphologyMale % Female %

Connective Tissue 93643 Peripheral neuroectodermal tumor 2 6.7 4 13.3 89003 Rhabdomyosarcoma, NOS 310.0 2 6.7 89103 Embryonal rhabdomyosarcoma, NOS 2 6.7 2 6.7 88033 Small cell sarcoma 1 3.3 1 3.3 80003 Neoplasm, malignant 1 3.3 0 0.0 88013 Spindle cell sarcoma 0 0.0 1 3.3 88053 Undifferentiated sarcoma 0 0.0 1 3.3 88063 Desmoplastic small round cell tumor 1 3.3 0 0.0 88523 Myxoid liposarcoma 0 0.0 1 3.3 89123 Spindle cell rhabdomyosarcoma 1 3.3 0 0.0 90403 Synovial sarcoma, NOS 1 3.3 0 0.0 90433 Synovial sarcoma, biphasic 0 0.0 1 3.3 90803 Teratoma, malignant, NOS 1 3.3 0 0.0 90853 Mixed germ cell tumor 1 3.3 0 0.0 94733 Primitive neuroectodermal tumor, NOS 1 3.3 0 0.0 95003 Neuroblastoma, NOS 1 3.3 0 0.0 95403 Malignant peripheral nerve sheath tumor 1 3.3 0 0.0

Bone 92603 Ewing sarcoma 724.1 5 17.2 91803 Osteosarcoma, NOS 517.2 4 13.8 94733 Primitive neuroectodermal tumor, NOS 1 3.4 1 3.4 88103 Fibrosarcoma, NOS 0 0.0 1 3.4 89633 Malignant rhabdoid tumor 1 3.4 0 0.0 90403 Synovial sarcoma, NOS 1 3.4 0 0.0 91833 Telangiectatic osteosarcoma 1 3.4 0 0.0 92313 Myxoid chondrosarcoma 0 0.0 1 3.4 92403 Mesenchymal chondrosarcoma 1 3.4 0 0.0

Kidney 89603 Nephroblastoma, NOS 11 44.0 9 36.0 83123 Renal cell carcinoma, NOS 0 0.0 3 12.0 80003 Neoplasm, malignant 1 4.0 0 0.0 95003 Neuroblastoma, NOS 1 4.0 0 0.0

Eye 95123 Retinoblastoma, undifferentiated313.6 7 31.8 95103 Retinoblastoma, NOS 1 4.5 5 22.7 95113 Retinoblastoma, differentiated 1 4.5 2 9.1 95023 Teratoid medulloepithelioma 0 0.0 2 9.1 89103 Embryonal rhabdomyosarcoma, NOS 1 4.5 0 0.0

Skin 88323 Dermatobrosarcoma, NOS 220.0 2 20.0 80903 Basal cell carcinoma, NOS 110.0 2 20.0 80763 Squamous cell carcinoma, microinvasive 0 0.0 1 10.0 80833 Basaloid squamous cell carcinoma 110.0 0 0.0 80973 Basal cell carcinoma, nodular 110.0 0 0.0

Adrenal Gland 95003 Neuroblastoma, NOS 952.9 7 41.2 94903 Ganglioneuroblastoma00.0 1 5.9

Ovary 90603 Dysgerminoma 4 50.0 90853 Mixed germ cell tumor 2 25.0 90643 Germinoma 1 12.5 90803 Teratoma, malignant, NOS112.5

SCRPart002.indd 26 27/05/2009 18:35:36 Cancer in the 13 Administrative Regions of the Kingdom, 2005

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

Colo-rectal 13.5 Breast 21.8 Colo-rectal 11.8 NHL 8.5 Thyroid 13.2 Breast 11.0 Lung 7.3 Colo-rectal 10.0 NHL 8.3 Leukemia 7.1 NHL 8.1 Thyroid 8.0 Prostate 6.9 Leukemia 4.8 Leukemia 6.0 Liver 5.2 Corpus Uteri 3.6 Lung 4.8 Stomach 4.7 Skin 3.2 Liver 3.8 Nasopharynx 4.2 Ovary 3.2 Brain, Nervous system 3.5 Hodgkin disease 4.1 Brain, Nervous system 3.0 Prostate 3.4 Brain, Nervous System 4.0 Liver 2.5 Skin 3.3 Other sites 34.6 Other sites 26.6 Other sites 36.2

010203040 010203040 010203040 Males (946) Females (972) All (1918)

Figure 2.8.1 Riyadh Region, 2005 (Percentage Distribution)

Colo-rectal 11.7 Breast 27.3 Breast 14.0 NHL 9.8 Colo-rectal 9.0 Colo-rectal 10.3 Prostate 7.7 Thyroid 7.1 NHL 8.0 Lung 7.1 NHL 6.1 Lung 5.0 Liver 7.0 Ovary 4.6 Leukemia 4.8 Leukemia 5.9 Corpus Uteri 4.4 Liver 4.3 Bladder 4.5 Leukemia 3.6 Thyroid 4.3 Stomach 3.9 Skin 3.2 Prostate 3.8 Skin 3.7 Cervix Uteri 3.2 Skin 3.4 Hodgkin disease 3.3 Lung 2.8 Stomach 3.2 Other sites 35.5 Other sites 28.7 Other sites 39.0

010203040 010203040 010203040 Males (949) Females (913) All (1862)

Figure 2.8.2 Makkah Region, 2005 (Percentage Distribution)

SCRPart002.indd 27 27/05/2009 18:35:37 Cancer in the 13 Administrative Regions of the Kingdom

NHL 9.8 Breast 30.4 Breast 15.5 Lung 10.5 Colo-rectal 8.1 Colo-rectal 9.1 Colo-rectal 10.1 Thyroid 7.8 NHL 7.7 Prostate 7.9 NHL 5.5 Lung 6.9 Leukemia 7.5 Leukemia 4.3 Leukemia 5.9 Hodgkin disease 5.9 Lung 3.3 Thyroid 5.3 Liver 4.6 Hodgkin disease 3.1 Hodgkin disease 4.5 Stomach 4.1 Corpus Uteri 3.3 Prostate 3.9 Bladder 4.1 Ovary 3.4 Liver 3.4 Brain, Nervous System 2.9 Cervix Uteri 3.0 Brain, Nervous system 2.8 Other sites 32.6 Other sites 27.7 Other sites 32.5

010203040 010203040 010203040

Males (611) Females (703) All (1314)

Figure 2.8.3 Eastern Region, 2005 (Percentage Distribution)

Colo-rectal 11.2 Breast 24.7 Breast 12.5 NHL 11.2 Colo-rectal 9.4 Colo-rectal 10.3 Liver 8.8 Thyroid 8.4 NHL 8.1 Leukemia 7.5 Leukemia 5.9 Leukemia 6.7 Hodgkin disease 6.5 NHL 4.9 Liver 5.6 Skin 6.1 Ovary 3.5 Thyroid 5.0 Bladder 4.8 Hodgkin disease 3.5 Hodgkin disease 5.0 Lung 4.4 Skin 3.1 Skin 4.6 Stomach 3.7 Corpus Uteri 3.1 Lung 3.1 Multiple Myeloma 3.7 Brain, Nervous system 3.1 Bladder 2.7 Other sites 32.0 Other sites 30.3 Other sites 36.3

010203040 010203040 010203040 Males (294) Females (287) All (581)

Figure 2.8.4 Madinah Region, 2005 (Percentage Distribution)

Colo-rectal 12.2 Thyroid 27.0 Thyroid 14.7 NHL 12.2 Breast 16.2 Breast 8.1 Lung 9.8 Skin 10.8 Leukemia 7.6 Leukemia 9.8 Mesothelioma 5.4 Colo-rectal 7.4 Larynx 7.3 Corpus Uteri 5.4 NHL 7.4 Brain, Nervous System 7.3 Kidney 5.4 Skin 6.6 Hodgkin disease 4.9 Leukemia 5.4 Lung 4.9 Tongue 2.4 Colo-rectal 2.7 Hodgkin disease 3.8 Nasopharynx 2.4 Gall bladder etc. 2.7 Larynx 3.7 Stomach 2.4 Cervix Uteri 2.7 Brain, Nervous system 3.7 Other sites 29.3 Other sites 16.2 Other sites 32.1

010203040 010203040 010203040 Males (41) Females (37) All (78)

Figure 2.8.5 Northern Region, 2005 (Percentage Distribution)

SCRPart002.indd 28 27/05/2009 18:35:37 Cancer in the 13 Administrative Regions of the Kingdom

Colo-rectal 13.8 Breast 26.4 Breast 13.8 NHL 8.1 Colo-rectal 12.4 Colo-rectal 13.1 Lung 7.5 Thyroid 11.8 Thyroid 9.6 Leukemia 5.9 Thyroid 7.5 Leukemia 6.2 NHL 5.7 Prostate 5.6 Oesophagus 3.9 Lung 4.3 Brain, Nervous System 5.6 NHL 3.4 Brain, Nervous system 3.9 Leukemia 5.6 Corpus Uteri 2.8 Hodgkin disease 3.3 Liver 2.2 Stomach 5.0 Oespphagus 3.2 Hodgkin disease 5.0 Skin 2.2 Prostate 2.8 Nasopharynx 3.8 Brain, Nervous system 2.2 Stomach 2.8 Other sites 32.5 Other sites 25.8 Other sites 31.1

010203040 010203040 010203040 Males (160) Females (178) All (338)

Figure 2.8.6 Qassim Region, 2005 (Percentage Distribution)

Tongue 11.3 Breast 21.3 Mouth 11.2 Leukemia 9.6 Mouth 14.2 Breast 11.2 Mouth 7.8 Thyroid 7.9 Leukemia 8.3 Colo-rectal 7.8 Leukemia 7.1 Tongue 7.9 Skin 7.8 NHL 5.5 Skin 6.2 Prostate 7.8 Tongue 4.7 Colo-rectal 5.4 Hodgkin disease 5.2 Skin 4.7 Thyroid 5.4 NHL 4.3 Oesophagus 3.1 NHL 5.0 Nasopharynx 3.5 Colo-rectal 3.1 Prostate 3.7 Oesophagus 3.5 Ovary 2.4 Hodgkin disease 3.7 Other sites 31.3 Other sites 26.0 Other sites 32.2

010203040 010203040 010203040 Males (115) Females (127)All (242)

Figure 2.8.7 Jazan Region, 2005 (Percentage Distribution)

Colo-rectal 20.8 Breast 21.7 Colo-rectal 16.2 NHL 11.7 Thyroid 14.5 Breast 11.5 Leukemia 11.7 Colo-rectal 11.6 Leukemia 9.5 Lung 6.5 NHL 7.2 NHL 9.5 Skin 5.2 Leukemia 7.2 Thyroid 8.5 Nasopharynx 3.9 Skin 4.3 Skin 4.8

Oesophagus 3.9. Connective, Soft tissue 2.9 Lung 3.2 Prostate 3.9 Corpus Uteri 2.9 Connective, Soft tissue 2.7 Hodgkin disease 3.9 Ovary 2.9 Brain, Nervous system 2.7 Salivary glands 2.6 Kidney 2.9 Hodgkin disease 2.7 Other sites 26.0 Other sites 21.7 Other sites 28.6

010203040 010203040 010203040 Males (77) Females (69) All (146)

Figure 2.8.8 Hail Region, 2005 (Percentage Distribution)

SCRPart002.indd 29 27/05/2009 18:35:38 Cancer in the 13 Administrative Regions of the Kingdom

Leukemia 18.2 Breast 16.1 Leukemia 12.3 Liver 13.6 Colo-rectal 9.7 NHL 9.4 Colo-rectal 9.1 Thyroid 9.7 Colo-rectal 9.4 Prostate 9.1 NHL 9.7 Breast 8.1 NHL 9.1 Brain, Nervous system 8.1 Liver 6.8 Stomach 4.5 Leukemia 6.5 Thyroid 6.0 Lung 4.5 Stomach 3.2 Prostate 4.5 Bone 4.5 Gall bladder etc. 3.2 Brain, Nervous system 4.0 Skin 4.5 Pancreas 3.2 Stomach 3.9 Bladder 4.5 Skin 3.2 Skin 3.9 Other sites 18.2 Other sites 29.0 Other sites 32.5

010203040 010203040 010203040 Males (44) Females (62) All (106)

Figure 2.8.9 Najran Region, 2005 (Percentage Distribution)

NHL 12.3 Breast 20.0 Breast 10.0 Colo-rectal 10.5 Skin 10.0 Skin 8.5 Bladder 8.8 Corpus Uteri 8.0 NHL 8.1 8.0 Stomach 7.0 Leukemia Leukemia 7.5 Stomach 6.0 Skin 7.0 Colo-rectal 7.3 Thyroid 6.0 Hodgkin disease 7.0 Stomach 6.5 Nasopharynx 4.0 Leukemia 7.0 Bladder 5.4 Colo-rectal 4.0 Lung 5.3 Lung 4.6 Lung 4.0 Bone 5.3 Hodgkin disease 4.5 Ovary 4.0 Prostate 5.3 Corpus Uteri 4.0 NHL 4.0 Other sites 24.6 Other sites 22.0 Other sites 33.5

010203040 010203040 010203040

Males (57) Females (50) All (107) Figure 2.8.10 Baha Region, 2005 (Percentage Distribution)

Prostate 11.1 Breast 15.7 Colo-rectal 9.7 Colo-rectal 10.0 Thyroid 10.6 NHL 8.4 NHL 8.5 Colo-rectal 9.4 Breast 7.8 Skin 7.0 Skin 8.2 Skin 7.6 Stomach 6.3 NHL 8.2 Thyroid 6.4 Bladder 5.5 Stomach 6.3 Stomach 6.3 Lung 4.4 Corpus Uteri 5.1 Prostate 5.5 Leukemia 4.4 Ovary 4.3 Leukemia 4.4 Liver 4.1 Leukemia 4.3 Bladder 3.4 Brain, Nervous System 4.1 Mouth 2.7 Lung 3.0 Other sites 34.7 Other sites 25.1 Other sites 37.6

010203040 010203040 010203040 Males (271) Females (255) All (526)

Figure 2.8.11 Asir Region, 2005 (Percentage Distribution)

SCRPart002.indd 30 27/05/2009 18:35:38 Cancer in the 13 Administrative Regions of the Kingdom

Colo-rectal 13.3 Thyroid 17.6 Thyroid 9.9 NHL 8.9 Breast 14.7 Colo-rectal 9.6 Liver 7.8 NHL 8.8 NHL 8.9 Oesophagus 5.9 Larynx 6.7 Breast 7.4 Colo-rectal 5.9 Bladder 6.7 Liver 6.3 Liver 4.9 Lung 5.6 Skin 5.2 Skin 4.9 Skin 5.6 Oesophagus 4.6 Hodgkin disease 3.9 Brain, Nervous system 5.6 Bladder 4.3 Leukemia 3.9 Mouth 4.4 Corpus Uteri 2.9 Leukemia 4.2 Prostate 4.4 Ovary 2.9 Larynx 3.8 Other sites 31.1 Other sites 23.5 Other sites 35.8

010203040 0102030 40 010203040 Males (90) Females (102) All (192)

Figure 2.8.12 Tabuk Region, 2005 (Percentage Distribution)

Leukemia 11.3 Breast 25.4 Breast 12.7 Colo-rectal 5.7 Leukemia 8.5 Leukemia 9.9 Liver 5.7 Corpus Uteri 6.8 Hodgkin disease 6.2 Pancreas 5.7 Hodgkin disease 6.8 NHL 6.2 Larynx 5.7 NHL 6.8 Liver 4.5 Prostate 5.7 Oesophagus 5.1 Thyroid 4.5 Bladder 5.7 Ovary 5.1 Oesophagus 4.4 Thyroid 5.7 Liver 3.4 Colo-rectal 3.7 Hodgkin disease 5.7 Mesothelioma 3.4 Corpus Uteri 3.4 NHL 5.7 Cervix Uteri 3.4 Pancreas 2.8 Other sites 37.7 Other sites 25.4 Other sites 41.6

010203040 010203040 01020304050 Males (53) Females (59) All (112)

Figure 2.8.13 Jouf Region, 2005 (Percentage Distribution)

SCRPart002.indd 31 27/05/2009 18:35:39 International Comparison of Age-Standardized Incidence Rates

Worldwide, it is estimated that around 11 million While in developing countries, lung cancer was ﬁrst people developed cancer in 2002. Of these, followed by stomach, liver, esophagus and colo- 53.7% were in developing countries and 46.5% rectal cancers. Among women, breast cancer was were in developed countries. According to the most common followed by colo-rectal, lung 2002 estimates, the most common cancer site and corpus uteri cancers in developed countries. among all men was lung cancer. However; in While in the developing countries breast cancer developed countries prostate was the leading was followed by cancers of the cervix, stomach cancer followed by lung, colo-rectal, and stomach. and lung.

Wales 595.5 United States (All Races) 525.9 Canada (Ontario) 461.0 Western Australia 356.1 Norway 329.2 Poland 253.6 Qatar 138.0 Bahrain 128.8 Kuwait 121.3 Oman 115.0 Saudi Arabia 74.1 United Arab Emirates 56.9 0 100 200 300400 500600 700

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

Wales 533.1 United States (All Races) 406.9 Canada (Ontario) 362.6 Norway 274.8 Western Australia 260.9 Poland 191.8 Bahrain 161.6 Qatar 156.4 Kuwait 140.7 Oman 92.8 United Arab Emirates 86.1 Saudi Arabia 74.4 0 100 200 300400 500600 700

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 66

SCRPart002.indd 32 27/05/2009 18:35:39 PART III CANCER INCIDENCE FOR MOST COMMON SITES 2005

SCRPart003.indd 33 27/05/2009 18:33:58 SCRPart003.indd 34 27/05/2009 18:33:58 Cancer Incidence for Most Common Sites, 2005

In this section, the incidence of the most relative frequencies. The relevant data incorporate common cancers among Saudi males and details for all patients presented over the period of females are outlined in accordance to their January through December 2005.

Cancer Male Female All % Breast 16 932 948 12.5 Colo-rectal 439 339 778 10.3 Non-Hodgkin lymphoma 346 250 596 7.9 Thyroid 93 380 473 6.3 Leukemia 259 182 441 5.8 Lung 261 86 347 4.6 Liver 211 81 292 3.9 Skin 152 129 281 3.7 Prostate 261 - 261 3.5 Hodgkin disease 160 99 259 3.4 Stomach 156 68 224 3.0 Brain, Nervous system 124 96 220 2.9 Bladder 155 35 190 2.5 Corpus Uteri - 143 143 1.9 Ovary - 136 136 1.8 Others 1096 878 1974 26.1 Total 3729 3834 7563 100.0

Table 3.1 Most Common Cancers among Saudis, 2005

SCRPart003.indd 35 27/05/2009 18:33:58 Female Breast (C 50)

There were 932 female breast cancer cases ASR were Eastern region at 30.0 /100,000, for year 2005. Breast cancer ranked first Makkah region at 20.9 /100,000, Riyadh region at among females accounting for 24.3% of all 18.6/100,000, Jouf region at 16.9/100,000 and Tabuk newly diagnosed female cancers (3,834) in year region at 12.5/100,000. The median age at diagnosis 2005. The ASR was 18.0/100,000 for female was 46 years (Range 21-100 years). population. The five regions with the highest

female 50

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, 2005

ICD-O-3 Code Morphology Total %

8500 Inltrating duct ca rcinoma, NOS717 76.9% 8520 Lobular carcinoma, NOS39 4.2% 8010 Carcinoma, NOS37 4.0% 8522 Inltr ating duct and lobular carcinoma23 2.5% 8000 Neoplasm, malignant22 2.4% 8523 Inltrating duct mi xed with other types of carcinoma18 1.9% 8510 Medullary carcinoma, NOS14 1.5% 8480 Mucinous adenocarcinoma 9 1.0% Others 53 5.7%

Table 3.1.2 Morphological Distribution of Female Breast Cancer in Saudi Arabia, 2005

12.4% 17.5% Distant Localised

25.4% Regional Unknown 44.6%

Figure 3.1.2 Stage Distribution of Female Breast Cancer, 2005

SCRPart003.indd 36 27/05/2009 18:33:59 Eastern 30.0 Makkah 20.9 Riyadh 18.6 Jouf 16.9 Tabuk 12.5 Madinah 11.3 Qassim 10.1 Hail 9.3 Northern 9.0 Najran 8.6 Baha 8.5 Asir 8.1 Jazan 7.5

0510 15 20 25 30 35

Figure 3.1.3 ASR* Regional Distribution of Female Breast Cancer in Saudi Arabia, 2005

Wales 156.4

United States (All Races) 123.7

Canada (Ontario) 99.2

Western Australia 81.2

Norway 75.7 Bahrain 58.4

Kuwait 53.6

Qatar 50.8

Poland 44.5

United Arab Emirates 24.2

Oman 19.3

Saudi Arabia 18.0

020406080100 120140 160180

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 66

SCRPart003.indd 37 27/05/2009 18:33:59 Colo-rectal (C18-C20)

There were 778 cases of colo-rectal cancer The five regions with the highest ASR were accounting for10.3% of all newly diagnosed cases Riyadh region at 12.5/100,000, Eastern region in year 2005. This cancer ranked ﬁrst among male at 10/100,000, Makkah region at 8.7/100,000, population and third among female population. Hail region at 7.8/100,000 and Tabuk region at It affected 439 (56.4%) males and 339 (43.6%) 7.1/100,000. The median age at diagnosis was 60 females with a male to female ratio of 129:100. The years among males (range 17-99 years) and 54 years overall ASR was 8.5 /100,000. ASR for males was among females (range 1-100 years). 9.7/100,000 and for females 7.2 /100,000.

60 male female

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 3.2.1 Age-Specific Incidence Rate (AIR) for Colo-rectal Cancer in Saudi Arabia, 2005

ICD-O-3 Code Morphology Male % Female %

8140 Adenocarcinoma, NOS 337 43.3% 255 32.8%

8480 Mucinous adenocarcinoma 32 4.1% 29 3.7%

8000 Neoplasm, malignant 9 1.2% 10 1.3%

8010 Carcinoma, NOS 8 1.0% 8 1.0%

8490 Signet ring cell carcinoma 9 1.2% 7 0.9%

8261 Adenocarcinoma in villous adenoma 6 0.8% 9 1.2%

8263 Adenocarcinoma in tubulovillous adenoma 9 1.2% 6 0.8%

8210 Adenocarcinoma in adenomatous polyp 9 1.2% 2 0.3%

Others 20 2.6% 13 1.7% Table 3.2.1 Morphological Distribution of Colo-rectal Cancer in Saudi Arabia, 2005

13.9% 15.0% 14.4% 27.1% 27.7% 27.4% Distant Localised Regional 37.8% 36.6% 35.8% 23.2% 19.5% 21.6% Unknown

Male Female All

Figure 3.2.2 Stage Distribution of Colo-rectal Cancer, 2005

SCRPart003.indd 38 27/05/2009 18:34:00 11.0 Riyadh 14.0 9.7 Eastern 10.2 7.3 Makkah 10.1 5.1 Hail 10.5 4.6 Tabuk 9.5 4.5 Madinah 6.8 4.6 Asir 6.1 1.7 Northern 9.0 4.7 Qassim 5.1 Najran 6.3 3.3 1.3 Baha 4.5 0.7 Jouf 3.9 1.0 Jazan 2.8

0246810121416

Figure 3.2.3 ASR* Regional Distribution of Colo-rectal Cancer in Saudi Arabia, 2005

Wales 55.7 78.9 United States (All Races) 40.9 53.4 Western Australia 29.5 39.1 Kuwait 12.9 18.3 Qatar 14.3 14.7 Bahrain 8.5 14.9 Poland 6.6 13.1 7.2 Saudi Arabia 9.7 United Arab Emirates 9.2 7.9 2.8 Oman 7.9

0102030405060708090

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 66

SCRPart003.indd 39 27/05/2009 18:34:01 Non-Hodgkin Lymphoma (C82-C85; C96)

There were 596 cases of Non-Hodgkin Lymphoma The five regions with the highest ASR were accounting for 7.9 % of all newly diagnosed Riyadh region at 7.4/100,000, Eastern region at cancers in year 2005. This cancer ranked second 7.1/100,000,Makkah region at 6.4/100,000, Tabuk among male population and fourth among female region at 5.5/100,000 and Najran regions at population. It affected 346(58.1%) males and 5.3/100,000. The median age at diagnosis was 46 250(41.9%) females with a male to female ratio of years among males (range 2-103 years) and 53 years 139:100. The overall ASR was 5.7/100,000. ASR for among females (range 1-94 years). males was 6.4/100,000 and 5.0/100,000 for females.

40 male female 35

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 3.3.1 Age-Specific Incidence Rate (AIR) for NHL in Saudi Arabia, 2005

ICD-O-3 Code Morphology Male % Female % 9680 Malignant lymphoma, large B-cell, diffuse, NOS 161 27.0% 116 19.5% 9591 Malignant lymphoma, non-Hodgkin, NOS 24 4.0% 23 3.9% 9590 Malignant lymphoma, NOS 21 3.5% 17 2.9% 9687 Burkitt lymphoma, NOS 20 3.4% 11 1.8% 9670 Malignant lymphoma, small B lymphocytic, NOS 21 3.5% 7 1.2% 9700 Mycosis fungoides 11 1.8% 8 1.3% 9698 Follicular lymphoma, grade 3 6 1.0% 10 1.7% 9702 Mature T-cell lymphoma, NOS 6 1.0% 9 1.5% 9714 Anaplastic large cell lymphoma, T cell and Null cell type 9 1.5% 6 1.0% 9690 Follicular lymphoma, NOS 8 1.3% 5 0.8% 9699 Marginal zone B-cell lymphoma, NOS 8 1.3% 5 0.8% 9691 Follicular lymphoma, grade 2 6 1.0% 6 1.0% 9695 Follicular lymphoma, grade 1 8 1.3% 4 0.7% 9729 Precursor T- cell lymphoblastic lymphoma 5 0.8% 6 1.0% 9684 Malignant lymphoma, large B-cell, diffuse, immunoblastic, NO S 6 1.0% 4 0.7% 9673 Mantle cell lymphoma 6 1.0% 1 0.2% 9675 Malignant lymphoma, mixed small and large cell, diffuse 4 0.7% 2 0.3% Others 16 2.7% 10 1.7% Table 3.3.1 Morphological Distribution of NHL in Saudi Arabia, 2005

SCRPart003.indd 40 27/05/2009 18:34:01 32.7% 28.4% 30.9% Distant Localised 40.8% 44.8% 42.4% Regional 16.8% 12.4% 14.9% Unknown 9.8% 14.4% 11.7% Male Female All Figure 3.3.2 Stage Distribution of NHL Cancer, 2002

Riyadh 7.7 7.1 6.2 Eastern 7.9 5.1 Makkah 7.7 Tabuk 5.9 5.1 Najran 6.0 4.6 1.7 Northern 6.9 3.1 Hail 5.5 4.1 Asir 4.2 Jouf 4.7 2.8 2.4 Madinah 4.4 1.2 Baha 5.6 Jazan 2.1 1.3 1.0 Qassim 2.3

0123456789

Figure 3.3.3 ASR* Regional Distribution of NHL Cancer in Saudi Arabia, 2005

16.4 United States (All Races) 24.4 17.5 Wales 19.5 14.5 Canada (Ontario) 20.9 9.3 Western Australia 12.7 8.0 Norway 11.9 6.8 Kuwait 12.0 Oman 5.4 8.4 Qatar 5.4 7.7 Saudi Arabia 5.0 6.4 Bahrain 7.3 3.9 Poland 3.5 5.3 United Arab Emirates 1.3 4.5

0510 15 20 25 30

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 66

SCRPart003.indd 41 27/05/2009 18:34:02 Thyroid (C 73)

There were 473 cases of thyroid cancer for The five regions with the highest ASR were year 2005. This cancer ranked second among Riyadh region at 5.6/100,000, Northern region at female population and thirteenth among male 5.1/100,000, Eastern region at 4.2/100,000, Tabuk population. It affected 93(19.3%) males and 380 region at 4.0 /100,000 and Hail region at 3.5/100,000. (80.3%) females with a male to female ratio of The median age at diagnosis was 44 years among 25:100. The overall ASR was 3.8/100,000. ASR was males (range 4-86 years) and 37 years among 1.6/100,000 for males and 6.0 /100,000 for females. females (range 8-99 years).

16 male female 14

6 AIR (per 100,000) 4

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, 2005

ICD-O-3 Code Morphology Male % Female % 8260 Papillary adenocarcinoma, NOS 62 13.1% 224 47.4% 8340 Papillary carcinoma, follicular variant 11 2.3% 61 12.9% 8341 Papillary microcarcinoma 0 0.0% 22 4.7% 8330 Follicular adenocarcinoma, NOS 3 0.6% 16 3.4% 8343 Papillary carcinoma, encapsulated 3 0.6% 10 2.1% 8335 Follicular carcinoma, minimally invasive 1 0.2% 11 2.3% 8050 Papillary carcinoma, NOS 2 0.4% 9 1.9% 8290 Oxyphilic adenocarcinoma 3 0.6% 6 1.3% 8510 Medullary carcinoma, NOS 4 0.8% 3 0.6% Others 4 0.8% 18 3.8% Table 3.4.1 Morphological Distribution of Thyroid Cancer in Saudi Arabia, 2005

4.5% 6.6% 21.5% 15.1% 22.9% 22.6% Distant Localised

45.3% Regional 28.0% 35.5% 27.4% 43.3% Unknown 27.5% Male Female All Figure 3.4.2 Stage Distribution of Thyroid Cancer, 2005

SCRPart003.indd 42 27/05/2009 18:34:02 Riyadh 9.0 2.2 Northern 9.4 0.7 Eastern 6.4 2.0 Tabuk 7.5 0.5 Hail 5.7 1.2 Asir 4.7 1.3 Qassim 3.7 2.1 Makkah 4.5 0.9 Jouf 2.2 3.1 Najran 3.9 0.5 Madinah 3.2 0.7 Baha 2.4 1.3 Jazan 2.9 0.7 0 12345678910

Figure 3.4.3 ASR* Regional Distribution of Thyroid Cancer in Saudi Arabia, 2005

Canada (Ontario) 22.1 5.8 United States (All Races) 15.6 5.6 Qatar 12.7 8.2 Bahrain 10.8 3.7 Kuwait 8.6 3.5 Western Australia 8.3 2.9 United Arab Emirates 6.5 2.7 Saudi Arabia 6.0 1.6 Norway 5.0 2.0 Oman 5.3 1.4 Poland 5.4 1.2 Wales 3.8 1.9

0510 15 20 25

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 66

SCRPart003.indd 43 27/05/2009 18:34:03 Leukemia (C91-C95)

There were 441 cases of leukemia accounting for The ﬁve regions with the highest ASR were Jouf 5.8 % of all newly diagnosed cancers in year 2005. region at 4.1/100,000, Najran region at 4.1/100,000, This cancer ranked ﬁfth for males and females and Eastern region at 3.5/100,000, Riyadh region at affected 259(58.7%) males and 182(41.3%) females 3.5/100,000 and Hail region at 3.1/100,000. The with a male to female ratio of 142:100. The overall median age at diagnosis is 18 years among males ASR was 2.9/100,000. ASR for males was 3.3/100,000 (range 0-103 years) and 20 years among females and 2.5/1000,000 for females. (range 1-86 years).

10 male female

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 3.5.1 Age-Specific Incidence Rate (AIR) for Leukemia in Saudi Arabia, 2005

ICD-O-3 Code Morphology Male % Female % 9835 Precursor cell lymphoblastic leukemia, NOS 54 12.2% 36 8.2% 9836 Precursor B-cell lymphoblastic leukemia 54 12.2% 25 5.7% 9863 Chronic myeloid leukemia, NOS 33 7.5% 24 5.4% 9861 Acute myeloid leukemia, NOS 20 4.5% 18 4.1% 9837 Precursor T-cell lymphoblastic leukemia 21 4.8% 3 0.7% 9866 Acute promyelocytic leukemia, t(15;17) (q22;q11-12) 6 1.4% 13 2.9% 9891 Acute monocytic leukemia 10 2.3% 9 2.0% 9823 B-cell chronic lymphocytic leukemia/small lymphocytic lymphoma 8 1.8% 9 2.0% 9874 Acute myeloid leukemia with maturation 7 1.6% 7 1.6% 9801 Acute leukemia, NOS 6 1.4% 7 1.6% 9867 Acute myelomonocytic leukemia 1 0.2% 8 1.8% 9800 Leukemia, NOS 4 0.9% 4 0.9% 9805 Acute biphenotypic leukemia 4 0.9% 4 0.9% 9910 Acute megakaryoblastic leukemia 5 1.1% 1 0.2% 9826 Burkitt cell leukemia 3 0.7% 2 0.5% 9940 Hairy cell leukemia 5 1.1% 0 0.0% Others 18 4.1% 12 2.7%

Table 3.5.1 Morphological Distribution of Leukemia in Saudi Arabia, 2005

SCRPart003.indd 44 27/05/2009 18:34:03 3.8 Jouf 4.4 3.7 Najran 4.5 3.0 Eastern 4.0 2.7 Riyadh 4.2 1.7 Hail 4.4 2.3 Makkah 3.4 1.4 Northern 4.1 2.2 Baha 2.7 2.3 Madinah 1.9 1.8 Jazan 1.8 1.8 Tabuk 1.5 1.7 Asir 1.6 2.1 Qassim 1.2

012345

Figure 3.5.2 ASR* Regional Distribution of Leukemia in Saudi Arabia, 2005

Wales 12.9 18.9 United States (All Races) 9.3 15.6 Western Australia 5.7 10.2 5.9 Kuwait 7.1 Norway 4.5 7.8 Bahrain 3.2 6.5 Oman 3.1 4.7 United Arab Emirates 4.4 2.0 Qatar 0.8 5.2 2.5 Saudi Arabia 3.3 1.9 Poland 2.7

0246810 12 14 16 18 20

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 66

SCRPart003.indd 45 27/05/2009 18:34:03 Lung (C33-C34)

There were 347 cases of lung cancer accounting The ﬁve regions with the highest ASR were Eastern for 4.6% of all diagnosed cases in year 2005. Lung region at 8.2/100,000, Riyadh region at 5.0/100,000, cancer ranked third among male population and Makkah region at 4.7/100,000, Northern region at twelveth among female population. It affected 261 3.3/100,000 and Tabuk region at 2.8 /100,000. The (75.2 %) males and 86 (24.8%) females with a male median age at diagnosis was 63 years among males to female ratio of 303:100. The overall ASR was (range 0-94 years) and 61 years among females 4.0/100,000. ASR was 6.1/100,000 for males and (range 17-90 years). 1.9/100,000 for females.

60 male female

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 3.6.1 Age-Specific Incidence Rate (AIR) for Lung Cancer in Saudi Arabia, 2005

ICD-O-3 Code Morphology Male % Female % 8140 Adenocarcinoma, NOS 60 17.3% 33 9.5% 8046 Non-small cell carcinoma 39 11.2% 11 3.2% 8070 Squamous cell carcinoma, NOS 37 10.7% 10 2.9% 8041 Small cell carcinoma, NOS 29 8.4% 1 0.3% 8000 Neoplasm, malignant 19 5.5% 5 1.4% 8010 Carcinoma, NOS 19 5.5% 2 0.6% 8012 Large cell carcinoma, NOS 13 3.7% 2 0.6% 8250 Bronchiolo-alveolar adenocarcinoma, NOS 5 1.4% 9 2.6% 8071 Squamous cell carcinoma, keratinizing, NOS 11 3.2% 2 0.6% 8020 Carcinoma, undifferentiated, NOS 7 2.0% 0 0.0% 8260 Papillary adenocarcinoma, NOS 2 0.6% 2 0.6% Others 20 5.8% 9 2.6%

Table 3.6.1 Morphological Distribution of Lung Cancer in Saudi Arabia, 2005

26.1% 20.9% 24.8% 53.6% 51.0% Distant 9.3% 61.6% Localised 13.5% Regional 14.9% 8.1% Unknown 8.0% 8.1% Male Female All

Figure 3.6.2 Stage Distribution of Lung Cancer, 2005

SCRPart003.indd 46 27/05/2009 18:34:04 Eastern 4.3 12.0 Riyadh 2.3 7.7 Makkah 2.5 6.8 0.0 Northern 6.5 0.0 Tabuk 5.5 1.7 Baha 2.6 0.9 Madinah 2.9 1.0 Asir 2.5 0.4 Qassim 2.8 1.0 Najran 1.9 0.0 Hail 2.9 1.4 Jouf 1.3 0.0 Jazan 0.9

02468101214

Figure 3.6.3 ASR* Regional Distribution of Lung Cancer in Saudi Arabia, 2005

Wales 60.5 85.1 United States (All Races) 52.2 73.2 Canada (Ontario) 43.3 60.4 Poland 14.4 60.2 18.4 Western Australia 37.9 Norway 21.3 33.7 Bahrain 2.0 21.9 3.2 Qatar 15.7 4.9 Kuwait 11.0 2.4 Oman 7.0 1.9 Saudi Arabia 6.1 1.2 United Arab Emirates 5.8

0102030405060708090

Figure 3.6.4 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 66

SCRPart003.indd 47 27/05/2009 18:34:04 Liver (C 22)

There were 292 cases of liver cancer accounting The ﬁve regions with the highest ASR were Tabuk for 3.9% of all newly diagnosed cases in year 2005. region at 5.7/100,000, Riyadh region at 4.5/100,000, This cancer ranked sixth in males, and thirteenth Eastern region at 4.1/100,000, Makkah region at in females and affected 211 (72.3%) males and 81 4.0/100,000 and Najran region at 3.5/100,000. (27.7%) females with a male to female ratio of The median age at diagnosis was 66 years in males 261:100. The overall ASR was 3.5/100,000. ASR was (range 6-104 years) and 64 years in female (range 4.9/100,000 for males and 1.8/100,000 for females. 0-93 years)

50 male female

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 3.7.1 Age-Specific Incidence Rate (AIR) for Liver Cancer in Saudi Arabia, 2005

ICD-O-3 Code Morphology Male % Female %

8170 Hepatocellular carcinoma, NOS 164 56.2% 51 17.5% 8000 Neoplasm, malignant 25 8.6% 7 2.4% 8160 Cholangiocarcinoma 8 2.7% 9 3.1% 8140 Adenocarcinoma, NOS 3 1.0% 3 1.0% 8010 Carcinoma, NOS 3 1.0% 2 0.7% 8180 Combined hepatocellular carcinoma and cholangiocarcinoma 2 0.7% 1 0.3% Others 6 2.1% 8 2.7%

Table 3.7.1 Morphological Distribution of Liver Cancer in Saudi Arabia, 2005

14.7% 16.0% 15.1%

9.9% 15.4% Distant 17.5% Localised

59.3% Regional 62.3% 63.5% 4.3% 14.8% 7.2% Unknown

Male Female All

Figure 3.7.2 Stage Distribution of Liver Cancer, 2005

SCRPart003.indd 48 27/05/2009 18:34:05 4.6 Tabuk 6.7 3.0 Riyadh 6.0 2.9 Eastern 5.3 1.4 Makkah 6.5 0.0 Najran 6.9 1.3 Madinah 4.5 1.2 Jouf 3.2 0.4 Asir 2.3 0.0 Baha 2.5 0.9 Qassim 1.2 0.0 Northern 1.9 Hail 0.6 0.8 Jazan 0.3 0.4

012345678

Figure 3.7.3 ASR* Regional Distribution of Liver Cancer in Saudi Arabia, 2005

3.7 Qatar 21.8 3.5 United States (All Races) 9.8 4.7 Wales 6.5 2.3 Oman 8.8 1.0 Kuwait 6.3 1.6 Canada (Ontario) 5.5 1.8 Saudi Arabia 4.9 1.8 Western Australia 4.4 3.8 Bahrain 2.1 1.5 Poland 2.6 1.4 Norway 2.0 1.1 United Arab Emirates 1.3

0510 15 20 25

Figure 3.7.4 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 66

SCRPart003.indd 49 27/05/2009 18:34:05 Skin (Non-Melanoma) (C 44)

There were 281 cases of skin cancer accounting The five regions with the highest ASR were for 3.7% of all newly diagnosed cases in year 2005. Northern region at 4.9/100,000, Asir region at This cancer ranked tenth for males and eighth 4.1/100,000, Tabuk region at 3.7/100,000, Riyadh for females. It affected 152(54.1%) males and region at 3.3/100,000 and Makkah region at 129(45.9%) females with a male to female ratio of 3.2/100,000. The median age at diagnosis was 118:100. The overall ASR was 3.1/100,000. ASR was 69 years among males (range 6-103 years) 3.3/100,000 for males and 2.8/100,000 for females. and 63 years among female (range 7-99 years).

40 male female 35 30 25 20 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 3.8.1 Age-Specific Incidence Rate (AIR) for Skin Cancer in Saudi Arabia, 2005

ICD-O-3 Code Morphology Male % Female %

8090 Basal cell carcinoma, NOS 69 24.6% 67 23.8% 8070 Squamous cell carcinoma, NOS 37 13.2% 19 6.8% 8832 Dermatobrosarcoma, NOS 14 5.0% 10 3.6% 8071 Squamous cell carcinoma, keratinizing, NOS 8 2.8% 7 2.5% 8097 Basal cell carcinoma, nodular 5 1.8% 4 1.4% 8094 Basosquamous carcinoma 3 1.1% 3 1.1% 8410 Sebaceous adenocarcinoma 3 1.1% 2 0.7% 8000 Neoplasm, malignant 2 0.7% 2 0.7% 8075 Squamous cell carcinoma, adenoid 2 0.7% 2 0.7% 8091 Multifocal supercial basal cell carcinoma 1 0.4% 2 0.7% 8098 Adenoid basal carcinoma 0 0.0% 3 1.1% Others 8 2.8% 8 2.8% Table 3.8.1 Morphological Distribution of Skin Cancer in Saudi Arabia, 2005

3.3% 0.8% 2.1% 46.1% 36.4% 41.6% 48.8% Distant Localised 44.7% 53.5% Regional Unknown 9.3% 5.9% 7.5% Male Female All Figure 3.8.2 Stage Distribution of Skin Cancer in Saudi Arabia, 2005

SCRPart003.indd 50 27/05/2009 18:34:06 Northern 8.2 1.5 4.1 Asir 4.1 3.4 Tabuk 4.0 3.4 Riyadh 3.2 2.8 Makkah 3.5 Baha 3.0 3.0 1.8 Madinah 2.9 1.7 Jazan 2.9 1.3 Najran 3.2 1.6 Eastern 2.6 Hail 1.9 2.0 Jouf 1.6 1.3 0.7 Qassim 0.9

0246810

Figure 3.8.3 ASR* Regional Distribution of Skin Cancer in Saudi Arabia, 2005

Poland 11.5 15.1 Norway 10.3 14.4

Qatar 8.3 5.3 Oman 3.4 4.8 2.8 Saudi Arabia 3.3 2.0 Bahrain 3.4 Western Australia 1.8 2.4

Kuwait 1.9 2.1 1.5 United Arab Emirates 2.0

0246810 12 14 16

Figure 3.8.4 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 66

SCRPart003.indd 51 27/05/2009 18:34:06 Prostate (C 61)

There were 261 cases of prostate cancer accounting the highest ASR were Eastern region at 9.1/100,000, for 7.0% of all newly diagnosed cases among Riyadh region at 8.5 /100,000, Makkah region males in year 2005. The ASR was 6.2/100,000 at 7.1/100,000, Asir region at 6.4/100,000 and among male population. This cancer ranked Jouf region at 4.4/100,000. The median age at fourth among males. The five regions with diagnosis was 71 years (range 6 -103 years).

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 3.9.1 Age-Specific Incidence Rate (AIR) for Prostate Cancer in Saudi Arabia, 2005

ICD-O Code Morphology Total %

8140 Adenocarcinoma, NOS 235 90.0% 8000 Neoplasm, malignant 17 6.5% 8010 Carcinoma, NOS 5 1.9% 8481 Mucin-producing adenocarcinoma 2 0.8% 8020 Carcinoma, undifferentiated, NOS 1 0.4% 8910 Embryonal rhabdomyosarcoma, NOS 1 0.4%

Table 3.9.1 Morphological Distribution of Prostate Cancer in Saudi Arabia, 2005

29.9% 24.9% Distant Localised Regional 8.0% Unknown 37.2%

Figure 3.9.2 Stage Distribution of Prostate Cancer, 2005

SCRPart003.indd 52 27/05/2009 18:34:07 Eastern 9.1

Riyadh 8.5

Makkah 7.1

Asir 6.4

Jouf 4.4

Tabuk 3.8

Najran 3.8

Jazan 3.0

Baha 2.3

Madinah 1.8

Hail 1.7

Qassim 1.6 Northern 0.0

0246810

Figure 3.9.3 ASR* Regional Distribution of Prostate Cancer in Saudi Arabia, 2005

Wales 156.4 United States (All Races) 150.5 Canada (Ontario) 137.0

Western Australia 100.5 Norway 91.7 Poland 27.3 Bahrain 13.9 Kuwait 13.5 Oman 11.4 Saudi Arabia 6.2 United Arab Emirates 5.6 Qatar 2.4

020406080100 120140 160180

Figure 3.9.4 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 66

SCRPart003.indd 53 27/05/2009 18:34:07 Hodgkin disease (C 81)

There were 259 cases of hodgkin disease cancer and 1.3/100,000 for females. The ﬁve regions with accounting for 3.4% of all newly diagnosed cases highest ASR were Eastern region at 2.2/100,000, in year 2005. This cancer ranked seventh among Riyadh region at 1.8/100,000, Makkah region male and ninth in female population. It affected at 1.8/100,000, Jouf region at 1.8/100,000 and 160 (61.8%) males and 99 (38.2%) females with a Madinah region at 1.2/100,000. The median age male to female ratio of 162:100. The overall ASR at diagnosis was 22 years (range 0-81 years) was 1.7/100,000. ASR was 2.0/100,000 for males in males and 20 years in females (range 2-92).

6 male female

AIR (per 100,000) 1

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 Hodgkin disease in Saudi Arabia, 2005

ICD-O-3 Code Morphology Male % Female % 96633 Hodgkin lymphoma, nodular sclerosis, NOS 67 25.9% 45 17.4% 96503 Hodgkin lymphoma, NOS 29 11.2% 10 3.9% 96523 Hodgkin lymphoma, mixed cellularity, NOS 17 6.6% 17 6.6% 96653 Hodgkin lymphoma, nodular sclerosis, grade 1 13 5.0% 7 2.7% 96513 Hodgkin lymphoma, lymphocyte-rich 12 4.6% 7 2.7% 96593 Hodgkin lymphoma, nodular lymphocyte predominance 13 5.0% 5 1.9% 96673 Hodgkin lymphoma, nodular sclerosis, grade 2 4 1.5% 6 2.3% 96533 Hodgkin lymphoma, lymphocyte depletion, NOS 4 1.5% 0 0.0% Others 1 0.4% 2 0.8%

Table 3.10.1 Morphological Distribution of Hodgkin disease in Saudi Arabia, 2005

31.3% 28.1% 35.4% 28.3% 32.8% 28.2% Distant Localised Regional 11.3% 7.1% 9.7% Unknown 29.4% 29.3% 29.3% Male Female All

Figure 3.10.2 Stage Distribution of Hodgkin disease, 2005

SCRPart003.indd 54 27/05/2009 18:34:08 1.4 Eastern 2.9 1.4 Riyadh 2.2 1.7 Makkah 1.9 Jouf 1.8 1.7 0.7 Madinah 1.6 Baha 0.4 1.9 Jazan 0.7 1.6 Northern 0.7 1.3 Tabuk 1.1 0.8 Asir 0.7 0.8 Hail 0.3 1.2 Qassim 0.3 0.9 Najran 0.4 0.0

01234

Figure 3.10.3 ASR* Regional Distribution of Hodgkin disease in Saudi Arabia, 2005

2.6 United States (All Races) 3.4 2.5 Canada (Ontario) 3.0 2.4 Bahrain 2.9 2.4 Kuwait 2.7 Wales 2.4 2.4 2.0 Norway 2.7 1.8 Poland 2.0 Western Australia 2.0 1.8 1.4 Oman 2.2 1.3 Saudi Arabia 2.0 0.0 Qatar 3.2 1.8 United Arab Emirates 0.4

01234

Figure 3.10.4 Comparison of ASR* for Hodgkin disease among Saudis with ASR in Selected Countries**

* ASR Per 100,000 ** Source for this information is summarized on page 66

SCRPart003.indd 55 27/05/2009 18:34:08 Stomach (C 16)

There were 224 cases of stomach cancer accounting The five regions with the highest ASR were for 3.0% of all newly diagnosed cases in year Asir region at 3.4/100,000, Makkah region at 2005. This cancer ranked eighth among male 2.9/100,000, Eastern region at 2.9/100,000, Riyadh population and fourteenth among female population. region at 2.8/100,000 and Najran region at It affected 156(69.6%) males and 68 (30.4%) 2.5/100,000. The median age at diagnosis was females with a male to female ratio of 229:100. 70 years among males (range 21-103 years) and The overall ASR was 2.6/100,000. ASR was 64 years among female (range 30-100 years). 3.5/100,000 for male and 1.6/100,000 for females.

45 40 male female 35 30 25 20 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 3.11.1 Age-Specific Incidence Rate (AIR) for Stomach Cancer in Saudi Arabia, 2005 ICD-O-3 Code Morphology Male % Female %

8140 Adenocarcinoma, NOS 80 35.7% 23 10.3% 8490 Signet ring cell carcinoma 30 13.4% 20 8.9% 8144 Adenocarcinoma, intestinal type 11 4.9% 6 2.7% 8010 Carcinoma, NOS 4 1.8% 3 1.3% 8070 Squamous cell carcinoma, NOS 4 1.8% 3 1.3% 8000 Neoplasm, malignant 3 1.3% 3 1.3% 8020 Carcinoma, undifferentiated, NOS 4 1.8% 1 0.4% 8481 Mucin-producing adenocarcinoma 4 1.8% 1 0.4% 8145 Carcinoma, diffuse type 2 0.9% 2 0.9% 8480 Mucinous adenocarcinoma 3 1.3% 1 0.4% 8936 Gastrointestinal stromal sarcoma 3 1.3% 1 0.4% 8211 Tubular adenocarcinoma 3 1.3% 0 0.0% Others 5 2.2% 4 1.8% Table 3.11.1 Morphological Distribution of Stomach Cancer in Saudi Arabia, 2005

28.2% 24.4% 17.6% 19.1% 25.0% 22.8% Distant Localised Regional 14.7% 23.5% 17.4% Unknown 32.7% 39.7% 34.8% Male Female All Figure 3.11.2 Stage Distribution of Stomach Cancer, 2005

SCRPart003.indd 56 27/05/2009 18:34:09 Asir 3.6 3.2 2.1 Makkah 3.6 1.6 Eastern 4.1 0.5 Riyadh 5.0 Najran 2.6 2.3 1.7 Baha 2.9 Madinah 0.7 2.1 0.0 Northern 2.5 Hail 0.7 1.3 Tabuk 1.7 0.0 Jazan 0.5 1.2 0.2 Qassim 1.5 Jouf 0.6 0.0 0123456

Figure 3.11.3 ASR* Regional Distribution of Stomach Cancer in Saudi Arabia, 2005

11.7 Wales 22.0 Oman 9.6 15.5 4.9 Poland 12.8 4.8 United States (All Races) 10.4 4.7 Canada (Ontario) 10.5 Bahrain 5.5 5.6 4.2 Norway 6.7 2.7 Western Australia 7.2 1.6 Saudi Arabia 3.5 United Arab Emirates 3.1 1.1 Qatar 3.2 0.8 0.0 Kuwait 3.3

0510 15 20 25

Figure 3.11.4 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 66

SCRPart003.indd 57 27/05/2009 18:34:09 Brain, Nervous System (C70-C72)

There were 220 cases of brain, nervous system 1.3/100,000 for females. The ﬁve regions with the cancer accounting for 2.9% of all newly diagnosed highest ASR were Riyadh region at 2.4/100,000, cases in year 2005. This cancer ranked eleventh Tabuk region at 2.3/100,000, Northern region for males and tenth among females. It affected 124 at 2.1/100,000, Najran region at 1.9/100,000 and (56.4%) males and 96(43.6%) females with a male Makkah region at 1.7/100,000. The median age at to female ratio of 129:100. The overall ASR was diagnosis was 35 years among males (range 0-88 1.7/100,000. ASR was 2.0/100,000 for males and years) and 22 years among female (range 0-79 years).

10 male female

4 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 3.12.1 Age-Specific Incidence Rate (AIR) for Brain Cancer in Saudi Arabia, 2005

ICD-O Code Morphology Male % Female % 9440 Glioblastoma, NOS 35 15.9% 24 10.9% 9470 Medulloblastoma, NOS 18 8.2% 11 5.0% 9400 Astrocytoma, NOS 11 5.0% 10 4.5% 9391 Ependymoma, NOS 8 3.6% 10 4.5% 9380 Glioma, malignant 6 2.7% 8 3.6% 9401 Astrocytoma, anaplastic 8 3.6% 2 0.9% 9450 Oligodendroglioma, NOS 5 2.3% 5 2.3% 8000 Neoplasm, malignant 5 2.3% 4 1.8% 9473 Primitive neuroectodermal tumor, NOS 3 1.4% 2 0.9% 8963 Malignant rhabdoid tumor 4 1.8% 0 0.0% 9382 Mixed glioma 3 1.4% 1 0.5% 9420 Fibrillary astrocytoma 2 0.9% 2 0.9% 9424 Pleomorphic xanthoastrocytoma 3 1.4% 1 0.5% 9471 Desmoplastic nodular medulloblastoma 1 0.5% 3 1.4% 9530 Meningioma, malignant 1 0.5% 3 1.4% 9390 Choroid plexus carcinoma 0 0.0% 3 1.4% Others 11 5.0% 7 3.2%

Table 3.12.1 Morphological Distribution of Brain Cancer in Saudi Arabia, 2005

SCRPart003.indd 58 27/05/2009 18:34:10 5.6% 6.3% 5.9% 32.3% 27.1% 30.0% Distant Localised 56.5% 58.3% Regional 8.3% 5.6% 6.8% 57.3% Unknown

Male Female All Figure 3.12.2 Stage Distribution of Brain Cancer in Saudi Arabia, 2005

1.7 Riyadh 3.0 0.2 Tabuk 4.4 0.0 Northern 4.1 Najran 3.8 0.0 1.4 Makkah 2.0 Eastern 1.7 1.4 0.7 Jouf 1.9 0.3 Asir 2.1 0.6 Qassim 1.4 Hail 1.0 1.0 Madinah 0.9 0.8 Baha 0.6 0.0 Jazan 0.1 0.1

012345

Figure 3.12.3 ASR* Regional Distribution of Brain Cancer in Saudi Arabia, 2005

Norway 13.5 12.5 Wales 7.8 10.3 United States (All Races) 5.6 7.5 Canada (Ontario) 5.4 6.7 5.3 Poland 6.5 3.7 Western Australia 5.8 Qatar 2.6 2.4 1.7 Bahrain 3.2 United Arab Emirates 2.4 1.7 1.4 Oman 2.5 1.6 Kuwait 2.2 1.3 Saudi Arabia 2.0

0 246810121416

Figure 3.12.4 Comparison of ASR* for Brain Cancer among Saudi with ASR in Selected Countries**

* ASR Per 100,000 ** Source for this information is summarized on page 66

SCRPart003.indd 59 27/05/2009 18:34:10 Bladder (C 67)

There were 190 cases of bladder cancer accounting and 0.8/100,000 for females. The ﬁve regions with for 2.5% of all newly diagnosed cases in year 2005. the highest ASR were Tabuk region at 3.3/100,000, This cancer ranked ninth among male population and Baha region at 2.8/100,000, Eastern region at twenty second among female population. It affected 2.6/100,000, Makkah region at 2.5 /100,000 and 155 (81.6%) males and 35 (18.4%) females with a Riyadh region at 2.2 /100,000. The median age male to female ratio of 443:100. The overall ASR at diagnosis was 65 among males (range 1-101 was 2.1/100,000. ASR was 3.3/100,000 for males years) and 64 among females (range 12-91 years).

45 40 male female 35 30 25 20 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 3.13.1 Age-Specific Incidence Rate (AIR) for Bladder Cancer in Saudi Arabia, 2005

ICD-O-3 % Code Morphology Male % Female 8130 Papillary transitional cell carcinoma 60 31.6% 15 7.9% 8120 Transitional cell carcinoma, NOS 64 33.7% 10 5.3% 8070 Squamous cell carcinoma, NOS 9 4.7% 5 2.6% 8010 Carcinoma, NOS 5 2.6% 1 0.5% 8000 Neoplasm, malignant 4 2.1% 1 0.5% 8140 Adenocarcinoma, NOS 3 1.6% 1 0.5% 8050 Papillary carcinoma, NOS 1 0.5% 1 0.5% 8071 Squamous cell carcinoma, keratinizing, NOS 2 1.1% 0 0.0% 8480 Mucinous adenocarcinoma 2 1.1% 0 0.0% Others 5 2.6% 1 0.5% Table 3.13.1 Morphological Distribution of Bladder Cancer in Saudi Arabia, 2005

21.3% 12.9% 14.3% 11.4% 20.0% 12.6%

Distant 14.3% Localised 19.5% Regional 20.6% 45.2% 60.0% 47.9% Unknown

Male Female All Figure 3.13.2 Stage Distribution of Bladder Cancer, 2005

SCRPart003.indd 60 27/05/2009 18:34:11 1.9 Tabuk 4.6 0.8 Baha 4.7 0.7 Eastern 4.5 1.1 Makkah 3.9 0.7 Riyadh 3.6 0.7 Asir 3.1 0.0 Jouf 3.2 1.1 Najran 1.9 0.4 Madinah 2.1 0.0 Northern 1.8 0.9 Jazan 0.8 0.0 Hail 1.3 0.0 Qassim 0.5

012345

Figure 3.13.3 ASR* Regional Distribution of Bladder Cancer in Saudi Arabia, 2005

17.1 Wales 43.1 United States (All Races) 9.4 37.3 5.8 Canada (Ontario) 20.7 Western Australia 9.7 10.6 Poland 3.0 15.9 1.1 Kuwait 11.0 2.2 Oman 8.2 Bahrain 1.6 8.0 0.0 Qatar 7.2 United Arab Emirates 0.7 3.8 0.8 Saudi Arabia 3.3

01020304050

Figure 3.13.4 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 66

SCRPart003.indd 61 27/05/2009 18:34:11 Corpus uteri (C 54)

There were143 cases of corpus uterine cancer The ﬁve regions with the highest ASR were Eastern among females accounting for 3.7 % of all newly region at 4.7/100,000, Riyadh region at 4.2/100,000, Jouf diagnosed cases for females (3,834) in year 2005. region at 4.2/100,000, Makkah region at 3.9/100,000 This cancer ranked sixth among female population. and Northern region at 3.9/100,000. The median The ASR was 3.4/100,000 for female population. age at diagnosis was 59 years (range 24-86 years).

AIR (per 100,000) 5

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 Corpus uterine Cancer in Saudi Arabia, 2005

ICD-O-3 Code Morphology Total %

8380 Endometrioid adenocarcinoma, NOS 78 49.1% 8140 Adenocarcinoma, NOS 20 12.6% 8260 Papillary adenocarcinoma, NOS 6 3.8% 8010 Carcinoma, NOS 5 3.1% 8310 Clear cell adenocarcinoma, NOS 5 3.1% 8980 Carcinosarcoma, NOS 5 3.1% 8460 Papillary serous cystadenocarcinoma 4 2.5% 8890 Leiomyosarcoma, NOS 4 2.5% 8930 Endometrial stromal sarcoma, NOS 4 2.5% 8461 Serous surface papillary carcinoma 2 1.3% 8950 Mullerian mixed tumor 2 1.3% Others 8 5.3%

Table 3.14.1 Morphological Distribution of Corpus uterine Cancer in Saudi Arabia, 2005

13.3% 10.5%

Distant Localised 22.4% Regional Unknown 53.8%

Figure 3.14.2 Stage Distribution of Corpus uterine Cancer, 2005

SCRPart003.indd 62 27/05/2009 18:34:12 Eastern 4.7

Riyadh 4.2

Jouf 4.2

Makkah 3.9

Northern 3.9

Baha 3.8

Asir 2.8

Tabuk 2.6

Madinah 1.8

Hail 1.3

Qassim 1.1

Jazan 0.8

Najran 0.5

012345

Figure 3.14.3 ASR* Regional Distribution of Corpus uterine Cancer in Saudi Arabia, 2005

Wales 25.2 United States (All Races) 24.4 Canada (Ontario) 19.2 Norway 16.2 Poland 13.3 Kuwait 11.0 Qatar 9.9

Western Australia 9.7 Bahrain 5.6 Oman 4.7 Saudi Arabia 3.4

United Arab Emirates 1.4

0510 15 20 25 30

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

* ASR Per 100,000 ** Source for this information is summarized on page 66

SCRPart003.indd 63 27/05/2009 18:34:12 Ovary Cancer (C 56)

There were 136 cases of ovarian cancer among regions with the highest ASR were Jouf region at females accounting for 3.5% of all newly diagnosed 4.7/100,000, Eastern region at 4.1/100,000, Makkah cases among females (3,834) in year 2005. This region at 3.9/100,000, Riyadh region at 2.8 /100,000 cancer ranked seventh among female population. and Asir region at 2.0/100,000. The median age The ASR was 2.8/100,000 for females. The ﬁve at diagnosis was 54 years (range 5-97 years).

4 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 3.15.1 Age-Specific Incidence Rate (AIR) for Ovarian Cancer in Saudi Arabia, 2005

ICD-O-3 Code Morphology Total % 8460 Papillary serous cystadenocarcinoma 30 22.1% 8140 Adenocarcinoma, NOS 25 18.4% 8000 Neoplasm, malignant 11 8.1% 9060 Dysgerminoma 8 5.9% 8010 Carcinoma, NOS 7 5.1% 8461 Serous surface papillary carcinoma 6 4.4% 8441 Serous cystadenocarcinoma, NOS 5 3.7% 8470 Mucinous cystadenocarcinoma,NOS 5 3.7% 8380 Endometrioid adenocarcinoma, NOS 4 2.9% 9085 Mixed germ cell tumor 4 2.9% 8260 Papillary adenocarcinoma, NOS 3 2.2% 8310 Clear cell adenocarcinoma, NOS 3 2.2% 8440 Cystadenocarcinoma, NOS 3 2.2% 8480 Mucinous adenocarcinoma 3 2.2% 8003 Malignant tumor, giant cell type 2 1.5% 8490 Signet ring cell carcinoma 2 1.5% 8620 Granulosa cell tumor, malignant 2 1.5% 9071 Yolk sac tumor 2 1.5% Others 11 8.1%

Table 3.15.1 Morphological Distribution of Ovarian Cancer in Saudi Arabia, 2005

SCRPart003.indd 64 27/05/2009 18:34:12 18.4%

5.1% Distant Localised 60.3% Regional 16.2% Unknown

Figure 3.15.2 Stage Distribution of Ovarian Cancer, 2005

Jouf 4.7

Eastern 4.1

Makkah 3.9

Riyadh 2.8

Asir 2.0

Najran 1.8

Madinah 1.7

Tabuk 1.6

Northern 1.3

Baha 1.1

Hail 1.0

Jazan 0.8 Qassim 0.5

012345

Figure 3.15.3 ASR* Regional Distribution of Ovarian Cancer in Saudi Arabia, 2005

Wales 27.0

Canada (Ontario) 13.2 United States (All Races) 12.5

Poland 11.1 Qatar 10.2 Western Australia 7.4 Bahrain 5.8 Oman 4.7

Kuwait 3.3 United Arab Emirates 2.9 Saudi Arabia 2.8 Norway 1.7

0510 15 20 25 30

Figure 3.15.4 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 66

SCRPart003.indd 65 27/05/2009 18:34:12 ** References

1 Cancer Incidence among Gulf Cooperation Council States National, 1998-2005.

2 Cancer Incidence in Wales, 2002-2006. Available from: http://www.wales.nhs.uk/sites3/Documents/242/incpub2006%5F31Jan08.pd f

3 Surveillance Epidemiology and End Results (SEER Cancer Statistics Review, 1975-2005. Available from: http://seer.cancer.gov/csr/1975_2005/results_merged/.

4 Cancer Incidence and Mortality in Western Australia, 2005. Available from: http://www.health.wa.gov.au/docreg/Reports/Diseases/Cancer/WACR_Cancer_incidence_mortality_full_2005.pdf

5 Cancer Incidence in Canada, 2004-2005. Available from: http://www.statcan.gc.ca/pub/82-231-x/82-231-x2007001-eng.pdf

6 Cancer in Poland in 2005, The Maria Sktodowska-Curie Memorial Cancer Center and Institute of Oncology

7 Cancer Incidence, Mortality, Survival and Prevalence in Norway, 2005. Institute of Population Based Cancer Research. Oslo, 2005

8 Descriptive epidemiology Group, IARC. Globocan, 2002. Available from: http://www.dep.iarc.fr/

SCRPart003.indd 66 27/05/2009 18:34:13 PART IV CANCER AMONG NON-SAUDIS 2005

SCRPart004.indd 67 20/05/2009 17:17:47 SCRPart004.indd 68 20/05/2009 17:17:47 Cancer Among Non- Saudi Population 2005

Between January and December 2005, a total of cancer had some significant differences. Those 2,453 cancer cases were reported among the Non- over 60 years represented 20 % and the 20 to Saudi population. Eighty four in situ cases and 5 54 age-group represented 60 % of non-Saudi cases of ICD-10 were excluded from the analysis. population. During 2005, approximately 5 % of As a result, the total number of cases analyzed were all cancers occurred before the age of 15, 28.3 2,364 out of this 1263(53.4%) were males and 1,101 % occurred between the ages 15 to 40 years, (46.4%) were females. The male to female ratio was 51.8% were between the ages 41-64, and 14.9 115:100. Taking into consideration the population % occurred after the age of 64. The median age structure of non-Saudis and the fact that cancer at diagnosis was 50 years in males (range 0-98 is primarily a disease of the elderly, the pattern of years) and 45 years in females (range 0-100 years).

Cancer All %

Breast 410 17.3% Colo-rectal 207 8.8% Non-Hodgkin lymphoma 174 7.4% Leukemia 163 6.9% Skin 112 4.7% Lung 108 4.6% Thyroid 91 3.8% Stomach 80 3.4% Liver 73 3.1% Bladder 65 2.7% Table 4.1 Ten Most common Cancers among non-Saudis, 2005

Nationality Male % Female % Total % Yemen 276 11.3% 222 9.1% 498 20.3% Sudan 151 6.2% 94 3.8% 245 10.0% Egypt 108 4.4% 98 4.0% 206 8.4% Pakistan 100 4.1% 70 2.9% 170 6.9% Syrian Arab Republic 76 3.1% 46 1.9% 122 5.0% Philippines 75 3.1% 111 4.5% 186 7.6% India 72 2.9% 41 1.7% 113 4.6% Bangladesh 65 2.6% 10 0.4% 75 3.1% Gaza Strip (Palestine) 50 1.5% 31 1.3% 68 2.8% United States of America 36 1.5% 12 0.5% 48 2.0% Nigeria 34 1.4% 22 0.9% 56 2.3% Jordan 28 1.1% 24 1.0% 52 2.1% Eritrea 25 1.0% 32 1.3% 57 2.3% GCCR Nationalities 24 1.0% 32 1.3% 56 2.3% Somalia 20 0.8% 41 1.7% 61 2.5% United Kingdom 20 0.8% 10 0.4% 30 1.2% Myanmar (formerly Burma) 19 0.8% 10 0.4% 29 1.2% Afghanistan 14 0.6% 13 0.5% 27 1.1% Lebanon 14 0.6% 13 0.5% 27 1.1% Ethiopia 13 0.5% 34 1.4% 47 1.9% Chad 9 0.4% 24 1.0% 33 1.3% Indonesia 8 0.3% 43 1.8% 51 2.1% Sri Lanka 6 0.2% 22 0.9% 28 1.1% Other Nationalities 86 3.5% 82 3.3% 168 6.8% Total 1316 53.6% 1137 46.4% 2453 100.0% Table 4.2 Distribution of Cancer Cases among Different Nationalities in Order of Relative Frequency

SCRPart004.indd 69 20/05/2009 17:17:47 Male 1263 Female 1101

Colo-rectal 145 11.8% Breast 403 36.6% NHL 120 9.5% Leukemia 65 5.9%

Leukemia 98 7.8% Colo-rectal 62 5.6%

Skin 85 6.7% Thyroid 59 5.4%

Lung 77 6.1% NHL 54 4.9%

Stomach 65 5.1% Cervix Uteri 52 4.7%

Prostate 59 4.7% Ovary 43 3.9%

Bladder 54 4.3% Corpus Uteri 36 3.3%

Liver 51 4.0% Lung 31 2.8%

Brain, Nervous system 47 3.7% Skin 27 2.5%

Figure 4.1 Ten Most Common Cancer among non-Saudis, 2005

700

600 male female

500

400

300

200 AIR (per 100,000) 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, 2005

SCRPart004.indd 70 20/05/2009 17:17:48 PART V TABLES

SCRPart005.indd 71 20/05/2009 17:18:49

- - 9.3 9.3 1.5 1.5 1.1 0.9 0.4 0.4 0.4 0.4 0.3 0.3 0.6 0.6 5.1 0.5 0.5 5.7 1.0 1.0 2.2 0.3 0.5 0.5 1.4 1.4 0.3 0.3 0.7 0.7 1.9 1.9 0.4 0.4 2.5 2.5 0.4 0.4 0.3 0.3 0.2 0.2 4.3 4.0 4.0 2.6 0.1 0.1 0.1 0.1 3.1 3.1 0.1 0.1 1.3 1.3 0.2 0.2 0.2 0.2 1.2 0.0 2.5 0.1 0.1 0.1 0.1 3.3 0.2 0.2 4 1 3 0 7 16 1.4 96 11 14 06 91 61 2121 11 71 407 616 95.92 89 438 658 100.0 81 10 13 16 29 22 52 4.8 13 18 20 30 49 4.2 15 13 17 18 31 42 4.1 17 3012 52 11 67 87 7.0 02 35 43 15 37 13 445156 29 7263033276 888744 4 08 924221832232 55 11 17 12 14 16 14 18 49 4.2 30 23 53 34 23 93 81 21 410171 18 1312 20 23 20 26 37 28 28 45 6.7 10 14 17 21 18 42 45 46 44 7.0 40 17 72 45 17 92 5-39 40-44 45-49 50-54 55-59 60-64 65-69 70-74 75 +% 9395734247 1334440224 6054000001 31 2937 1411231011 0 16 16 5-29 30-3 43 853987589782 05 10 54 48 101043 61 21 14 -9 10-14 15-19 20-2 42 15 18 30 23 003253 51 110141118161617242130282728314 03011261 34 11 0101 133 91 87 112 112 98 11 21 133 93 90 114 115 100 11 61 01 0000001203337645 6 0001002030144353 6 00000023015379 31 04 0011122101101001 3 01 0311310000000210 2 05000024 61 0000000001013011 4 0000000111248947 000003126338 0000010110022233 7 00001072 00000017 0000000020123104 4 0011002124 71 0000000103155842 7 0020000102020101 4 001000012482 00000010011568 00000013 0001111013102111 3 01 41 0100010000000121 5 002323245244 0000000213310432 7 0674395574213322 7 0000000130422101 2 001000000124 010048 01 0100001247 0510000110001200 4 011237 41 02 0900000000001000 0 05 600000000000110202 000000000000000000 300000000001200000 200000000000010001 400000000001101010 800000000002031020 600000000000200013 100000000000010000 300000000101000001 300000000000002001 000000000000000000 600120011000001000 40 32 55 15 96 14 11 53 22 17 36 13 82 48 17 51 11 26 70 16 45 92 15 93 10 346 149 179 11 40 156 250 189 211 261 152 261 155 124 160 Tot. UNK 0- 45 357 70 372 90 Lip SITE Tongue Mouth Immunoproliferative dis. Multiple Myeloma Lymphoid leukemia All sites but C44 Salivary Glands Myeloid leukemia leukemia unspec. Tonsil Other & unspecied All Sites Other oropharynx Nasopharynx Hypopharynx Pharynx unspec. Oesophagus Stomach Small intestine Colon Rectum Anus Liver Gall bladder etc. Nose, sinuses, etc. Pancreas Larynx Trachea, Bronchus, Lung Other Thoracic Organs Bone Melanoma of Skin Other Skin Mesothelioma Kaposi sarcoma Connective, Soft Tissue Breast Penis Prostate Testis Other male genital Kidney Renal pelvis Ureter Bladder Other urinary organs Eye Thyroid Adrenal gland Brain, Nervous System Other Endocrine Hodgkin Disease C00 ICD (10) C01-C02 C03-C06 C82-C85; C96C88 Non Hodgkin lymphoma C90 C91 All but C44 C07-C08 C92-C94 C95 C9 Other All C10 C11 C12-C13 C14 C15 C16 C17 C18 C19-C20 C21 C22 C23-C24 C30-C31 C25 C32 C33-C34 C37-C38 C40-C41 C43 C44 C45 C46 C47; C49 C50 C60 C61 C62 C63 C64 C65 C66 C67 C68 C69 C73 C74 C70-C72 C75 C81 Table 5.1.1 Age Distribution of Cancer Cases among Saudi Males, 2005 Distribution of Cancer Cases among Saudi Males, Age 5.1.1 Table

SCRPart005.indd 72 20/05/2009 17:18:50 2.6 2.0 0.2 0.5 2.4 0.2 0.1 0.3 0.0 0.1 0.0 0.4 2.5 0.6 0.2 0.3 0.3 0.1 0.1 0.0 0.0 0.2 0.2 0.2 0.5 1.6 0.4 0.8 0.4 0.3 0.9 1.3 0.3 0.2 1.6 0.9 1.1 0.3 0.0 0.2 5 1.7 2 3.7 4 3.5 9 3.7 1 9.9 3 3.4 10 2.5 62 61 59 16 12 1.8 11 16 2.2 1214 17 2.1 8 1.3 69 19 33 33 68 47 71 55460 18 14 20 16 17 25 3.8 7131612121 0101812143 18 35 03 716191410131 61 71 41118252613171 01 31 512131 18 18 18 18 29 32 19 25 6.5 1316 18 27 29 16 27 11 11 26 5.1 5-39 40-44 45-49 50-54 55-59 60-64 65-69 70-74 75+ % 5051524313 18 57 8 142 157 151 104 86 64 46 38 38 24.3 14 295 363 388 321 314 361 237 249 332 97 21 34935266131 40001010012 5-29 30-3 43 301220103223 4121 17 0266 10 40 14 42 81 01 35 05 15 40 56 47 51 37 39 20 17 21 15 18 0232 82 000000000000112 0000111012252126 0000003000102123 0000000112210120 2000101101103011 72 41 15 61 00000001325583 4101 2141 -4 5-9 10-14 15-19 20-2 42 16 97 61 78 10 71 07100000000000001 02001100000000100 00300011121300001 00000000000000000 000000013142 41 000000042156 61 00000000112113302 00000100001001001 01 02 71 0449 00000113 21 00000000000000000 00000000010112011 00000103112342301 00001012 31 08311112346648354 02 02110221011110002 00002013544222412 00001000003270121 04368330352060114 0044728549 91 00000500121100000 13101336 61 0014 01000558 00001055 00000002011102011 00010011143142548 00000114 51 00000104047634627 00002000021001022 2000 022130021423 81 000000011675 81 0014152347 51 00000000001210101 4 97 62 82 108 145 146 217 299 370 393 331 324 379 249 263 365 100 600010200000102000 600000000001200003 100000000001000000 200000000000001100 400000100000001020 100000000000000010 600000000000121002 700010000100113000 100000000000001000 40 20 00 20 00 21 60 90 14 13 96 66 68 99 21 86 60 75 15 32 17 49 10 35 95 44 10 81 63 Tot UN K0 250 143 136 147 380 197 142 932 129 383 4 370 54 g .0 Lun an s1 , stem g y ans a9 g e5 nx etc .1 ec. , y ec .0 e1 p ecied or a6 p ec. p y Soft Tissue elom a2 , p s4 nx nx har us y y y lan d9 p roliferative dis g r r Bronchus g s4 , p Glands elvi y ha p ha ha es Total le M . nx uns sinuses Nervous S y hoid leukemia kin Disease p p p , , ue g us Uteri y y p nx p g osi sarcom a7 ina o g p y eloid leukemi p g e2 m y p yp y y Small intestin Stomach Connective Uterus Uns Other Thoracic Or M Other Female Genital Placenta Brain leukemia uns All A SITE Li Other Endocrin Hod L All sites but C44 Ton Tonsil Other oro Naso Oeso Lar Ovar Thyroid Colon Rectum Anu s9 Ureter Bladder E Immuno Multi Trachea Cervix Uteri Cor Mouth H Phar Renal Other & uns Bon e3 Melanoma of Skin Breast Kidne Liver Gall bladder etc. Pancrea Nose Other urinar Adrenal Salivar Other Skin Mesotheliom Vulva Va Ka C49 ; C16 C17 C82-C85; C96 Non Hodgkin lymphoma C55 C37-C38 C92-C94 All C70-C72 C95 C57 C58 ICD10 C00 C75 C81 Not C44 C91 C9 C10 C11 C56 C73 C15 C01-C02 C32 C66 C67 C18 C19-C20 C21 C88 C69 C90 C33-C34 C47 C53 C54 C03-C06 C65 Other C12-C13 C14 C64 C40-C41 C43 C50 C74 C68 C22 C23-C24 C25 C30-C31 C07-C08 C44 C45 C51 C52 C46 Table 5.1.2 Age Distribution of Cancer Cases among Saudi Females, 2005 Distribution of Cancer Cases among Saudi Females, Age 5.1.2 Table

SCRPart005.indd 73 20/05/2009 17:18:50 ASR World Rate Crude 10.6 286.001.9 367.5 272.9 553.6 350.5 555.1 514.4 519.7 43.9 42.1 74.1 70.8 -4 5-9 10-14 15-19 20-24 25-29 30-34 35-39 40-44 45-49 50-54 55-59 60-64 65-69 70-74 75+ 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.3 0.4 0.0 0.8 0.0 1.3 0.0 0.0 0.1 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 0.0 0.0 0.0 0.0 0.0 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 0.0 1.5 0.0 0.0 0.8 0.0 0.1 Tot UN K0 37293577 0.0 0.0 12.3 12.3 8.2 8.0 8.4 8.1 11.6 11.4 14.7 14.3 13.5 13.2 19.9 19.2 29.0 28.0 42.0 41.5 72.5 105. 22 71.3 103. 42 - 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 0.0 0.0 0.0 0.0 0.0 346 0.0 1.0 0.9 1.3 1.1 2.3 2.2 2.7 3.4 5.7 6.5 13.2 18.7 20.8 26.5 39.2 37.1 4.1 6.4 179 0.0 0.5 0.0 0.0 0.0 0.0 0.3 0.7 1.2 2.8 3.1 3.5 8.7 12.3 27.4 27.8 43.9 2.1 3.8 124 0.0 1.8 0.9 1.0 0.4 1.0 0.7 0.5 1.8 1.9 2.2 2.2 5.3 6.9 6.6 10.1 1.7 1.5 2.0 82 0.0 0.0 0.1 0.0 0.0 0.0 0.0 0.2 0.4 0.9 2.5 0.9 10.0 6.2 11.3 15.2 14.3 1.0 1.9 17 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.4 0.0 0.3 0.9 2.0 0.8 0.0 5.1 3.4 0.2 0.4 22 0.0 0.0 0.0 0.0 0.0 0.1 0.0 0.2 0.2 0.0 0.0 0.9 1.3 1.5 2.8 3.8 5.9 0.3 0.5 96 0.0 1.2 0.3 0.4 0.8 1.3 0.3 1.5 0.6 1.7 3.4 1.8 2.7 3.9 0.9 6.3 5.1 1.1 1.4 51 0.0 0.1 0.3 1.1 1.5 0.5 0.1 0.7 0.2 0.2 0.6 1.3 0.7 0.0 0.9 1.3 0.0 0.6 0.6 10 0.0 0.8 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.7 0.0 0.0 0.0 0.0 0.1 0.1 13 0.0 0.0 0.2 0.0 0.0 0.0 0.0 0.2 0.0 0.5 0.0 0.9 0.0 0.8 0.0 55 1.3 0.0 3.4 0.0 0.2 0.0 0.2 0.0 0.0 0.0 0.3 0.5 0.0 0.2 1.6 1.3 4.7 6.9 2.8 13.9 9.3 0.6 1.2 26 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.3 0.2 0.7 0.9 0.4 0.0 3.1 2.8 2.5 5.9 0.3 0.5 15 0.0 93 0.5 0.0 0.1 0.1 0.0 0.1 0.0 0.2 0.0 0.3 0.0 0.9 0.2 0.5 0.2 2.2 0.0 2.2 0.0 1.9 0.0 2.5 0.7 3.5 1.5 5.3 0.0 5.4 0.0 3.8 3.4 5.1 3.4 0.2 1.1 0.2 1.6 17 0.0 0.0 0.0 0.1 0.1 0.1 0.1 0.0 0.2 0.7 0.3 0.0 1.3 0.8 0.9 1.3 2.5 0.2 0.3 8 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.6 0.0 2.0 0.8 0.0 2.5 0.0 0.1 0.2 6 0.0 0.0 0.1 0.2 0.0 0.0 0.1 0.2 0.0 0.0 0.0 0.0 0.0 0.8 0.0 0.0 0.0 0.1 0.1 3 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.2 0.0 0.3 0.0 0.0 0.0 0.0 0.0 0.8 0.0 0.0 211 0.0 0.0 0.1 0.1 0.0 0.0 0.3 0.2 0.4 0.9 2.2 7.5 17.4 23.1 31.2 34.1 50.6 2.5 4.9 189 0.0 0.0 0.0 0.0 0.0 0.0 0.1 1.2 2.4 1.9 5.9 10.5 14.7 13.9 30.3 29.0 19.4 2.2 4.2 250 0.0 0.0 0.0 0.0 0.1 0.0 0.9 0.3 2.6 4.7 7.2 8.8 17.4 28.5 26.5 35.4 38.0 2.9 5.5 155 0.0 0.1 0.0 0.0 0.0 0.0 0.1 0.3 0.8 1.7 5.3 5.3 9.4 12.3 13.2 22.7 41.3 1.8 3.3 152 0.0 0.0 0.2 261 0.3 0.0 0.2 0.0 0.4 0.1 0.3 0.0 0.7 0.0 1.0 0.0 0.5 0.0 1.2 0.0 1.8 0.0 8.7 0.2 13.1 0.6 17.0 39.2 1.8 35.4 11.4 23.1 1.8 49.2 84.6 3.3 73.4 3.1 6.2 156 0.0 0.0 0.0 0.0 0.0 0.4 0.1 0.3 1.2 0.7 0.9 3.5 8.7 13.9 18.9 37.9 41.3 1.8 3.5 149 0.0 3.7 2.6 1.0 2.7 1.3 0.7 0.2 0.6 0.7 1.2 1.8 2.7 0.0 1.9 2.5 3.4 1.8 1.7 114 0.0 0.0 0.0 0.3 0.2 0.6 0.4 0.9 2.8 2.4 5.3 5.3 6.0 7.7 8.5 13.9 3.4 1.3 2.2 261 0.0 0.0 0.0 0.0 0.0 0.0 0.1 0.5 2.0 3.3 5.3 9.2 12.0 32.4 42.5 58.1 37.1 3.1 6.1 160 0.0 0.5 1.3 1.6 3.1 3.0 2.2 1.5 0.6 2.1 1.6 3.1 2.0 3.1 1.9 5.1 5.9 1.9 2.0 36 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.2 0.0 0.7 0.3 2.2 3.3 6.2 3.8 2.5 5.9 0.4 0.8 45 0.0 0.1 0.0 0.0 0.4 1.0 2.2 1.0 0.0 1.2 1.2 0.0 0.0 0.0 0.0 0.0 0.8 0.5 0.5 11 0.0 0.1 0.0 0.0 0.0 0.1 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.8 1.9 1.3 4.2 0.1 0.2 32 0.0 0.0 0.0 0.1 0.0 0.0 0.3 0.0 0.6 0.0 0.3 1.8 2.7 2.3 4.7 3.8 5.1 0.4 0.7 16 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.2 0.6 0.0 1.2 0.9 1.3 0.8 0.0 1.3 1.7 0.2 0.3 15 0.0 0.0 0.1 0.1 0.1 0.3 0.3 0.2 0.0 0.2 0.3 0.0 0.7 0.0 0.0 1.3 2.5 0.2 0.2 53 0.0 0.0 0.0 0.0 0.0 48 0.0 0.0 0.0 0.0 0.2 0.0 0.2 0.0 0.2 0.0 0.6 0.0 1.8 0.1 5.3 0.0 92 6.9 0.0 0.0 3.8 1.0 0.2 8.8 0.1 0.3 13.5 0.1 2.2 0.6 0.0 4.0 1.2 0.1 6.2 10.4 0.0 11.4 0.7 5.1 0.6 0.6 1.4 4.7 1.2 2.2 8.0 8.5 5.7 12.6 5.1 1.1 1.9 40 0.0 0.0 0.0 0.0 0.0 0.0 0.1 0.3 0.0 0.7 0.9 1.3 4.7 4.6 3.8 6.3 5.1 0.5 0.9 14 0.0 0.3 0.1 0.1 0.3 0.1 0.0 0.0 0.0 0.0 0.0 0.0 0.0 1.5 0.9 0.0 1.7 0.2 0.2 11 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.2 0.0 70 0.4 0.0 2.0 0.5 0.0 0.6 0.9 0.4 1.3 0.3 3.4 1.2 0.1 0.7 0.9 0.2 1.4 0.9 0.6 0.4 2.0 2.3 1.9 2.5 5.9 0.8 1.0 6 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.9 0.0 0.0 0.0 1.3 2.5 0.1 0.1 3 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.3 0.9 0.0 0.0 0.0 0.0 0.0 0.0 0.1 1 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.7 0.0 0.0 0.0 0.0 0.0 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 0.4 0.7 0.0 1.9 0.0 1.7 0.1 0.1 2 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.7 0.0 0.0 0.0 0.8 0.0 0.0 g .0 a Lun an s , d ste m g y ans a g e nx etc . ec. , y ec .4 e p ecie or enital a p p y Soft Tissue g elom a , s nx nx har us y y y lan d p roliferative dis g Bronchus s g , p Glands elvi y ha p har har es Total le M sinuses Nervous S nx uns y hoid leukemia kin Disease p p p , , ue g y p nx p g osi sarcom a o g roi d y p e y m p yp y y Nose Pancrea Gall bladder etc. Liver Anu s Rectum Ka Other male Colon Other urinar Mesotheliom Testis Small intestin Bladder Immuno leukemia uns Other Skin Prostate Hod Other oro Salivar Myeloid leukemi H Melanoma of Skin Penis All A Tonsil Other Thoracic Or Other Endocrin Oeso Lar L Ureter E Multi Stomach Trachea Kidne Renal Mouth Ton Brain Adrenal Other & uns Phar Bon e Breast Naso Th SITE Li Connective All sites but C44 C49 ; C30-C31 C25 C23-C24 C22 C21 C19-C20 C46 C63 C68 C18 C45 C62 C88 C67 C17 C95 C44 C61 C81 C10 C92-C94 C07-C08 C43 C60 C12-C13 All C37-C38 C75 C9 C32 C91 C15 C82-C85; C96 Non Hodgkin lymphom C66 C90 C69 C16 C65 C33-C34 C64 C47 C03-C06 Other C01-C02 C70-C72 C74 C40-C41 C50 C14 C11 C73 ICD10 C00 Not C44 Table 5.1.3 Cancer Incidence Cases among Saudi Males by Age Group (per 100,000), 2005 (per 100,000), Group Age 5.1.3 Cancer Incidence Cases among Saudi Males by Table

SCRPart005.indd 74 20/05/2009 17:18:51 ASR World Rate Crude 99.7 262.5 229.1 285.4 346.4 43.7 71.6 06.1 275.6 240.7 301.5 380.9 45.2 74.4 -4 5-9 10-14 15-19 20-24 25-29 30-34 35-39 40-44 45-49 50-54 55-59 60-64 65-69 70-74 75+ 0.0 0.2 0.0 0.0 0.1 0.1 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 1.0 0.0 0.0 0.1 0.1 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 0.0 0.0 0.0 0.0 0.0 1 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 0.0 1.1 0.0 0.0 0.0 Tot UN K0 3705 4.0 9.0 5.6 6.5 11.0 16.9 19.8 36.3 58.0 95.1 137.3 157. 21 3834 4.0 9.0 5.7 6.8 11.1 17.5 20.1 36.8 58.8 96.9 139.1 162. 12 - 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 0.0 0.0 0.0 0.0 0.0 250 0.0 0.4 0.4 0.8 0.8 1.7 1.7 2.5 1.4 4.7 6.3 8.8 11.5 21.1 30.9 21.8 26.1 3.0 5.0 380 0.0 0.0 0.1 0.3 1.6 5.0 7.8 8.0 10.0 9.7 13.7 9.8 10.8 15.3 14.5 6.9 11.5 4.5 6.0 136 0.0 0.0 0.4 0.3 0.7 0.2 1.1 0.8 0.8 2.4 147 3.2 1.0 8.3 0.3 8.3 0.1 11.6 11.6 0.0 13.8 0.1 14.6 0.4 1.6 0.4 2.8 1.0 1.2 3.4 4.6 2.4 8.9 14.5 15.4 19.5 26.1 1.7 3.2 49 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.2 0.8 0.7 2.4 3.2 5.8 2.9 16.1 8.4 0.6 1.2 12 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.5 0.0 0.0 0.0 0.5 0.0 1.5 1.0 2.3 3.1 0.1 0.3 95 0.0 0.0 0.0 0.0 0.0 0.1 0.1 0.7 1.0 3.9 4.2 6.4 7.0 5.8 5.8 10.3 10.4 1.1 2.0 36 0.0 0.1 0.4 0.5 1.0 0.6 0.6 0.0 0.0 0.0 0.4 0.0 0.6 0.0 0.0 1.1 2.1 0.4 0.4 10 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.2 0.3 0.7 1.0 0.6 96 0.0 0.0 1.0 1.3 2.3 0.9 0.0 24 0.9 0.0 0.8 0.1 0.0 1.2 0.2 0.0 0.4 0.0 0.7 0.0 1.8 0.1 0.8 0.1 1.8 0.2 1.0 0.0 3.8 0.3 4.4 0.7 1.0 1.0 3.4 3.2 1.0 1.5 1.1 1.0 1.3 2.3 6.3 0.3 0.5 20 0.0 1.5 0.0 0.0 0.0 92 0.0 1.0 0.0 0.6 0.0 0.2 0.0 0.3 0.0 1.4 0.0 0.6 0.0 0.3 0.0 1.9 0.0 1.6 1.0 1.6 1.1 3.5 2.1 1.5 3.2 0.2 3.6 0.3 3.9 6.9 0.0 1.1 1.4 12 0.0 0.2 0.0 0.0 0.0 0.1 0.0 0.2 0.2 0.0 0.4 0.5 0.0 2.2 0.0 1.1 1.0 0.1 0.2 9 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.3 0.0 0.3 0.4 0.5 0.0 1.5 0.0 1.1 1.0 0.1 0.2 6 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.4 1.0 0.6 0.0 1.0 0.0 1.0 0.1 0.1 4 0.0 0.0 0.0 0.0 0.0 0.1 0.0 0.0 0.0 0.0 0.4 0.0 0.0 0.7 0.0 0.0 1.0 0.0 0.1 7 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.3 0.0 0.5 0.6 1.5 0.0 1.1 1.0 0.1 0.2 9 0.0 0.6 0.1 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 1.0 0.1 0.1 142 0.0 0.0 0.0 0.0 0.1 0.0 0.7 0.8 3.1 1.8 6.0 7.8 12.1 10.2 9.6 14.9 19.9 1.7 3.0 197 0.0 0.1 0.0 0.0 0.0 0.6 0.7 1.4 2.5 4.7 9.5 14.2 10.2 19.6 10.6 12.6 27.2 2.3 4.2 129 0.0 0.0 0.1 0.3 0.1 0.6 0.3 0.5 0.8 1.8 1.8 4.9 6.4 13.1 11.6 16.1 34.5 1.5 2.8 932 2.0 0.0 0.0 0.0 0.0 1.2 3.6 11.5 27.8 41.1 53.1 50.9 54.8 46.5 44.4 43.7 39.7 11.0 18.0 143 0.0 0.0 0.0 0.0 0.0 0.1 0.1 0.5 0.4 3.7 3.9 8.8 15.9 18.9 12.5 19.5 12.5 1.7 3.4 63 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.2 0.2 1.6 2.5 2.4 5.1 10.2 6.8 5.7 9.4 0.7 1.5 81 0.0 0.2 0.2 0.1 0.3 0.0 0.0 0.3 0.2 1.0 0.7 1.5 5.1 11.6 7.7 13.8 17.8 1.0 1.8 10 0.0 0.0 0.0 0.0 0.0 0.6 0.0 0.0 0.2 0.5 0.4 0.5 0.0 0.0 0.0 0.0 0.0 0.1 0.1 35 0.0 0.0 0.0 0.1 0.0 0.0 0.1 0.2 0.2 1.0 1.1 0.5 2.5 1.5 4.8 4.6 8.4 0.4 0.8 10 0.0 0.0 0.0 0.0 0.2 0.0 0.0 0.0 0.0 0.5 0.4 0.0 0.0 0.7 0.0 2.3 2.1 0.1 0.2 68 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.7 0.4 0.3 1.8 2.9 3.8 9.4 2.9 18.4 12.5 0.8 1.6 44 0.0 0.0 0.0 0.0 0.0 0.1 0.0 0.7 0.0 1.0 2.5 2.9 1.9 2.9 5.8 2.3 7.3 0.5 1.0 13 0.0 0.0 0.3 0.0 0.0 0.0 0.1 0.2 0.2 0.5 0.4 1.5 0.0 0.0 0.0 14 0.0 0.0 1.0 0.0 0.2 0.0 0.2 0.0 0.0 0.0 0.0 0.0 0.2 0.3 0.7 0.5 0.6 2.2 2.9 0.0 2.1 0.2 0.3 99 0.0 0.2 0.6 0.8 2.4 2.6 1.0 0.8 0.0 1.3 0.4 2.4 1.3 2.9 2.9 1.1 3.1 1.2 1.3 66 0.0 0.0 0.0 0.0 0.0 86 0.0 0.0 0.0 0.0 0.2 0.0 0.6 0.0 0.3 0.1 1.4 0.0 1.0 0.1 2.5 0.3 8.0 0.6 60 8.7 0.0 2.6 6.9 26.1 0.7 3.9 0.3 3.9 0.8 0.1 4.5 1.5 0.1 9.4 0.1 2.9 12.6 0.1 16.7 0.3 1.0 0.6 1.0 1.9 2.1 2.9 2.5 5.8 2.9 5.7 4.2 0.7 1.2 21 0.0 0.0 0.0 0.0 0.0 0.1 0.0 0.5 0.2 0.3 0.7 1.5 2.5 1.5 2.9 0.0 1.0 0.2 0.5 75 0.0 2.0 1.2 1.5 0.2 0.4 0.0 0.2 0.4 0.5 0.0 0.5 0.0 2.2 1.9 2.3 3.1 0.9 0.9 15 0.0 0.2 0.1 0.1 0.0 0.2 0.3 0.2 0.0 0.3 0.4 0.5 0.6 0.0 0.0 0.0 2.1 0.2 0.2 32 17 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.2 0.1 0.0 0.0 0.1 0.0 0.5 0.0 1.0 0.0 1.0 0.0 1.4 49 1.1 1.0 0.0 1.0 1.3 0.4 4.5 1.5 0.3 0.0 3.9 0.5 1.0 1.1 0.8 2.3 2.1 0.4 1.0 0.4 0.4 0.2 0.0 0.6 0.6 0.4 1.3 0.7 0.0 3.8 0.0 1.0 1.1 4.2 0.6 0.7 1 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 0.7 0.0 0.0 0.0 0.0 0.0 6 0.0 0.0 0.0 0.1 0.0 0.2 0.0 0.0 0.0 0.0 0.0 0.5 0.0 1.5 0.0 0.0 0.0 0.1 0.1 1 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.4 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 4 0.0 0.0 0.0 0.0 0.0 0.1 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.7 0.0 2.3 0.0 0.0 0.1 6 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.5 1.3 0.7 0.0 0.0 2.1 0.1 0.1 7 0.0 0.0 0.0 0.1 0.0 0.0 0.0 0.0 0.2 0.0 0.0 0.5 0.6 2.2 0.0 0.0 0.0 0.1 0.2 6 ------0.4 1.0 - - - - 3.1 0.1 0.1 2 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 0.7 1.0 0.0 0.0 0.0 0.1 g .0 a Lun an s , d ste m g y ans a g e5 nx etc . ec. , y ec . e p ecie or a p ec. p y Soft Tissue elom a , i p s nx nx har us y y y lan d p roliferative dis g Bronchus s g , p Glands elvi y ha p har har es Total le M . sinuses Nervous S nx uns y hoid leukemia kin Disease p p p , , ue g us Uteri y y p nx p g osi sarcom a ina o g p y eloid leukemi p g e m y p yp y y Nose Pancrea Gall bladder etc. Liver Anu s Rectum Ka Mesotheliom Colon Va Kidne Other urinar Immuno Cor Other Skin Vulva Placenta Other oro Hod Small intestin Bladder Salivar Melanoma of Skin Other Female Genital All A Tonsil Ovar Lar Adrenal L Ureter E Multi Stomach Trachea Other Thoracic Or Cervix Uter Uterus Uns Renal Mouth M Brain leukemia uns Other & uns H Phar Bon e Breast All sites but C44 Naso Thyroi d Other Endocrin SITE Li Oeso Ton Connective C49 ; C30-C31 C25 C23-C24 C22 C21 C19-C20 C46 C45 C18 C64 C52 C88 C68 C54 C58 C44 C51 C81 C10 C67 C17 C07-C08 C57 C43 All C9 C56 C74 C32 C91 C82-C85; C96 Non Hodgkin lymphom C66 C90 C69 C16 C37-C38 C65 C33-C34 C47 C53 C55 C92-C94 C03-C06 Other C70-C72 C95 C40-C41 C50 C12-C13 C14 Not C44 C75 C11 C73 C15 ICD10 C00 C01-C02 Table 5.1.4 Cancer Incidence Cases among Saudi Females by Age Group (per 100,000), 2005 (per 100,000), Group Age by 5.1.4 Cancer Incidence Cases among Saudi Females Table

SCRPart005.indd 75 20/05/2009 17:18:51 .7 .0 .0 .0 .5 .0 .3 .0 .0 .2 .5 .4 .4 .6 .0 .0 .0 .3 .0 .3 .0 .6 .0 .0 0.5 SR .2 0.1 .4 0.8 .0 0.0 .6 0.8 .8.4.8.0 1.2 .0 0.8 .2 1.4 1.4 0.0 0.4 .8.4.0.0 3.0 0.4 0.0 0.0 .0 0.0 .2 0.3 .8.0 2.9 0.0 .6 0.5 .0 0.0 .0.2 0.0 1.6 .6.8.2 4.5 3.2 0.1 .0 1.3 .6 0.9

Crud eA .6 0. 60 .0 0. 00 .0 0. 00 .0 0. 00 .7 0. 40 .0 0. 00 .5 0. 81 .0 0. 00 .0 0. 00 .9 0. 20 .7 0. 40 .7 0. 40 .5 0. 81 .7 0. 40 .0 0. 00 .0 0. 00 .0 0. 00 .0 1. 61 .0 0. 00 .7 0. 40 .0 0. 00 .7 0. 40 .0 0. 00 .0 0. 00 0. 90 1. 70 0. 00 2. 60 3. 50 1. 70 3. 50 4. 31 0. 00 0. 90 7. 81 1. 70 0. 00 0. 00 0. 00 0. 90 7. 81 0. 00 2. 60 0. 00 0. 00 5. 21 7. 81 0. 90 4. 31 2. 60 Jazan 1. 32 32 00 00 00 21 00 43 00 00 10 21 21 43 21 00 00 00 87 00 21 00 21 00 00 .% 31 ot .3 .6 .0 .0 .1 .0 .0 .0 .0 .0 .2 .0 .4 .9 .5 .0 .0 .6 .0 .3 .0 .0 .0 .0 RT 9.4 106 92.2 21. 23 AS 00 .0 0. 01 .0 0. 02 .3 1. 40 .2 4. 73 .5 2. 94 .0.3.5.0 0. 02 .3 1. 24 3. 35 0. 00 2. 51 .9.0.0.0 2. 39 0. 02 0. 00 0. 00 .0 0. 00 .0 0. 01 .5.0 3. 09 0. 00 .3 1. 63 .0 0. 00 .0.5 0. 00 1. 96 .0.6.0 0. 01 0. 59 0. 01 .5 5. 65 .9 2. 63 3. 63 Crude .8 0. 61 .8 0. 60 .0 0. 00 .0 0. 00 .8 0. 61 .0 0. 00 .0 0. 00 .0 0. 00 .0 0. 00 .0 0. 00 .5 1. 31 .0 0. 00 .5 1. 31 .5 1. 30 .8 0. 60 .0 0. 00 .0 0. 00 .8 0. 60 .0 0. 00 .3 1. 91 .0 0. 00 .0 0. 00 .0 0. 00 .0 0. Baha % 0. 00 0. 00 3. 51 8. 83 7. 02 0. 00 3. 51 7. 02 0. 00 3. 51 5. 31 0. 00 0. 00 0. 00 0. 00 0. 00 7. 02 0. 00 3. 51 0. 00 0. 00 7. 02 0. 00 1. 80 0. 00 5. 31 3. 03 2. 34 11 11 00 00 11 00 00 00 00 00 23 00 23 23 11 00 00 11 00 35 71 00 00 00 00 39 7 100.0 36.1 42.4 115 100.0 23.0 33.4 t. To .3 .6 .0 .1 .5 .0 .6 .0 .0 .1 .7 .0 .9 .1 .0 .1 .5 .5 .0 .5 .2 .0 .0 .2 .4 SR 30 .5 2. 10 .6 0. 90 .4 0. 62 .1 3. 15 .4.4.1.7 3. 24 .1 0. 50 .5 3. 32 2. 84 0. 10 2. 32 .2.8.0.7 6. 43 1. 10 0. 00 1. 10 .0 0. 00 .0 1. 40 .7.0 4. 14 0. 00 .1 0. 12 .1 0. 10 .1.8 0. 10 0. 84 .3.6.0 0. 50 0. 81 0. 00 .7 2. 53 ir Crud eA 41 As .7 0. .2 0. 81 .1 0. 40 .0 0. 00 .4 0. 10 .7 0. 30 .0 0. 00 .1 0. 40 .0 0. 00 .0 0. 00 .4 0. 10 .5 0. 60 .0 0. 00 .3 1. 31 .7 1. 42 .0 0. 00 .4 0. 10 .1 0. 40 .1 1. 51 .0 0. 00 .8 0. 70 .5.0 3. 24 0. 00 .0 0. 00 .4 0. 10 1. 50 1. 10 1. 10 0. 40 2. 20 0. 00 1. 80 0. 00 2. 61 0. 00 0. 40 0. 40 0. 40 2. 20 1. 50 0. 00 1. 14 .7 40 20 62 31 00 10 20 00 31 00 00 10 41 00 93 00 10 31 20 00 51 00 00 10 .% 01 03 14 38 11 4. 11 15 5. 52 171512 6. 32 11 5. 52 4. 41 4. 11 19 7. 02 12 4. ot 252 93.0 34.9 49. 15 271 100.0 37.6 53. 25 ST a2 TE ssue d7 hom stem L SI l0 Ti in a1 e6 ft mp e1 AL nx a1 s0 e3 organs erative dis. Sk a0 in ly nx nx le genita a of in s3 Gland e3 n Diseas ch t0 nx unspec. y5 x4 s6 ll intestin unoprolif phoid leukemi a1 roid pophary ngue nsil achea, Bronchus, Lung esotheliom elanom ultiple Myelom ther urinary esophagus ther ma ther & unspecie ther Sk ther orophary ther Endocrin olon enal pelvis asophary odg ki on Hodgk ll Sites but C44 ll Sites drenal gland ye ancrea ladder to ma ma nu s1 idne hary enis aposi sarcom hy esti ar yn iver ym ip mm Brain, Nervous Sy Tr Nose, sinuses, etc. Rectum Gall bladder etc. Ureter Prostat Breas Hy Connective, So Myeloid leukemi a1 Myeloid leukemia unspec. To Mout h4 Salivary To Bone Other Thoracic Organs 6N ) rO 10th ( l but C4 4A lA C7 4A C70-C72 C7 3T C6 9E C3 2L C33-C34 C2 5P C30-C31 C6 7B C6 8O C1 6S C1 7S C1 8C C19-C20 C2 1A C2 2L C23-C24 C66 C1 5O C61 C50 C6 2T C6 3O C6 4K C6 5R C1 4P C6 0P Al C12-C13 C47; C49 Othe Al C1 1N C4 4O C4 5M C4 6K C92-C94 C95 C1 0O C4 3M C9 0M C9 1L C01-C02 C7 5O C8 1H C82-C85; C9 C03-C06 C07-C08 C9 C40-C41 C8 8I C0 0L ICD C37-C38 Table 5.2.1 Number, Relative Frequencies, Age Standardized and Crude Rates for All Cancer Cases Among Saudi Males by Site Administrative Region, 2005

SCRPart005.indd 76 20/05/2009 17:18:52 SR Crud eA Qassim 1 0.6 0.1 0.1 0 0.0 0.0 0.0 4 2.5 0.6 0.9 0 0.0 0.0 0.0 1 0.6 0.1 0.1 1 0.6 0.1 0.3 1 0.6 0.1 0.2 6 3.8 0.8 1.2 0 0.0 0.0 0.0 0 0.0 0.0 0.0 2 1.3 0.3 0.5 1 0.6 0.1 0.3 1 0.6 0.1 0.2 8 5.0 1.1 0.9 5 3.1 0.7 1.2 1 0.6 0.1 0.1 0 0.0 0.0 0.0 0 0.0 0.0 0.0 8 5.0 1.1 0.9 8 5.0 1.1 2.0 0 0.0 0.0 0.0 3 1.9 0.4 0.4 1 0.6 0.1 0.1 8 5.0 1.1 1.5 9 5.6 1.3 1.4 4 2.5 0.6 1.0 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 0.0 2 1.3 0.3 0.5 6 3.8 0.8 1.3 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 6 3.8 0.8 1.4 0 0.0 0.0 0.0 0 0.0 0.0 0.0 1 0.6 0.1 0.3 1 0.6 0.1 0.2 1 0.6 0.1 0.2 9 5.6 1.3 1.6 0 0.0 0.0 0.0 3 1.9 0.4 0.6 1 0.6 0.1 0.1 2 1.3 0.3 0.3 4 2.5 0.6 0.6 Hail 0 0.0 0.0 0.0 0 0.0 0.0 0.0 4 5.2 1.8 2.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 1 1.3 0.4 0.5 5 6.5 2.2 2.9 12 7.5 1.7 2.8 1 1.3 0.4 0.8 1 1.3 0.4 0.7 0 0.0 0.0 0.0 1 1.3 0.4 0.4 1 1.3 0.4 0.4 5 6.5 2.2 2.9 0 0.0 0.0 0.0 3 3.9 1.3 1.1 1 1.3 0.4 0.8 0 0.0 0.0 0.0 0 0.0 0.0 0.0 90 11.7 0.0 4.0 0.0 5.5 0.0 13 8.1 1.8 2.3 6 7.8 2.7 4.0 14 8.8 2.0 3.1 3 3.9 1.3 1.2 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 2 2.6 0.9 1.2 12 7.5 1.7 2.1 2 2.6 0.9 1.3 2 2.6 0.9 1.0 3 3.9 1.3 1.5 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 2 2.6 0.9 1.3 3 3.9 1.3 1.7 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 1 1.3 0.4 0.4 1 1.3 0.4 0.7 0 0.0 0.0 0.0 2 2.6 0.9 1.1 2 2.6 0.9 1.1 0 0.0 0.0 0.0 3 3.9 1.3 1.7 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 1 1.3 0.4 0.4 2 2.6 0.9 0.9 1.0 SR Tot. % Crude ASR Tot .% Crud eA 0.0 0.0 0.0 0.3 0.1 0.2 0.7 0.1 0.1 0.0 0.0 0.0 2.7 0.6 1.1 2.0 0.4 0.5 0.3 0.1 0.2 0.0 0.0 0.0 0.0 0.0 0.0 1.4 0.3 0.7 0.3 0.1 0.1 1.7 0.4 0.7 0.0 0.0 0.0 0.0 0.0 0.0 1.2 2.5 4.4 Madinah 8 2.7 0.6 1 0.3 0.1 0.2 0 0.0 0.0 0.0 2 0.7 0.1 0.4 3 1.0 0.2 0.4 2 0.7 0.1 0.4 8 2.7 0.6 1.8 6 2.0 0.4 0.8 6 2.0 0.4 1.2 0 0.0 0.0 0.0 0 0.0 0.0 0.0 2 0.7 0.1 0.3 6 2.0 0.4 0.8 0 0.0 0.0 0.0 0 0.0 0.0 0.0 4 1.4 0.3 0.5 0 0.0 0.0 0.0 0 0.0 0.0 0.0 1 0.3 0.1 0.1 3 1.0 0.2 0.3 2 0.7 0.1 0.2 9 3.1 0.7 1.8 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 1 0.3 0.1 0.1 9 6.5 1.4 3.7 1 3.7 0.8 1.9 31 18 6.1 1.3 2.9 13 4.4 1.0 2.9 13 4.4 1.0 1.0 26 8.8 1.9 4.5 19 6.5 1.4 1.6 25 8.5 1.9 5.0 10 13.0 4.4 6.5 11 3.7 0.8 2.1 14 4.8 1.0 2.1 276 93.9 20.3 43.1 73 94.8 31.9 42.0 156 97.5 21.4 29.8 294 100.0 21.6 46.0 77 100.0 33.7 44.0 160 100.0 22.0 30.7 Tot .% .0 a3 a1 a6 .0 e0 ALL SITES a0 e4 a1 d1 s0 s8 d5 Connective, Soft Tissue Kaposi sarcom Mesotheliom Other Skin Melanoma of Skin Bon e2 Other Thoracic Organs Trachea, Bronchus, Lung All Sites but C44 All Sites Larynx Other & unspecie d1 Nose, sinuses, etc .0 leukemia unspec. Pancrea Myeloid leukemi Gall bladder etc. Lymphoid leukemia Liver Multiple Myelom Immunoproliferative dis Anu s1 Rectum Hodgkin Disease Colon Other Endocrin Adrenal glan Small intestin Thyroi Stomach Brain, Nervous System Oesophagus Eye Pharynx unspec Other urinary organs Hypopharynx Bladder Nasopharynx Ureter Renal pelvi Other oropharynx Kidney Tonsil Other male genital Salivary Glands Testis Mouth Prostate Tongue Penis Lip Breast ) 10th ( C47; C49 C46 C45 C44 C43 C40-C41 C37-C38 C33-C34 All but C44 All C32 Other C30-C31 C95 C25 C92-C94 C23-C24 C91 C22 C90 C88 C21 C82-C85; C96 Non Hodgkin lymphom C19-C20 C81 C18 C75 C74 C17 C73 C16 C70-C72 C15 C69 C14 C68 C12-C13 C67 C11 C66 C65 C10 C64 C9 C63 C07-C08 C62 C03-C06 C61 C01-C02 C60 C00 C50 ICD Table 5.2.1 continued ...... 5.2.1 continued Table

SCRPart005.indd 77 20/05/2009 17:18:52 6.5 4.0 3. 26 Crude ASR 03 Northern 28.6 72.3 41 100. Crude ASR Tot .% Tabuk 100.0 ot .% Crude AS RT Jouf 3.2 4.4 9.2 5 5.6 1.6 4.4 4 9.8 3.3 8.2 71 40.3 53 100.0 33.4 60.8 90 25.2 ran j Crude ASR Tot .% 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 2.3 0.6 0.4 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 3 5.7 1.9 4.7 1 1.1 0.3 1.0 0 0.0 0.0 0.0 2.30.0 0.6 0.0 0.5 0.0 3 02.3 5.7 0.0 0.6 1.9 0.0 1.1 3.1 0.0 2 0 2.2 0.0 0.6 0.0 0.5 0.0 1 0 2.4 0.0 0.8 0.0 0.7 0.0 2.3 0.6 1.1 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 0.00.0 0 0.0 0.0 0.0 0.0 0.0 0 0.00.0 00.0 0.0 0.0 0.09.1 0.0 0.0 0.0 0.0 2.3 0.0 0.0 2.5 0 0 1 0.0 0.0 0 4 1.9 0.0 0.0 0.0 7.5 0.6 0.0 0.0 0.0 2.5 1.4 0.0 3.3 0 0 1 0.0 0.0 0 1.1 0.0 0.0 0.0 0.3 0.0 0.0 0.0 0.7 0.0 0 1 0.0 1 2.4 0.0 2.4 0.8 0.0 0.8 1.5 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 0.0 0.0 0.0 0 0.0 0.0 0.09.1 0 2.3 0.0 4.6 0.0 0.0 3 5.7 0 1.9 0.0 2.8 0.0 0.0 8 8.9 2.6 5.1 5 12.2 4.1 6.9 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 4.5 1.1 0.8 0 0.0 0.0 0.0 10.0 1.1 0.0 0.3 0.0 0.3 3 0 5.7 0.0 1.9 0.0 1.7 0.0 3 3.3 1.0 0.8 2 4.9 1.6 1.3 Na 12 2.3 4.5 0.6 1.1 1.1 1.9 3 1 5.7 1.9 1.9 0.6 4.7 1.3 6 5 6.7 5.6 1.9 1.6 5.7 5.5 3 4 7.3 9.8 2.4 3.3 6.0 0 61 13.6 2.3 3.4 0.6 6.9 0.7 3 0 5.7 0.0 1.9 0.0 3.2 0.0 7 0 7.8 0.0 2.2 0.0 6.7 0.0 1 1 2.4 2.4 0.8 0.8 1.9 2.2 000 0.04 0.00 0.00 0.0 9.10 0.0 0.0 0.0 0.0 0.00 2.3 0.0 0.02 0.0 0.00 0.0 0.0 3.8 10 0.0 4.5 0.0 00 0.0 0.0 0 0.0 1.9 0.0 0.0 3 1.1 0.0 0.0 0 0.0 0.0 0.0 0 0.6 0.0 5.7 1.9 2 0.0 0.0 0.0 0.0 0.0 0.0 0.9 0.0 0 1.9 3.8 0.0 0.0 34 0.0 0.0 0 0.0 0.0 4.4 2 10 1.3 5.7 9.1 0.0 0 1 0.0 0.0 0 0.0 2.2 1.9 0.0 2.1 4 1.9 2.3 0.0 1.9 1 0.0 0.0 0.0 0 0.6 0.6 0.0 4.4 3.2 2.0 2 0.0 0.6 1.1 0.0 0.0 0.0 1.4 0.5 0.0 0 1.3 2.2 0.0 1.9 6 2 0.3 0.0 0 0.0 0.0 3.8 0 0 0 0.6 6.7 3.8 0.3 0 5 0.0 0.0 0 0.0 0.0 0.0 0.0 2.2 0 1.9 1.3 0.0 5.6 1 0.0 0.0 0.0 0 0.0 0.0 0.0 0.0 4.6 1.1 0 0.0 1.6 2.4 0.0 0.0 0.0 0.0 0.0 0.0 0 0.0 0.0 0.0 4.4 1 3 0.8 0.0 0 0.0 0.0 0.0 0 1 0.0 2.4 3.3 0.8 3 0.0 0.0 0.0 0.0 1.1 0.0 0.8 1.0 7.3 0.0 0.0 0.0 0.3 1.8 0.7 2.4 0.0 0.0 0.8 4.1 2 1 4.9 2.4 1.6 0.8 2.9 0.6 13 2.3 6.8 0.6 1.7 0.7 2.6 1 2 1.9 3.8 0.6 1.3 1.4 2.5 11 1 12.2 1.1 3.5 0.3 8.5 1.0 1 4 2.4 9.8 0.8 3.3 1.9 7.1 12 2.3 4.5 0.6 1.1 0.7 2.3 2 0 3.8 0.0 1.3 0.0 2.6 0.0 3 0 3.3 0.0 1.0 0.0 3.4 0.0 0 1 0.0 2.4 0.0 0.8 0.0 2.5 02 0.0 4.5 0.0 1.1 0.0 3.2 0 1 0.0 1.9 0.0 0.6 0.0 1.3 0 5 0.0 5.6 0.0 1.6 0.0 4.0 0 1 0.0 2.4 0.0 0.8 0.0 1.5 000 0.00 0.01 0.00 0.0 0.00 0.0 2.30 0.0 0.0 0.0 0.0 0.0 0.0 0.6 0.0 0.0 0.0 0.0 0 0.0 1.5 0 0.0 0.0 1 0.0 0.0 0 0.0 0.0 0 1.9 0 0.0 0.0 2 0.0 0.0 0 0.6 0.0 0.0 0.0 3.8 0.0 0.0 0.0 0.6 0.0 0.0 0 1.3 0.0 0 0.0 0.0 4 0.0 2.9 0 0.0 0.0 0 4.4 0 0.0 0.0 1 0.0 0.0 1 1.3 0.0 0.0 0.0 1.1 0.0 0.0 1.1 4.2 0.0 0.0 0 0.3 0.0 1 0.3 0.0 0 0.0 0.2 0 2.4 1.1 0 0.0 0 0.0 0.0 1 0.8 0.0 0 0.0 0.0 0.0 0.0 2.4 1.9 0.0 0.0 0.0 0.0 0.0 0.8 0.0 0.0 0.0 1.9 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 1 1.1 0.3 1.0 1 2.4 0.8 1.2 2 95.5 24.1 37.1 52 98.1 32.8 59.5 85 94.4 27.0 68.3 40 97.6 32.4 62.5 44 100.0 Tot .% .0 a4 d1 44 a0 a4 .0 e1 a0 ALL SITES e0 a0 d0 s0 s0 e2 Larynx Trachea, Bronchus, Lung Hodgkin Disease Nose, sinuses, etc .0 Adrenal glan Other Endocrin All Sites Liver Gall bladder, etc. Pancrea Connective, Soft Tissue Breast Penis Prostate Testis Other male genital Kidney Renal pelvi Ureter Bladder Other urinary organs Eye Brain, Nervous System Thyroi d1 Multiple Myelom Lymphoid leukemia Myeloid leukemi leukemia unspec. Other & unspecie Colon Rectum Anu s1 Kaposi sarcom Immunoproliferative dis Oesophagus Stomach Small intestin Melanoma of Skin Other Skin Mesotheliom Lip Tongue Mouth Salivary Glands Tonsil Other oropharynx Nasopharynx Hypopharynx Pharynx unspec Other Thoracic Organs Bon ) 10th ( C32 C33-C34 C81 All but C44 All Sites but C4 C30-C31 C74 C75 All C22 C23-C24 C25 C47; C49 C50 C60 C61 C62 C63 C64 C65 C66 C67 C68 C69 C70-C72 C73 C90 C91 C92-C94 C95 Other C18 C19-C20 C21 C46 C88 C15 C16 C17 C43 C44 C45 C82-C85; C96 Non Hodgkin lymphom C00 C01-C02 C03-C06 C07-C08 C9 C10 C11 C12-C13 C14 ICD C37-C38 C40-C41 Table 5.2.1 continued ...... 5.2.1 continued Table

SCRPart005.indd 78 20/05/2009 17:18:52 SR Crud eA Eastern Province 2 0.3 0.1 0.4 4 0.7 0.3 0.7 2 0.3 0.1 0.4 8 1.3 0.6 0.8 2 0.3 0.1 0.4 8 1.3 0.6 1.5 2 0.3 0.1 0.2 3 0.5 0.2 0.5 4 0.7 0.3 0.8 0 0.0 0.0 0.0 4 0.7 0.3 0.7 1 0.2 0.1 0.3 2 0.3 0.1 0.2 2 0.3 0.1 0.4 1 0.2 0.1 0.1 9 1.5 0.7 1.7 0 0.0 0.0 0.0 0 0.0 0.0 0.0 3 0.5 0.2 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 0 0.0 0.0 0.0 0 0.0 0.0 0.0 7 1.1 0.5 0.4 0 0.0 0.0 0.0 6 1.0 0.4 0.7 0 0.0 0.0 0.0 0 0.0 0.0 0.0 3 0.5 0.2 0.3 Makkah 4 0.4 0.2 0.4 1 0.1 0.1 0.1 1 0.1 0.1 0.1 6 0.6 0.3 0.5 8 0.8 0.4 0.9 3 0.3 0.2 0.2 4 0.4 0.2 0.3 0 0.0 0.0 0.0 6 0.6 0.3 0.5 0 0.0 0.0 0.0 3 0.3 0.2 0.2 6 0.6 0.3 0.5 5 0.5 0.3 0.4 0 0.0 0.0 0.0 4 0.4 0.2 0.4 2 0.2 0.1 0.1 3 0.3 0.2 0.3 2 0.2 0.1 0.2 1 0.1 0.1 0.1 0 0.0 0.0 0.0 1 0.1 0.1 0.1 6 0.6 0.3 0.4 6 0.6 0.3 0.5 1 0.1 0.1 0.1 2 0.2 0.1 0.2 6 0.6 0.3 0.6 SR Tot. % Crude ASR Tot .% Crud eA adh y 0.5 0.3 0.5 0.2 0.1 0.2 0.5 0.3 0.4 0.0 0.0 0.0 0.4 0.2 0.5 0.3 0.2 0.1 0.1 0.1 0.0 0.2 0.1 0.3 0.0 0.0 0.0 0.1 0.1 0.0 2.1 1.0 1.3 15 1.6 0.8 0.9 10 1.6 0.7 0.9 Ri 4 0.4 0.2 0.3 4 0.4 0.2 0.3 9 1.0 0.5 1.2 2 0.2 0.1 0.2 9 1.0 0.5 1.1 13 1.4 0.7 1.2 4 0.4 0.2 0.3 8 0.8 0.4 1.0 10 1.1 0.5 0.9 0 0.0 0.0 0.0 1 0.1 0.1 0.2 0 0.0 0.0 0.0 0 0.0 0.0 0.0 1 0.1 0.1 0.1 0 0.0 0.0 0.0 4 0.4 0.2 0.3 4 0.4 0.2 0.4 4 0.4 0.2 0.4 14 1.5 0.8 1.4 0 0.0 0.0 0.0 1 0.1 0.1 0.2 2 0.2 0.1 0.2 7 1.8 0.9 0.7 10 1.1 0.5 0.7 2 4.4 2.2 4.5 49 5.2 2.7 4.5 33 5.4 2.5 5.5 4 2.5 1.2 1.9 25 2.6 1.4 1.7 19 3.1 1.4 1.7 0 2.1 1.0 2.5 27 2.8 1.5 2.7 14 2.3 1.0 2.4 7 1.8 0.9 2.0 10 1.1 0.5 0.9 11 1.8 0.8 2.0 0 8.5 4.1 7.1 93 9.8 5.1 7.7 60 9.8 4.5 7.9 6 2.7 1.3 2.2 14 1.5 0.8 0.9 17 2.8 1.3 2.0 20 32 3.4 1.6 3.2 35 3.7 1.9 3.5 18 2.9 1.3 2.6 69 7.3 3.5 7.7 67 7.1 3.6 6.8 64 10.5 4.8 12.0 41 4.3 2.1 2.1 28 3.0 1.5 1.5 25 4.1 1.9 2.1 49 5.2 2.5 6.0 66 7.0 3.6 6.5 28 4.6 2.1 5.3 39 4.1 2.0 2.2 31 3.3 1.7 1.9 36 5.9 2.7 2.9 47 5.0 2.4 5.2 42 4.4 2.3 3.8 40 6.5 3.0 7.1 81 8.6 4.2 8.8 69 7.3 3.8 6.3 22 3.6 1.6 3.1 38 4.0 2.0 3.0 30 3.2 1.6 2.0 18 2.9 1.3 1.4 44 4.7 2.3 5.0 37 3.9 2.0 3.6 25 4.1 1.9 4.1 34 3.6 1.7 3.6 43 4.5 2.3 3.9 25 4.1 1.9 4.5 40 4.2 2.1 3.4 28 3.0 1.5 2.3 11 1.8 0.8 1.8 31 3.3 1.6 2.9 27 2.8 1.5 2.3 14 2.3 1.0 2.1 10 1.1 0.5 0.5 12 1.3 0.7 0.6 65 6.9 3.3 8.5 73 7.7 4.0 7.1 48 7.9 3.6 9.1 914 96.6 47.3 89.3 914 96.3 49.9 79.2 593 97.1 43.9 89.0 946 100.0 48.9 92.5 949 100.0 51.8 82.7 611 100.0 45.2 91.6 Tot .% .0 a8 a1 a2 .0 e3 ALL SITES a5 e2 a2 d1 s1 s2 d2 Connective, Soft Tissue Kaposi sarcom Mesotheliom Other Skin Melanoma of Skin Bon e1 All Sites but C44 Other Thoracic Organs All Sites Trachea, Bronchus, Lung Other & unspecie d4 Larynx leukemia unspec. Myeloid leukemi Nose, sinuses, etc .5 Lymphoid leukemia Pancrea Multiple Myelom Gall bladder, etc. Immunoproliferative dis Liver Anu s4 Hodgkin Disease Rectum Other Endocrin Adrenal glan Colon Thyroi Small intestin Brain, Nervous System Stomach Eye Oesophagus Other urinary organs Pharynx unspec Bladder Hypopharynx Ureter Nasopharynx Renal pelvi Other oropharynx Kidney Tonsil Other male genital Salivary Glands Testis Mouth Prostate Tongue Penis Lip Breast ) 10th ( C47; C49 C46 C45 C44 C43 C40-C41 All but C44 C37-C38 All C33-C34 Other C32 C95 C92-C94 C30-C31 C91 C25 C90 C23-C24 C88 C22 C82-C85; C96 Non Hodgkin lymphom C21 C81 C19-C20 C75 C74 C18 C73 C17 C70-C72 C16 C69 C15 C68 C14 C67 C12-C13 C66 C11 C65 C10 C64 C9 C63 C07-C08 C62 C03-C06 C61 C01-C02 C60 C00 C50 ICD Table 5.2.1 continued ...... 5.2.1 continued Table

SCRPart005.indd 79 20/05/2009 17:18:53 SR

Crud eA Jazan 2 1.6 0.4 0.8 0 0.0 0.0 0.0 6 4.7 1.1 1.7 0 0.0 0.0 0.0 3 2.4 0.6 1.0 2 1.6 0.4 0.3 1 0.8 0.2 0.2 0 0.0 0.0 0.0 4 3.1 0.8 1.0 4 3.1 0.8 0.6 0 0.0 0.0 0.0 0 0.0 0.0 0.0 1 0.8 0.2 0.4 0 0.0 0.0 0.0 0 0.0 0.0 0.0 7 5.5 1.3 2.1 0 0.0 0.0 0.0 3 2.4 0.6 0.7 0 0.0 0.0 0.0 0 0.0 0.0 0.0 1 0.8 0.2 0.3 0 0.0 0.0 0.0 0 0.0 0.0 0.0 1 0.8 0.2 0.1 2 1.6 0.4 0.5 1 0.8 0.2 0.2 2 1.6 0.4 0.5 0 0.0 0.0 0.0 1 0.8 0.2 0.2 3 2.4 0.6 0.9 2 1.6 0.4 0.5 0 0.0 0.0 0.0 4 3.1 0.8 1.2 0 0.0 0.0 0.0 0 0.0 0.0 0.0 1 0.8 0.2 0.3 1 0.8 0.2 0.3 2 1.6 0.4 0.4 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 3 2.4 0.6 0.8 0 0.0 0.0 0.0 1 0.8 0.2 0.2 2 1.6 0.4 0.5 2 1.6 0.4 0.8 1 0.8 0.2 0.4 0 0.0 0.0 0.0 6 4.7 1.1 2.1 0 0.0 0.0 0.0 1 0.8 0.2 0.2 2 1.6 0.4 0.3 127 100.0 24.6 35.5 Baha 0 0.0 0.0 0.0 0 0.0 0.0 0.0 5 10.0 2.8 3.0 0 0.0 0.0 0.0 2 4.0 1.1 1.9 1 2.0 0.6 0.4 2 4.0 1.1 1.2 0 0.0 0.0 0.0 0 0.0 0.0 0.0 2 4.0 1.1 1.0 2 4.0 1.1 1.7 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 1 2.0 0.6 0.9 2 4.0 1.1 1.2 0 0.0 0.0 0.0 1 2.0 0.6 0.4 1 2.0 0.6 0.8 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 3 6.0 1.7 2.4 10 7.9 1.9 2.9 0 0.0 0.0 0.0 1 2.0 0.6 0.6 2 4.0 1.1 1.3 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 1 2.0 0.6 0.8 3 6.0 1.7 1.7 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 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 2 4.0 1.1 1.3 0 0.0 0.0 0.0 0 0.0 0.0 0.0 2 4.0 1.1 1.1 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 4 8.0 2.2 3.8 0 0.0 0.0 0.0 18 14.2 3.4 5.6 1 2.0 0.6 0.9 0 0.0 0.0 0.0 1 2.0 0.6 0.6 0 0.0 0.0 0.0 0 0.0 0.0 0.0 1 2.0 0.6 0.3 0.6 SR Tot. % Crude ASR Tot .% Crud eA Asir 0.4 0.1 0.3 0.0 0.0 0.0 3.1 1.1 1.6 0.8 0.3 0.2 1.6 0.5 0.9 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 1.2 0.4 0.7 0.0 0.0 0.0 0.4 0.1 0.1 0.4 0.1 0.1 1.2 0.4 0.6 0.4 0.1 0.1 0.0 0.0 0.0 1.6 0.5 0.8 4 1.6 0.5 1 0.4 0.1 0.2 1 0.4 0.1 0.2 0 0.0 0.0 0.0 6 2.4 0.8 0.6 4 1.6 0.5 1.0 0 0.0 0.0 0.0 4 1.6 0.5 0.7 5 2.0 0.7 1.3 2 0.8 0.3 0.4 3 1.2 0.4 0.3 2 0.8 0.3 0.3 0 0.0 0.0 0.0 3 1.2 0.4 0.7 1 0.4 0.1 0.2 1 0.4 0.1 0.3 1 0.4 0.1 0.2 2 0.8 0.3 0.5 1 0.4 0.1 0.3 2 0.8 0.3 0.4 1 0.4 0.1 0.1 0 0.0 0.0 0.0 0 0.0 0.0 0.0 1 0.4 0.1 0.3 0 0.0 0.0 0.0 7 2.7 0.9 1.5 1 0.4 0.1 0.3 1 0.4 0.1 0.3 0 0.0 0.0 0.0 0 0.0 0.0 0.0 1 8.2 2.8 4.1 7 10.6 3.6 4.7 0 15.7 5.3 8.1 10 20.0 5.6 8.5 27 21.3 5.2 7.5 21 8.2 2.8 4.1 14 5.5 1.9 2.8 10 3.9 1.3 1.8 16 6.3 2.1 3.6 11 4.3 1.5 2.0 13 5.1 1.7 2.8 255 100.0 33.5 50.1 50 100.0 28.2 35.8 234 91.8 30.7 46.0 45 90.0 25.4 32.8 121 95.3 23.5 33.8 Tot .% .0 a2 a0 a4 .0 e0 ALL SITES a1 t4 e3 a0 d1 s1 s3 d2 Connective, Soft Tissue Kaposi sarcom Mesotheliom Other Skin All Sites Melanoma of Skin Other & unspecie d8 Bon e2 leukemia unspec. Myeloid leukemi Other Thoracic Organs Lymphoid leukemia Trachea, Bronchus, Lung Multiple Myelom Larynx Immunoproliferative dis Nose, sinuses, etc .0 Pancrea Hodgkin Disease Gall bladder, etc. Other Endocrin Adrenal glan Liver Thyroi Anu s1 Brain, Nervous System Rectum Eye Colon Other urinary organs Small intestin Bladder Stomach Ureter Oesophagus Renal pelvi Pharynx unspec Kidney Hypopharynx Placenta Nasopharynx Other Female Genital Other oropharynx Ovary. Tonsil Uterus Unspec. Salivary Glands Corpus Uteri Cervix Uter i4 Mouth Vagina Tongue Vulva Lip Female Breas All Sites but C44 ) 10th ( C47; C49 C46 C45 C44 All C43 Other C40-C41 C95 C92-C94 C37-C38 C91 C33-C34 C90 C32 C88 C30-C31 C82-C85; C96 Non Hodgkin lymphom C25 C81 C23-C24 C75 C74 C22 C73 C21 C70-C72 C19-C20 C69 C18 C68 C17 C67 C16 C66 C15 C65 C14 C64 C12-C13 C64 C11 C58 C10 C57 C9 C56 C07-C08 C55 C54 C03-C06 C53 C01-C02 C52 C00 C51 All but C44 ICD Table 5.2.2 Number, Relative Frequencies, Age Standardized and Crude Rates for All Cancer Cases Among Saudi Females by Site Region, 2005

SCRPart005.indd 80 20/05/2009 17:18:53 Crude ASR Qassim 7.8 23.0 35.1 00.0 23.5 35.8 81 SR Tot .% 28.7 38.9 17 Hail SR Tot. % Crud eA 0.3 0.4 2 2.9 0.8 0.7 2 1.1 0.3 0.4 Crud eA Madinah 0.00.0 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 0.0 0.0 0.0 0.0 0.0 1.7 0.4 0.4 1 1.4 0.4 0.4 1 0.6 0.1 0.1 2.8 0.6 1.1 3 4.3 1.3 1.0 8 4.5 1.1 1.8 0.00.0 0.00.7 0.0 0.0 0.2 0.0 0.3 0 0 0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0 0 2 0.0 0.0 0.0 1.1 0.0 0.0 0.3 0.0 0.4 1.40.3 0.3 0.1 0.6 0.2 1 0 1.4 0.0 0.4 0.0 0.7 0.0 0 1 0.0 0.6 0.0 0.1 0.0 0.2 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0.7 0.2 0.3 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0.0 0.0 0.0 0 0.0 0.0 0.0 1 0.6 0.1 0.3 0.0 0.0 0.0 0 0.0 0.0 0.0 00.0 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 5.6 1.3 2.7 4 5.8 1.7 2.2 12 6.7 1.6 2.8 4 4.9 1.1 2.4 5 7.2 2.1 3.1 6 3.4 0.8 1.0 4 8.4 1.9 3.2 10 14.5 4.2 5.7 21 11.8 2.8 3.7 1 24.7 5.6 11.3 15 21.7 6.3 9.3 47 26.4 6.2 10.1 4 1.4 9 3.1 0.7 1.8 3 4.3 1.3 1.9 4 2.2 0.5 0.7 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 1 0.3 0.1 0.2 0 0.0 0.0 0.0 3 1.7 0.4 0.7 3 1.0 0.2 0.5 1 1.4 0.4 0.3 1 0.6 0.1 0.1 5 1.7 0.4 0.9 0 0.0 0.0 0.0 2 1.1 0.3 0.4 6 2.1 0.5 0.7 1 1.4 0.4 0.4 2 1.1 0.3 0.2 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 7 2.4 0.5 1.3 0 0.0 0.09 0.0 3.1 2 0.7 1.1 0.9 0.3 2 0.4 2.9 0.8 1.0 4 2.2 0.5 0.6 7 2.4 0.5 1.3 1 1.4 0.43 0.6 1.0 4 0.2 2.2 0.2 0.5 1 0.9 1.4 0.4 0.4 0 0.0 0.0 0.0 5 1.7 0.4 1.0 5 7.2 2.10 2.9 13 0.0 0.0 7.3 0.0 1.7 2.7 0 0.0 0.0 0.0 0 0.0 0.0 0.0 4 1.4 0.3 0.7 1 1.4 0.4 0.72 1 0.7 0.6 0.2 0.1 0.4 0.2 0 0.0 0.0 0.0 0 0.0 0.0 0.0 6 2.1 0.5 1.1 0 0.0 0.0 0.00 7 0.0 3.9 0.0 0.9 0.0 1.3 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.06 3 2.1 1.7 0.5 0.4 0.9 0.7 2 2.9 0.8 1.2 3 1.7 0.4 0.4 3 1.0 0.2 0.4 0 0.0 0.0 0.00 3 0.0 1.7 0.0 0.4 0.0 0.7 1 1.4 0.4 0.6 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.00 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 0.0 0.0 0.0 0 0.0 0.0 0.00 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 2 0.7 0.2 0.3 1 1.4 0.4 0.39 1 3.1 0.6 0.7 0.1 1.8 0.1 2 2.9 0.8 1.3 5 2.8 0.7 1.1 1 0.3 0.1 0.1 0 0.0 0.0 0.06 1 2.1 0.6 0.5 0.1 0.7 0.1 1 1.4 0.4 0.7 3 1.7 0.4 0.7 0 0.0 0.0 0.0 0 0.0 0.0 0.00 1 0.0 0.6 0.0 0.1 0.0 0.2 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 0.00 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 10 3.5 0.8 0.7 1 1.4 0.4 0.3 3 1.7 0.4 0.3 22 7.7 1.7 3.5 3 4.3 1.3 2.2 9 5.1 1.2 2.0 10 3.5 0.8 1.7 2 2.9 0.8 1.0 2 1.1 0.3 0.5 287 100.0 22.7 44.0 69 100.0 278 96.9 22.0 42.2 66 95.7 27.4 37.0 17 49 Tot .% .0 a1 d1 a2 a8 .0 e0 ALL SITES a0 t7 e0 a0 d0 s0 s4 d2 Mesotheliom Kaposi sarcom Connective, Soft Tissue Other Skin Bon e5 Melanoma of Skin Other & unspecie All Sites Other Thoracic Organs Myeloid leukemi leukemia unspec. Trachea, Bronchus, Lung Hodgkin Disease Immunoproliferative dis Multiple Myelom Lymphoid leukemia Nose, sinuses, etc .1 Larynx Adrenal glan Other Endocrin Pancrea Thyroi Gall bladder, etc. Brain, Nervous System Anu s2 Liver Eye Small intestin Colon Rectum Other urinary organs Stomach Bladder Pharynx unspec Oesophagus Renal pelvi Ureter Hypopharynx Kidney Nasopharynx Placenta Other oropharynx Ovary. Other Female Genital Tonsil Uterus Unspec. Salivary Glands Corpus Uteri Mouth Cervix Uteri Tongue Vagina Lip Female Breas Vulva All Sites but C44 ) 10th ( C45 C46 C47; C49 C44 C40-C41 C43 Other All C37-C38 C92-C94 C95 C33-C34 C81 C82-C85; C96C88 C90 C91 Non Hodgkin lymphom C30-C31 C32 C74 C75 C25 C73 C23-C24 C70-C72 C21 C22 C69 C17 C18 C19-C20 C68 C16 C67 C14 C15 C65 C66 C12-C13 C64 C11 C64 C10 C57 C58 C9 C56 C07-C08 C55 C03-C06 C54 C01-C02 C53 ICD C00 C51 C52 All but C44 Table 5.2.2 continued ...... 5.2.2 continued Table

SCRPart005.indd 81 20/05/2009 17:18:54 0.0 ion ion g Crude ASR Northern Re Crude ASR Tot .% Tabuk ot .% Crude AS RT Jouf ran Crude ASR Tot .% j 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 3.2 1.1 2.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0.03.2 0.0 1.1 0.0 2.8 0 1 0.0 1.7 0.0 0.6 0.0 1.5 0 1 0.0 1.0 0.0 0.3 0.0 0.3 0 1 0.0 2.7 0.0 0.8 0.0 2.2 3.2 1.1 0.9 4 6.8 2.5 4.2 6 5.9 2.0 5.6 3 8.1 2.4 5.2 0.0 0.0 0.0 0 0.00.0 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 0.0 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 0.0 0 0.0 0.0 0.0 0 0.09.70.0 0.00.0 3.3 0.0 0.0 3.2 0.0 6.0 0.0 1.1 0.0 4 1.9 0 0 6.8 0.0 2 0.0 2.5 0.0 3.4 0.0 4.7 0.0 1.3 0.0 9 2.3 0 0 8.8 0.0 0 0.0 3.0 0.0 0.0 0.0 5.9 0.0 0.0 0.0 1 0.0 0 0 2.7 0.0 2 0.0 0.8 0.0 5.4 0.0 1.7 0.0 1.6 0.0 1.4 0.0 0.0 0.0 2 3.4 1.3 2.9 1 1.0 0.3 0.9 2 5.4 1.6 4.1 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 9.70.0 3.3 0.0 3.9 0.0 2 0 3.4 0.0 1.3 0.0 2.2 0.0 18 17.6 0 6.1 0.0 7.5 0.0 10 0.0 27.0 0 8.1 0.0 9.4 0.0 0.0 0.0 0.0 0.0 0 0.0 0.0 0.0 1 1.0 0.3 0.3 0 0.0 0.0 0.0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 Na 01 0.0 1.6 0.0 0.6 0.0 1.0 0 1 0.0 1.7 0.0 0.6 0.0 1.4 1 0 1.0 0.0 0.3 0.0 0.9 0.0 0 0 0.0 0.0 0.0 0.0 0.0 0 0.0 0.0 0.0 2 3.4 1.3 1.2 5 4.9 1.7 4.6 0 0.0 0.0 0.0 10 1.602 0.01 0.6 0.00 3.22 0.0 1.60 1.3 0.0 0.02 1.1 3.20 0.0 0.6 0.0 0.0 0.0 3.2 10 2.0 1.1 0.01 0.5 0.0 00 0.0 1.1 1.7 0.0 00 1.8 0.0 1.6 2 0.0 0.0 0.0 4 0.9 0.6 0.0 0.0 0.0 0 0.0 0.6 3.4 3 0.0 0.0 6.8 0 1.5 0.0 0.0 0.0 0.0 0 1.1 1.3 5.1 1 0.0 0.0 2.5 0.0 0.0 0.0 0.0 0.0 2 0 2.3 1.9 1.7 0 4.2 0.0 0 0 0.0 0.0 2.0 0.0 1 0 4.7 0.6 0.0 1 0.0 0.0 0.0 3 0.0 0.7 0.0 1.0 0.0 0 0.5 0.0 1.0 3 0.0 0.0 2.9 0 0.5 0.0 0.3 0.0 0.0 0 0.0 0.3 2.9 2 0.0 0.0 1.0 0.0 1.1 0.0 0.0 0.0 0 0 0.9 1.0 2.0 2 2.6 0.0 0 0 0.0 0.0 0.0 0.0 0 0 1.6 0.7 2.0 1 0.0 0.0 0.0 2 0.0 0.0 0.0 0.0 0.0 0 1.1 0.7 2.7 1 0.0 0.0 5.4 0 0.0 0.0 0.0 0.0 0.0 0 1.9 0.8 2.7 2 0.0 0.0 1.6 0.0 0.0 0.0 0.0 0.0 0 1.7 0.8 5.4 0 3.9 0.0 0 0.0 0.0 0.0 0 1.3 1.6 0.0 0.0 0.0 0.0 0.0 0.0 3.9 0.0 0.0 0.0 0.0 0.0 0.0 0.0 51 8.1 1.6 2.8 0.6 5.4 0.9 1 0 1.7 0.0 0.6 0.0 0.7 0.0 3 3 2.9 2.9 1.0 1.0 2.4 2.2 1 0 2.72 0.0 0.80 3.2 0.0 1.7 0.0 1.1 0.0 0.0 1.8 0.0 3 0 5.1 0.0 1.9 0.0 1.5 0.0 3 1 2.9 1.0 1.0 0.3 1.5 0.3 0 0 0.0 0.0 0.0 0.0 0.0 0.0 12 1.6 3.2 0.6 1.1 1.6 2.6 3 1 5.1 1.7 1.9 0.6 4.6 0.6 6 2 5.9 2.0 2.0 0.7 5.2 1.7 0 0 0.0 0.0 0.0 0.0 0.0 0.0 1 1.6 0.6 0.4 4 6.8 2.5 1.8 4 3.9 1.4 1.1 1 2.7 0.8 0.7 12 1.6 3.2 0.6 1.1 1.1 1.3 1 1 1.7 1.7 0.6 0.6 0.55 1.6 8.1 0 5 2.8 0.0 4.9 3.8 0.0 1.7 0.0 1 3.4 1.7 0 4 0.6 0.0 10.8 0.7 0.0 3.3 0.0 1 8.2 1.0 0.3 0.2 0 0.0 0.0 0.0 100 1.60 0.00 0.00 0.6 0.00 0.0 0.01 0.0 0.0 1.3 0.0 0.0 0.0 0.0 1.6 0.0 0.0 0.0 0.0 0 0.0 0.6 0 0.0 0 0.0 0.0 0 1.3 0.0 0 0.0 0 0.0 0.0 0 0.0 0.0 0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0 0.0 0.0 0 0.0 2 0.0 0.0 0 0.0 0.0 0 2.0 0 0.0 0.0 1 0.0 0.0 0 0.7 0.0 0.0 0.0 1.0 0.0 0.0 0.0 1.7 0.0 0.0 0.3 0 0.0 0.0 0 0.0 0 0.9 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 0.0 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 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 16.1 5.6 8.6 15 25.4 9.5 16.9 15 14.7 5.1 12.5 6 16.2 4.9 9.0 0 96.8 33.7 54.9 58 98.3 36.5 60.9 97 95.1 32.5 65.4 33 89.2 26.6 46.2 62 100.0 34.8 56.2 59 100.0 37.0 63.0 102 100.0 34.2 68.8 37 100.0 29.9 54.4 Tot .% .0 a6 d2 46 a0 .0 a2 e0 a0 c2 t1 ALL SITES e0 a0 d0 s0 s2 d6 e0 Larynx Trachea, Bronchus, Lung Nose, sinuses, etc .0 Liver Gall bladder et Pancrea All Sites Connective, Soft Tissue Female Breas Vulva Vagina Cervix Uteri Corpus Uteri Uterus Unspec. Ovary. Other Female Genital Placenta Kidney Renal pelvi Ureter Bladder Other urinary organs Eye Brain, Nervous System Colon Rectum Anu s0 Immunoproliferative dis Multiple Myelom Lymphoid leukemia Myeloid leukemi leukemia unspec. Other & unspecie Kaposi sarcom Oesophagus Stomach Small intestin Hodgkin Disease Melanoma of Skin Other Skin Mesotheliom Thyroi Lip Tongue Mouth Salivary Glands Tonsil Other oropharynx Nasopharynx Hypopharynx Pharynx unspec Adrenal glan Other Endocrin Other Thoracic Organs Bon ) 10th ( C32 C33-C34 C30-C31 C22 C23-C24 C25 All C47; C49 C51 C52 C53 C54 C55 C56 C57 C58 C64 C64 C65 C66 C67 C68 C69 C70-C72 C18 C19-C20 C21 C88 C90 C91 C92-C94 C95 Other C46 C15 C16 C17 C81 C82-C85; C96 Non Hodgkin lymphom All but C44 All Sites but C4 C43 C44 C45 C73 C00 C01-C02 C03-C06 C07-C08 C9 C10 C11 C12-C13 C14 C74 C75 ICD C37-C38 C40-C41 Table 5.2.2 continued ...... 5.2.2 continued Table

SCRPart005.indd 82 20/05/2009 17:18:54 7 00 Crude ASR Eastern Province 0 0.0 0.0 0.0 0 0.0 0.0 0.0 9 1.3 0.7 1.6 1 0.1 0.1 0.2 0 0.0 0.0 0.0 5 0.7 0.4 0.4 3 0.4 0.2 0.5 4 0.6 0.3 0.8 3 0.4 0.2 0.6 0 0.0 0.0 0.0 3 0.4 0.2 0.5 1 0.1 0.1 0.2 8 1.1 0.6 1.6 4 0.6 0.3 0.4 3 0.4 0.2 0.6 4 0.6 0.3 0.3 0 0.0 0.0 0.0 3 0.4 0.2 0.4 4 0.6 0.3 0.7 8 1.1 0.6 1.6 0 0.0 0.0 0.0 1 0.1 0.1 0.1 0 0.0 0.0 0.0 2 0.3 0.2 0.1 4 0.6 0.3 0.6 2 0.3 0.2 0.3 4 0.6 0.3 0.5 0 0.0 0.0 0.0 6 0.9 0.5 1.3 0 0.0 0.0 0.0 2 0.3 0.2 0.2 4 0.6 0.3 0.6 2 0.3 0.2 0.3 5 0.7 0.4 0.8 1 0.1 0.1 0.2 0 0.0 8 1.1 0.6 0.7 Makkah 100.0 50.2 78.3 703 100.0 54.9 104. 0 0.0 0.0 0.0 0 0.0 0.0 0.0 3 0.3 0.2 0.2 2 0.2 0.1 0.2 6 0.7 0.3 0.3 1 0.1 0.1 0.1 1 0.1 0.1 0.1 1 0.1 0.1 0.1 0 0.0 0.0 0.0 0 0.0 0.0 0.0 4 0.4 0.2 0.2 1 0.1 0.1 0.1 1 0.1 0.1 0.1 7 0.8 0.4 0.6 0 0.0 0.0 0.0 4 0.4 0.2 0.4 1 0.1 0.1 0.1 2 0.2 0.1 0.2 0 0.0 0.0 0.0 0 0.0 0.0 0.0 2 0.2 0.1 0.2 2 0.2 0.1 0.2 8 0.9 0.4 0.6 2 0.2 0.1 0.2 4 0.4 0.2 0.4 0 0.0 0.0 0.0 2 0.2 0.1 0.1 6 0.7 0.3 0.6 1 0.1 0.1 0.1 5 0.5 0.3 0.4 0 0.0 0.0 0.0 1 0.1 0.1 0.1 SR Tot. % Crude ASR Tot .% 0.4 0.4 15 1.6 0.8 1.0 Crud eA adh y 0.4 0.2 0.5 0.1 0.1 0.1 0.0 0.0 0.0 0.4 0.2 0.4 0.0 0.0 0.0 0.3 0.2 0.1 0.2 0.1 0.1 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 Ri 7 0.7 3 0.3 0.2 0.3 3 0.3 0.2 0.2 4 0.4 0.2 0.4 0 0.0 0.0 0.0 2 0.2 0.1 0.1 1 0.1 0.1 0.1 7 0.7 0.4 0.7 12 1.3 0.7 1.1 6 0.6 0.3 0.5 22 2.4 1.2 2.1 2 0.2 0.1 0.2 2 0.2 0.1 0.1 4 0.4 0.2 0.5 1 0.1 0.1 0.0 9 0.9 0.5 0.9 0 0.0 0.0 0.0 2 0.2 0.1 0.2 1 0.1 0.1 0.1 2 0.2 0.1 0.1 5 0.5 0.3 0.4 2 0.2 0.1 0.2 2 0.2 0.1 0.2 0 0.0 0.0 0.0 2 0.2 0.1 0.3 3 3.4 1.8 3.6 36 3.9 2.0 3.4 17 2.4 1.3 2.8 0 1.0 0.5 0.5 3 2.4 1.2 1.3 18 2.0 1.0 1.4 18 2.6 1.4 1.8 5 1.5 0.8 1.8 9 8.1 4.2 7.7 56 6.1 3.1 5.1 39 5.5 3.1 6.2 2 1.2 0.6 1.5 11 1.2 0.6 1.2 13 1.8 1.0 2.5 2 2.3 1.2 2.4 29 3.2 1.6 2.5 21 3.0 1.6 3.8 31 3.2 1.7 3.4 29 3.2 1.6 2.8 21 2.2 1.1 1.2 13 1.4 0.7 0.7 12 1.7 0.9 1.2 22 2.3 1.2 2.3 26 2.8 1.4 2.5 23 3.3 1.8 4.3 22 2.3 1.2 1.4 23 2.5 1.3 1.7 22 3.1 1.7 1.4 17 1.7 0.9 2.1 18 2.0 1.0 1.8 24 2.5 1.3 3.0 15 1.6 0.8 1.4 15 2.1 1.2 2.9 29 3.0 1.6 1.7 21 2.3 1.1 1.4 18 2.6 1.4 1.7 32 3.3 1.7 3.6 37 4.1 2.0 3.5 27 3.8 2.1 4.6 65 6.7 3.5 7.4 45 4.9 2.5 3.8 30 4.3 2.3 5.1 12 1.2 0.6 1.6 10 1.1 0.5 1.0 16 2.3 1.3 3.2 16 1.6 0.9 1.6 14 1.5 0.8 1.1 12 1.7 0.9 1.9 31 3.2 1.7 2.8 42 4.6 2.3 3.9 24 3.4 1.9 4.1 35 3.6 1.9 4.2 40 4.4 2.2 3.9 23 3.3 1.8 4.7 972 100.0 52.3 89.8 913 128 13.2 6.8 9.0 65 7.1 3.5 4.5 55 7.8 4.3 6.4 212 21.8 11.3 18.6 249 27.3 13.6 20.9 214 30.4 16.8 30.0 941 96.8 50.6 86.4 884 96.8 48.6 75.5 694 98.7 54.2 103.1 Tot .% .0 a7 d3 a1 a2 .0 e0 ALL SITES a4 e0 a1 d3 s0 s1 Connective, Soft Tissue Kaposi sarcom Mesotheliom All Sites Other Skin Other & unspecie Melanoma of Skin leukemia unspec. Bon e1 Myeloid leukemi Other Thoracic Organs Lymphoid leukemia Trachea, Bronchus, Lung Multiple Myelom Immunoproliferative dis Larynx Nose, sinuses, etc .4 Hodgkin Disease Pancrea Other Endocrin Gall bladder etc. Adrenal glan Liver Thyroid Anu s2 Brain, Nervous System Rectum Eye Colon Other urinary organs Small intestin Bladder Stomach Ureter Renal pelvi Oesophagus Kidney Pharynx unspec Placenta Hypopharynx Other Female Genital Nasopharynx Ovary. Other oropharynx Uterus Unspec. Tonsil Corpus Uteri Salivary Glands Cervix Uter i2 Mouth Vagina Tongue Vulva Lip Female Breast All Sites but C44 ) 10th ( C47; C49 C46 C45 All C44 Other C43 C95 C40-C41 C92-C94 C37-C38 C91 C33-C34 C90 C88 C32 C82-C85; C96 Non Hodgkin lymphom C30-C31 C81 C25 C75 C23-C24 C74 C22 C73 C21 C70-C72 C19-C20 C69 C18 C68 C17 C67 C16 C66 C65 C15 C64 C14 C64 C12-C13 C58 C11 C57 C10 C56 C9 C55 C07-C08 C54 C03-C06 C53 C01-C02 C52 C00 C51 All but C44 ICD Table 5.2.2 continued ...... 5.2.2 continued Table

SCRPart005.indd 83 20/05/2009 17:18:55 0.2 1.3 1.1 0.5 0.4 0.1 2.6 0.2 0.2 1.5 0.9 7.6 3.9 0.3 4.0 1.9 1.2 6.1 0.4 1.8 0.2 1.3 0.6 6.7 0.3 0.3 3.0 0.6 0.0 0.8 0.0 2.2 0.2 0.1 4.3 0.0 9.5 0.3 3.7 2.5 0.2 1.7 2.8 0.1 0.0 2.7 3.4 1.6 5.1 4 5.1 11 12 4.7 03 854 511 71 6857 8733 76 6543 26 11 14 11 71 899244 20 11 38 51 10 11 12 15 15 13 17 01 49 09 21 9 124 122 158 157 103 83 57 57 93.27 51 41 01 38 56 61 94 0- 25- 30- 35- 40- 45- 50- 55- 60- 65- 70- 75+ % 22 24321310220000 -9 10- 15 -2 05 917162 0000000100000001 0000000002012100 0000000010111000 0000000001000000 0000000001100000 0001000000011000 0000111000001000 0000000110000201 0000000001200000 0000000001330001 0000000000021100 0000010010001010 0000001110121000 0000000000000000 0000000000000000 0000000010000100 0000000000010000 0000000000000000 1000011000000000 0000000000001100 1000000000000000 0000000000000000 29 17 16 22 29 45 69 93 133 137 171 174 111 90 60 60 100 10000003021130131 00000001132320200 00002114544560010 00000001122113224 000000026688 00000000010411301 1000104997 00000224447697130 03000111128884662 00000001122355113 00000001022113302 00000000162650021 00000100 00141201022102000 0000000649 04001253562421210 100000000218 00002114101000000 01112010434044120 0000001015 13332132584812001 00000151539321200 144236 00000000135331311 01 72 01212434213541100 01110153681453211 00020022320220302 00001202 20 60 51 10 20 30 40 50 30 80 40 40 70 00 00 20 10 00 41 20 10 00 16 14 33 19 65 11 96 49 51 24 15 23 77 16 85 38 59 10 28 54 47 32 21 35 34 43 20 64 Tot UNK 0- 45 120 1178 126 37 SITE Lip Tongue Mouth Salivary Glands Tonsil Other oropharynx Nasopharynx Hypopharynx Pharynx unspec. Oesophagus Stomach Small intestine Colon Rectum Anus Liver Gall bladder etc. Pancreas Nose, sinuses, etc. Other Thoracic Organs Larynx Trachea, Bronchus, Lung Bone Melanoma of Skin Other Skin Mesothelioma Kaposi sarcoma Connective, Soft Tissue Breast Penis Prostate Testis Other male genital Kidney Renal pelvis Ureter Bladder Other urinary organs Eye Immunoproliferative dis. Brain, Nervous System Thyroid Adrenal gland Multiple Myeloma Lymphoid leukemia Myeloid leukemia Other Endocrine Hodgkin Disease Non Hodgkin lymphoma leukemia unspec. Other & unspecied All Sites All sites but C44 ) 10 ( ICD C00 C01-C02 C03-C06 C07-C08 C9 C10 C11 C12-C13 C14 C15 C16 C17 C18 C19-C20 C21 C22 C23-C24 C25 C30-C31 C37-C38 C32 C33-C34 C40-C41 C43 C44 C45 C46 C47; C49 C50 C60 C61 C62 C63 C64 C65 C66 C67 C68 C69 C88 C70-C72 C73 C74 C90 C91 C92-C94 C75 C81 C82-C85; C96 C95 Other All All but C44 Table 5.3.1 Age Distribution of Cancer Cases among non-Saudi Males, 2005 Distribution of Cancer Cases among non-Saudi Males, Age 5.3.1 Table

SCRPart005.indd 84 20/05/2009 17:18:55 % 0.0 4.5 0.2 0.2 0.1 0.0 0.5 0.4 0.0 0.3 0.1 1.3 0.0 1.5 0.0 1.1 4.9 0.0 0.3 0.3 4.7 3.3 0.5 2.8 1.5 3.1 0.4 0.0 0.5 2.5 1.5 1.0 1.1 0.1 3.9 0.0 0.0 5.4 1.4 0.5 0.0 0.4 0.3 0.3 2.9 1.0 2.5 0.1 0.0 2.7 0.1 2.0 0.8 1.1 0-64 65-69 70-74 75+ 262100 7612100 64 103 90 66 61 41 41 100 58 94 88 65 60 41 38 98 47445143 17 31 07 15 5-39 40-44 45-49 50-54 55-5 96 11 05 139 13 81 61 31 12 48 67 75 75 38 26 20 15 10 13 36.6 2244 22 24 44 106 139 13 91 11110111011000 62 97 31 69 -4 5-9 10-14 15-19 20-24 25-29 30-3 43 33 18 00000032776584251 23 02111111212100000 00000000203311213 00000000000000000 00103220031000000 01205433516573612 00000000000000000 00000014 00000014336652231 00000013330351615 03100011202013200 01 02201443221312000 00001100321042011 12112001003000000 02000003113101000 00003233 00000000000000000 000224 00000000222321120 00000000000000000 000004 00000012316243334 00000001014120200 00110011016921103 00002014344131610 00110012022213421 00000000013211211 000000000000000000 200000001010000000 000000000000000000 202000000000000000 100000000010000000 500000001010001110 410000001100001000 000000000000000000 300000010010001000 100000000000000010 000000000000000000 300000001010010000 300000100001000100 600000000000020220 401000000101100000 000000000000000000 502000001001000001 100001000000000000 000000000000000000 500000002001110000 400000000110000011 300000000001200000 300000000101010000 100000000000001000 000000000000000000 100000001000000000 900000001100203011 50 14 16 12 54 52 36 31 16 34 27 16 11 12 43 59 15 32 11 27 30 22 12 Tot UN K0 403 1101 107 42 - - - - g Lun ans , stem g ans y g nx etc. ec. , y ec. p ecied or p ec. p y Soft Tissue eloma , p nx nx har us y y y land p roliferative dis. g r r Bronchus g , p Glands elvis y ha p ha ha es Total le M . nx uns sinuses Nervous S y hoid leukemia kin Disease p p p , , ue g us Uteri y y p nx p g osi sarcoma ina o g p y eloid leukemia p g e m y p yp y y All sites but C44 Connective All A Bone Vulva Lar Other Endocrine Hod L SITE Li Tonsil Naso Oeso Ovar Thyroid Ton Stomach Ureter Immuno Multi Trachea Cervix Uteri Cor Uterus Uns Mouth Other Thoracic Or Renal M Other & uns Phar Brain leukemia uns H Melanoma of Skin Breast Va Other Female Genital Other oro E Adrenal Small intestine Colon Bladder Salivar Placenta Other Skin Rectum Other urinar Mesothelioma Ka Kidne Anus Liver Gall bladder etc. Pancreas Nose Not C44 C47; C49 All C40-C41 C51 C75 C81 C32 C91 C15 C9 C11 C56 C73 ICD10 C00 C90 C82-C85; C96C88 Non Hodgkin lymphoma C01-C02 C16 C66 C33-C34 C53 C54 C55 C37-C38 C65 C92-C94 Other C03-C06 C70-C72 C95 C12-C13 C14 C57 C43 C50 C52 C10 C74 C69 C17 C18 C67 C07-C08 C58 C44 C19-C20 C68 C64 C45 C46 C21 C22 C23-C24 C25 C30-C31 Table 5.3.2 Age Distribution of Cancer Cases among non-Saudi Females, 2005 Distribution of Cancer Cases among non-Saudi Females, Age 5.3.2 Table

SCRPart005.indd 85 20/05/2009 17:18:55 0 0 0.1 ASR World 00 00 00 0 0.3 000 0.2 00 00 0.1 0.4 0.3 0.6 0.8 1.4 0.4 0.6 0.10.1 0.4 0.2 0.1 0.1 0.1 0.1 0.2 0.2 0.1 0.2 0.8 1.1 0.10.7 0.1 0.9 0.2 0.2 Rate Crude 00 00 10 0.6 0.2 0.4 0.6 0.2 1 1.3 0.3 1.4 1.3 0.4 1.3 0.6 0.1 0.6 10.6 1.1 1.5 00 00 01 00 01 02 02 01 01 00 00 00 00 9.7 0 0.7 0.9 19.4 10.6 0.5 1.1 000 000 000 000 000 00 5.7 11.5 5-69 70-74 75+ 0000 00 00 0000 00 9.7 34.4 58.3 21.3 1.1 3.9 2.4 2.4 0 9.7 0 0.1 0.3 2.4 5.7 0000 2.3 2.4 5.7 1.1 2.4 17.2 2.3 2.3 0 17.2 1.1 2.4 1.1 2.4 16.9 57.3 29.1 42.6 1.5 4.8 5.8 14.5 45.8 48.6 74.5 1.7 5.6 2.4 16.9 34.4 106.9 127.7 1.3 7.3 0.1 21.7 11.5 38.9 42.6 1.4 3.9 10.1 16.9 5.7 29.1 0 1.1 2.3 41 49 41 100000 41 000000 41 000000 0-54 55-59 60-6 46 02 23 01 0000 0000 000 01 0.3 1.5 3.4 0.3 0.6 0 1.1 4.8 5.7 0.3 0.3 0.5 0.2 0 0.5 1.1 2.4 0.2 0.4 0.3 0.2 0.2 00000 000000000 0.7 1.9 3.7 0.1 0.2 0.1 1.1 0.6 3 5.6 0.1 0.6 1.4 1.5 3.4 2.4 17.2 9.7 10.6 0.5 1.4 00 0.8 0.6 1.7 4.2 6.4 19.1 19.3 40.1 29.1 31.9 1.9 4.7 0.10.1 0.1 0 0.4 0.4 0.6 0.6 1.5 0.5 5.6 12.1 1.1 5.7 7.2 17.2 9.7 31.9 0.5 1.9 0.1 0.1 0.6 0.6 1.5 2.3 0 11.5 0.10.3 0.1 0.8 0.4 1.1 0.6 2.3 0.5 1.1 7.2 11.5 19.4 42.6 0.4 2 0.4 0 0.4 0.3 0.5 3.4 0 5.7 29.1 10.6 0.4 1.3 0.1 0.1 0.2 0 0.5 2.3 2.4 0-34 35-39 40-44 45-4 95 00 0.2 0 0.1 0.9 1.4 8.4 13.5 14.5 28.7 9.7 10.6 1.2 3 0.2 0.3 0.3 0.4 0.4 0.2 0.1 0000000 0.60.3 0.30.3 0.2 0.5 0.2 0.1 0.6 0.1 0.7 0.1 0.4 2.3 0.3 0.3 0.8 0.1 0.7 0.6 2.5 1.5 2.3 2.4 11.5 00 0.6 0 0.6 1.2 1.3 1.3 2.8 5.4 13.5 36.2 45.8 48.6 42.6 2.1 6 0.6 0.6 0.81.3 0.4 0.3 0.7 0.2 1.1 0.5 0.6 0.1 2 0 2.3 0.3 2.4 11.5 9.7 0 0.9 1.4 0.6 1.3 0.3 0.2 0.5 0.7 0.7 1.1 2.5 6.8 0.6 0.6 0 0.3 0.6 1.9 2.5 1.1 000 00 00000000000000 0000 0.5 2.2 0.6 0.6 0 0.1 0 0.4 0.6 0.5 0 4.8 -4 5-9 10-14 15-19 20-24 25-2 93 0.4 0.4 0000000 000000000 1000 00000 0000000 0000000 0000000 00 100000000 0000 0000000 0000000 000000 00000000 1000000 000 00000 0000 00000 0000 00000000 4000000000000 80000000000 5100000000 400000 30000000000 70000000 000000000000000000 60000000000 10 10000000000 30000 500000000 2000000000000000 2000000000 1000000000000 000000000000000000 20000000000000 4000000 000000000000000000 41 20000000000 000000000000000000 43 0 0.4 0.5 0.5 0 0.3 0.8 0.4 0.8 1.5 0.3 2 5.6 7.2 11.5 9.7 10.6 1 1.8 85 11 96 49 5124 15 0 1.3 14 16 59 10 19 65 54 23 16 3520 0 4.3 2.3 1.1 2.5 1 0.3 0.1 0.4 0.2 33 77 28 0 0.4 0.532 0.5 1.3 0 0.2 064 0.6 0.6 1.1 0 4.5 9.7 5.7 19.4 0 0.6 1.5 38 0 1.7 47 1 1.3 1.421 1.6 1.3 0.3 0.5 0.3 0.7 1.5 1.1 4 1.1 4.8 34 0 0.4 0.9 0.5 1.3 1.3 0.5 0.5 0.3 0.2 0.8 2.5 4.5 2.4 5.7 Tot UN K0 120 1 1.7 1.8 1.1 1.9 1.9 0.9 1.3 1.7 2.6 2.5 9.9 12.4 14.5 28.7 38.9 31.9 2.7 5.3 12631178 7.0 7.0 12.3 12.3 7.9 7.9 8.6 8.6 13.9 13.9 9.0 9.0 7.4 7.4 8.8 8.0 12.7 12.1 25.2 23.5 38.9 34.7 85.1 196.0 78.7 267.7 176.9 515.8 248.4 582.7 475.7 638.2 553.6 606.3 28.0 26.1 73.9 69.2 g Lun ans , stem g ans y g nx etc. ec. , y ec. p ecied or enital p p y Soft Tissue g eloma , nx nx har us y y y land p roliferative dis. g Bronchus g , p Glands elvis y ha p har har es Total le M sinuses Nervous S nx uns y hoid leukemia kin Disease p p p , , ue g y p nx p g osi sarcoma o g roid y p e y m p yp y y Ka leukemia uns Mesothelioma Salivar Myeloid leukemia Renal Melanoma of Skin Other Skin Tonsil Other oro Small intestine Colon Rectum Anus Liver Gall bladder ect. Pancreas Nose Trachea Connective Mouth Other & uns Other Thoracic Or Li Bone Breast Penis Prostate Testis Oeso Lar Naso E Immuno Multi Ton Stomach Ureter Bladder Other urinar Kidne SITE All A All sites but C44 Hod Th Brain Adrenal H Phar Other male Other Endocrine L C46 C95 C45 C92-C94 C07-C08 C65 C43 C44 C9 C10 C17 C18 C19-C20 C21 C22 C23-C24 C25 C30-C31 C33-C34 C47; C49 C03-C06 Other C37-C38 C00 C40-C41 C50 C60 C61 C62 C32 C15 C11 C90 C88 C69 C01-C02 C66 C67 C68 C16 C64 ICD10 All Not C44 C81 C73 C82-C85; C96 Non Hodgkin lymphoma C70-C72 C74 C12-C13 C14 C63 C75 C91 Table 5.3.3 Incidence Rates for Cancer Cases among non-Saudi Males by Age Group (per 100,000), 2005

SCRPart005.indd 86 20/05/2009 17:18:56 ASR World 00 00 00 00 00 5.1 118.9 0.5 38.8 6.5 122.3 Rate Crude 88.4 415.0 731.2 614.4 502. 25 97.2 421.4 743.4 614.4 541. 95 5-59 60-64 65-69 70-74 75+ 5-39 40-44 45-49 50-5 45 -4 5-9 10-14 15-19 20-24 25-29 30-3 43 0.0 0.0 0.0 0.0 0.0 0.0 0.4 0.5 0.0 0.0 4.4 0.0 19.1 0.0 15.0 13.2 0.5 1.6 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 6.4 0.0 0.0 0.0 0.1 0.3 0.0 0.0 0.0 0.0 0.0 0.0 0.4 0.0 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 0.00.0 0.0 0.0 0.0 0.0 0.0 0.7 0.5 0.0 0.0 0.0 1.3 0.0 0.0 0.0 4.4 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.2 0.0 0.3 0.0 0.1 0.1 0.00.0 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 0.0 0.0 0.0 1.3 0.0 4.4 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.2 0.3 0.00.0 0.0 0.0 0.0 0.00.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.4 0.0 0.0 0.5 0.0 0.4 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.8 0.0 0.0 0.0 6.4 0.0 0.0 0.0 0.0 0.0 0.0 0.0 6.4 0.0 0.0 0.00.0 0.2 0.0 0.0 0.4 0.0 0.0 0.0 0.2 0.0 0.3 0.0 0.0 0.0 0.0 0.00.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 15.0 0.0 0.0 0.4 0.0 0.1 0.8 0.3 0.0 0.0 0.0 6.4 12.2 15.0 0.0 0.3 1 0.0 0.0 0.0 0.00.0 0.0 0.0 0.0 0.0 0.0 0.00.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.7 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 1.3 0.0 0.0 2.2 0.0 0.0 4.4 0.0 0.0 0.0 0.0 0.0 0.0 0.00.0 0.00.0 0.0 0.0 0.0 0.00.0 0.3 0.0 0.0 0.0 0.0 0.0 0.4 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.00.0 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 0.0 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 0.0 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 0.0 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 0.0 0.0 0.00.0 0.0 0.0 0.0 0.00.0 0.4 0.0 0.0 0.0 0.0 0.0 0.8 0.0 0.0 0.0 0.0 0.6 0.0 0.0 0.0 4.4 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 1.3 0.0 0.0 0.0 0.2 0.0 0.0 0.2 0.0 0.0 12.2 0.0 0.0 0.0 0.0 0.0 0.2 0.5 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 8.8 0.0 24.4 30.0 0.0 0.3 1.7 0.4 0.0 0.0 0.0 0.0 0.0 0.0 0.5 0.0 1.3 2.2 0.0 0.0 0.0 0.0 0.0 0.2 0.3 0.0 0.0 0.0 0.0 0.0 0.0 0.4 0.0 0.8 0.0 0.0 0.00.9 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.1 0.4 0.1 0.0 0.0 1.3 0.0 0.0 0.0 0.0 0.0 13.2 0.3 0.5 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 0.0 0.0 0.90.0 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 0.0 0.0 0.8 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 0.1 0.1 0.1 0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.5 0.8 0.0 0.0 0.0 0.0 0.0 15.0 13.2 0.2 0.6 14.6 8.8 3.5 14.8 14.4 17.2 37.7 69.7 108.6 207.3 206. 73 90 10 10 30 10 30 00 10 41 00 30 00 50 00 50 00 00 00 00 0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.030 0.0 0.0 0.000 0.0 0.030 0.0 0.0 0.0 0.0 60 40 20 50 00 20 10 40 12 0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.8 3.9 4.4 4.4 6.4 24.4 15.0 13.2 0.6 2.2 30 0 0.0 0.0 0.0 1.3 0.0 0.4 1.4 1.5 3.1 5.3 2.2 13.2 6.4 73.1 15.0 0.0 1.5 4.2 27 0 0.0 0.5 0.6 0.0 0.0 0.4 0.4 0.0 0.8 7.9 19.8 8.8 6.4 12.2 0.0 39.7 1.4 3.4 59 0 0.0 0.0 1.1 1.3 2.4 2.4 3.9 5.0 5.5 9.2 13.2 4.4 12.8 12.2 0.0 0.0 3 3.7 1532 0 0.0 022 0.0 0.0 0 0.0 0.0 0.0 0.0 0.0 0.5 0.0 0.0 0.6 0.0 0.0 0.0 0.0 0.4 0.0 1.0 0.7 0.4 1.6 1.5 0.7 2.6 0.8 0.0 6.6 7.9 1.6 8.8 4.4 2.6 17.7 6.4 19.1 4.4 12.2 36.5 30.011 4.4 44.9 19.1 0.0 52.9 0 48.7 0.8 30.0 0.0 1.6 13.2 0.0 2.2 5.4 54 1.1 0.0 0.0 3.9 0 0.0 0.4 0.0 1.0 0.4 0.0 0.0 3.4 0.8 2.4 5.3 1.2 2.2 1.1 8.8 2.5 0.0 0.8 24.4 7.9 0.0 11.0 30.9 0.0 19.1 0.6 73.1 15.0 1.6 26.4 2.7 7 52 0 0.0 0.0 0.0 0.0 0.0 0.4 1.4 7.5 3.1 9.2 8.8 17.7 31.9 12.2 59.9 39.7 2.6 6.1 11 1 0.912 0.5 0 0.6 0.9 1.3 0.043 0.0 0.0 0.0 0 0.0 0.4 0.0 0.0 0.0 0.0 0.0 0.0 0.0 1.1 3.9 2.0 0.5 0.0 1.2 0.8 0.0 1.2 3.9 0.0 1.1 2.2 0.0 1.527 0.0 0.0 8.650 6.4 0 0.0 9.2 0.0 0.9 0 0.6 4.4 0.0 1.0 0.0 26.5 0.6 0.0 12.8 0.0 0.0 12.2 0.7 0.6 0.0 0.0 2.4 0.0 0.8 0.0 1.6 0.0 2.2 1.1 1.2 1.0 0.7 3.8 1.6 3.5 1.3 5.5 6.6 7.9 11.0 4.4 35.3 12.8 25.5 0.0 24.4 74.9 0.0 13.2 0.0 2.5 1.4 6.6 1.9 16 0 0.0 0.0 0.0 0.7 0.6 0.0 0.0 1.5 1.6 1.3 0.0 17.7 12.8 0.0 15.0 13.2 0.8 2.2 31 0 0.0 0.0 0.0 0.0 0.0 0.4 1.116 1.5 2.4 0 0.0 1.314 6.6 0.5 22.1 0.0 0 6.4 0.0 0.9 73.1 0.0 15.0 0.5 66.1 0.4 0.6 0.4 1.6 0.7 1.0 0.6 5.6 0.0 0.4 2.6 0.4 0.0 1.0 4.4 0.8 19.1 2.6 24.4 2.2 0.0 0.0 0.0 0.0 0.8 0.0 2.2 0.0 0.0 0.7 0.7 16 0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 1.0 0.0 3.9 6.6 4.4 6.4 24.4 15.0 39.7 0.8 2.9 12 0 0.0 0.5 0.0 2.0 1.2 0.8 0.0 0.0 2.4 1.3 0.0 0.0 0.0 0.0 0.0 0.0 0.6 0.6 36 0 0.0 0.0 0.0 0.0 0.0 0.4 1.4 1.5 2.4 7.9 13.2 22.1 12.8 24.4 44.9 13.2 1.8 4.8 34 0 7.1 4.3 0.6 0.7 0.6 0.4 0.0 0.5 0.8 1.3 0.0 4.4 6.4 0.0 0.0 0.0 1.7 2.1 Tot UN K0 403 0 0.0 0.0 0.0 0.0 2.4 4.8 16.9 33.7 58.8 98.5 83.5 114.8 127.7 182.7 149.8 171. 82 107 42 1101 2 14.6 9.3 4.1 14.8 14.4 17.6 38.1 69.7 109.4 215.2 226. 53 g Lun ans , stem g y ans g nx etc. ec. , y ec. p ecied or p ec. p y Soft Tissue eloma , p nx nx har us y y y land p roliferative dis. g r r Bronchus g , p Glands elvis y ha p ha ha es Total le M . nx uns sinuses Nervous S y hoid leukemia kin Disease p p p , , ue g us Uteri y y p nx p g osi sarcoma ina o g p y eloid leukemia p g e m y p yp y y Nose Pancreas Adrenal Gall bladder ect. Mesothelioma Ka All A Rectum Anus Renal Other urinar Immuno Uterus Uns Cor Melanoma of Skin Other Skin Breast Vulva Va Other Female Genital Placenta Kidne leukemia uns H All sites but C44 Tonsil Other oro Naso Oeso Stomach Small intestine Lar Other Thoracic Or Ovar Thyroid Colon Liver Ureter Bladder E Multi Ton Trachea Connective Cervix Uteri SITE Li Salivar M Other & uns Bone Brain Phar Other Endocrine Mouth Hod L C30-C31 C25 C74 C23-C24 C45 C46 All C65 C19-C20 C21 C68 C88 C55 C54 C43 C44 C50 C51 C52 C95 C57 C58 C64 C12-C13 Not C44 C56 C9 C10 C73 C15 C32 C37-C38 C11 C16 C17 C18 C22 C66 C67 C69 C82-C85; C96 Non Hodgkin lymphoma C90 C01-C02 C33-C34 C47; C49 C53 ICD10 C00 C92-C94 Other C07-C08 C40-C41 C70-C72 C14 C75 C03-C06 C81 C91 Table 5.3.4 Incidence Rates for Cancer Cases among non-Saudi Females by Age Group (per 100,000), 2005 (per 100,000), Group Age by Cancer Cases among non-Saudi Females 5.3.4 Incidence Rates for Table

SCRPart005.indd 87 20/05/2009 17:18:56 SCRPart005.indd 88 20/05/2009 17:18:56 PART VI APPENDICES

SCRPart006.indd 89 30/05/2009 12:46:17 APPENDIX: A Reporting Health care Facilities

Asir Region Abha General Hospital (Maternity) Mahael General Hospital Abha Private Hospital Majaridah General Hospital AFH Military South Hospital Maternity Hospital (Wasat Al Khamis) Ahad Raﬁdah General Hospital Namas General Hospital Ahli Hospital (Abha) King Abdallah Bin Abdul Aziz Hospital (Bisha) Asir Central Hospital (Abha) Sabt Alaya Hospital Asir Hospital NOS Sarat Obeidah General Hospital Dhahran Janoob Hospital Saudi German Hospital (Abha) Khamis Mushayt Civil Hospital Tathleeth General Hospital King Fahad Hosp, AFH (Khamis Mushayt) Unknown Asir Hospital King Fahad Hospital (Bisha) King Faisal Military Hospital Baha Region King Fahd Hospital (Baha) Baljurashi General Hospital Unknown Baha Hospital Eastern Province Abqaiq Health Center (ARAMCO) King Fahad Specialist Hospital (DM) Ahsa Hospital (Hofuf) King Khalid General Hospital Amal Hospital (DM) King Khalid Military Complex Anak General Hospital Mana General Hospital (Khobar) Arabian Oil Company (Khafji Joint Operations Hosp) Mana General Hospital (DM) ARAMCO Clinic Mana General Hospital (Hofuf) Armed Forces Hospital (Hafr Al batin) Mana General Hospital (Jubail) Astoon Hospital (Thomairy) Maternity & Children's Hospital Badr Rubaie Dispensary Maternity & Children's Hospital (Hofuf) Dammam Central Hospital Mousa Hospital (Hofuf) Dhahran Health Center (ARAMCO Hospital) Mouwasat Dispensary(DM) Dossary Hospital Mouwasat Hospital (DM) Dr Fakhry & Mouhawis Hospital Noor Khan Hospital (Hafr Batin) Eastern Province Hospital Obeid Hospital (Hofuf) Fanateer Hospital Prince Saud Bin Jalawi Hospital Faraby Dispensary Qatif Central Hospital General Security Hospital Qatif General Hospital Harbeesh Hospital (Hofuf) Ras Tanura Center (ARAMCO Clinic) Imam Abdul Rahman Bin Faisal NGHA (DM) Rowdha Dispensary Jubail General Hospital Saad Specialist Medical Center (Khobar) Jufer Hospital (Hofuf) Saddiq Hospital Khafji General Hospital Salama Hospital King Abdul Aziz Airbase Tadawy General Hospital King Abdul Aziz Navy Base Tapline Qaisuma Hospital King Abdul Aziz Port Clinic Unknown Eastern Province King Abdul Aziz (NGH) Hofuf Uyun Hospital (Ahsa) King Fahad Hospital of the University (Khobar) Yousif Hospital King Fahad Hospital (Hofuf) Zamil Hospital King Fahad Military Medical Complex (AFH) Hail Region Baqa Hospital King Khaled General Hospital Hail General Hospital Maternity & Children's Hospital (Hail) Hail Hospital NOS Unknown Hail Hospital Khaleej Female Clinic

SCRPart006.indd 90 30/05/2009 12:46:17 APPENDIX: A (continued...)

Jazan Region Abu Arish General Hospital King Fahd Central Hospital Aridah Hospital King Fahd Specialist Hospital Fayfa General Hospital Samtah General Hospital Jazan General Hospital Unknown Jazan Hospital Jazan Hospital NOS Jouf Region Dawamat Jandal Hospital Qurayat Psychiatric Hospital Jouf Hospital NOS Skaka General Hospital King Faisal Qurayyat Hospital Tabarjal General Hospital Prince Abd Rahman Sudairi Sakaka General Hospital Unknown Jouf Hospital Qurayat General Hospital Madinah Region Alborg Lab Mahd General Hospital Aneis Al Khair Lab Meeqat Hospital Ansar Hospital Mouwasat Hospital (Madinah) Badr General Hospital (Yanboa) Ohoud Hospital Dar Hospital Prince Abd Mohsen Ola General Hospital Dr Hamed Al Ahmadi Hospital Royal Commission Medical Center (Yanboa) Ees General Hospital (Yanboa) Salam Dispensary Hanakyah General Hospital Saudi German Hospital (MD) Ijlal Hospital (Tariq Bin Laden Hosp) Specialist Dental Center Khaybar General Hospital Tariq Bin Laden Hospital (Ijlal) King Fahad Hospital Unknown Madinah Hospital King Fahad Hospital Yanboa General Hospital Madina Hospital, NOS Zahra Private Hospital Madina National Hospital Zen Laboratory Madinah Maternity & Children's Hospital Makkah Region Abd Rahman Qari Center Elaj Laboratory (JD) Abuzinada Hospital Eye Hospital (JD) Adwani General Hospital (Taif) Hada Military Hospital (AFH) Ajiyad General Hospital (MK) Hai Jamea Hospital Alawi Tunsi & Bros Hospital Hamra Hospital AlBorg Lab (JD) Hayat Hospital (JD) AlBorg Lab (MK) Hera General Hospital (MK) Amen Hospital (Taif) Ibn Sina Hospital (MK) Ansar Hospital (JD) Jazerah Hospital (JD) Bugshan General Hospital (JD) Jedaani Hospital Central Hospital Jeddah General Hospital Dr Abd Rahman Bakhsh Hospital (MK) Khuramah Hospital Dr Abd Rahman Bakhsh Hosp, Mina'a(JD) (Dar Shifa Hosp) King Abdul Aziz Hospital & Onc CTR (JD) Dr Abd Rahman Bakhsh Hosp, Sharaﬁah (JD) King Abdul Aziz Hospital (Al Zaher) (MK) Dr Erfan & Bagedo Hospital King Abdul Aziz Specialist Hospital (Taif) Dr Ghassan Pharaon Hospital King Abdul Aziz University Hospital (JD) Dr Khalid Idriss Hospital King Fahad General Hospital Dr Siddiqa Maternity Hospital King Fahad, AFH (JD) Dr Solaiman Fakeeh Hospital King Fahd Air Base Hospital King Faisal (Al Sheshah) Hospital (MK) Rabegh General Hospital King Faisal Hospital (Taif) Raﬁe Hospital (MK) King Faisal Specialist Hospital & Research Center (JD) Ranyah Hospital

SCRPart006.indd 91 30/05/2009 12:46:17 APPENDIX: A (continued...)

Makkah Region continued ….. Maghraby Eye Hospital (JD) Royal Commission Medical Center (Yanboa) Makkah Hospital NOS Salamah Hospital Maternity & Children's Saudi German Hospital (JD) Maternity & Children's Hospital (JD) Saudi Hospital Maternity & Children's Hospital (Taif) Saudi Medical Services (JD) Muhammad Saleh Bashrahil Hospital (MK) Saudia Airlines Medical Services Mustaqbal Hospital (Dhagastani) Shaty Hospital Nahda National Hospital (Taif) Shefaa Medical Center New Jeddah Clinic Sheffaa Hospital New Jeddah Hospital Taif Chest Hospital Noor Specialist Hospital (MK) Taif Children's Hospital (Taif) Nourah Oncology Center (King AbdulAziz Med. City) (NGHAJ) Thagher Hospital Pioneers Laboratory Umm Qura Poly Clinic Quen Hospital United Doctors Hospital (Shaty Hosp) Qunfudah General Hospital Unknown Makkah Hospital Najran Region King Khaled Hospital (Najran) Sharourah Armed Forces Hospital (AFH) Najran Armed Forces Hospital Sharourah General Hospital Najran General Hospital Unknown Najran Hospital Najran Hospital NOS Northern Region Arar Central Hospital Turayf General Hospital Rafha General Hospital Qassim Region Bukairiya General Hospital Midhnab General Hospital Buraidah Central Hospital Rass General Hospital King Fahd Specialist Hospital (Buraidah) Unknown Qassim Region King Saud University Hospital (Onaizah) Maternity & Children's Hospital (Buraidah) Riyadh Region Abdullah Medical Clinic Dr Abdl Rahman Mishari Hospital Adama Hospital Dr Fahd Sheduokhy Polyclinic Advance Cell Laboratory Dr Moagel's Polyclinic AFH Millitary (RKH Program) Dr Mofarreh Polyclinic Aﬁf General Hospital Dr Suliman Habib MedicalCTR Aﬂaj General Hospital Elixir International Polyclinic AlBorg Lab (RY) Eman General Hospital Anda Medical Laboratory Faleh International Hospital (Al Ali General Hosp) Armed Forces Wadi Dawasir (AFH) Finger Print Laboratory Bustan Clinic Green Cresent Hospital Chest Diseases Hospital (King Saud) Gulf Radiology Center College of Dentistry KSU Hammadi Hospital Consulting Clinic Hariq General Hospital Consulting Radiologist & Diag. Center Hotta Bani Tammim Hospital Dallah Hospital How Medical Clinic Dawadmi General Hospital Howtat Sudair Hospital Delta Medical Laboratories Huraymila General Hospital Derma Hospital Ibn Sina Lab(RY) Jafel International Hospital Quwayiyah General Hospital Jazeera Laboratories Rathawiah Medical Specialized Center Jazeera Medical Clinic Rawabi Qurtuba Clinic

SCRPart006.indd 92 30/05/2009 12:46:18 APPENDIX: A (continued...)

Riyadh Region Continued…. King Abdul Aziz Medical City (NGH) (RY) Riyadh Medical Complex King Abdul Aziz University Hospital (RY) Saati Medical Center Clinic King Fahad Medical City Saudi German Hospital King Faisal Specialist Hospital & Research Centre Security Forces Hospital King Khaled Eye Specialist Hospital Shaqra General Hospital King Khaled General Hospital Shifa Health Center King Khaled International Airport Hospital Shifa Jazeera Polyclinic King Khaled University Hospital Specialized Medical Center Mamlaka Hospital (Kingdom) Sports Medicine Hospital Maternity & Children's Hospital (RY) Sughayyer Clinic Mobarak Hospital Sulail Hospital Mouwasat Hospital (Ry) Sulemaniya Children's Hospital Muzhamiyah General Hospital Ta'awoun 1 Polyclinic Nakaha Hospital (Convalescent) (RY) Taif Medical Center (RY) Nukhba Medical Center (Elite) Thadeq General Hospital (RY) Obeid Hospital(RY) Unknown Riyadh Hospital Olaya Medical Center Wadi Dawasser Hospital Osrah International Hospital Watan Clinic Prince Salman Bin Abdul Aziz Hospital Watani Hospital (Ry National) Riyadh Care Hospital (Social Insurance) Yamamah Hospital Riyadh Hospital NOS Zulﬁ General Hospital Tabuk Region Dhuba General Hospital Prince Fahad Bin Sultan Hospital (Tabuk) Haql General Hospital Tabuk Civil King Fahad Hospital (Tabuk) Tabuk Hospital NOS King Khalid General Hospital Umlujj General Hospital (Hawra) King Khalid Military Hospital Unknown Tabuk Hospital Maternity & Children's Hospital (Tabuk) Wajh General Hospital North West Armed Force Hospital International Hospitals in the Following Countries Austria Niger Bahrain Nigeria Bangladesh Pakistan Egypt Philippines Ethiopia Qatar France Sudan Germany Syrian Arab Republic India United Arab Emirates Indonesia United Kingdom Jordan United States of America Kuwait Unknown International Hospital Lebanon Yemen

SCRPart006.indd 93 30/05/2009 12:46:18 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 Registrar: Mohamed Hayder, CTR Tel: 01-442-3929 Epidemiologist: Haya Al Eid, BDS, DFE, CTR Fax: 01-442-3924 Data Manager: Suad O. Arteh, MA Email: [email protected] [email protected]

Armed Forces Hospitals Director: Rizqullah Assiri, MD Riyadh Military Hospital PO Box 7897, Riyadh 11159 Tel: 01-477-7714 x 6747 Fax: 01-477-6743 x 6743

Central Region Director: Dahish Ajarim, MD King Khalid University Hospital PO Box 2925, Riyadh 11461 Tel: 01-467-9488/2398 Fax: 01-467-9487

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: 03-869-6741

King Abdulaziz University Director: Prof. Mohmoud Shaheen Al Ahwal, MD Hospital Faculty of Medicine PO Box 80215, Jeddah 21589 Tel: 02-624-0000 x 18244/18253 Fax: 02-617-1412

King Faisal Specialist Hospital & Directors: Shouki Bazarbashi, MD Research Center Ali Al-Zahrani, MD, PhD MBC-64 PO Box 3354, Riyadh 11211 Tel: 01-442-3938, 464 -7272 x 24541

SCRPart006.indd 94 30/05/2009 12:46:18 APPENDIX: B Continued....

Madinah & Northern Region Director: Ahmed Tarawa, MD King Fahad Hospital Madinah Al Monawarah Tel: 04-486-1500 x 3760 Fax: 04-836-0951

National Guard Hospitals Director: Abdulwahab Andejani, MD King Abdulaziz Medical City (KKNGH) PO Box 9515, Jeddah 21423 Tel: 02-624-0000 x 4085/4086 Fax: 02-624-0000 x 7242

Security Forces Hospital Director: Abdulaziz Saleh Aba Hussein, MD PO Box 3643, Riyadh 11481 Tel: 01-477-4480 x 1193 Fax: 01-476-4757, 01-477-4480 x 3184

Southern Region Director: Abdul Rahman Al Shehri, MD King Khalid University PO Box 641, Abha Tel: 07-224-0711 / 224 -7800 x 118 Fax: 07-224-0964 / 224 -7570

Western Region Director: Hasnah Al Ghamdi, MD King Abdulaziz Hosp. & Oncology Center PO Box 31467, Jeddah 21497 Tel: 02-637-5555 x 2283/2200 Fax: 02-637-9811

Ministry of Health Representative: Mohammad Y. Saeedi, MD Kingdom of Saudi Arabia PO Box 335157, Riyadh 11314 Tel: 01-475-0426 x 201/202 Fax: 01-472-0428

Nasser Al Hamdan, Dep. Chairman 1992 - 2006

Edward De Vol, PhD Director January 2001 - April 2006

Hadir Meir, MD Director January 2001 - August 2005

Hassan Trabulsi, MD Director November 2001 - June 2007

SCRPart006.indd 95 30/05/2009 12:46:18 APPENDIX C : DATA REQUEST FORM

Saudi Cancer Registry �ﻟﺴﺠﻞ �ﻟﺴﻌﻮ�� ﻟﻸ�� Ministry of Health �� ﻟﺼﺤﺔ Kingdom of Saudi Arabia �ﳌﻤﻠﻜﺔ �ﻟﻌﺮﺑﻴﺔ �ﻟﺴﻌﻮ�ﻳﺔ

Request for data from the Saudi Cancer Registry All requests should be submitted to the attention of the Chairman of Directors, Saudi Cancer Registry, MCB 64, P.O. Box 3354, Riyadh 11211, Saudi Arabia, Fax: +966 1 442 3924

Name : Date Submitted : Department : Hospital : Telephone :

Information Requested: (Specify Patient Population, Time Period, Year/s, Anatomic Site/Histology, Staging information, Region, etc.)

Purpose of Request: (Specify Presentation at conference/meeting/publication, clinical/epidemiological study, personal information, etc.)

Collaborators and Co-authors:

Requesters afr mation statement: I hereby, the requester of the above data afrm that the data given to me by the SCR will be treated with utmost condentiality in relation to patient’s identity. I also afrm that the data given to me will not be presented or published by me or any of my collaborators as an original work but rather can be cited in my presentations and/or publication with acknowledgment of the SCR.

Requesters Signature Date

For Ofcial use only :

Request : Approved Denied

Chairman SCR Board of Directors Signature

Date

SCRPart006.indd 96 30/05/2009 12:46:20 APPENDIX D: Cancer Registration Abstract Form

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