Cancer Incidence in
Peninsular Malaysia 2003-2005
Edited by: Dr Gerard Lim Chin Chye Dr Sanjay Rampal Dato’ Dr Halimah Yahaya
National Cancer Registry
NATIONAL CANCER REGISTRY ACKNOWLEDGES GRANTS FROM:
Ministry of Health, Malaysia AND SUPPORT FROM:
Majlis Kanser Nasional National Cancer Council
Design & Printing by : Konsep Niaga (+603) 2148 6413
Cancer Incidence in Peninsular Malaysia, 2003-2005 The Third Report of the National Cancer Registry, Malaysia Edited by Gerard Lim Chin Chye Sanjay Rampal Halimah Yahaya
National Cancer Registry
Ministry of Health Malaysia
January 2008 Š National Cancer Registry, Malaysia
Published by: National Cancer Registry
This report is copyrighted. However it may be freely reproduced without the permission of NCR. Acknowledgment would be appreciated and the suggested citation is: GCC Lim, S Rampal, Y Halimah (Eds). Cancer Incidence in Peninsular Malaysia, 2003 - 2005. National Cancer Registry. Kuala Lumpur 2008. The National Cancer Registry report is also published electronically on: Jabatan Kesihatan Awam, MOH : http://www.cancer.gov.my MAKNA : http://www.makna.org.my College of Radiology, Academy of Medicine : http://www.radiologymalaysia.org College of Pathology, Academy of Medicine : http://www.acadmed.org.my Malaysian Oncological Society : http://www.malaysiaoncology.org
2003-2005
TABLE OF CONTENTS
Page
CONTENTS
i
CONTENTS
i
ABBREVIATIONS
xiii
FOREWORD BY THE MINISTER OF HEALTH, MALAYSIA
1
FOREWORD BY THE DIRECTOR GENERAL OF HEALTH, MALAYSIA
2
ACKNOWLEDGEMENTS
3
NATIONAL CANCER REGISTRY PARTICIPATING CENTRES
4
ADVISORY COMMITTEE
8
EXPERT PANEL
9
NATIONAL CANCER REGISTRY UNIT
14
EXECUTIVE SUMMARY
15
1.0
NATIONAL CANCER REGISTRY
19
1.1
Background
19
1.2
Objectives
19
1.3
Operations of the National Cancer Registry
19
1.4
Sponsors Of The NCR
20
2.0
3.0 4.0
5.0
MALAYSIA AND ITS POPULATION
21
2.1
Geography
21
2.2
Population Of Peninsular Malaysia
22
2.3
Infrastructure
23
2.4
Socioeconomic Status
23
2.5
Health Status and Facilities
24
METHODS
25
3.1
32
Evaluation of the Quality of NCR Data
CANCER INCIDENCE IN MALAYSIA 2003-2005
38
4.1
Overall Cancer Incidence
38
4.2
Cancer Incidence by Site
40
4.3
Cancer Incidence by Site, Ethnicity and Sex
43
4.4
Cancer Incidence by Site, Age and Sex
45
SELECTED CANCER SITES 2003-2005
61
5.1
TONGUE (ICDO: C01-C02)
61
5.2
SALIVARY GLAND (ICDO: C07-C08)
64
5.3
MOUTH (ICDO: C03-C06)
67
5.4
NASOPHARYNX (ICDO: C11)
71
5.5
OESOPHAGUS (ICDO: C15)
77
5.6
STOMACH (ICDO: C16)
80
5.7
LARGE BOWEL (ICDO: C18-C21)
83
5.8
LIVER (ICDO: C22)
87
5.9
GALLBLADDER (ICDO: C23-C24)
90
CONTENTS
i
2003-2005
TABLE OF CONTENTS
5.10
PANCREAS (ICDO: C25)
93
5.11
NOSE and SINUSES (ICDO: C30-C31)
99
5.12
LARYNX (ICDO: C32)
103
5.13
LUNG (ICDO: C33-C34)
106
5.14
BONE (ICDO: C40-C41)
111
5.15
OTHER SKIN
117
5.16
MELANOMA
120
5.17
FEMALE BREAST (ICDO: C50)
125
5.18
CERVIX UTERI (ICDO: C53)
131
5.19
CORPUS UTERI (ICDO: C54)
134
5.20
OVARY (ICDO: C56-C57)
137
5.21
PROSTATE (ICDO: C61)
143
5.22
BLADDER (ICDO: C67)
145
5.23
KIDNEY and OTHER URINARY ORGANS (ICDO: C64, C65, C66, C68)
148
5.24
BRAIN and OTHER NERVOUS SYSTEM (ICDO: C70-C72)
153
5.25
THYROID (ICDO: C73)
156
5.26
LYMPHOMA
161
5.26.1
Hodgkin’s Lymphoma
164
5.26.2
Non Hodgkin’s Lymphoma
166
5.27
LEUKAEMIA
171
5.27.1
Lymphatic Leukaemia
174
5.27.2
Myeloid Leukaemia
176
REFERENCES
ii
CONTENTS
Page
179
2003-2005
LIST OF TABLES
Page
Table 2.2.1:
Age, sex and ethnic distribution of the population of Peninsular Malaysia, 2004
23
Table 2.4.1:
Malaysia: Percentage Distribution of Employed Persons by Occupation
23
Table 2.5.1:
Perinatal, neonatal, infant and maternal mortality rate for Malaysia, 2004
24
Table 4.1.1:
Cancer Incidence per 100,000 population (CR) and Age-standardized incidence (ASR), by sex, Malaysia 2003-2005
38
Table 4.1.2:
Cancer Incidence per 100,000 population (CR) by age and sex, Peninsular Malaysia 2003-2005
38
Table 4.1.3:
Cancer Incidence per 100,000 population (CR) and Age-standardized incidence (ASR), by ethnicity and sex, Peninsular Malaysia 2003-2005
39
Table 4.1.4:
Age specific Cancer Incidence per 100,000 population, by ethnicity and sex, Peninsular Malaysia 2003-2005
39
Table 4.2.1:
Cancer Incidence per 100,000 population (CR) and Age-standardized incidence (ASR), by site and sex, Peninsular Malaysia 2003-2005
41
Table 5.1.1:
Tongue Cancer Incidence per 100,000 population (CR) and Agestandardized incidence (ASR), by sex and ethnicity, Peninsular Malaysia 2003-2005
61
Table 5.1.2:
Tongue Age specific Cancer Incidence per 100,000 population, by ethnicity and sex, Peninsular Malaysia 2003-2005
61
Table 5.1.3:
Number of Tongue cases by subsite, Peninsular Malaysia 2003-2005
62
Table 5.1.4:
Number (%) of Tongue cases by morphology, Peninsular Malaysia 20032005
62
Table 5.2.1:
Salivary Gland Cancer Incidence per 100,000 population (CR) and Agestandardized incidence (ASR), by sex and ethnicity, Peninsular Malaysia 2003-2005
64
Table 5.2.2:
Salivary Gland Age specific Cancer Incidence per 100,000 population, by ethnicity and sex, Peninsular Malaysia 2003-2005
64
Table 5.2.3:
Number (%) of Salivary Gland cases by morphology, Peninsular Malaysia 2003-2005
65
Table 5.2.4:
Number of Salivary Gland cases by subsite, Peninsular Malaysia 20032005
66
Table 5.3.1:
Mouth Cancer Incidence per 100,000 population (CR) and Agestandardized incidence (ASR), by sex and ethnicity, Peninsular Malaysia 2003-2005
67
Table 5.3.2:
Mouth Cancer Incidence per 100,000 population (CR) and Agestandardized incidence (ASR), by ethnicity and sex, Peninsular Malaysia 2003-2005
67
Table 5.3.3:
Number of Mouth cases by subsite, Peninsular Malaysia 2003-2005
68
Table 5.3.4:
Number (%) of Mouth cases by morphology, Peninsular Malaysia 20032005
69
CONTENTS
iii
2003-2005
LIST OF TABLES
iv
Page
Table 5.4.1:
Nasopharynx Cancer Incidence per 100,000 population (CR) and Agestandardized incidence (ASR), by sex and ethnicity, Peninsular Malaysia 2003-2005
71
Table 5.4.2:
Nasopharynx Age specific Cancer Incidence per 100,000 population, by ethnicity and sex, Peninsular Malaysia 2003-2005
71
Table 5.5.1:
Oesophagus Cancer Incidence per 100,000 population (CR) and Agestandardized incidence (ASR), by sex and ethnicity, Peninsular Malaysia 2003-2005
77
Table 5.5.2:
Oesophagus Age specific Cancer Incidence per 100,000 population, by ethnicity and sex, Peninsular Malaysia 2003-2005
77
Table 5.5.3:
Number of Oesophagus cases by subsite, Peninsular Malaysia 2003-2005
78
Table 5.5.4:
Number (%) of Oesophagus cases by morphology, Peninsular Malaysia 2003-2005
78
Table 5.6.1:
Stomach Cancer Incidence per 100,000 population (CR) and Agestandardized incidence (ASR), by sex and ethnicity, Peninsular Malaysia 2003-2005
80
Table 5.6.2:
Stomach Age specific Cancer Incidence per 100,000 population, by ethnicity and sex, Peninsular Malaysia 2003-2005
80
Table 5.6.3:
Number of Stomach cases by subsite, Peninsular Malaysia 2003-2005
81
Table 5.6.4:
Number (%) of Stomach cases by morphology, Peninsular Malaysia 20032005
81
Table 5.7.1:
Large Bowel Cancer Incidence per 100,000 population (CR) and Agestandardized incidence (ASR), by sex and ethnicity, Peninsular Malaysia 2003-2005
83
Table 5.7.2:
Large Bowel Age specific Cancer Incidence per 100,000 population, by ethnicity and sex, Peninsular Malaysia 2003-2005
83
Table 5.7.3:
Number of Large Bowel cases by subsite, Peninsular Malaysia 2003-2005
84
Table 5.7.4:
Number (%) of Large Bowel cases by morphology, Peninsular Malaysia 2003-2005
85
Table 5.8.1:
Liver Cancer Incidence per 100,000 population (CR) and Agestandardized incidence (ASR), by sex and ethnicity, Peninsular Malaysia 2003-2005
87
Table 5.8.2:
Liver Age specific Cancer Incidence per 100,000 population, by ethnicity and sex, Peninsular Malaysia 2003-2005
87
Table 5.8.3:
Number (%) of Liver cases by morphology, Peninsular Malaysia 20032005
88
Table 5.9.1:
Gallbladder Cancer Incidence per 100,000 population (CR) and Agestandardized incidence (ASR), by sex and ethnicity, Peninsular Malaysia 2003-2005
90
Table 5.9.2:
Gallbladder Age specific Cancer Incidence per 100,000 population, by ethnicity and sex, Peninsular Malaysia 2003-2005
90
Table 5.9.3:
Number of Gallbladder cases by subsite, Peninsular Malaysia 2003-2005
91
Table 5.9.4:
Number (%) of Gallbladder cases by morphology, Peninsular Malaysia 2003-2005
91
Table 5.10.1:
Pancreas Cancer Incidence per 100,000 population (CR) and Agestandardized incidence (ASR), by sex and ethnicity, Peninsular Malaysia 2003-2005
93
CONTENTS
2003-2005
LIST OF TABLES Table 5.10.2: Table 5.10.3: Table 5.10.2: Table 5.10.4: Table 5.10.3: Table 5.11.1: Table 5.10.4: Table5.11.2: 5.11.1: Table Table 5.11.3: Table 5.11.2: Table 5.11.4: Table 5.11.3: Table 5.12.1: Table 5.11.4: Table5.12.2: 5.12.1: Table Table 5.12.3: Table 5.12.2: Table 5.12.4: Table 5.12.3: Table 5.13.1: Table 5.12.4: Table5.13.2: 5.13.1: Table Table 5.13.3: Table 5.13.2: Table 5.13.4: Table 5.13.3: Table 5.14.1: Table 5.13.4: Table5.14.2: 5.14.1: Table Table 5.14.3: Table 5.14.2: Table 5.14.4: Table 5.14.3: Table 5.15.1: Table 5.14.4: Table5.15.2: 5.15.1: Table Table 5.15.3: Table 5.15.2: Table 5.15.4: Table 5.15.3: Table 5.15.4:
Pancreas Age specific Cancer Incidence per 100,000 population, by ethnicity and sex,LIST Peninsular 2003-2005 OF Malaysia TABLES
Number of Pancreas cases by subsite, Peninsular Malaysia 2003-2005 Pancreas Age specific Cancer Incidence per 100,000 population, by Number Pancreas cases by morphology, ethnicity(%) and of sex, Peninsular Malaysia 2003-2005 Peninsular Malaysia 2003-2005 Number of Pancreas cases by subsite, Peninsular Malaysia 2003-2005 Nose and Sinuses Cancer Incidence per 100,000 population (CR) and Number (%) of Pancreas Peninsular Malaysia Age-standardized incidence cases (ASR),bybymorphology, sex and ethnicity, Peninsular 2003-2005 Malaysia 2003-2005 Noseand and Sinuses Cancer Incidence per 100,000 population (CR) and Nose Sinuses Age specific Cancer Incidence per 100,000 population, Age-standardized incidence (ASR), by sex and ethnicity, Peninsular by ethnicity and sex, Peninsular Malaysia 2003-2005 Malaysia 2003-2005 Number of Nose and Sinuses cases by subsite, Peninsular Malaysia Nose and Sinuses Age specific Cancer Incidence per 100,000 population, 2003-2005 by ethnicity and sex, Peninsular Malaysia 2003-2005 Number (%) of Nose and Sinuses cases by morphology, Peninsular Number2003-2005 of Nose and Sinuses cases by subsite, Peninsular Malaysia Malaysia 2003-2005 Larynx Cancer Incidence per 100,000 population (CR) and AgeNumber (%)incidence of Nose(ASR), and Sinuses cases by morphology, Peninsular standardized by sex and ethnicity, Peninsular Malaysia Malaysia 2003-2005 2003-2005 LarynxAge Cancer per 100,000 population (CR)byand AgeLarynx specificIncidence Cancer Incidence per 100,000 population, ethnicity standardized incidence (ASR), by sex and ethnicity, Peninsular Malaysia and sex, Peninsular Malaysia 2003-2005 2003-2005 Number of Larynx cases by subsite, Peninsular Malaysia 2003-2005 Larynx Age specific Cancer Incidence per 100,000 population, by ethnicity Number of LarynxMalaysia cases by morphology, Peninsular Malaysia 2003and sex,(%) Peninsular 2003-2005 2005 Number of Larynx cases by subsite, Peninsular Malaysia 2003-2005 Lung Cancer Incidence per 100,000 population (CR) and AgeNumber (%)incidence of Larynx(ASR), cases by by sex morphology, Peninsular Malaysia 2003standardized and ethnicity, Peninsular Malaysia 2005 2003-2005 LungAge Cancer per 100,000 population (CR)byand AgeLung specificIncidence Cancer Incidence per 100,000 population, ethnicity standardized incidence (ASR), by sex and ethnicity, Peninsular Malaysia and sex, Peninsular Malaysia 2003-2005 2003-2005 Number of Lung cases by subsite, Peninsular Malaysia 2003-2005 Lung Age specific Cancer Incidence per 100,000 population, by ethnicity Number of Lung Malaysia cases by2003-2005 morphology, Peninsular Malaysia 2003and sex,(%) Peninsular 2005 Number of Lung cases by subsite, Peninsular Malaysia 2003-2005 Bone Cancer Incidence per 100,000 population (CR) and AgeNumber (%)incidence of Lung (ASR), cases by Peninsular Malaysia 2003standardized by morphology, sex and ethnicity, Peninsular Malaysia 2005 2003-2005 BoneAge Cancer per 100,000 population (CR)byand AgeBone specificIncidence Cancer Incidence per 100,000 population, ethnicity standardized incidence (ASR), by sex and ethnicity, Peninsular Malaysia and sex, Peninsular Malaysia 2003-2005 2003-2005 Number of Bone cases by subsite, Peninsular Malaysia 2003-2005 Bone Age specific Cancer Incidence per 100,000 population, by ethnicity Number of BoneMalaysia cases by2003-2005 morphology, Peninsular Malaysia 2003and sex,(%) Peninsular 2005 Number of Bone cases by subsite, Peninsular Malaysia 2003-2005 Other Skin Cancer Incidence per 100,000 population (CR) and AgeNumber (%)incidence of Bone (ASR), cases by Peninsular Malaysia 2003standardized by morphology, sex and ethnicity, Peninsular Malaysia 2005 2003-2005 OtherSkin SkinAge Cancer Incidence 100,000perpopulation (CR) and AgeOther specific Cancer per Incidence 100,000 population, by standardized incidence (ASR), by sex and ethnicity, Peninsular Malaysia ethnicity and sex, Peninsular Malaysia 2003-2005 2003-2005 Number of Other Skin cases by subsite, Peninsular Malaysia 2003-2005 Other Skin Age specific Cancer Incidence per 100,000 population, by Ten most and common of OtherMalaysia Skin cases by morphology, Peninsular ethnicity sex, Peninsular 2003-2005 Malaysia 2003-2005 Number of Other Skin cases by subsite, Peninsular Malaysia 2003-2005 Ten most common of Other Skin cases by morphology, Peninsular Malaysia 2003-2005 v v
Page 93 Page 94 93 94 94 99 94 9999 100 99 101 100 103 101 103 103 104 103 104 104 106 104 106 106 107 106 107 107 111 107 111 111 112 111 113 112 117 113 117 117 118 117 118 118 118
CONTENTS
2003-2005
LIST OF TABLES Table 5.16.1: Table5.16.2: 5.16.1: Table Table 5.16.3: Table 5.16.2: Table 5.17.1: Table 5.16.3: Table5.17.2: 5.17.1: Table Table 5.17.3: Table 5.17.2: Table 5.18.1: Table 5.17.3: Table5.18.2: 5.18.1: Table Table 5.18.3: Table 5.18.2: Table 5.19.1: Table 5.18.3: Table5.19.2: 5.19.1: Table Table 5.19.3: Table 5.19.2: Table 5.20.1: Table 5.19.3: Table5.20.2: 5.20.1: Table Table 5.20.3: Table 5.20.2: Table 5.21.1: Table 5.20.3: Table5.21.2: 5.21.1: Table Table 5.21.3: Table 5.21.2: Table 5.22.1: Table 5.21.3: Table5.22.2: 5.22.1: Table Table 5.22.2:
Melanoma Cancer Incidence per 100,000 population (CR) and Agestandardized incidence by sex and ethnicity, Peninsular Malaysia LIST (ASR), OF TABLES 2003-2005 MelanomaAge Cancer Incidence 100,000perpopulation and AgeMelanoma specific Cancer per Incidence 100,000 (CR) population, by standardized incidence (ASR), by sex and ethnicity, Peninsular Malaysia ethnicity and sex, Peninsular Malaysia 2003-2005 2003-2005 Number of Melanoma cases by subsite, Peninsular Malaysia 2003-2005 Melanoma Age specific Cancer Incidence per 100,000 population, by Female Breast Cancer Incidence per 100,000 population (CR) and Ageethnicity and sex, Peninsular Malaysia 2003-2005 standardized incidence (ASR), by ethnicity, Peninsular Malaysia 2003Number of Melanoma cases by subsite, Peninsular Malaysia 2003-2005 2005 FemaleBreast BreastAge Cancer Incidence 100,000 (CR) and AgeFemale specific Cancer per Incidence perpopulation 100,000 population, by standardized incidence (ASR), by ethnicity, Peninsular Malaysia 2003ethnicity, Peninsular Malaysia 2003-2005 2005 Number (%) of Female Breast cases by morphology, Peninsular Malaysia Female Breast Age specific Cancer Incidence per 100,000 population, by 2003-2005 ethnicity, Peninsular Malaysia 2003-2005 Cervix Uteri Cancer Incidence per 100,000 population (CR) and AgeNumber (%) incidence of Female (ASR), Breast cases by morphology, Peninsular standardized by ethnicity, Peninsular MalaysiaMalaysia 20032003-2005 2005 CervixUteri UteriAge Cancer Incidence 100,000perpopulation (CR) and AgeCervix specific Cancer per Incidence 100,000 population, by standardized incidence (ASR), by ethnicity, Peninsular Malaysia 2003ethnicity, Peninsular Malaysia 2003-2005 2005 Number (%) of Cervix Uteri cases by morphology (WHO), Peninsular Cervix Uteri Age specific Cancer Incidence per 100,000 population, by Malaysia 2003-2005 ethnicity, Peninsular Malaysia 2003-2005 Corpus Uteri Cancer Incidence per 100,000 population (CR) and AgeNumber (%)incidence of Cervix(ASR), Uteri cases by morphology Peninsular standardized by ethnicity, Peninsular(WHO), Malaysia 2003Malaysia 2003-2005 2005 CorpusUteri UteriAge Cancer Incidence 100,000perpopulation (CR) and AgeCorpus specific Cancer per Incidence 100,000 population, by standardized incidence (ASR), by ethnicity, Peninsular Malaysia 2003ethnicity, Peninsular Malaysia 2003-2005 2005 Number (%) of Corpus Uteri cases by morphology (WHO), Peninsular Corpus 2003-2005 Uteri Age specific Cancer Incidence per 100,000 population, by Malaysia ethnicity, Peninsular Malaysia 2003-2005 Ovary Cancer Incidence per 100,000 population (CR) and AgeNumber (%)incidence of Corpus(ASR), Uteri cases by morphology Peninsular standardized by ethnicity, Peninsular(WHO), Malaysia 2003Malaysia 2003-2005 2005 OvaryAgeCancer per 100,000 population (CR) and AgeOvary specificIncidence Cancer Incidence per 100,000 population, by ethnicity, standardized incidence (ASR), by ethnicity, Peninsular Malaysia 2003Peninsular Malaysia 2003-2005 2005 Number (%) of Ovary cases by morphology (WHO), Peninsular Malaysia Ovary Age specific Cancer Incidence per 100,000 population, by ethnicity, 2003-2005 Peninsular Malaysia 2003-2005 Prostate Cancer Incidence per 100,000 population (CR) and AgeNumber (%) incidence of Ovary cases (WHO), Peninsular standardized (ASR),bybymorphology ethnicity, Peninsular MalaysiaMalaysia 20032003-2005 2005 Prostate Age Cancer Incidence 100,000per population and AgeProstate specific Cancerper Incidence 100,000 (CR) population, by standardized incidence (ASR), by ethnicity, Peninsular Malaysia 2003ethnicity, Peninsular Malaysia 2003-2005 2005 Number (%) of Prostate cases by morphology, Peninsular Malaysia 2003Prostate Age specific Cancer Incidence per 100,000 population, by 2005 ethnicity, Peninsular Malaysia 2003-2005 Bladder Cancer Incidence per 100,000 population (CR) and AgeNumber (%)incidence of Prostate casesby bysex morphology, Peninsular Malaysia 2003standardized (ASR), and ethnicity, Peninsular Malaysia 2005 2003-2005 Bladder Age Cancer Incidence 100,000per population and AgeBladder specific Cancerper Incidence 100,000 (CR) population, by standardized incidence (ASR), by sex and ethnicity, Peninsular Malaysia ethnicity and sex, Peninsular Malaysia 2003-2005 2003-2005
120 Page
Bladder Age specific Cancer Incidence per 100,000 population, by ethnicity and sex, Peninsular Malaysia 2003-2005
145
vi vi
CONTENTS
Page
vi
120 120 121 120 125 121 125 125 126 125 131 126 131 131 132 131 134 132 134 134 135 134 137 135 137 137 139 137 143 139 143 143 144 143 145 144 145 145
2003-2005
LIST OF TABLES Table 5.22.3: Table 5.23.1: Table 5.22.3: Table 5.23.1: Table 5.23.2: Table 5.23.3: Table 5.23.2: Table 5.23.4: Table 5.23.3: Table 5.24.1: Table 5.23.4: Table 5.24.1: Table 5.24.2: Table 5.24.3: Table 5.24.2: Table 5.24.4: Table 5.24.3: Table 5.25.1: Table 5.24.4: Table 5.25.1: Table 5.25.2: Table 5.25.3: Table 5.25.2: Table 5.26.1: Table 5.25.3: Table 5.26.1: Table 5.26.2: Table 5.26.3: Table 5.26.2: Table 5.26.4: Table 5.26.3: Table 5.26.1.1: Table 5.26.4: Table 5.26.1.1: Table 5.26.1.2: Table 5.26.2.1: Table 5.26.1.2: Table 5.26.2.1: Table 5.26.2.2: Table 5.26.2.2:
Number (%) of Bladder cases by morphology, Peninsular Malaysia 20032005 LIST OF TABLES
Page 146 Page
Kidney and Other Urinary Organs Cancer Incidence per 100,000 Number (%) of Bladder cases by morphology, Peninsular Malaysia 2003population (CR) and Age-standardized incidence (ASR), by sex and 2005 ethnicity, Peninsular Malaysia 2003-2005 Kidney and Other Urinary Organs Cancer Incidence per 100,000 Kidney and Other Urinary Organs Age specific Cancer Incidence per population (CR) and Age-standardized incidence (ASR), by sex and 100,000 population, by ethnicity and sex, Peninsular Malaysia 2003-2005 ethnicity, Peninsular Malaysia 2003-2005 Number of Kidney and Other Urinary Organs cases by subsite, Peninsular Kidney and Other Urinary Organs Age specific Cancer Incidence per Malaysia 2003-2005 100,000 population, by ethnicity and sex, Peninsular Malaysia 2003-2005 Number (%) of Kidney and Other Urinary Organs cases by morphology, Number of Kidney and Other Urinary Organs cases by subsite, Peninsular Peninsular Malaysia 2003-2005 Malaysia 2003-2005 Brain and Other Nervous System Cancer Incidence per 100,000 Number (%) of Kidney and Other Urinary Organs cases by morphology, population (CR) and Age-standardized incidence (ASR), by sex and Peninsular Malaysia 2003-2005 ethnicity, Peninsular Malaysia 2003-2005 Brain and Other Nervous System Cancer Incidence per 100,000 Brain and Other Nervous System Age specific Cancer Incidence per population (CR) and Age-standardized incidence (ASR), by sex and 100,000 population, by ethnicity and sex, Peninsular Malaysia 2003-2005 ethnicity, Peninsular Malaysia 2003-2005 Number of Brain and Other Nervous System cases by subsite, Peninsular Brain and Other Nervous System Age specific Cancer Incidence per Malaysia 2003-2005 100,000 population, by ethnicity and sex, Peninsular Malaysia 2003-2005 Number (%) of Brain and Other Nervous System cases by morphology, Number of Brain and Other Nervous System cases by subsite, Peninsular Peninsular Malaysia 2003-2005 Malaysia 2003-2005 Thyroid Cancer Incidence per 100,000 population (CR) and AgeNumber (%) of Brain and Other Nervous System cases by morphology, standardized incidence (ASR), by sex and ethnicity, Peninsular Malaysia Peninsular Malaysia 2003-2005 2003-2005 Thyroid Cancer Incidence per 100,000 population (CR) and AgeThyroid Age specific Cancer Incidence per 100,000 population, by standardized incidence (ASR), by sex and ethnicity, Peninsular Malaysia ethnicity and sex, Peninsular Malaysia 2003-2005 2003-2005 Number (%) of Thyroid cases by morphology, Peninsular Malaysia 2003Thyroid Age specific Cancer Incidence per 100,000 population, by 2005 ethnicity and sex, Peninsular Malaysia 2003-2005 Lymphoma Cancer Incidence per 100,000 population (CR) and AgeNumber (%) of Thyroid cases by morphology, Peninsular Malaysia 2003standardized incidence (ASR), by sex and ethnicity, Peninsular Malaysia 2005 2003-2005 Lymphoma Cancer Incidence per 100,000 population (CR) and AgeLymphoma Age specific Cancer Incidence per 100,000 population, by standardized incidence (ASR), by sex and ethnicity, Peninsular Malaysia ethnicity and sex, Peninsular Malaysia 2003-2005 2003-2005 Number of Lymphoma cases by subsite, Peninsular Malaysia 2003-2005 Lymphoma Age specific Cancer Incidence per 100,000 population, by ethnicity Peninsular cases Malaysia Number and (%) sex, of Lymphoma by 2003-2005 morphology, Peninsular Malaysia 2003-2005 Number of Lymphoma cases by subsite, Peninsular Malaysia 2003-2005 Hodgkin Lymphoma Cancer Incidence per 100,000 population (CR) and Number (%) of Lymphoma cases by morphology, Peninsular Malaysia Age-standardized incidence (ASR), by sex and ethnicity, Peninsular 2003-2005 Malaysia 2003-2005 Hodgkin Lymphoma Cancer Incidence per 100,000 population (CR) and Hodgkin Lymphoma Age specific Cancer Incidence per 100,000 Age-standardized incidence (ASR), by sex and ethnicity, Peninsular population (CR) by sex, Peninsular Malaysia 2003-2005 Malaysia 2003-2005 Non Hodgkin Lymphoma Cancer Incidence per 100,000 population (CR) Hodgkin Lymphoma Age specific Cancer Incidence per 100,000 and Age-standardized incidence (ASR), by sex and ethnicity, Peninsular population (CR) by sex, Peninsular Malaysia 2003-2005 Malaysia 2003-2005 Non Hodgkin Lymphoma Cancer Incidence per 100,000 population (CR) Non Hodgkin Lymphoma Age specific Cancer Incidence per 100,000 and Age-standardized incidence (ASR), by sex and ethnicity, Peninsular population (CR) by sex, Peninsular Malaysia 2003-2005 Malaysia 2003-2005
148 146
Non Hodgkin Lymphoma Age specific Cancer Incidence per 100,000 population (CR) by sex, Peninsular Malaysia 2003-2005
166
148 148 149 148 149 149 153 149 153 153 154 153 154 154 156 154 156 156 157 156 161 157 161 161 162 161 163 162 164 163 164 164 166 164 166 166
vii vii
CONTENTS
vii
2003-2005
LIST OF TABLES Table 5.27.1: Table Table 5.27.1: 5.27.2: Table 5.27.1.1: Table 5.27.2: Table Table 5.27.1.1: 5.27.1.2: Table 5.27.2.1: Table 5.27.1.2: Table Table 5.27.2.1: 5.27.2.2: Table 5.27.2.2:
Leukaemia Cancer Incidence per 100,000 population (CR) and Agestandardized incidence (ASR), by sex and ethnicity, Peninsular Malaysia LIST OF TABLES 2003-2005 Leukaemia Cancer Incidence perIncidence 100,000 per population and AgeLeukaemia Age specific Cancer 100,000(CR) population, by standardized incidence (ASR), by sex and ethnicity, Peninsular Malaysia ethnicity and sex, Peninsular Malaysia 2003-2005 2003-2005 Lymphatic Leukaemia Cancer Incidence per 100,000 population (CR) and Leukaemia Age specific Cancer Incidence 100,000 population, by Age-standardized incidence (ASR), by sexper and ethnicity, Peninsular ethnicity and sex, Peninsular Malaysia 2003-2005 Malaysia 2003-2005 Lymphatic per 100,000 population and Lymphatic Leukaemia LeukaemiaCancer Age Incidence specific Cancer Incidence per (CR) 100,000 Age-standardized incidence (ASR), by sex and ethnicity, population, by ethnicity and sex, Peninsular Malaysia 2003-2005Peninsular Malaysia 2003-2005 Myeloid Leukaemia Cancer Incidence per 100,000 population (CR) and Lymphatic Leukaemia Age (ASR), specific byCancer Incidence 100,000 Age-standardized incidence sex and ethnicity,perPeninsular population, by ethnicity and sex, Peninsular Malaysia 2003-2005 Malaysia 2003-2005 Myeloid per 100,000 population and Myeloid Leukaemia LeukaemiaCancer Age Incidence specific Cancer Incidence per (CR) 100,000 Age-standardized incidence (ASR), by sex and ethnicity, Peninsular population, by ethnicity and sex, Peninsular Malaysia 2003-2005 Malaysia 2003-2005
171 Page
Myeloid Leukaemia Age specific Cancer Incidence per 100,000 population, by ethnicity and sex, Peninsular Malaysia 2003-2005
176
viii viii
CONTENTS
Page
viii
171 171 174 171 174 174 176 174 176 176
2003-2005
LIST OF FIGURES
Page
Figure 2.2.1:
Age and sex distribution of the population of Peninsular Malaysia 2004
22
Figure 2.2.2:
Ethnicity in Peninsular Malaysia, 2004
22
Figure 2.5.1:
Most common causes of death in Malaysia government hospitals, 20032005
24
Figure 3.1:
Flow Chart for Overall Operations of the NCR
25
Figure 3.2:
Flow Chart for Receiving data
27
Figure 3.3:
Flow Chart for Data Management Process
28
Figure 4.2:
Ten most frequent cancers, Peninsular Malaysia 2003-2005
40
Figure 4.2.1(a):
Ten most frequent cancers in males, Peninsular Malaysia 2003-2005
40
Figure 4.2.1(b):
Ten most frequent cancers in females, Peninsular Malaysia 2003-2005
40
Figure 4.3.1(a):
Ten most frequent cancers in males by ethnic groups, Peninsular Malaysia 2003-2005
43
Figure 4.3.1(b):
Ten most frequent cancers in females by ethnic groups, Peninsular Malaysia 2003-2005
44
Figure 4.4.1(a):
Ten most frequent cancers in males by age groups, Peninsular Malaysia 2003-2005
45
Figure 4.4.1(b):
Ten most frequent cancers in females by age groups, Peninsular Malaysia 2003-2005
46
Figure 5.1.1:
Tongue Age specific Cancer Incidence per 100,000 population by sex, Peninsular Malaysia 2003-2005
62
Figure 5.1.2:
Tongue International comparisons – Age-standardized Incidence per 100,000 population by sex, Peninsular Malaysia 2003-2005
63
Figure 5.2.1:
Salivary Gland Age specific Cancer Incidence per 100,000 population by sex, Peninsular Malaysia 2003-2005
65
Figure 5.2.2:
Salivary Gland International comparisons – Age-standardized Incidence per 100,000 population by sex, Peninsular Malaysia 2003-2005
66
Figure 5.3.1:
Mouth Age specific Cancer Incidence per 100,000 population by sex, Peninsular Malaysia 2003-2005
68
Figure 5.3.2:
Mouth International comparisons – Age-standardized Incidence per 100,000 population by sex, Peninsular Malaysia 2003-2005
70
Figure 5.4.1:
Nasopharynx Age specific Cancer Incidence per 100,000 population by sex, Peninsular Malaysia 2003-2005
72
Figure 5.4.2:
Nasopharynx International comparisons – Age-standardized Incidence per 100,000 population by sex, Peninsular Malaysia 2003-2005
73
Figure 5.5.1:
Oesophagus Age specific Cancer Incidence per 100,000 population by sex, Peninsular Malaysia 2003-2005
78
Figure 5.5.2:
Oesophagus International comparisons – Age-standardized Incidence per 100,000 population by sex, Peninsular Malaysia 2003-2005
79
Figure 5.6.1:
Stomach Age specific Cancer Incidence per 100,000 population by sex, Peninsular Malaysia 2003-2005
81
Figure 5.6.2:
Stomach International comparisons – Age-standardized Incidence per 100,000 population by sex, Peninsular Malaysia 2003-2005
82
Figure 5.7.1:
Large Bowel Age specific Cancer Incidence per 100,000 population by sex, Peninsular Malaysia 2003-2005
84
CONTENTS
ix
2003-2005
LIST OF FIGURES
x
Page
Figure 5.7.2:
Large Bowel International comparisons – Age-standardized Incidence per 100,000 population by sex, Peninsular Malaysia 2003-2005
86
Figure 5.8.1:
Liver Age specific Cancer Incidence per 100,000 population by sex, Peninsular Malaysia 2003-2005
88
Figure 5.8.2:
Liver International comparisons – Age-standardized Incidence per 100,000 population by sex, Peninsular Malaysia 2003-2005
89
Figure 5.9.1:
Gallbladder Age specific Cancer Incidence per 100,000 population by sex, Peninsular Malaysia 2003-2005
91
Figure 5.9.2:
Gallbladder International comparisons – Age-standardized Incidence per 100,000 population by sex, Peninsular Malaysia 2003-2005
92
Figure 5.10.1:
Pancreas Age specific Cancer Incidence per 100,000 population by sex, Peninsular Malaysia 2003-2005
94
Figure 5.10.2:
Pancreas International comparisons – Age-standardized Incidence per 100,000 population by sex, Peninsular Malaysia 2003-2005
95
Figure 5.11.1:
Nose and Sinuses Age specific Cancer Incidence per 100,000 population by sex, Peninsular Malaysia 2003-2005
100
Figure 5.11.2:
Nose and Sinuses International comparisons – Age-standardized Incidence per 100,000 population by sex, Peninsular Malaysia 2003-2005
102
Figure 5.12.1:
Larynx Age specific Cancer Incidence per 100,000 population by sex, Peninsular Malaysia 2003-2005
104
Figure 5.12.2:
Larynx International comparisons – Age-standardized Incidence per 100,000 population by sex, Peninsular Malaysia 2003-2005
105
Figure 5.13.1:
Lung Age specific Cancer Incidence per 100,000 population by sex, Peninsular Malaysia 2003-2005
107
Figure 5.13.2:
Lung International comparisons – Age-standardized Incidence per 100,000 population by sex, Peninsular Malaysia 2003-2005
108
Figure 5.14.1:
Bone Age specific Cancer Incidence per 100,000 population by sex, Peninsular Malaysia 2003-2005
112
Figure 5.14.2:
Bone International comparisons – Age-standardized Incidence per 100,000 population by sex, Peninsular Malaysia 2003-2005
114
Figure 5.15.1:
Other Skin Age specific Cancer Incidence per 100,000 population by sex, Peninsular Malaysia 2003-2005
118
Figure 5.15.2:
Other Skin International comparisons – Age-standardized Incidence per 100,000 population by sex, Peninsular Malaysia 2003-2005
119
Figure 5.16.1:
Melanoma Age specific Cancer Incidence per 100,000 population by sex, Peninsular Malaysia 2003-2005
121
Figure 5.16.2:
Melanoma International comparisons – Age-standardized Incidence per 100,000 population by sex, Peninsular Malaysia 2003-2005
122
Figure 5.17.1:
Female Breast Age specific Cancer Incidence per 100,000 population, Peninsular Malaysia 2003-2005
127
Figure 5.17.2:
Female Breast International comparisons – Age-standardized Incidence per 100,000 population by sex, Peninsular Malaysia 2003-2005
127
Figure 5.18.1:
Cervix Uteri Age specific Cancer Incidence per 100,000 population, Peninsular Malaysia 2003-2005
132
Figure 5.18.2:
Cervix Uteri International comparisons – Age-standardized Incidence per 100,000 population by sex, Peninsular Malaysia 2003-2005
133
CONTENTS
2003-2005
LIST OF FIGURES Figure 5.19.1: Figure 5.19.2: Figure 5.19.1: Figure 5.20.1: Figure 5.19.2: Figure 5.20.2: Figure 5.20.1: Figure 5.21.1: Figure 5.20.2: Figure 5.21.2: Figure 5.21.1: Figure 5.22.1: Figure 5.21.2: Figure 5.22.2: Figure 5.22.1: Figure 5.23.1: Figure 5.22.2: Figure 5.23.2: Figure 5.23.1: Figure Figure 5.23.2: 5.24.1: Figure 5.24.2: Figure 5.24.1: Figure Figure 5.24.2: 5.25.1: Figure 5.25.2: Figure 5.25.1: Figure 5.26.1: Figure 5.25.2: Figure 5.26.1.1: Figure 5.26.1: Figure 5.26.1.2: Figure 5.26.1.1: Figure Figure 5.26.1.2: 5.26.2.1: Figure 5.26.2.2: Figure 5.26.2.1: Figure Figure:5.26.2.2: 5.27.1 Figure: 5.27.2 Figure: 5.27.1 Figure: 5.27.2
Corpus Uteri Age specific Cancer Incidence per 100,000 population, Peninsular Malaysia 2003-2005 LIST OF FIGURES
Page 135 Page
Corpus Uteri International comparisons – Age-standardized Incidence Corpus Uteripopulation Age specific Cancer Incidence per 2003-2005 100,000 population, per 100,000 by sex, Peninsular Malaysia Peninsular Malaysia 2003-2005 Ovary Age specific Cancer Incidence per 100,000 population, Peninsular Corpus International comparisons – Age-standardized Incidence MalaysiaUteri 2003-2005 per 100,000 population by sex, Peninsular Malaysia 2003-2005 Ovary International comparisons – Age-standardized Incidence per Ovary Age specific Cancer Incidence per 100,000 population, Peninsular 100,000 population by sex, Peninsular Malaysia 2003-2005 Malaysia 2003-2005 Prostate Age specific Cancer Incidence per 100,000 population, Ovary International comparisons – Age-standardized Incidence per Peninsular Malaysia 2003-2005 100,000 population by sex, Peninsular Malaysia 2003-2005 Prostate International comparisons – Age-standardized Incidence per Prostate Age specific Incidence 100,000 population, 100,000 population by sex,Cancer Peninsular Malaysiaper 2003-2005 Peninsular Malaysia 2003-2005 Bladder Age specific Cancer Incidence per 100,000 population by sex, Prostate comparisons – Age-standardized Incidence per PeninsularInternational Malaysia 2003-2005 100,000 population by sex, Peninsular Malaysia 2003-2005 Bladder International comparisons – Age-standardized Incidence per Bladder specific Incidence per 100,000 population by sex, 100,000 Age population byCancer sex, Peninsular Malaysia 2003-2005 Peninsular Malaysia 2003-2005 Kidney and Other Urinary Organs Age specific Cancer Incidence per Bladder International comparisons – Malaysia Age-standardized 100,000 population by sex, Peninsular 2003-2005Incidence per 100,000 population by sex, Peninsular Malaysia 2003-2005 Kidney and Other Urinary Organs Age specific Cancer Incidence per Kidney Other Urinary Organsand Agesex, specific CancerMalaysia Incidence per 100,000and population, by ethnicity Peninsular 2003100,000 population by sex, Peninsular Malaysia 2003-2005 2005 Kidneyand andOther OtherNervous Urinary System Organs Age Age specific specific Cancer Cancer Incidence Incidence per Brain per 100,000 population,byby ethnicity and Malaysia sex, Peninsular Malaysia 2003100,000 population sex, Peninsular 2003-2005 2005 Brain and Other Nervous System International comparisons – AgeBrain and Other Nervousper System Agepopulation specific Cancer Incidence per standardized Incidence 100,000 by sex, Peninsular 100,000 Malaysiapopulation 2003-2005by sex, Peninsular Malaysia 2003-2005
136 135
Brain Nervous International comparisons – AgeThyroidand AgeOther specific CancerSystem Incidence per 100,000 population by sex, standardized Incidence per 100,000 population by sex, Peninsular Peninsular Malaysia 2003-2005 Malaysia 2003-2005 Thyroid International comparisons – Age-standardized Incidence per Thyroid specific IncidenceMalaysia per 100,000 population by sex, 100,000 Age population byCancer sex, Peninsular 2003-2005 Peninsular Malaysia 2003-2005 Lymphoma Age specific Cancer Incidence per 100,000 population by Thyroid International comparisons sex, Peninsular Malaysia 2003-2005 – Age-standardized Incidence per 100,000 population by sex, Peninsular Malaysia 2003-2005 Hodgkin Lymphoma Age specific Cancer Incidence per 100,000 Lymphoma Cancer Incidence per 100,000 population by population byAge sex,specific Peninsular Malaysia 2003-2005 sex, Peninsular Malaysia 2003-2005 Hodgkin Lymphoma International comparisons – Age-standardized Hodgkin specificby Cancer IncidenceMalaysia per 100,000 Incidence Lymphoma per 100,000Age population sex, Peninsular 2003population by sex, Peninsular Malaysia 2003-2005 2005 Hodgkin Lymphoma International comparisons – Age-standardized Non Hodgkin Lymphoma Age specific Cancer Incidence per 100,000 Incidence per 100,000 population by sex, Peninsular Malaysia 2003population by sex, Peninsular Malaysia 2003-2005 2005 Non Hodgkin Lymphoma International comparisons – Age-standardized Non Hodgkin Age specific Cancer Incidence per 100,000 Incidence per Lymphoma 100,000 population by sex, Peninsular Malaysia 2003population by sex, Peninsular Malaysia 2003-2005 2005 Non Hodgkin Lymphoma International comparisons – Age-standardized Leukaemia Age specific Cancer Incidence per 100,000 population by Incidence per 100,000 population by sex, Peninsular Malaysia 2003sex, Peninsular Malaysia 2003-2005 2005 Leukaemia International comparisons – Age-standardized Incidence per Leukaemia Age specific Cancer Incidence per 2003-2005 100,000 population by 100,000 population by sex, Peninsular Malaysia sex, Peninsular Malaysia 2003-2005
155 157
Leukaemia International comparisons – Age-standardized Incidence per 100,000 population by sex, Peninsular Malaysia 2003-2005
173
138 136 138 138 144 138 144 144 146 144 147 146 150 147 150 150 150 155 155 155
158 157 162 158 164 162 165 164 165 166 167 166 167 172 173 172
xi xi
CONTENTS
xi
2003-2005
LIST OF FIGURES Figure 5.27.1.1: Figure: 2.27.1.2: Figure 5.27.1.1: Figure: 2.27.1.2: Figure 5.27.2.1: Figure: 2.27.2.2: Figure 5.27.2.1: Figure: 2.27.2.2:
Lymphatic Leukaemia Age specific Cancer Incidence per 100,000 population byLIST sex, Peninsular Malaysia 2003-2005 OF FIGURES
Lymphoid Leukaemia International comparisons – Age-standardized Lymphatic Leukaemia specific IncidenceMalaysia per 100,000 Incidence per 100,000 Age population by Cancer sex, Peninsular 2003population by sex, Peninsular Malaysia 2003-2005 2005 Lymphoid Leukaemia Age International – Age-standardized Myeloid Leukaemia specific comparisons Cancer Incidence per 100,000 Incidence per 100,000 population by sex, Peninsular Malaysia 2003population by sex, Peninsular Malaysia 2003-2005 2005 Myeloid Leukaemia International comparisons – Age-standardized Myeloid specific Cancer Incidence per 100,000 Incidence Leukaemia per 100,000Age population by sex, Peninsular Malaysia 2003population by sex, Peninsular Malaysia 2003-2005 2005 Myeloid Leukaemia International comparisons – Age-standardized Incidence per 100,000 population by sex, Peninsular Malaysia 20032005
xii xii
CONTENTS
xii
Page 175 Page 175 175 175 177 178 177 178
2003-2005
Abbreviations Abbreviations
ASR ASR CR CR
CRC CRC CRU CRU
CumR CumR HMIS HMIS IACR IACR IARC IARC IC IC ICD ICD
ICD ICD -10 -10 ICD-O ICD-O MOH MOH NCR NCR QC QC SDP SDP
SOP SOP USA USA
WHO WHO NSCLC NSCLC
Age-standardized Age-standardized Incidence Incidence Rate Rate Crude Incidence Incidence Rate Rate Crude Clinical Clinical Research Research Centre Centre Cancer Registry Unit Cancer Registry Unit Cumulative Cumulative Risk Risk Hospital Management Hospital Management Information Information System System International International International International
Association Association of of Cancer Cancer Registry Registry Agency Agency for for Cancer Cancer Research Research
Identification Identification Card Card International Classification International Classification of of Disease, Disease, WHO WHO International International International International
th
th Classification Edition Classification of of Diseases Diseases 10 10 Edition Classification of Disease for Oncology, Classification of Disease for Oncology, WHO WHO
Ministry Ministry of of Health, Health, Malaysia Malaysia National Cancer Registry National Cancer Registry Quality Quality Control Control Source Source Data Data Provider Provider or or Producer Producer Standard Standard Operating Operating Procedure Procedure United States of America United States of America World World Health Health Organization Organization Non Small Cell Non Small Cell Lung Lung Carcinoma Carcinoma
xiii xiii ABBREVIATIONS
xiii
2003-2005
xiv
2003-2005
FOREWORD BY THE MINISTER OF HEALTH, MALAYSIA
1
2003-2005
2
FOREWORD BY THE DIRECTOR GENERAL OF HEALTH, MALAYSIA
2003-2005
ACKNOWLEDGEMENTS
2003-2005
NATIONAL CANCER REGISTRY PARTICIPATING CENTRES
2003-2005
NATIONAL CANCER REGISTRY PARTICIPATING CENTRES
2003-2005
NATIONAL CANCER REGISTRY PARTICIPATING CENTRES
2003-2005
NATIONAL CANCER REGISTRY PARTICIPATING CENTRES
2003-2005
ADVISORY COMMITTEE
2003-2005
EXPERT PANEL
2003-2005
10
EXPERT PANEL
2003-2005
EXPERT PANEL
11
2003-2005
12
EXPERT PANEL
2003-2005
EXPERT PANEL
13
2003-2005
14
NATIONAL CANCER REGISTRY UNIT
2003-2005
TheThirdReportoftheNCRdescribesthemorbidityburdenofcancerfrom1stJanuary2003to31st December2005.Thisreportismainlyadescriptivereportofthedatacollectedfortheaboveperiod togetherwithadetailedanalysisoftopographyandmorphology,interpretationandcomparisonofthe saiddata. In 2003, 2004 and 2005, NCRreceived 42,963, 48,549 and 46,048 notifications respectively from various hospitals, laboratories and clinics, both public and private, making a total of 137,560 notifications. This report includes 75,735 incident cases from the whole of Malaysia with 67,792 incidentcasesreportedfromPeninsularMalaysia. This report has the advantage of a large source population that produces precise incidence estimates.Asummaryofthedataforthewholecountry(PeninsularandEastMalaysia)ispresented inTable4.1.1.However,thedetailedanalysisis presentedforPeninsularMalaysia.Welimitedthe presentation of the detailed analyses, as the ascertainment rate for Peninsular is more confidently determined. The information derived from this report is representative of the cancer burden to MalaysianslivinginPeninsularMalaysia. In this report, comparisons between groups within and outside the country were based on Age SpecificRatesinordertoovercomethepossibleextraneouseffectofdifferencesinagecomposition ofthevariousgroups. Female breast cancer is presented on its own as in previous reports while noting that male breast cancer contributed a further 257 cases. The figures for bone cancer, liver cancer and brain cancer werecomparabletointernationalfigures,thusreflectingthequalityoftheexpertinput,asmetastases tothesesiteswereconsciouslyexcludedfrombeingreportedasprimarytumoursfromthesesites. The main contributors of the data, the Source Data Providers (SDP) has increased over the years. ThetotalnumberofactiveSDPsincreasedfrom141in2002to193in2005.However,somecancers may still be underreported even though the numbers of SDPs had been increased to include radiologists,chestphysicians,surgeons,gastroenterologists. A total of 67,792 new cancers cases were diagnosed among Malaysians in Peninsular Malaysia in the years 2003 2005, comprising 29,596 males (43.7%) and 38,196 females (56.3%). The annual cruderateformaleswas100.2per100,000populationand132.1per100,000forfemales;whereas the age standardized incidence rate for all cancers was 136.9 per 100,000 males, and 156.4 per 100,000females. In comparison with the second NCR report for 2003, the figures for this report were similar. For instance,ethnicvariationsweresimilartotheNCRSecondReport2003.Overall,thisreportshowed thattheChinesepopulationhadthehighestCRof174.1per100,000malesand218.1per100,000 females. This was followed by the Indians who had CR of 89.6 per 100,000 males and 150.7 per 100,000 females. The Malays had relatively lower CR of 60.2 per 100,000 males and 82.6 per 100,000females. A similar ethnic variation was seen in the Penang Cancer Registry Report 1999 2003. In the PenangReport,theChinesehadaCRof169.2per100,000malesand217.7per100,000females; followedbytheIndianswithaCRof85.7per100,000malesand147.2per100,000females;withthe MalayshavingaCRof60.6per100,000malesand79.0per100,000females. In this report, the cumulative lifetime risk for Malaysians in Peninsular Malaysia developing cancer was14.8%formalesand15.9%forfemales.Thistranslatestoanestimatedriskof1in7males,and 1in6femalesdevelopingcancerintheirlifetime.
EXECUTIVE SUMMARY
15
2003-2005
In this third report, cancers from the colon and rectum are grouped together as coming from one cancer site. This is to standardize the report for comparison to other national and international reports. ThemostfrequentcancerinMalaysianswasbreastcancer(18.0%)followedbylargebowelcancer (11.9%)andlungcancer(7.4%).Thetenmostfrequentcancersinmalesandfemalesarepresented inFigures4.2.1(a)and4.2.1(b)andtheaccompanyingtables. Amongst males, large bowel cancer (14.5%; ASR 20.9) was the most frequent cancer followed by cancers of the lung (12.2%; ASR 18.1), nasopharynx (7.8%; ASR 9.2), prostate (7.3%; ASR 12.0), leukaemia (6.5%; ASR 7.0) and lymphoma (6.2%; ASR 7.7). In females, the most frequent cancer was breast cancer (31.3%; ASR 47.4), followed by cancers of the cervix uteri (10.6%; ASR 16.1), large bowel(9.9%; ASR16.8),ovary(4.3%;ASR6.4),leukaemia(3.7%;ASR 5.2)and lung(3.6%; ASR6.2). Generally, the incidence of cancers was reported more in males than females in most countries. However the male to female (M:F) sex ratio in this report was 1: 1.3. A similar trend was noted in earlierNCRreports.Consistentwithotherregionalregistries,therewaspredominanceoffemalesto malesincancersofthethyroidasseenbyaM:Fratioof1:3. Thevariationofthetenmostfrequentcancerincidencebysexandmajorethnicgroupsisshownin Figure 4.3.1(a) and 4.3.1(b) and the accompanying tables. Overall, this report showed that the ChinesehadsignificantlyhigherASRper100,000populationof182.9(males)and201.5(females), compared with the Indians (ASR of 134.4 in males and 186.3 in females) and the Malays (ASR of 89.6 in males and 106.4 in females). The following estimates of cancers are presented as a proportiontothetotalsubgroupandasanASRper100,000populationforcomparisonpuposes. AmongstMalaymales,largebowelcancer(12.6%;ASR12.3)wasthemostcommoncancerfollowed by leukaemia (11.2%; ASR 7.2), lung cancer (11.1%; ASR 11.2), lymphoma (9.0%; ASR 7.4) and prostatecancer(6.6%;ASR7.7). Large bowel cancer was also the leading cause of cancer in Chinese males (16.9%; ASR 31.5) followedbycancersofthelung(14.2%;ASR26.8),nasopharynx(10.7%;ASR17.0),prostate(7.8%; ASR15.8)andstomach(5.9%;ASR11.3). In Indian males, the most frequent cancers were large bowel (11.5%; ASR 15.7), prostate (8.7%; ASR14.8),stomach(8.0%;ASR11.9),lung(7.0%;ASR9.9)andlymphoma(6.4%;ASR6.9) The most frequent cancers for Malay females are cancers of the breast (33.6%; ASR 34.9), large bowel(8.2%;ASR9.7),cervixuteri(8.1%;ASR8.7),Leukaemia(6.0%;ASR5.3)andovary(5.0%; ASR5.2). In the Chinese females, the most frequent cancers were cancers of the breast (30.3%; ASR 59.9), largebowel(12.8%;ASR26.2),cervixuteri(11.8%;ASR23.2),lung(5.1%;ASR10.6)andstomach (3.8%;ASR7.7). AmongsttheIndianfemalesbreastcancer(31.2%;ASR54.2)wasfollowedbycancersofthecervix uteri(8.8%;ASR16.4),mouth(6.5%;ASR14.5),largebowel(6.3%;ASR12.9)andcorpusuteri (4.0%;ASR8.0).
16
EXECUTIVE SUMMARY
16
2003-2005
For most tumour sites, Chinese had the highest ASR except for the following cancers: lymphoma (ASR highest in Malay males and females); lymphatic leukemia (ASR highest in Malay and Indian males,andMalayfemales);myeloidleukemia(ASRhighestinMalaymales,Indianfemales);larynx (highestinIndianmalesandfemales);mouth(highestinIndianmalesandfemales);tongue(highest in Indian males and females); oesophagus (highest in Indian males and females); bone (highest in Indianfemales);corpusuteri(highestinIndianfemales);brainandnervoussystem(highestinIndian females),thyroid(highestinMalaymales). In tumour sites not mentioned in the previous paragraph, Malays had the lowest ASR among the major ethnic groups. For stomach cancer, Malay males and females had an incidence much lower thantheothermajorethnicgroups.Inthemouth,Chinesehadthelowestamongfemales,although amongmalestheMalayshadthelowestASR.InNasopharyngealcancer,Indianmalesandfemales hadthelowestASR. The other surprising finding in this report was the high ranking of leukemia amongst Malay Males. However,thiswasconsistentwiththeKelantanCancerRegistryReport19992003wherebyleukemia was the third most frequent cancer among all Males, and second highest among Malay Males.By contrast, in the Penang Cancer Registry 19992003, leukemia featured eighth among males and eighthamongfemales. An unexpected finding is that prostate cancer was the secondmost common cancer in Indian males.ProstatecancerrankedfourthamongmalecancersinMalaysia.Interestingly,theagespecific incidencerateinChinese(ASR15.8)andIndians(ASR14.8)inMalaysiawerehigherthanthosein Taiwan(ASR11.9),HongKong(ASR8.6)andMumbai(ASR7.4).ThisfindingforMalaysianIndian males could be due to chance variation in a smaller sample compared to the other major ethnic groups. However, in Singapore Indians, the numbers of cases reported for lung and prostate were very close (68 and 65 respectively), with the ASR for these two organs being 10.0 and 9.9 in this populationin Singapore. The ASRforprostatecancerin MalaysianIndians(14.8per 100,000)was higher than that reported for Indians in the Singapore Cancer Registry and various other Indian CancerRegistries. ThevariationincancerincidencebyageandsexispresentedinFigures4.4.1(a)and4.4.1(b)andin detailintheaccompanyingtable.Thefollowingestimatesofcancersarepresentedasaproportionto thetotalsubgroupandasCRper100,000populationforcomparison. Themostfrequentcancersinmalechildrenchildren(014years)wereleukaemias(47.6%,CR7.7), brain cancers (11.2%, CR 1.8), lymphomas (9.5%, CR 1.5), cancer of kidneys (3.9%,; CR 0.6) and thebones(3.7%;CR0.6). Similarly, in female children aged 014 years, the most frequent cancers are leukemia(45.4%; CR 5.8),brain(13.3%;CR1.7),lymphoma(6.2%,CR0.8),bones(4.3%;CR0.5)andkidneys(3.6%;CR 0.5). In the age group of young male adults (1549 years old), the common cancers were nasopharynx (15.9%; CR 7.7), large bowel (10.7%, CR 5.2), lymphomas (9.6%; CR 4.7), leukaemias (9.2%; CR 4.4)andlung(6.6%;CR3.2). Inwomenaged1549years,thecommoncancerswerebreast(39.1%;CR37.8),cervixuteri(13.5%; CR13.1),largebowel(5.4%;CR5.3),ovary(5.2%;CR5.1)andthyroid(4.9%;CR4.7). In older subjects (50 69 years), cancers of the large bowel (16.6%; CR 63.4), lung (15.4%; CR 58.7), prostate (7.2%; CR 27.3), nasopharynx (7.1%; CR 27.2) and lymphoma (5.3%; CR 20.0) predominatedinmen.Whereasthemostfrequentcancerinwomenaged5069werebreast(31.9%, CR149.3), largebowel(11.1%;CR52.0), cervixuteri(10.1%;CR 47.1),lung(4.5%;CR20.9)and corpusuteri(4.5%;CR20.9).
EXECUTIVE SUMMARY
17
2003-2005
Intheoldestgroup(aged≥70years),themostcommoncancersinmenwerelargebowel(17.4%:CR 177.2),prostate(16.5%:CR167.7),lung(14.6%:CR147.6),stomach(7.3%:CR74.4)andbladder (5.3%: CR 54.3). While in women aged ≥ 70 years, the most frequent cancers were large bowel (20.0%; CR 133.7), breast (15.7%; CR 105.1), cervix uteri (6.9%; CR 46.2), lung (6.6%; CR 44.2), stomach(6.3%;CR42.5).
18
EXECUTIVE SUMMARY
18
2003-2005
TheMalaysianNationalCancerRegistry(NCR)isaservicesupportedbyMinistryofHealth,Malaysia (MOH)tocollectinformationaboutcancerincidenceinMalaysia.Thisinformationisvitalinplanning andevaluationofcancerservicesbythegovernementalagencies,NonGovernementalOrganizations (NGO),privateprovidersandtheindustry. InNovember2001,theHonorableMinisterofHealthMalaysiadirectedtheClinicalResearchCentre (CRC) to establish a National Cancer Registry (NCR). Following this directive, the NCR’s Sponsor Groupwasformed.ThemembershipcomprisedofOncologist,Pathologist,Haematologist,Paediatric Oncologist,HeadoftheCancerResearchCentreintheInstituteofMedicalResearch,Directorofthe Disease Control Division and the Director of the Medical Development Division. In April 2002, the NCR obtained approval from the Director General of Health to setup its operations and was subsequentlyawardedaMedicalResearchGrantgrantinJune2002bytheDeputyDirectorGeneral ofHealth(Research&TechSupport). Administratively, the NCR began as one of the seven clinical registries under the umbrella of the ClinicalResearchCentre, MinistryofHealth.In2005,astheregistry‘matured’theadministrationof the registry was handed over to the Department of Radiotherapy and Oncology, Hospital Kuala Lumpur. In response to the call by the Director General of Health for a single Cancer Registry in Malaysia,theDivisionofPublicHealth(DPH)hastakenoverthemanagementoftheNCRfrom2007 onwards. This is timely as the DPH is in the midst of expanding its cancer registration system at a nationallevel.Itishopedthatwithasinglemanagementsystem,theregionalregistriesalongwiththe national registry would be able to produce national data more effectively and efficiently. This will providethemuchneededimpetusforfurtherdevelopmentofcancerprogrammesandinitiatives. TheobjectivesofNationalCancerRegistryareto: 1. Determine the disease burden attributable to cancer by quantifying the magnitude of cancer morbidityandmortality,anditsgeographicandtemporaltrendsinMalaysia. 2. Identify subgroups in the population at high risk of cancer to whom cancer prevention effort shouldbetargeted. 3. Stimulate and facilitate epidemiological research on cancer with respect to cancer etiology, diagnosisandprognosis. 4. Evaluatecancertreatment,controlandpreventionprogramme. TheNCRreceiveddatavoluntarilyoncancerincidencemainlyfromindividualdoctorswhoprovided cancer diagnostic services or who cared for cancer patients. Information on cancer incidence was alsoextractedusingthetheMinistryofHealth’sHospitalInformationSystem.
NATIONAL CANCER REGISTRY
19
2003-2005
ThedaytodayoperationsoftheNCRcanbecategorizedastwoessentialcomponents: a. b.
These are the daytoday administration, site and data management operationsofaRegistry.Itentailsgeneraladministrationoftheregistry,initiatingandmaintaining siteparticipationintheregistry,dataacquisition,datastorage,dataprocessing(datatransmittal, review, coding, cleaning, query, reconciling, transferring and archiving), data quality assurance, andperiodicsitemonitoringandretraining.
Anelectronicdatabaseserverwasusedtostorethedataand a database application was used to automate most of the work processes involved in data management. The database management system required routine administration, maintenance andcontinuingdevelopmentandenhancementtomeetthedynamicneedsofthisregistry.
Oncology,HaematologyandPathologyservices,MOH DivisionofDiseaseControl,PublicHealthDepartment,MOH MedicalDevelopmentDivision,MOH CancerResearchCentre,InstituteforMedicalResearch,MOH ClinicalResearchCentre,HospitalKualaLumpur,MOH
20
NATIONAL CANCER REGISTRY
20
2003-2005
2 MalaysiaislocatedintheSouthEastAsianregionandcoversanareaof329,961km .Itsharesits borderswithSingapore,Thailand,IndonesiaandBrunei.TheSouthChinaSeaseparatesWestand East Malaysia; West Malaysia being a peninsular region of the Asian Continent whereas East Malaysia is located on the Island of Borneo. There are a total of 13 states and three Federal Territoriesasfollows: PeninsularMalaysia
NorthernRegion:Perlis,Kedah,Penang,Perak EastCoastRegion:Kelantan,Terengganu,Pahang CentralRegion:Selangor,FederalTerritoryofKualaLumpurandFederalTerritoryof Putrajaya SouthernRegion:NegeriSembilan,Malacca,Johor EastMalaysia
Sarawak Sabah FederalTerritoryofLabuan Malaysia enjoys an equatorial climate. It is hot and humid throughout the year with an average o temperatureof27 Candanannualrainfallthatexceeds2000mm.Therainyseasonsareinfluenced bythemonsoontradewinds.
MALAYSIA AND ITS POPULATION
21
2003-2005
The age distribution of Malysia is dynamic over the years and the country currently experiences a highbirthratewithadeclineofthedeathrates.Theagepyramidstillhasalargebasebuttheelderly proportion is increasing. The age and sex distribution of the population of Peninsular Malaysia is showninFigure2.2.1.Malaysiaisamultiethniccountry,withtheMalaysbeingthemajorityfollowed bytheChinese,Indians,IndigenousgroupsandOrangAsli.Agraphicalrepresentationoftheethnic distributioninPeninsularMalaysiaisshowninFigure2.2.2. 116300
75+ 7074
109200
129200
172400
6569 6064
189700
242900
239300
329000
5559
314300
454200
5054
155300
441500
548800
4549
539200
604300
4044
Female
608800
3539
659200
668200
3034
676400
682100
737900
2529
736000
886300
2024
866400
996500
1519
Male
957500
1044400
1014
983600
1105000
59
1037900
04 1158700 1500000
1089500 1000000
500000
0
500000
1000000
1500000
9%
2%
27%
Malay
62%
Chinese
Indian
Others
22
MALAYSIA AND ITS POPULATION
22
2003-2005
Thisreportcoversincidentcancercasesfrom2003to2005.Thustheage,sexandethnicdistribution in 2004 can be used to represent the average age, sex and ethnic distribution of the study base (averagedistributionofthedenominatorusedforincidentratecalculation). ThetotalpopulationofPeninsularMalaysiain2004was19.5millionwhichconsistedof9.84million (50.5%)malesand9.64million(49.5%)females.Therewere12.0million(61.5%)Malays,5.2million (26.7%)Chineseand1.8million(9.2%)Indians. 04 59
799,100 743,100
753,300 700,000
231,900 240,200
214,800 221,100
93,000 91,800
89,600 88,500
1,158,700 1,105,000
1,089,500 1,037,900
12,000 10,000
1014
707,300
669,600
227,000
207,300
8,600
82,900
1,044,400
983,600
9,000
1519 2024 2529 3034 3539 4044 4549 5054 5559 6064 6569 7074 75+
658,600 566,500 433,800 384,100 376,900 339,400 300,600 243,700 171,400 124,000 88,000 55,500 63,500
637,600 559,000 442,000 396,200 387,400 346,100 299,700 240,800 167,600 125,500 99,800 67,100 79,900
228,900 216,700 205,400 200,600 200,400 192,500 182,100 158,700 124,500 96,400 68,800 44,200 41,800
213,700 206,300 197,100 194,600 196,700 187,500 173,400 148,600 113,300 89,900 70,800 49,800 63,400
87,400 81,700 73,600 69,600 67,300 62,300 56,900 45,300 28,700 19,500 13,500 8,100 8,900
83,300 79,800 75,400 72,000 68,900 63,800 58,100 46,300 29,200 20,900 17,000 10,800 10,200
996,500 886,300 737,900 676,400 659,200 604,300 548,800 454,200 329,000 242,900 172,400 109,200 116,300
957,500 866,400 736,000 682,100 668,200 608,800 539,200 441,500 314,300 239,300 189,700 129,200 155,300
9,000 8,000 8,000 6,000 6,000 6,000 6,000 5,000 4,000 4,000 3,000 2,000 2,000
Infrastructure such as roads, public transportation and telecommunication in Malaysia are well developed.Thereisgoodcoverageforelectricityandwatercoverage. ThemainoccupationsinMalaysiaof2004areshownin Legislators,seniorofficialsandmanagers
8.6%
Professionals
5.6%
Techniciansandassociateprofessionals
12.1%
Clericalworkers
9.3%
Serviceworkersandshopandmarketsalesworkers
14.8%
Skilledagriculturalandfisheryworkers
13.2%
Craftandrelatedtradeworkers
11.7%
Plantandmachineoperatorsandassemblers
14.1%
Elementaryoccupations
10.7%
MALAYSIA AND ITS POPULATION
23
2003-2005
Since independence, the health status of Malaysia has been enhanced by improved socio economicalstatus,healthinfrastructureandservices.Thefollowingstatisticsarepresentedfor2004 unlessstatedotherwiseasitrepresentsanaverageofthe20032005period. Lifeexpectancyatbirthwas70.4yearsand76.2yearsinMalaysianmalesandfemalesrespectively. InfantMortalityRatewas5.9per1000livebirthswhereasMaternalMortalityRatewas0.3per1000 livebirths (Table 2.5.1). The doctor to population ratio was 1:1402 and there were 119 government hospitals, 6 nonMOH government hospitals, 218 private hospitals, 859 MOH health clinics, 1924 MOH rural clinics, 93 MOH maternal and child health clinics, 165 mobile clinics and 1969 dental clinics.Governmenthospitalsandprivatehospitalsprovided28,966and10,542bedsrespectively. Perinatalmortalityrate* 6.8 Maternalmortalityrate* 0.3 Infantmortalityrate* 5.9 Neonatalmortalityrate* 3.8 *Per1000livebirths
WithMalaysiansenjoyingbetterhealthstatuscurrentlycomparedwiththeirpredecessors,itwasthen no surprise that malignant neoplasm ranked among its top five causes of death in the years 2003 2005. 18 16
16.54
15.63
15.1
14.41
14.52
14.31
14 12 10.11
9.54
9.34
10
8.4
8.27
8
6.29
8.19 6.07
6
5.67
4 2 0 2003 Septicaemia
HeartDiseases
2004 M alignantNeo plasms
24
MALAYSIA AND ITS POPULATION
24
2005 Cerebro vascularDiseases
A ccident
2003-2005
METHODS
25
2003-2005
26
METHODS
2003-2005
METHODS
27
2003-2005
28
METHODS
2003-2005
METHODS
29
2003-2005
•
• • • •
= =
∑
∑
30
METHODS
2003-2005
= = =
∑
∑
∑
METHODS
31
2003-2005
• • •
• •
•
32
METHODS
2003-2005
• •
•
•
• • • •
• •
•
• • •
•
• •
METHODS
33
2003-2005
34
METHODS
2003-2005
METHODS
35
2003-2005
36
METHODS
2003-2005
METHODS
37
2003-2005
38
CANCER INCIDENCE IN MALAYSIA 2003-2005
2003-2005
CANCER INCIDENCE IN MALAYSIA 2003-2005
39
2003-2005
40
CANCER INCIDENCE IN MALAYSIA 2003-2005
CANCER INCIDENCE IN MALAYSIA 2003-2005
2003-2005
41
42
CANCER INCIDENCE IN MALAYSIA 2003-2005
2003-2005
2003-2005
CANCER INCIDENCE IN MALAYSIA 2003-2005
43
2003-2005
44
CANCER INCIDENCE IN MALAYSIA 2003-2005
2003-2005
CANCER INCIDENCE IN MALAYSIA 2003-2005
45
2003-2005
46
CANCER INCIDENCE IN MALAYSIA 2003-2005
Pages 47 to 58 have been left out intentionally.
2003-2005
58
CANCER INCIDENCE IN MALAYSIA 2003-2005
2003-2005
59
2003-2005
60
CANCER INCIDENCE IN MALAYSIA 2003-2005
2003-2005
BUCCAL CAVITY
61
2003-2005
62
BUCCAL CAVITY
2003-2005
BUCCAL CAVITY
63
2003-2005
64
BUCCAL CAVITY
2003-2005
BUCCAL CAVITY
65
2003-2005
66
BUCCAL CAVITY
2003-2005
BUCCAL CAVITY
67
2003-2005
68
BUCCAL CAVITY
2003-2005
BUCCAL CAVITY
69
2003-2005
70
BUCCAL CAVITY
2003-2005
NASOPHARYNX
71
2003-2005
72
NASOPHARYNX
2003-2005
NASOPHARYNX
73
2003-2005
74
SELECTED CANCER SITES 2003-2005
2003-2005
75
2003-2005
76
SELECTED CANCER SITES 2003-2005
2003-2005
DIGESTIVE SYSTEM
77
2003-2005
78
DIGESTIVE SYSTEM
2003-2005
DIGESTIVE SYSTEM
79
2003-2005
80
DIGESTIVE SYSTEM
2003-2005
DIGESTIVE SYSTEM
81
2003-2005
82
DIGESTIVE SYSTEM
2003-2005
DIGESTIVE SYSTEM
83
2003-2005
84
DIGESTIVE SYSTEM
2003-2005
DIGESTIVE SYSTEM
85
2003-2005
86
DIGESTIVE SYSTEM
2003-2005
DIGESTIVE SYSTEM
87
2003-2005
88
DIGESTIVE SYSTEM
2003-2005
DIGESTIVE SYSTEM
89
2003-2005
90
DIGESTIVE SYSTEM
2003-2005
DIGESTIVE SYSTEM
91
2003-2005
92
DIGESTIVE SYSTEM
2003-2005
DIGESTIVE SYSTEM
93
2003-2005
94
DIGESTIVE SYSTEM
2003-2005
DIGESTIVE SYSTEM
95
2003-2005
96
LARYNX
2003-2005
LARYNX
97
2003-2005
98
LUNG
2003-2005
NOSE, SINUSES, LARYNX AND LUNGS
99
2003-2005
100
NOSE, SINUSES, LARYNX AND LUNGS
2003-2005
NOSE, SINUSES, LARYNX AND LUNGS
101
2003-2005
102
NOSE, SINUSES, LARYNX AND LUNGS
2003-2005
NOSE, SINUSES, LARYNX AND LUNGS
103
2003-2005
104
NOSE, SINUSES, LARYNX AND LUNGS
2003-2005
NOSE, SINUSES, LARYNX AND LUNGS
105
2003-2005
106
NOSE, SINUSES, LARYNX AND LUNGS
2003-2005
NOSE, SINUSES, LARYNX AND LUNGS
107
2003-2005
108
NOSE, SINUSES, LARYNX AND LUNGS
2003-2005
OTHER SKIN
109
2003-2005
110
MELANOMA
2003-2005
BONE AND CONNECTIVE TISSUE
111
2003-2005
112
BONE AND CONNECTIVE TISSUE
2003-2005
BONE AND CONNECTIVE TISSUE
113
2003-2005
114
BONE AND CONNECTIVE TISSUE
2003-2005
FEMALE BREAST
115
2003-2005
116
FEMALE BREAST
2003-2005
SKIN AND MELANOMA
117
2003-2005
118
SKIN AND MELANOMA
2003-2005
SKIN AND MELANOMA
119
2003-2005
120
SKIN AND MELANOMA
2003-2005
SKIN AND MELANOMA
121
2003-2005
122
SKIN AND MELANOMA
2003-2005
CORPUS UTERI
123
2003-2005
124
OVARY
2003-2005
* Editorial Note: Singapore estimates in the above write-up are based on Singapore Cancer Registry Report No. 6, Trends In Cancer Incidence in Singapore 1968-2002 (Reference 10); whereas Singapore estimates for Figure 5.17.2 are based on Cancer Incidence in Five Continents (Reference 4).
FEMALE BREAST
125
2003-2005
126
FEMALE BREAST
2003-2005
FEMALE BREAST
127
2003-2005
128
PROSTATE
2003-2005
PROSTATE
129
2003-2005
130
BLADDER
2003-2005
FEMALE GENITAL ORGANS
131
2003-2005
132
FEMALE GENITAL ORGANS
2003-2005
FEMALE GENITAL ORGANS
133
2003-2005
134
FEMALE GENITAL ORGANS
2003-2005
FEMALE GENITAL ORGANS
135
2003-2005
136
FEMALE GENITAL ORGANS
2003-2005
FEMALE GENITAL ORGANS
137
2003-2005
138
FEMALE GENITAL ORGANS
2003-2005
FEMALE GENITAL ORGANS
139
2003-2005
140
SELECTED CANCER SITES 2003-2005
2003-2005
SELECTED CANCER SITES 2003-2005
141
2003-2005
142
SELECTED CANCER SITES 2003-2005
2003-2005
PROSTATE, BLADDER, KIDNEY AND OTHER URINARY ORGANS
143
2003-2005
144
PROSTATE, BLADDER, KIDNEY AND OTHER URINARY ORGANS
2003-2005
PROSTATE, BLADDER, KIDNEY AND OTHER URINARY ORGANS
145
2003-2005
146
PROSTATE, BLADDER, KIDNEY AND OTHER URINARY ORGANS
2003-2005
PROSTATE, BLADDER, KIDNEY AND OTHER URINARY ORGANS
147
2003-2005
148
PROSTATE, BLADDER, KIDNEY AND OTHER URINARY ORGANS
2003-2005
PROSTATE, BLADDER, KIDNEY AND OTHER URINARY ORGANS
149
2003-2005
150
PROSTATE, BLADDER, KIDNEY AND OTHER URINARY ORGANS
2003-2005
SELECTED CANCER SITES 2003-2005
151
2003-2005
152
SELECTED CANCER SITES 2003-2005
2003-2005
BRAIN AND OTHER NERVOUS SYSTEM, THYROID
153
2003-2005
154
BRAIN AND OTHER NERVOUS SYSTEM, THYROID
2003-2005
BRAIN AND OTHER NERVOUS SYSTEM, THYROID
155
2003-2005
156
BRAIN AND OTHER NERVOUS SYSTEM, THYROID
2003-2005
BRAIN AND OTHER NERVOUS SYSTEM, THYROID
157
2003-2005
158
BRAIN AND OTHER NERVOUS SYSTEM, THYROID
2003-2005
SELECTED CANCER SITES 2003-2005
159
2003-2005
160
SELECTED CANCER SITES 2003-2005
2003-2005
LYMPHOMA
161
2003-2005
162
LYMPHOMA
2003-2005
LYMPHOMA
163
2003-2005
164
LYMPHOMA
2003-2005
LYMPHOMA
165
2003-2005
166
LYMPHOMA
2003-2005
LYMPHOMA
167
2003-2005
168
SELECTED CANCER SITES 2003-2005
2003-2005
SELECTED CANCER SITES 2003-2005
169
2003-2005
170
SELECTED CANCER SITES 2003-2005
2003-2005
LEUKAEMIA
171
2003-2005
172
LEUKAEMIA
2003-2005
LEUKAEMIA
173
2003-2005
174
LEUKAEMIA
2003-2005
LEUKAEMIA
175
2003-2005
176
LEUKAEMIA
2003-2005
LEUKAEMIA
177
2003-2005
178
LEUKAEMIA
2003-2005
REFERENCES
1) First Report of the National Cancer Registry. Cancer Incidence in Malaysia 2002. Lim, GCC and Halimah, Y. National Cancer Registry. Kuala Lumpur 2003. 2) 2nd Report of the National Cancer Registry. Cancer Incidence in Malaysia 2003. Lim, GCC and Halimah, Y. National Cancer Registry. Kuala Lumpur 2004. 3) International Classification of Diseases for Oncology 3rd edition. Fritz. A., Percy. C., Jack. A., Shanmugaratnam, K., Sobin, L., Parkin, D. M. and Whelan, S. World Health Organization, Geneva, 2000. 4) Cancer Incidence in Five Continents Volumes I to VIII. Parkin, D.M., Whelan, S.L., Ferlay, J. and Storm, H. IARC CancerBase No 7, Lyon, 2005. 5) Malaysia, Year Book of Statistics 2006. Department of Statistics, Malaysia, 2006. 6) Health Facts 2002. Planning and Development Division (Information and Documentation System Unit), Ministry of Health Malaysia, 2004. 7) Health Facts 2003. Planning and Development Division (Information and Documentation System Unit), Ministry of Health Malaysia, 2004. 8) Health Facts 2004. Planning and Development Division (Information and Documentation System Unit), Ministry of Health Malaysia, 2005. 9) Health Facts 2005. Planning and Development Division (Information and Documentation System Unit), Ministry of Health Malaysia, 2006. 10) Trends In Cancer Incidence in Singapore 1968-2002. A Seow, W P Koh, K S Chia, L M Shi, H P Lee, K Shanmugaratnam (editors). Singapore Cancer Registry Report No. 6. Singapore Cancer Registry, 2004. 11) Penang Cancer Report 1999-2003. Bina Rai, S., Devaraj, T., Aishah, K., Rokiah, M. and Nor Asikin, A.K. Penang Cancer Registry, 2005. 12) Kelantan Cancer Registry Report 1999-2003. Fauziah, M.N., Hamizah, M.S., Norazmi, A., and Lila, P.M.M. Kelantan Cancer Registry, 2006. 13) Epidemiology of Cancer in Sarawak 1996-2000. Ooi, CH., Kiyu, A., Yao, SK., Helli, B., Mastulu, W. and Assan, J. Sarawak Cancer Registry, Sarawak Health Department, Sarawak. 2005.
REFERENCES
179
2003-2005
180
REFERENCES