Egypt was completely lacking incidence rates at national level until the results given in the current report were obtained. Available statistics were proportions derived from single or multicenter hospital registries that could not be used for calculation of incidence rates [
The National Cancer Registry Program (NCRP) was established in 2008 and became the only source for cancer incidence in the country [
For registration purposes, Egypt was stratified into 3 geographical strata (regions), namely, Lower Egypt (north of Cairo), Middle Egypt (south of Cairo), and Upper Egypt (further south, reaching the southern frontier of the country). The current report covered three districts (governorate), each representing one of the 3 regions, namely, Damietta (Nile delta), Minya (Middle Egypt), and Aswan (Upper Egypt) (Figure
Map of Egypt showing the location of the 5 peripheral registries of the national network of population-based cancer registries National Cancer Institute, Cairo, and South Egypt Cancer Institute, Assiut.
Trained medical doctors in the 3 registries abstracted records from their cancer centers and regularly visited establishments that dealt with cancer within the governorate for active data collection from medical records. Other sources of data were major tertiary centers on the national level as the National Cancer Institute of Cairo University, Pediatric Oncology Hospital in Cairo, and South Egypt Cancer Institute of Assiut University. Data managers in these institutions reported incident cancer cases among residents of the 3 governorates that were diagnosed/treated in these institutions. Health Insurance Organization and the Government-Subsidized Treatment Program periodically supplied their data. Death registers in local health directorates were regularly checked for cancer deaths from the 3 governorates.
A web-based software was developed for online data entry, validity checks, and data analysis. The database was centralized in the Ministry of Communication and Information Technology server (Figure
The NCRP Web Based System (3-Tier Architecture).
For the current report, we used data from Aswan (2008), Minya (2009), and Damietta (2009–2011) to represent the 3 geographical strata of Egypt (Table
Population parameters of the 3 regions of Egypt and corresponding registries used in the current report to calculate regional and national incidence rates.
Region characteristics | Upper Egypt | Middle Egypt | Lower Egypt |
---|---|---|---|
Regional Registry | Aswan | Minia | Damietta |
Registration period | 2008 | 2009 | 2009–2011 |
Registry Population | 1,074,131 | 4,426,528 | 3,586,056** |
Region population* | 4,645,449 | 16,161,200 | 30,342,291 |
We developed a model to use incidence data of the population-based registries of the 3 regions (Lower, Middle, and Upper Egypt) to get incidence rates for the entire country. The first step was to apply the age-specific incidence rates of each registry to the population of the stratum it represented to get the number per gender of incident cases in different age groups and for all ages together in this region using data of Egypt last census [
The crude incidence rates on the national level for all sites excluding nonmelanoma skin cancer (C44) were 113.1/100,000 (both sexes), 115.7/100,000 (males), and 110.3/100,000 (females). The age-standardized rates (world) were 166.6/100,000 (both sexes), 175.9/100,000 (males), and 157.0/100,000 (females) as shown in Table
Incidence rates of Cancer in Egypt (/100,000 populations) classified by region and sex for all cancer sites with and without nonmelanoma skin cancer (C44).
Males | Females | All | Male : female ratio | |||||
---|---|---|---|---|---|---|---|---|
Crude rate | ASR | Crude rate | ASR | Crude rate | ASR | Crude rate | ASR | |
(95% CI) | (95% CI) | (95% CI) | (95% CI) | (95% CI) | (95% CI) | |||
All sites | ||||||||
(i) Upper Egypt | 97.1 | 142.8 | 116.9 | 167.1 | 107.0 | 155.0 | 0.8 : 1 | 0.9 : 1 |
(89.1–105.8) | (133.1–153.2) | (108.1–126.5) | (156.5–178.4) | (101.0–113.3) | (147.7–162.6) | |||
(ii) Middle Egypt | 109.7 | 170.0 | 95.9 | 132.1 | 102.9 | 151.1 | 1.1 : 1 | 1.3 : 1 |
(105.4–114.1) | (164.7–175.5) | (91.1–100.2) | (127.4–137.0) | (100.0–106.0) | (147.5–154.8) | |||
(iii) Lower Egypt | 138.5 | 191.8 | 131.7 | 173.3 | 135.2 | 182.6 | 1.1 : 1 | 1.1 : 1 |
(133.2–144.0) | (185.6–198.2) | (126.5–137.2) | (167.3–179.6) | (131.4–139.1) | (178.2–187.1) | |||
(iv) Calculated rates of Egypt | 117.3 | 178.5 | 111.7 | 159.1 | 114.5 | 169.0 | 1.1 : 1 | 1.1 : 1 |
(116.0–118.6) | (176.9–180.2) | (110.4–113.0) | (157.6–160.7) | (113.6–115.5) | (167.9–170.2) | |||
|
||||||||
All sites (excluding nonmelanoma skin cancer C44) | ||||||||
(i) Upper Egypt | 96.0 | 141.0 | 115.1 | 163.9 | 105.5 | 152.5 | 0.8 : 1 | 0.9 : 1 |
(88.1–1104.6) | (131.4–151.4) | (106.3–124.5) | (153.4–175.1) | (99.5–111.8) | (145.5–160.1) | |||
(ii) Middle Egypt | 108.0 | 167.2 | 94.9 | 130.7 | 101.6 | 149.0 | 1.1 : 1 | 1.3 : 1 |
(103.8–112.3) | (162.0–172.6) | (90.9–99.1) | (126.0–135.6) | 98.7–104.6) | (145.5–152.6) | |||
(iii) Lower Egypt | 136.7 | 189.1 | 130.1 | 170.9 | 133.5 | 180.0 | 1.1 : 1 | 1.1 : 1 |
(131.5–142.2) | (182.9–195.5) | (124.8–135.5) | (164.9–177.1) | (129.7–137.3) | (175.7–184.4) | |||
(iv) Calculated rates of Egypt | 115.7 | 175.9 | 110.3 | 157.0 | 113.1 | 166.6 | 1 : 1 | 1.1 : 1 |
(114.4–117.0) | (174.3–177.5) | (109.0–111.6) | (155.4–158.5) | (112.2–114.0) | (165.5–167.8) |
Calculated age-specific incidence rates, crude rates, and ASR (World), males, Egypt 2008–2011.
Site | 0–4 | 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+ | Crude rate | ASR | % |
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Lip | — | — | — | — | — | — | 0.5 | — | 0.3 | — | 0.8 | 1.4 | 0.6 | 1.8 | 8.7 | 1.5 | 0.3 | 0.4 | 0.23% |
Tongue | — | — | — | — | — | — | — | — | 0.3 | 1.4 | 1.3 | 3.1 | 1.9 | 1.8 | — | 2.2 | 0.3 | 0.5 | 0.27% |
Mouth | — | — | — | 0.1 | — | — | 0.2 | 0.5 | 0.8 | 1.5 | 2.5 | 4.6 | 0.6 | 2.6 | 1.4 | — | 0.5 | 0.6 | 0.41% |
Salivary glands | — | — | 0.1 | — | 0.1 | — | — | 0.2 | — | — | 0.7 | 1.4 | 2.0 | 2.6 | 4.5 | 5.2 | 0.3 | 0.5 | 0.25% |
Tonsil | — | — | — | — | — | — | — | — | 0.3 | — | — | — | — | — | — | — | — | — | 0.01% |
Other oropharynx | — | — | — | — | 0.1 | — | — | — | — | — | 0.4 | 0.6 | — | 0.8 | 2.8 | — | 0.1 | 0.1 | 0.07% |
Nasopharynx | — | — | — | — | 0.3 | — | — | 0.2 | — | — | 3.4 | 0.4 | — | 3.6 | — | 5.2 | 0.3 | 0.4 | 0.26% |
Hypopharynx | — | — | — | 0.1 | — | — | — | — | 0.3 | — | 0.9 | 1.4 | 0.6 | — | 1.4 | 1.5 | 0.2 | 0.2 | 0.13% |
Pharynx unspec. | — | — | — | — | — | — | 0.2 | — | — | 1.0 | — | — | — | — | — | 1.5 | 0.1 | 0.1 | 0.07% |
Esophagus | — | — | — | — | 0.3 | 0.2 | 0.3 | — | 1.4 | 1.8 | 6.1 | 4.1 | 11.2 | 10.8 | 24.4 | 14.7 | 1.4 | 2.3 | 1.20% |
Stomach | — | 0.1 | 0.1 | — | 0.3 | 0.2 | 0.7 | 0.5 | 2.0 | 2.6 | 5.0 | 6.0 | 11.9 | 6.4 | 21.5 | 14.1 | 1.5 | 2.3 | 1.26% |
Small intestine | 0.1 | — | — | — | — | — | 0.5 | 0.5 | 0.6 | 0.3 | 0.4 | 1.4 | — | 0.8 | — | 1.5 | 0.2 | 0.3 | 0.17% |
Colon | — | — | — | 0.1 | 0.3 | 0.7 | 2.1 | 2.5 | 1.9 | 6.5 | 14.2 | 11.0 | 19.8 | 18.9 | 31.5 | 32.6 | 3.1 | 4.7 | 2.63% |
Rectum | — | — | — | 0.1 | 0.7 | 1.2 | 0.7 | 1.2 | 2.2 | 2.0 | 3.4 | 4.1 | 3.4 | 2.6 | 8.7 | 1.5 | 1.0 | 1.3 | 0.84% |
Anus | — | — | — | — | 0.3 | — | 0.5 | 0.5 | 0.6 | 0.6 | — | 2.1 | 2.0 | 1.0 | — | — | 0.3 | 0.3 | 0.24% |
Liver | 0.3 | 0.4 | 0.4 | 0.2 | 0.3 | 1.3 | 1.4 | 6.1 | 21.2 | 76.3 | 174.2 | 258.7 | 323.1 | 313.8 | 327.1 | 363.5 | 39.5 | 61.8 | 33.63% |
Gallbladder and so forth | — | — | — | — | — | 0.4 | — | 0.5 | 0.6 | 0.6 | 1.0 | 1.0 | 5.9 | 1.0 | 4.7 | 7.4 | 0.5 | 0.7 | 0.40% |
Pancreas | — | — | — | — | — | — | 1.3 | 0.2 | 2.5 | 7.7 | 9.0 | 14.9 | 25.3 | 26.4 | 12.7 | 19.3 | 2.7 | 4.2 | 2.31% |
Nose, sinuses and so forth | — | 0.1 | — | — | — | — | — | 0.5 | 0.3 | — | 1.2 | — | — | — | 1.4 | 8.2 | 0.2 | 0.3 | 0.17% |
Larynx | — | — | — | — | — | — | 0.2 | — | 2.1 | 2.6 | 6.6 | 6.8 | 18.2 | 11.0 | 23.2 | 32.5 | 1.9 | 3.1 | 1.58% |
Trachea, Bronchus, Lung | 0.1 | — | 0.1 | 0.4 | 0.8 | 1.2 | 1.2 | 3.0 | 3.8 | 12.5 | 19.3 | 39.1 | 49.0 | 49.3 | 73.9 | 76.1 | 6.7 | 10.4 | 5.69% |
Other Thoracic organs | 0.3 | — | — | 0.1 | 0.2 | 0.2 | — | — | 0.6 | 1.2 | 2.8 | 3.5 | 3.2 | 7.1 | 9.8 | 8.9 | 0.8 | 1.2 | 0.65% |
Bone | 0.1 | 1.2 | 1.4 | 0.7 | 1.8 | 0.8 | 1.0 | 1.0 | 1.4 | 2.0 | 4.2 | 3.7 | 13.9 | 8.6 | 8.4 | 15.6 | 1.9 | 2.5 | 1.62% |
Melanoma of skin | — | — | — | — | 0.1 | 0.2 | — | — | 0.6 | — | — | 0.4 | — | 1.8 | 2.8 | — | 0.1 | 0.2 | 0.11% |
Other skin | 0.6 | — | 0.1 | — | 0.3 | 0.4 | 0.5 | 0.5 | 1.1 | 0.6 | 3.2 | 4.5 | 14.0 | 14.2 | 18.5 | 30.4 | 1.6 | 2.6 | 1.35% |
Mesothelioma | — | — | — | — | — | — | — | — | — | 0.8 | 0.5 | 1.4 | — | 0.8 | — | — | 0.1 | 0.2 | 0.10% |
Kaposi sarcoma | — | — | — | — | — | — | 0.2 | — | — | — | 1.1 | — | 1.3 | 0.8 | 1.4 | — | 0.1 | 0.2 | 0.10% |
Connective, Soft tissue | 0.3 | 0.1 | 0.1 | 0.6 | 1.1 | 2.0 | 1.3 | 1.3 | 3.1 | 3.5 | 3.6 | 8.3 | 4.6 | 6.1 | 18.8 | 2.2 | 1.7 | 2.2 | 1.47% |
Breast | — | — | — | — | — | 0.4 | — | 0.3 | 2.2 | 0.3 | 2.5 | 3.1 | 3.4 | 3.6 | 2.8 | 5.9 | 0.6 | 0.9 | 0.51% |
Penis | — | — | — | — | — | — | — | — | — | — | — | — | — | — | — | — | — | — | 0.00% |
Prostate | — | — | — | — | — | 0.2 | 0.3 | — | 0.3 | 1.3 | 4.1 | 11.2 | 24.6 | 47.5 | 90.3 | 216.5 | 5.0 | 9.3 | 4.27% |
Testis | — | 0.1 | — | — | 1.1 | 1.2 | 0.7 | 1.5 | 0.6 | 0.6 | 0.4 | 0.4 | 0.6 | — | 1.4 | 2.2 | 0.5 | 0.5 | 0.43% |
Other male genital | — | — | — | — | — | — | — | — | — | — | 0.4 | — | — | 0.8 | 1.4 | — | — | 0.1 | 0.04% |
Kidney | 1.2 | 0.1 | — | — | — | 0.2 | 0.2 | 0.5 | 0.5 | 3.4 | 6.9 | 9.8 | 7.9 | 16.9 | 14.1 | 22.3 | 1.8 | 2.7 | 1.53% |
Renal pelvis | — | — | — | — | 0.1 | — | — | 0.2 | 0.6 | 0.3 | 0.4 | 1.9 | 2.0 | 1.8 | 2.8 | 4.4 | 0.3 | 0.4 | 0.25% |
Ureter | — | — | — | — | — | — | — | — | — | — | — | — | — | — | 1.4 | 3.0 | — | 0.1 | 0.04% |
Bladder | 0.1 | 0.1 | — | 0.3 | 0.1 | 1.2 | 1.7 | 2.2 | 4.0 | 9.2 | 28.7 | 68.4 | 97.2 | 128.6 | 194.8 | 205.6 | 12.6 | 21.1 | 10.71% |
Other urinary organs | — | — | — | — | — | — | — | — | — | — | — | — | 0.6 | — | — | — | — | — | 0.01% |
Eye | 0.5 | 0.3 | — | — | — | — | — | — | — | 0.4 | 0.4 | 1.8 | 0.6 | — | — | — | 0.2 | 0.2 | 0.16% |
Brain, Nervous tissue | 2.9 | 3.0 | 1.8 | 1.7 | 1.5 | 3.3 | 4.2 | 6.8 | 7.3 | 7.3 | 15.5 | 14.5 | 27.2 | 30.4 | 46.7 | 91.4 | 6.4 | 9.0 | 5.48% |
Thyroid | — | — | — | — | 0.2 | 0.8 | 1.2 | 1.9 | 1.1 | 3.2 | 4.5 | 4.3 | 6.6 | 8.7 | 3.0 | — | 1.1 | 1.5 | 0.95% |
Adrenal gland | 0.3 | 0.1 | — | — | — | — | — | — | — | — | — | 0.6 | — | 0.8 | 1.4 | — | 0.1 | 0.1 | 0.08% |
Other endocrine | 0.5 | — | 0.1 | — | 0.3 | — | — | 0.5 | 0.3 | 1.0 | 0.4 | 1.3 | 0.6 | — | 2.8 | — | 0.3 | 0.4 | 0.25% |
Hodgkin disease | 0.5 | 1.7 | 1.7 | 1.5 | 1.5 | 1.4 | — | 0.2 | 1.7 | 2.5 | 2.0 | 1.4 | 5.3 | 6.1 | 2.8 | 1.5 | 1.5 | 1.7 | 1.29% |
Non-Hodgkin lymphoma | 1.1 | 1.2 | 1.5 | 1.0 | 2.2 | 2.5 | 2.1 | 3.6 | 5.8 | 16.6 | 24.4 | 36.0 | 33.8 | 29.5 | 38.1 | 28.8 | 6.4 | 8.8 | 5.48% |
Immunoproliferative dis. | — | — | — | — | — | — | — | — | — | — | — | — | — | — | — | — | — | — | 0.00% |
Multiple myeloma | — | — | — | — | — | — | 0.5 | 0.5 | 1.1 | 0.4 | 3.1 | 3.9 | 8.0 | 0.8 | 2.8 | 2.9 | 0.6 | 0.9 | 0.53% |
Lymphoid leukemia | 3.9 | 2.2 | 0.7 | 0.2 | 1.4 | — | 0.7 | 1.5 | 1.1 | 1.8 | 1.5 | 5.0 | 6.0 | 8.9 | 5.6 | — | 1.8 | 2.1 | 1.50% |
Myeloid Leukemia | 0.8 | 0.4 | 0.3 | 0.8 | 1.0 | 0.4 | 1.1 | 0.7 | 1.4 | 1.8 | 4.2 | 3.3 | 3.4 | 2.6 | 4.5 | 1.5 | 1.1 | 1.3 | 0.96% |
Leukemia unspec. | 1.0 | 1.2 | 1.1 | 0.6 | 2.1 | 2.2 | 1.7 | 0.5 | 2.1 | 4.7 | 1.8 | 6.0 | 8.0 | 3.5 | 7.3 | 20.8 | 2.1 | 2.6 | 1.80% |
Other & unspecified | 2.4 | 2.8 | 0.9 | 1.7 | 1.3 | 1.8 | 3.3 | 3.1 | 6.1 | 15.0 | 22.9 | 25.2 | 44.9 | 54.7 | 64.7 | 83.6 | 7.6 | 11.2 | 6.52% |
|
|||||||||||||||||||
All sites Total | 17.1 | 15.4 | 10.5 | 10.5 | 20.1 | 23.9 | 30.6 | 42.8 | 83.8 | 195.4 | 389.6 | 582.4 | 793.5 | 840.2 | 1096.1 | 1335.6 | 117.3 | 178.5 | 100.00% |
All sites but C44# | 16.6 | 15.4 | 10.4 | 10.5 | 19.8 | 23.5 | 30.0 | 42.4 | 82.7 | 194.9 | 386.4 | 577.9 | 779.5 | 826.0 | 1077.5 | 1305.3 | 115.7 | 175.9 | 98.65% |
Calculated age-specific incidence rates, crude rates, and ASR (World), females, Egypt 2008–2011.
Site | 0–4 | 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+ | Crude rate | ASR | % |
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Lip | — | — | — | — | — | — | — | — | 0.3 | 1.4 | 0.8 | 0.5 | 1.6 | 0.8 | 1.3 | 4.7 | 0.2 | 0.4 | 0.21% |
Tongue | — | — | — | — | — | 0.5 | — | — | — | 0.4 | 0.4 | 1.2 | 0.7 | — | — | 15.4 | 0.3 | 0.5 | 0.26% |
Mouth | — | 0.1 | 0.1 | — | — | — | — | — | 0.3 | 1.0 | 0.8 | 0.5 | 1.4 | 2.9 | 6.1 | 2.7 | 0.3 | 0.5 | 0.28% |
Salivary glands | — | — | 0.3 | — | — | — | — | — | — | 0.7 | — | 2.9 | 0.7 | 2.9 | — | — | 0.2 | 0.3 | 0.18% |
Tonsil | — | — | — | — | — | — | — | — | — | — | — | — | — | 2.2 | — | 1.4 | — | 0.1 | 0.04% |
Other oropharynx | — | — | — | — | — | — | — | — | — | 0.3 | — | 0.7 | — | 0.8 | — | — | — | 0.1 | 0.04% |
Nasopharynx | 0.1 | — | 0.1 | — | — | — | — | — | — | — | — | — | 1.6 | — | — | — | 0.1 | 0.1 | 0.06% |
Hypopharynx | — | — | — | — | — | 0.2 | — | 0.4 | 0.3 | 1.0 | 0.9 | 0.5 | — | 1.1 | — | — | 0.2 | 0.2 | 0.16% |
Pharynx unspec. | — | — | — | — | — | 0.2 | — | — | — | — | — | — | — | — | — | — | — | — | 0.01% |
Esophagus | — | — | — | — | — | 0.2 | — | — | 2.0 | 1.3 | 0.8 | 3.7 | 11.1 | 10.6 | 9.2 | 5.4 | 0.9 | 1.5 | 0.79% |
Stomach | — | 0.1 | — | — | — | — | 2.0 | 1.4 | 3.1 | 5.1 | 5.7 | 5.1 | 9.7 | 16.3 | 18.7 | 14.8 | 1.8 | 2.7 | 1.65% |
Small intestine | — | — | — | — | — | — | — | 0.4 | — | 1.9 | 1.7 | — | 1.4 | 5.2 | 4.8 | — | 0.4 | 0.5 | 0.32% |
Colon | — | — | — | — | 0.5 | 0.5 | 1.0 | 2.4 | 2.9 | 7.9 | 9.4 | 7.9 | 10.4 | 25.2 | 16.2 | 29.4 | 2.5 | 3.8 | 2.28% |
Rectum | — | — | — | — | 0.1 | 1.1 | 1.2 | 0.7 | 1.9 | 1.7 | 1.9 | 2.9 | 3.0 | 3.9 | 4.4 | 5.4 | 0.8 | 1.1 | 0.72% |
Anus | — | — | — | — | — | 0.2 | — | — | 0.3 | — | 0.5 | — | 1.6 | — | 1.3 | — | 0.1 | 0.1 | 0.09% |
Liver | 1.0 | — | 0.5 | — | — | 0.9 | 2.0 | 3.3 | 12.5 | 25.2 | 43.2 | 89.3 | 129.3 | 143.9 | 167.9 | 150.4 | 15.1 | 24.4 | 13.54% |
Gallbladder and so forth | — | — | — | — | 0.3 | — | 0.5 | 0.5 | 0.3 | 1.3 | 2.5 | 3.3 | 2.2 | 3.7 | 6.9 | 6.0 | 0.6 | 0.9 | 0.55% |
Pancreas | — | — | — | — | — | 0.4 | — | 0.5 | 0.6 | 3.0 | 3.4 | 8.6 | 9.0 | 18.7 | 24.4 | 19.5 | 1.6 | 2.6 | 1.41% |
Nose, sinuses and so forth | 0.1 | — | — | — | — | — | — | — | 0.3 | 0.7 | 1.2 | 1.2 | 5.4 | — | — | — | 0.3 | 0.4 | 0.23% |
Larynx | — | — | — | — | — | — | — | — | 0.3 | 1.0 | 2.0 | — | 3.0 | — | 3.0 | 2.1 | 0.3 | 0.4 | 0.23% |
Trachea, Bronchus, Lung | 0.7 | — | 0.1 | 0.1 | 0.5 | 2.0 | 1.0 | 1.5 | 1.7 | 6.9 | 12.3 | 11.7 | 15.1 | 11.3 | 35.9 | 38.0 | 3.0 | 4.5 | 2.70% |
Other Thoracic organs | — | — | — | — | — | — | — | — | 0.8 | 1.7 | 1.6 | 2.6 | 1.6 | 3.0 | 1.3 | 10.7 | 0.5 | 0.7 | 0.42% |
Bone | 0.7 | 0.1 | 1.1 | 2.0 | 1.4 | 0.7 | 0.7 | 2.2 | 0.9 | 2.3 | 6.5 | 6.7 | 12.0 | 4.5 | 2.6 | 16.9 | 2.0 | 2.5 | 1.80% |
Melanoma of skin | — | — | — | — | — | — | — | — | 0.6 | — | — | — | — | 2.2 | 4.4 | — | 0.1 | 0.2 | 0.10% |
Other skin | 0.3 | — | — | 0.2 | — | 0.4 | 0.5 | — | 2.0 | 2.7 | 1.2 | 8.6 | 10.4 | 14.0 | 14.9 | 11.8 | 1.4 | 2.2 | 1.24% |
Mesothelioma | — | — | — | — | — | — | — | — | — | — | 1.2 | 0.5 | 3.0 | 1.1 | 4.8 | — | 0.2 | 0.3 | 0.17% |
Kaposi sarcoma | — | — | — | — | — | — | — | — | — | — | — | — | — | 0.8 | — | — | — | — | 0.01% |
Connective, Soft tissue | 1.2 | 0.3 | 0.7 | 0.4 | 1.5 | 2.1 | 1.7 | 1.2 | 2.0 | 2.0 | 2.9 | 2.4 | 6.2 | 3.9 | 3.1 | 13.4 | 1.6 | 1.9 | 1.42% |
Breast | — | — | — | — | 3.1 | 9.5 | 29.2 | 49.0 | 86.0 | 106.2 | 136.0 | 172.9 | 177.4 | 166.3 | 138.7 | 148.6 | 35.8 | 48.8 | 32.04% |
Vulva | 0.1 | — | 0.1 | — | — | — | — | — | — | 0.3 | — | 1.0 | — | 0.8 | — | 1.4 | 0.1 | 0.1 | 0.09% |
Vagina | — | — | — | — | — | — | — | — | — | — | — | 1.0 | 3.0 | 3.3 | — | 1.4 | 0.2 | 0.3 | 0.14% |
Cervix Uteri | — | — | — | — | — | 0.2 | 0.2 | — | 0.6 | 3.6 | 6.5 | 9.1 | 8.3 | 10.5 | 1— | 9.4 | 1.3 | 2.0 | 1.17% |
Corpus Uteri | — | — | — | — | — | — | 0.5 | 0.2 | 0.6 | 1.3 | 0.7 | 8.1 | 4.3 | 3.0 | 3.0 | 12.1 | 0.7 | 1.1 | 0.62% |
Uterus unspec. | — | — | — | 0.5 | 1.2 | 0.4 | 0.7 | 0.5 | 1.8 | 1.6 | 11.1 | 9.5 | 21.5 | 20.4 | 31.4 | 21.2 | 2.5 | 3.9 | 2.27% |
Ovary | — | — | 0.5 | 0.4 | 0.8 | 1.5 | 1.5 | 3.3 | 8.7 | 17.2 | 20.3 | 24.0 | 19.6 | 17.2 | 2— | 26.3 | 4.6 | 6.3 | 4.12% |
Other female genital | — | — | — | — | — | — | — | 0.3 | — | — | — | — | — | — | 1.3 | 2.1 | 0.1 | 0.1 | 0.05% |
Placenta | — | — | — | — | — | 0.4 | — | — | — | — | — | — | — | — | — | — | — | — | 0.03% |
Kidney | 1.5 | 0.1 | — | — | — | 0.5 | 0.8 | 0.5 | 0.6 | 2.9 | 2.3 | 1.0 | 10.4 | 10.7 | 1.3 | 7.3 | 1.1 | 1.6 | 0.97% |
Renal pelvis | — | 0.3 | — | — | — | 0.6 | — | 0.2 | — | 0.7 | 0.4 | 0.5 | 1.6 | 0.8 | — | — | 0.2 | 0.3 | 0.19% |
Ureter | — | — | — | — | — | — | — | — | — | — | — | — | — | — | — | — | — | — | 0.00% |
Bladder | 0.1 | — | — | 0.2 | — | 0.2 | — | 0.7 | 0.8 | 5.3 | 8.2 | 18.6 | 20.2 | 37.8 | 43.6 | 53.9 | 3.3 | 5.5 | 2.96% |
Other urinary organs | — | — | — | — | — | — | — | — | — | — | — | — | — | 2.2 | — | — | — | 0.1 | 0.03% |
Eye | 0.1 | 0.3 | — | — | — | — | 0.5 | — | — | — | — | 1.2 | 0.7 | 0.8 | — | 1.4 | 0.2 | 0.2 | 0.14% |
Brain, Nervous tissue | 3.3 | 2.1 | 1.9 | 0.8 | 2.9 | 0.7 | 4.5 | 6.5 | 6.6 | 9.5 | 11.3 | 12.1 | 31.4 | 26.3 | 33.1 | 72.2 | 5.8 | 8.0 | 5.18% |
Thyroid | — | — | — | — | 2.7 | 2.8 | 10.2 | 7.2 | 6.4 | 9.7 | 10.2 | 11.0 | 9.0 | 2.6 | 10.4 | 14.2 | 3.7 | 4.3 | 3.28% |
Adrenal gland | 1.5 | 0.1 | — | — | — | — | — | — | — | — | — | 1.2 | — | — | — | 1.4 | 0.2 | 0.3 | 0.20% |
Other endocrine | — | 0.1 | — | 0.1 | 0.1 | 0.3 | — | 0.5 | 0.3 | 0.3 | 0.4 | 1.0 | 0.7 | 0.8 | — | — | 0.2 | 0.2 | 0.19% |
Hodgkin disease | — | 0.6 | 0.4 | 1.9 | 1.3 | 0.4 | 1.2 | 0.7 | 0.6 | 0.4 | — | 1.2 | 3.8 | — | — | — | 0.8 | 0.8 | 0.70% |
Non-Hodgkin lymphoma | 0.9 | 0.7 | — | 1.1 | 0.8 | 1.2 | 1.7 | 3.3 | 3.8 | 8.6 | 16.0 | 23.4 | 24.1 | 16.8 | 31.3 | 36.7 | 4.2 | 6.1 | 3.80% |
Immunoproliferative dis. | — | — | — | — | — | — | — | — | — | — | — | — | — | — | — | — | — | — | 0.00% |
Multiple myeloma | — | — | — | — | — | — | — | — | 0.6 | 1.4 | 0.8 | 1.2 | 2.3 | 4.4 | 6.1 | 2.7 | 0.4 | 0.6 | 0.34% |
Lymphoid leukemia | 2.0 | 0.7 | 0.9 | 0.4 | 0.5 | — | 0.7 | 0.7 | 1.4 | 1.0 | 2.7 | 1.7 | 2.8 | 3.9 | 4.4 | — | 1.0 | 1.2 | 0.93% |
Myeloid Leukemia | 0.5 | 0.3 | 0.7 | 0.2 | 1.5 | 1.5 | 1.4 | 1.0 | 0.9 | 0.7 | 4.0 | 3.1 | 6.8 | 7.5 | — | 4.9 | 1.3 | 1.6 | 1.14% |
Leukemia unspec. | 0.4 | 0.7 | 0.7 | 1.3 | 0.9 | 1.7 | 1.5 | 0.7 | 1.4 | 2.7 | 3.3 | 5.5 | 6.1 | 8.3 | 7.4 | 14.8 | 1.7 | 2.2 | 1.55% |
Other & unspecified | 1.4 | 0.9 | 1.9 | 1.7 | 2.4 | 3.9 | 4.6 | 5.5 | 9.6 | 12.5 | 23.8 | 37.3 | 39.9 | 42.1 | 42.6 | 70.5 | 7.7 | 10.8 | 6.93% |
|
|||||||||||||||||||
All sites Total | 16.1 | 7.8 | 10.1 | 11.4 | 22.4 | 34.9 | 69.7 | 95.2 | 163.7 | 255.3 | 359.1 | 506.5 | 633.7 | 665.8 | 715.9 | 850.5 | 111.7 | 159.1 | 100.00% |
All sites but C44# | 15.8 | 7.8 | 10.1 | 11.2 | 22.4 | 34.6 | 69.3 | 95.2 | 161.6 | 252.5 | 357.9 | 497.8 | 623.3 | 651.8 | 701.0 | 838.7 | 110.3 | 157.0 | 98.76% |
Calculated age specific incidence rates for Egypt 2008–2011.
Calculated age specific incidence rates for liver cancer in Egypt 2008–2011.
Calculated age specific incidence rates for breast cancer in Egypt 2008–2011.
Calculated age specific incidence rates for urinary bladder cancer in Egypt 2008–2011.
Table
The most frequent cancers in Egypt estimated using the results of the National Population-Based Registry Program of Egypt 2008–2011.
Site | % | Crude rate | ASR | |
---|---|---|---|---|
Males | Liver | 33.63 | 39.5 | 61.8 |
Bladder | 10.71 | 12.6 | 21.1 | |
Lung# | 5.69 | 6.7 | 10.4 | |
Non-Hodgkin lymphoma | 5.48 | 6.4 | 8.8 | |
Brain## | 5.48 | 6.4 | 8.8 | |
Prostate | 4.27 | 5.0 | 9.3 | |
|
||||
Females | Breast | 32.04 | 35.8 | 48.8 |
Liver | 13.54 | 15.1 | 24.4 | |
Brain## | 5.18 | 5.8 | 8.0 | |
Ovary | 4.12 | 4.6 | 6.3 | |
Non-Hodgkin lymphoma | 3.80 | 4.2 | 6.1 | |
Thyroid | 3.28 | 3.7 | 4.3 | |
|
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Both Sexes | Liver | 23.81 | 27.5 | 43.6 |
Breast | 15.41 | 17.8 | 24.3 | |
Bladder | 6.94 | 8.0 | 13.5 | |
Brain## | 5.29 | 6.1 | 8.5 | |
Non-Hodgkin lymphoma | 4.64 | 5.4 | 7.5 | |
Lung# | 4.22 | 4.9 | 7.5 |
##Includes brain and nervous system tumors.
The frequencies of individual sites of cancer and their incidence rates by geographical stratum and sex are detailed in Tables
Incidence rates/100,000 population of individual cancer sites in Lower, Middle, and Upper Egypt: males.
Primary site | Lower Egypt | Middle Egypt | Upper Egypt | ||||||
---|---|---|---|---|---|---|---|---|---|
2009–2011 | 2009 | 2008 | |||||||
Crude | ASR | % | Crude | ASR | % | Crude | ASR | % | |
Lip | 0.4 | 0.4 | 0.28% | 0.3 | 0.5 | 0.24% | 0.4 | 0.6 | 0.38% |
Tongue | 0.3 | 0.3 | 0.20% | 0.2 | 0.4 | 0.20% | 1.1 | 1.5 | 1.15% |
Mouth | 0.2 | 0.3 | 0.16% | 0.8 | 1.1 | 0.73% | 1.3 | 1.9 | 1.34% |
Salivary glands | 0.3 | 0.4 | 0.20% | 0.4 | 0.5 | 0.36% | 0.6 | 0.9 | 0.57% |
Tonsil | 0.0 | 0.0 | 0.00% | 0.0 | 0.1 | 0.04% | 0.0 | 0.0 | 0.00% |
Other oropharynx | 0.0 | 0.0 | 0.00% | 0.2 | 0.3 | 0.20% | 0.2 | 0.3 | 0.19% |
Nasopharynx | 0.5 | 0.5 | 0.35% | 0.1 | 0.1 | 0.12% | 0.6 | 1.0 | 0.57% |
Hypopharynx | 0.0 | 0.0 | 0.00% | 0.3 | 0.5 | 0.28% | 0.6 | 0.9 | 0.57% |
Pharynx unspec. | 0.1 | 0.1 | 0.04% | 0.1 | 0.1 | 0.08% | 0.2 | 0.3 | 0.19% |
Esophagus | 1.0 | 1.3 | 0.71% | 1.8 | 3.0 | 1.61% | 3.9 | 5.5 | 4.01% |
Stomach | 1.4 | 2.0 | 0.98% | 1.7 | 2.5 | 1.53% | 2.4 | 3.8 | 2.48% |
Small intestine | 0.1 | 0.1 | 0.04% | 0.5 | 0.6 | 0.44% | 0.2 | 0.2 | 0.19% |
Colon | 4.0 | 5.4 | 2.91% | 2.3 | 3.7 | 2.10% | 2.4 | 3.7 | 2.48% |
Rectum | 0.9 | 1.1 | 0.67% | 1.2 | 1.6 | 1.13% | 0.7 | 1.1 | 0.76% |
Anus | 0.4 | 0.4 | 0.28% | 0.2 | 0.2 | 0.16% | 0.4 | 0.5 | 0.38% |
Liver | 57.8 | 81 | 41.71% | 22.4 | 37.6 | 20.42% | 11.5 | 17.5 | 11.83% |
Gallbladder and so forth | 0.5 | 0.5 | 0.39% | 0.4 | 0.7 | 0.32% | 1.3 | 2.2 | 1.34% |
Pancreas | 3.2 | 4.4 | 2.28% | 2.1 | 3.5 | 1.94% | 3.5 | 5.4 | 3.63% |
Nose, sinuses and so forth | 0.1 | 0.1 | 0.04% | 0.4 | 0.6 | 0.32% | 0.6 | 0.9 | 0.57% |
Larynx | 0.8 | 1.3 | 0.59% | 3.3 | 5.7 | 3.03% | 3.9 | 6.0 | 4.01% |
Trachea, Bronchus, Lung | 7.6 | 10.1 | 5.47% | 6.3 | 10.8 | 5.77% | 7.4 | 11.5 | 7.63% |
Other Thoracic organs | 1.0 | 1.3 | 0.71% | 0.8 | 1.2 | 0.69% | 0.6 | 0.8 | 0.57% |
Bone | 1.9 | 2.4 | 1.34% | 2.3 | 3.4 | 2.10% | 1.5 | 1.9 | 1.53% |
Melanoma of skin | 0.2 | 0.2 | 0.12% | 0.1 | 0.1 | 0.12% | 0.0 | 0.0 | 0.00% |
Other skin | 1.8 | 2.7 | 1.30% | 1.7 | 2.8 | 1.53% | 1.1 | 1.8 | 1.15% |
Mesothelioma | 0.0 | 0.0 | 0.00% | 0.3 | 0.4 | 0.24% | 0.4 | 0.6 | 0.38% |
Kaposi sarcoma | 0.1 | 0.1 | 0.08% | 0.2 | 0.3 | 0.16% | 0.0 | 0.0 | 0.00% |
Connective, Soft tissue | 2.5 | 2.6 | 1.77% | 0.5 | 0.8 | 0.48% | 3.0 | 3.8 | 3.05% |
Breast | 0.7 | 0.8 | 0.47% | 0.4 | 0.6 | 0.32% | 1.1 | 1.8 | 1.15% |
Penis | 0.0 | 0.0 | 0.00% | 0.0 | 0.0 | 0.00% | 0.0 | 0.0 | 0.00% |
Prostate | 6.7 | 11.7 | 4.84% | 2.9 | 5.2 | 2.66% | 5.7 | 9.2 | 5.92% |
Testis | 0.5 | 0.4 | 0.35% | 0.5 | 0.7 | 0.48% | 0.4 | 0.5 | 0.38% |
Other male genital | 0.0 | 0.0 | 0.00% | 0.1 | 0.2 | 0.12% | 0.0 | 0.0 | 0.00% |
Kidney | 2.2 | 3.2 | 1.61% | 1.7 | 2.5 | 1.53% | 0.9 | 1.3 | 0.95% |
Renal pelvis | 0.2 | 0.3 | 0.12% | 0.5 | 0.8 | 0.48% | 0.4 | 0.5 | 0.38% |
Ureter | 0.1 | 0.1 | 0.04% | 0.0 | 0.1 | 0.04% | 0.0 | 0.0 | 0.00% |
Bladder | 12.2 | 19 | 8.82% | 15.6 | 26.4 | 14.25% | 12.2 | 19.3 | 12.60% |
Other urinary organs | 0.0 | 0.0 | 0.00% | 0.0 | 0.0 | 0.00% | 0.2 | 0.3 | 0.19% |
Eye | 0.1 | 0.2 | 0.08% | 0.3 | 0.4 | 0.24% | 0.7 | 0.6 | 0.76% |
Brain, Nervous tissue | 6.2 | 8.1 | 4.49% | 8.0 | 12.5 | 7.26% | 5.2 | 6.7 | 5.34% |
Thyroid | 1.3 | 1.5 | 0.91% | 1.2 | 1.7 | 1.05% | 0.7 | 1.1 | 0.76% |
Adrenal gland | 0.0 | 0.0 | 0.00% | 0.1 | 0.2 | 0.12% | 0.6 | 0.8 | 0.57% |
Other endocrine | 0.1 | 0.1 | 0.08% | 0.6 | 0.8 | 0.56% | 0.4 | 0.4 | 0.38% |
Hodgkin disease | 1.6 | 1.8 | 1.18% | 1.7 | 2.0 | 1.53% | 1.5 | 1.5 | 1.53% |
Non-Hodgkin lymphoma | 8.3 | 10.3 | 6.03% | 5.2 | 7.6 | 4.76% | 2.8 | 4.2 | 2.86% |
Immunoproliferative dis. | 0.0 | 0.0 | 0.00% | 0.0 | 0.0 | 0.00% | 0.0 | 0.0 | 0.00% |
Multiple myeloma | 0.7 | 0.9 | 0.51% | 0.7 | 1.1 | 0.61% | 0.2 | 0.3 | 0.19% |
Lymphoid leukemia | 1.7 | 2.2 | 1.22% | 1.8 | 2.3 | 1.61% | 3.0 | 3.1 | 3.05% |
Myeloid Leukemia | 0.9 | 1.0 | 0.63% | 1.6 | 1.8 | 1.45% | 1.9 | 2.5 | 1.91% |
Leukemia unspec. | 2.4 | 3.1 | 1.73% | 2.0 | 2.6 | 1.86% | 1.1 | 1.1 | 1.15% |
Other & unspecified | 5.9 | 8.3 | 4.25% | 13.9 | 17.6 | 12.67% | 8.7 | 13 | 8.97% |
|
|||||||||
All sites Total | 138.5 | 191.8 | 100.00% | 109.7 | 170 | 100.00% | 97.1 | 142.8 | 100.00% |
All sites but C44# | 136.7 | 189.1 | 98.70% | 108 | 167.2 | 98.47% | 96 | 141 | 98.85% |
Incidence rates/100,000 population of individual cancer sites in Lower, Middle, and Upper Egypt: females.
Primary site | Lower Egypt | Middle Egypt | Upper Egypt | ||||||
---|---|---|---|---|---|---|---|---|---|
2009–2011 | 2009 | 2008 | |||||||
Crude | ASR | % | Crude | ASR | % | Crude | ASR | % | |
Lip | 0.3 | 0.4 | 0.26% | 0.2 | 0.4 | 0.24% | 0.0 | 0.0 | 0.00% |
Tongue | 0.3 | 0.5 | 0.26% | 0.3 | 0.5 | 0.34% | 0.2 | 0.2 | 0.16% |
Mouth | 0.1 | 0.2 | 0.09% | 0.5 | 0.8 | 0.53% | 0.9 | 1.5 | 0.80% |
Salivary glands | 0.2 | 0.2 | 0.13% | 0.3 | 0.4 | 0.29% | 0.2 | 0.4 | 0.16% |
Tonsil | 0.1 | 0.1 | 0.04% | 0.0 | 0.1 | 0.05% | 0.0 | 0.0 | 0.00% |
Other oropharynx | 0.0 | 0.0 | 0.00% | 0.1 | 0.1 | 0.10% | 0.2 | 0.3 | 0.16% |
Nasopharynx | 0.1 | 0.1 | 0.04% | 0.0 | 0 | 0.05% | 0.2 | 0.2 | 0.16% |
Hypopharynx | 0.0 | 0.0 | 0.00% | 0.4 | 0.4 | 0.38% | 0.6 | 0.9 | 0.48% |
Pharynx unspec. | 0.0 | 0.0 | 0.00% | 0.0 | 0.0 | 0.05% | 0.0 | 0.0 | 0.00% |
Esophagus | 0.9 | 1.2 | 0.65% | 1.2 | 1.9 | 1.25% | 1.1 | 1.6 | 0.96% |
Stomach | 2.3 | 3.2 | 1.73% | 1.2 | 1.8 | 1.25% | 1.9 | 3.1 | 1.60% |
Small intestine | 0.3 | 0.5 | 0.22% | 0.4 | 0.6 | 0.43% | 0.6 | 0.9 | 0.48% |
Colon | 3.0 | 4.2 | 2.30% | 2.2 | 3.2 | 2.31% | 2.4 | 3.5 | 2.08% |
Rectum | 0.9 | 1.0 | 0.65% | 1.0 | 1.2 | 1.01% | 0.7 | 1.3 | 0.64% |
Anus | 0.1 | 0.1 | 0.04% | 0.1 | 0.2 | 0.14% | 0.2 | 0.3 | 0.16% |
Liver | 21.6 | 32.6 | 16.37% | 8.6 | 13.7 | 8.95% | 6.0 | 8.7 | 5.12% |
Gallbladder and so forth | 0.5 | 0.5 | 0.35% | 0.6 | 0.9 | 0.58% | 1.9 | 3.1 | 1.60% |
Pancreas | 2.1 | 3.2 | 1.60% | 0.9 | 1.4 | 0.91% | 1.7 | 2.3 | 1.44% |
Nose, sinuses and so forth | 0.3 | 0.5 | 0.26% | 0.1 | 0.2 | 0.14% | 0.2 | 0.2 | 0.16% |
Larynx | 0.2 | 0.3 | 0.17% | 0.3 | 0.4 | 0.29% | 0.4 | 0.7 | 0.32% |
Trachea, Bronchus, Lung | 3.7 | 5.3 | 2.82% | 2.2 | 3.1 | 2.26% | 2.4 | 3.8 | 2.08% |
Other Thoracic organs | 0.6 | 0.8 | 0.43% | 0.5 | 0.7 | 0.48% | 0.0 | 0.0 | 0.00% |
Bone | 2.0 | 2.3 | 1.52% | 1.8 | 2.4 | 1.92% | 3.4 | 4.4 | 2.88% |
Melanoma of skin | 0.2 | 0.3 | 0.17% | 0.0 | 0.1 | 0.05% | 0.0 | 0.0 | 0.00% |
Other skin | 1.7 | 2.4 | 1.26% | 1.0 | 1.5 | 1.06% | 1.9 | 3.1 | 1.60% |
Mesothelioma | 0.3 | 0.3 | 0.22% | 0.2 | 0.3 | 0.24% | 0.4 | 0.7 | 0.32% |
Kaposi sarcoma | 0.0 | 0.0 | 0.00% | 0.0 | 0.1 | 0.05% | 0.0 | 0.0 | 0.00% |
Connective, Soft tissue | 2.3 | 2.6 | 1.78% | 0.4 | 0.6 | 0.38% | 1.9 | 2.2 | 1.60% |
Breast | 43.8 | 53 | 33.22% | 25.8 | 35.6 | 26.84% | 45.3 | 64.5 | 38.72% |
Vulva | 0.0 | 0.0 | 0.00% | 0.3 | 0.4 | 0.34% | 0.0 | 0.0 | 0.00% |
Vagina | 0.1 | 0.2 | 0.09% | 0.1 | 0.2 | 0.14% | 0.6 | 1.0 | 0.48% |
Cervix Uteri | 1.7 | 2.4 | 1.26% | 1.0 | 1.5 | 1.06% | 0.6 | 0.9 | 0.48% |
Corpus Uteri | 0.6 | 0.9 | 0.43% | 0.6 | 0.9 | 0.67% | 1.7 | 2.9 | 1.44% |
Uterus unspec. | 3.7 | 5.3 | 2.77% | 1.0 | 1.3 | 1.06% | 2.4 | 3.8 | 2.08% |
Ovary | 5.1 | 6.4 | 3.90% | 3.6 | 5.0 | 3.75% | 7.1 | 10.2 | 6.08% |
Other female genital | 0.0 | 0.0 | 0.00% | 0.0 | 0.1 | 0.05% | 0.4 | 0.6 | 0.32% |
Placenta | 0.0 | 0.0 | 0.00% | 0.0 | 0.0 | 0.05% | 0.2 | 0.2 | 0.16% |
Kidney | 1.1 | 1.6 | 0.87% | 1.2 | 1.8 | 1.25% | 0.7 | 1.1 | 0.64% |
Renal pelvis | 0.2 | 0.3 | 0.17% | 0.2 | 0.3 | 0.19% | 0.2 | 0.2 | 0.16% |
Ureter | 0.0 | 0.0 | 0.00% | 0.0 | 0.0 | 0.00% | 0.0 | 0.0 | 0.00% |
Bladder | 3.7 | 5.9 | 2.77% | 3.1 | 4.9 | 3.27% | 3.6 | 5.7 | 3.04% |
Other urinary organs | 0.1 | 0.1 | 0.04% | 0.0 | 0.0 | 0.00% | 0.0 | 0.0 | 0.00% |
Eye | 0.1 | 0.1 | 0.04% | 0.3 | 0.5 | 0.34% | 0.2 | 0.2 | 0.16% |
Brain, Nervous tissue | 5.8 | 7.4 | 4.42% | 7.4 | 11.1 | 7.70% | 2.4 | 2.9 | 2.08% |
Thyroid | 5.1 | 5.4 | 3.90% | 1.6 | 2.1 | 1.64% | 3.6 | 4.2 | 3.04% |
Adrenal gland | 0.2 | 0.3 | 0.17% | 0.2 | 0.3 | 0.24% | 0.2 | 0.2 | 0.16% |
Other endocrine | 0.1 | 0.0 | 0.04% | 0.5 | 0.7 | 0.53% | 0.2 | 0.2 | 0.16% |
Hodgkin disease | 1.0 | 0.7 | 0.74% | 1.0 | 1.0 | 1.01% | 0.9 | 0.9 | 0.80% |
Non-Hodgkin lymphoma | 5.4 | 6.7 | 4.11% | 4.2 | 5.8 | 4.43% | 2.6 | 3.8 | 2.24% |
Immunoproliferative dis. | 0.0 | 0.0 | 0.00% | 0.0 | 0.0 | 0.00% | 0.0 | 0.0 | 0.00% |
Multiple myeloma | 0.7 | 0.9 | 0.52% | 0.1 | 0.3 | 0.14% | 0.2 | 0.0 | 0.16% |
Lymphoid leukemia | 1.0 | 1.1 | 0.74% | 1.2 | 1.6 | 1.25% | 1.5 | 1.6 | 1.28% |
Myeloid Leukemia | 0.9 | 1.1 | 0.65% | 1.7 | 2.0 | 1.78% | 2.2 | 3.3 | 1.92% |
Leukemia unspec. | 1.8 | 2.4 | 1.34% | 1.6 | 2.0 | 1.68% | 1.9 | 2.3 | 1.60% |
Other & unspecified | 5.9 | 8.2 | 4.46% | 14.3 | 15.5 | 14.86% | 9.2 | 12.9 | 7.84% |
|
|||||||||
All sites Total | 131.7 | 173.3 | 100.00% | 95.9 | 132.1 | 100.00% | 116.9 | 167.1 | 100.00% |
All sites but C44# | 130.1 | 170.9 | 98.74% | 94.9 | 130.7 | 98.94% | 115.1 | 163.9 | 98.40% |
Proportions and incidence rates of the most frequently observed cancers in the 3 regions of Egypt.
Lower Egypt | Middle Egypt | Upper Egypt | ||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|
2009–2011 | 2009 | 2008 | ||||||||||
Site | % | Crude rate | ASR | Site | % | Crude rate | ASR | Site | % | Crude rate | ASR | |
Males | Liver | 41.7 | 57.8 | 81.0 | Liver | 20.4 | 22.4 | 37.6 | Bladder | 12.6 | 12.2 | 19.3 |
Bladder | 8.8 | 12.2 | 19.0 | Bladder | 14.2 | 15.6 | 26.4 | Liver | 11.8 | 11.5 | 17.5 | |
NHL | 6.0 | 8.3 | 10.3 | Brain# | 7.3 | 8.0 | 12.5 | Lung## | 7.6 | 7.4 | 11.5 | |
Lung## | 5.5 | 7.6 | 10.1 | Lung## | 5.8 | 6.3 | 10.8 | Leukemia | 6.1 | 6.0 | 6.7 | |
Prostate | 4.8 | 6.7 | 11.7 | Leukemia | 4.9 | 5.4 | 6.7 | Prostate | 5.9 | 5.7 | 9.2 | |
|
||||||||||||
Females | Breast | 33.2 | 43.8 | 53.0 | Breast | 26.8 | 25.8 | 35.6 | Breast | 38.7 | 45.3 | 64.5 |
Liver | 16.4 | 21.6 | 32.6 | Liver | 8.9 | 8.6 | 13.7 | Ovary | 6.1 | 7.1 | 10.2 | |
Brain# | 4.4 | 5.8 | 7.4 | Brain# | 7.7 | 7.4 | 11.1 | Liver | 5.1 | 6.0 | 8.7 | |
NHL | 4.1 | 5.4 | 6.7 | Leukemia | 4.7 | 4.5 | 5.6 | Leukemia | 4.8 | 5.6 | 7.2 | |
Thyroid | 3.9 | 5.1 | 5.4 | NHL | 4.4 | 4.2 | 5.8 | Uterus | 3.5 | 4.1 | 6.7 | |
|
||||||||||||
Both Sexes | Liver | 29.6 | 40.1 | 56.8 | Liver | 15.2 | 15.6 | 25.7 | Breast | 21.6 | 23.1 | 33.2 |
Breast | 16.1 | 21.7 | 26.9 | Breast | 12.4 | 12.8 | 18.1 | Liver | 8.2 | 8.8 | 13.1 | |
Bladder | 5.9 | 8.0 | 12.5 | Bladder | 9.2 | 9.5 | 15.7 | Bladder | 7.4 | 7.9 | 12.5 | |
NHL | 5.1 | 6.9 | 8.5 | Brain# | 7.5 | 7.7 | 11.8 | Leukemia | 5.4 | 5.7 | 7.0 | |
Brain# | 4.5 | 6.0 | 7.8 | Leukemia | 4.8 | 4.9 | 6.2 | Lung## | 4.6 | 4.9 | 7.7 |
##Includes trachea, bronchus and lung tumors.
Among males in the 3 regions, liver and bladder cancer occupied the top 2 ranks. The proportion and ASR of liver cancer were highest in Lower Egypt (41.7% and 81.0/100,000) and lowest in Upper Egypt (11.8% and 17.5/100,000). Cancer of the lung occupied the third or fourth ranks representing 5–7% of cancers and Non-Hodgkin lymphoma was among the 5 most common cancers in Lower Egypt only having a proportion of 6.0% and ASR 10.3/100,000.
Among females, the pattern in the 3 regions was dominated by the high frequency of breast cancer and liver cancer. Proportion of liver cancer was highest in Lower Egypt (16.4%), less in Middle Egypt, and lowest in Upper Egypt (8.9% and 5.1% resp.).
During the period 2013–2050, population of Egypt is expected to increase to approximately 160% the 2013 population size. Applying the current age-specific incidence rates to successive populations would lead to a progressive increase in number of incident cases from 114,985 in 2013 to 331,169 in 2050, approximately 290% of 2013 incidence (Table
Estimated number of cancer cases, Egypt 2013–2050.
2013 | 2015 | 2020 | 2025 | 2050 | |||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Males | Females | Total | Males | Females | Total | Males | Females | Total | Males | Females | Total | Males | Females | Total | |
Lip | 135 | 126 | 262 | 146 | 135 | 281 | 178 | 164 | 342 | 206 | 202 | 408 | 438 | 427 | 866 |
Tongue | 155 | 175 | 330 | 164 | 185 | 349 | 186 | 231 | 417 | 219 | 296 | 515 | 417 | 763 | 1180 |
Mouth | 228 | 163 | 391 | 243 | 178 | 420 | 275 | 216 | 491 | 314 | 261 | 575 | 544 | 528 | 1071 |
Salivary glands | 147 | 108 | 255 | 158 | 117 | 275 | 189 | 130 | 319 | 222 | 153 | 375 | 495 | 265 | 760 |
Tonsil | 6 | 31 | 37 | 6 | 33 | 40 | 9 | 41 | 50 | 11 | 54 | 65 | 13 | 129 | 142 |
Other oropharynx | 42 | 25 | 67 | 45 | 28 | 73 | 54 | 30 | 85 | 63 | 37 | 100 | 132 | 65 | 198 |
Nasopharynx | 145 | 32 | 178 | 154 | 34 | 188 | 171 | 40 | 211 | 207 | 42 | 249 | 428 | 68 | 496 |
Hypopharynx | 72 | 80 | 152 | 76 | 85 | 161 | 88 | 96 | 184 | 102 | 111 | 213 | 200 | 173 | 372 |
Pharynx unspec. | 35 | 7 | 42 | 36 | 7 | 43 | 42 | 7 | 48 | 55 | 7 | 62 | 94 | 8 | 102 |
Oesophagus | 699 | 485 | 1184 | 746 | 525 | 1271 | 897 | 644 | 1542 | 1065 | 762 | 1827 | 2249 | 1504 | 3752 |
Stomach | 726 | 969 | 1695 | 772 | 1045 | 1816 | 922 | 1249 | 2171 | 1080 | 1484 | 2565 | 2185 | 2877 | 5062 |
Small intestine | 98 | 179 | 277 | 106 | 194 | 300 | 120 | 229 | 349 | 134 | 274 | 408 | 223 | 507 | 730 |
Colon | 1522 | 1339 | 2862 | 1618 | 1437 | 3055 | 1893 | 1715 | 3608 | 2225 | 2063 | 4287 | 4465 | 4120 | 8585 |
Rectum | 464 | 406 | 871 | 490 | 432 | 922 | 568 | 502 | 1070 | 645 | 584 | 1230 | 1097 | 1052 | 2149 |
Anus | 133 | 50 | 183 | 142 | 53 | 195 | 162 | 65 | 227 | 178 | 71 | 249 | 291 | 127 | 418 |
Liver | 19646 | 8345 | 27991 | 20932 | 9043 | 29975 | 24420 | 10900 | 35320 | 28580 | 12933 | 41513 | 59047 | 26425 | 85471 |
Gallbladder and so forth | 235 | 324 | 559 | 248 | 350 | 598 | 297 | 413 | 710 | 348 | 488 | 835 | 715 | 967 | 1682 |
Pancreas | 1350 | 876 | 2226 | 1440 | 957 | 2397 | 1676 | 1160 | 2836 | 1961 | 1405 | 3366 | 3912 | 2971 | 6883 |
Nose, sinuses and so forth | 98 | 136 | 234 | 104 | 144 | 247 | 124 | 170 | 294 | 154 | 186 | 340 | 340 | 322 | 661 |
Larynx | 933 | 134 | 1067 | 993 | 142 | 1136 | 1194 | 173 | 1367 | 1428 | 201 | 1629 | 3094 | 395 | 3489 |
Trachea, Bronchus, Lung | 3304 | 1586 | 4890 | 3530 | 1703 | 5233 | 4168 | 2031 | 6198 | 4889 | 2404 | 7293 | 10176 | 4895 | 15071 |
Other Thoracic organs | 368 | 260 | 628 | 393 | 277 | 670 | 464 | 335 | 798 | 551 | 415 | 966 | 1149 | 897 | 2046 |
Bone | 889 | 957 | 1846 | 935 | 1011 | 1946 | 1068 | 1174 | 2242 | 1216 | 1330 | 2546 | 2212 | 2401 | 4613 |
Melanoma of skin | 60 | 59 | 119 | 66 | 66 | 132 | 82 | 84 | 166 | 95 | 105 | 200 | 181 | 207 | 388 |
Other skin | 797 | 749 | 1547 | 853 | 813 | 1666 | 1018 | 973 | 1990 | 1205 | 1160 | 2365 | 2641 | 2306 | 4947 |
Mesothelioma | 55 | 106 | 161 | 58 | 116 | 174 | 65 | 143 | 207 | 76 | 161 | 238 | 135 | 321 | 456 |
Kaposi sarcoma | 60 | 8 | 68 | 63 | 9 | 72 | 72 | 10 | 82 | 81 | 13 | 95 | 159 | 28 | 187 |
Connective, Soft tissue | 801 | 751 | 1552 | 846 | 787 | 1633 | 981 | 901 | 1882 | 1113 | 1026 | 2139 | 1924 | 1796 | 3720 |
Breast | 287 | 17905 | 18192 | 306 | 19105 | 19411 | 362 | 22320 | 22682 | 422 | 25793 | 26215 | 807 | 45243 | 46050 |
Vulva | 0 | 52 | 52 | 0 | 56 | 56 | 0 | 63 | 63 | 0 | 76 | 76 | 0 | 146 | 146 |
Vagina | 0 | 95 | 95 | 0 | 103 | 103 | 0 | 126 | 126 | 0 | 147 | 147 | 0 | 305 | 305 |
Cervix Uteri | 0 | 701 | 701 | 0 | 752 | 752 | 0 | 882 | 882 | 0 | 1039 | 1039 | 0 | 2039 | 2039 |
Corpus Uteri | 0 | 392 | 392 | 0 | 426 | 426 | 0 | 502 | 502 | 0 | 600 | 600 | 0 | 1256 | 1256 |
Uterus unspec. | 0 | 1353 | 1353 | 0 | 1456 | 1456 | 0 | 1758 | 1758 | 0 | 2055 | 2055 | 0 | 4143 | 4143 |
Ovary | 0 | 2288 | 2288 | 0 | 2434 | 2434 | 0 | 2830 | 2830 | 0 | 3311 | 3311 | 0 | 5957 | 5957 |
Other female genital | 0 | 30 | 30 | 0 | 34 | 34 | 0 | 44 | 44 | 0 | 55 | 55 | 0 | 134 | 134 |
Placenta | 0 | 14 | 14 | 0 | 14 | 14 | 0 | 14 | 14 | 0 | 15 | 15 | 0 | 18 | 18 |
Penis | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
Prostate | 2544 | 0 | 2544 | 2747 | 0 | 2747 | 3398 | 0 | 3398 | 4295 | 0 | 4295 | 10785 | 0 | 10785 |
Testis | 229 | 0 | 229 | 240 | 0 | 240 | 266 | 0 | 266 | 291 | 0 | 291 | 425 | 0 | 425 |
Other male genital | 21 | 0 | 21 | 22 | 0 | 22 | 28 | 0 | 28 | 33 | 0 | 33 | 73 | 0 | 73 |
Kidney | 877 | 561 | 1438 | 934 | 594 | 1528 | 1080 | 693 | 1774 | 1274 | 801 | 2076 | 2628 | 1487 | 4115 |
Renal pelvis | 141 | 99 | 240 | 152 | 103 | 255 | 183 | 115 | 297 | 214 | 126 | 341 | 446 | 196 | 642 |
Ureter | 22 | 0 | 22 | 24 | 0 | 24 | 31 | 0 | 31 | 41 | 0 | 41 | 111 | 0 | 111 |
Bladder | 6362 | 1872 | 8234 | 6852 | 2038 | 8891 | 8228 | 2481 | 10709 | 9746 | 3016 | 12762 | 21783 | 6554 | 28337 |
Other urinary organs | 8 | 21 | 29 | 8 | 23 | 31 | 10 | 27 | 37 | 11 | 35 | 46 | 22 | 72 | 94 |
Eye | 89 | 82 | 171 | 92 | 87 | 180 | 98 | 96 | 194 | 104 | 108 | 212 | 160 | 195 | 355 |
Brain, Nervous tissue | 3072 | 2933 | 6004 | 3256 | 3133 | 6389 | 3779 | 3721 | 7500 | 4390 | 4351 | 8740 | 8439 | 8450 | 16888 |
Thyroid | 547 | 1759 | 2306 | 582 | 1867 | 2448 | 661 | 2106 | 2767 | 748 | 2363 | 3111 | 1298 | 3814 | 5113 |
Adrenal gland | 43 | 105 | 149 | 46 | 109 | 155 | 52 | 113 | 166 | 57 | 121 | 178 | 102 | 180 | 282 |
Other endocrine | 129 | 95 | 224 | 136 | 100 | 236 | 156 | 114 | 269 | 174 | 125 | 300 | 273 | 188 | 462 |
Hodgkin disease | 647 | 321 | 968 | 673 | 336 | 1008 | 751 | 371 | 1123 | 837 | 397 | 1234 | 1245 | 527 | 1772 |
Non-Hodgkin lymphoma | 3053 | 2188 | 5241 | 3223 | 2345 | 5568 | 3689 | 2755 | 6444 | 4240 | 3202 | 7442 | 7749 | 6135 | 13884 |
Immunoproliferative dis. | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
Multiple myeloma | 316 | 200 | 516 | 334 | 218 | 552 | 386 | 264 | 650 | 432 | 321 | 753 | 819 | 644 | 1463 |
Lymphoid leukaemia | 801 | 471 | 1272 | 841 | 493 | 1335 | 926 | 551 | 1477 | 1000 | 603 | 1604 | 1535 | 896 | 2431 |
Myeloid Leukaemia | 511 | 614 | 1125 | 534 | 642 | 1176 | 595 | 727 | 1323 | 666 | 810 | 1476 | 1054 | 1358 | 2412 |
Leukemia unspec. | 965 | 842 | 1807 | 1005 | 891 | 1896 | 1131 | 1027 | 2157 | 1295 | 1188 | 2483 | 2226 | 2169 | 4395 |
Other & unspecified | 3692 | 3965 | 7657 | 3921 | 4232 | 8153 | 4573 | 4971 | 9543 | 5358 | 5793 | 11151 | 10582 | 11026 | 21607 |
|
|||||||||||||||
All sites Total | 57558 | 57426 | 114985 | 61288 | 61495 | 122783 | 71759 | 72496 | 144255 | 84045 | 84679 | 168723 | 171494 | 159675 | 331169 |
All sites but C44# | 56761 | 56677 | 113438 | 60435 | 60683 | 121117 | 70742 | 71523 | 142265 | 82840 | 83519 | 166358 | 168854 | 157369 | 326223 |
Estimated number of cases in Egypt (2013–2050).
Estimated number of cases in Egypt (2013–2050) and causes of the increase in cases.
When the National Cancer Registry Program of Egypt was designed, there had been a number of challenges that were addressed. One of the most important challenges was design of a sample that could be representative of such a big country. Other challenges included complete capture of incident cancer cases among residents of selected governorates and best guarantee of quality of data and sustainability of the program to avoid going through survey-like data collection that need to be repeated, a methodology that proved to be inappropriate [
Dealing with population-based registration, the word national might be confusing. Actually, and with the exception of very few examples mainly old registries like that of Denmark and registries in small countries like Singapore, complete national coverage is not accomplished [
With this in mind, Egypt was geographically stratified for registration purposes into 3 regions: Lower Egypt, to the north of Cairo, and Middle, and Upper Egypt to the south. Three governorates were selected from the 3 regions representing 20.9% of the total population of Egypt. The greater Cairo, including the capital city, and Alexandria, the second capital (approximately 18 million population), were not included in the program due to difficulty in data collection and coverage of a population that daily migrates in and out of these 2 regions. Other regions that were not covered were frontier governorates; namely Matrooh, New Valley, Red Sea, and Sinai, together representing 3.3% of total population [
To ensure complete coverage of incident cancer patients in the selected governorates, data were actively collected from medical records of oncology centers within the governorates and from national referral centers like National Cancer Institute in Cairo. Registration covered health-insured patients and patients treated on government-subsidized treatment program would minimize under registration considered a point of strength of the registry. Also, regular check of death registers helped to decrease the possibility of under registration. Death certificate only cases (DCO) accounted for almost 8% of cases which could be considered an acceptable level for a newly established registry [
One of the elements that contributed to the National Cancer Registry Program of Egypt was the use of a unique national identification number for duplicate elimination to prevent over registration, which is a serious threat to population-based registries [
We also developed a mathematical model to apply the regional age-specific incidence rates to the corresponding population structure to get national estimates of all cancers and for individual cancer sites for any specified year. Mathematical modeling is a common practice used to estimate national rates from statistics of regional registries. Recently, a model was developed for china to get national rates based upon regional registries [
Nonetheless, the program has its points of weakness. The data should be carefully interpreted in view of the short initial phase of registration that would be of better accuracy on successive years [
The results given in the current report are the first ever published incidence rates on a national and regional level for Egypt derived from a population-based cancer registry program. These incidence rates would replace the proportions that have always been derived from hospital-based results [
The estimated incidence rates showed differences between the 3 regions that were mainly in the incidence of liver and bladder cancers. Among males, the proportion of incident liver cancer was highest in Lower Egypt (41.7%) and next in Middle Egypt (20.4%) and lowest in Upper Egypt (11.8%). Bladder cancer ranked next to liver cancer in Lower Egypt (8.8%). In Middle Egypt, the proportion was 14.2%, still lower than liver cancer. In Upper Egypt, liver cancer was still the most common cancer, with a small difference from bladder cancer (12.6%). These differences could be attributed to the high prevalence of hepatitis C viral infection (HCV), which is one of the highest prevalence rates worldwide [
Among females, the pattern in Lower, Middle, and Upper Egypt was dominated by the high frequency of breast cancer (33.8%, 26.8% and 38.7% resp.) and liver cancer (16.4%, 8.9% and 5.1% resp.). This pattern of liver cancer was similar to that of males with similar relation to the prevalence of HCV. Other differences in site distribution between the 3 regions will be detailed in a separate publication [
The national age standardized incidence rates for all cancers in Egypt, excluding nonmelanoma skin cancer, were 175.9/100,000 for males, 157.0/100,000 for females, and 166.6/100,000 for both sexes. The age-standardized rates were intermediate between the rates of more and less developed countries [
The model used in our study revealed the seriousness of the liver cancer that ranked first among cancers in males (33.6%) and next to breast cancer. Among females the proportion of breast cancer was 32.0% followed by liver cancer (13.5%). The high prevalence of HCV especially genotype IV would explain this high incidence [
Incidence rate of bladder cancer that ranked next to liver cancer in males was also high. The age-standardized rates are 16.9/100,000 (more developed) and 5.3/100,000 (less developed) compared to 21.1/100,000 in Egypt. Breast cancer was the most frequent cancer among females. The age-standardized rates are 74.1/100,000 (more developed), 31.3/100,000 (less developed), and 48.8/100,000 (Egypt). Analysis of individual sites of cancers will be detailed in a separate publication [
Applying the model over successive years for the projected populations showed an increase in number of incident cases from approximately 115,000 patients in 2013 to more than 331,000 in 2050, almost 3-fold increase. The fraction of increase due to population growth gradually decreased over the years with a corresponding increase in the fraction due to demographic transition with ageing of the population. The cancer problem in Egypt would thus be expected to continue simply due to the inevitable ageing of the population with better standards of health care (Table
Estimated cancer incidence in the period 2013–2050 and causes of increase.
2013 | 2015 | 2020 | 2025 | 2050 | |
---|---|---|---|---|---|
Estimated population | 85294388 (100%) | 88487396 (103.7%) | 96260017 (112.9%) | 103742157 (121.6%) | 137872522 (161.6%) |
Number of cases#1 | 114985 | 122783 (106.8%) | 144255 (125.5%) | 168723 (146.7%) | 331169 (288.0%) |
Increased cases from 2013#2 | 7798 (6.8%) | 29270 (25.5%) | 53738 (46.7%) | 216184 (188.0%) | |
Increased cases due to population growth#3 | 4303 | 14783 | 24869 | 70880 | |
Increased cases due to population structure change#4 | 3494 | 14487 | 28869 | 145304 | |
% Increase due to population growth#5 | 55.20% | 50.50% | 46.28% | 32.79% |
N.B.
#1Number of expected cases depending on 2013 rates of incidence.
#2Number of increased cases from 2013 number of cases.
#3Number of increased cases (from 2013) that is attributed to increase in population number (population growth).
#4Number of increased cases (from 2013) that is attributed to change in population structure (aging of population) and not to population growth.
#5Percent of increased number of cases (from 2013) that can be attributed to population growth only (not due to change in population structure).
Rates estimated by the model developed for the study were based on certain assumptions that should be considered in interpretation of results. These assumptions were: (a) constant age-specific rates during the study period; (b) populations of Greater Cairo and Alexandria would be considered a mosaic of the 3 registration regions and would affect the number of incident cases, and not rates; and (c) exclusion of frontier governorates (3.3% of total population of Egypt) that need special studies to get reliable cancer statistics.
These results are the first ever published incidence rates for Egypt on a national and regional level and clearly demonstrated the seriousness of the cancer problem of Egypt with age-adjusted incidence rates approaching those of the more developed countries. Liver cancer is a serious if not the most serious cancer problem in Egypt. Nonetheless, these rates should be carefully interpreted being based on a short initial phase of registration and a mathematical model that used regional incidence rates.
(1) Number of incident cancer cases
(2) Total incident cases in region
(3) Total incident cases in the 3 regions
(4) Incident cases in total Egypt
(5) Calculation of national age specific incidence rates
The same procedure was followed applying
For estimation of incident cancer in a specific year till 2050, the national age specific incidence rates by sex were applied to the corresponding population structure [
Age specific incidence rate
Age standardized rate
Death certificate only
Hepatitis C virus
International Agency for Research on Cancer
International Statistical Classification of Diseases and related health problems, 10th revision
National Cancer Registry Program of Egypt
Non-Hodgkin Lymphoma
Surveillance, Epidemiology, and End Results Program.
The authors declare that there is no conflict of interests regarding the publication of this paper.
The authors acknowledge the important role played by staff of the Ministry of Communication and Information technology specially Dr. Hesham El Deeb engineers El-Sayed Abdelwahid and Mohamed Hamid who were actively behind success of the registry. The dedication of data managers who supervised peripheral registries’ activities during the initial phase of registration, namely, Drs. Amir Bishara (Aswan), Hassan Afifi (Minya), Tarek Heikal (Damietta), and Professor Nelly Alieldin (National Cancer Institute, Cairo University) is also acknowledged. Furthermore, this work would have not been accomplished without the remarkable effort of abstractors, coders, and supporting staff in participating registries.