Cancer treatment in Pakistan: challenges & obstacles.
BACKGROUND
There is no population based tumor registry in Pakistan except for Karachi. A Department based tumor registry was established to determine the patterns of cancers in Pakistan especially Punjab. Other objectives were to determine socioeconomic status, disease stage, co-morbid conditions. We also tried to determine if patients had received optimal treatment on diagnosis.


METHODS
3,274 patients presented to the Department of Oncology between 1995-2000. All patients had histopathologically confirmed diagnosis of cancer. Demographic data included age, sex, socioeconomic status, smoking, other co-morbid and occupation.


RESULTS
The Oncology Department drains a catchment area of approximately 400 square kms in Punjab. Breast cancer was the most common cancer in females while leukemias and lymphomas were most common in males. Poor socio-economic status was present in 89% of cases. Illiteracy was present in 76%. Comorbid conditions like hepatitis B & C were present in 37% of patients. Advanced disease was documented in 59% patients. Optimal treatment on initial diagnosis was not provided to 45% patients.


CONCLUSIONS
Advanced stage, poor socio-economic status, illiteracy were common. Associated co-morbid conditions were a major cause in delay in treatment. Optimal treatment was not provided to majority of patients. All these factors are contributing to poor cure rates seen in Pakistan.
Aziz
Zeba
Z
Department of Oncology, Allama Iqbal Medical College, LCCHS, 13/2 V Block, Phase II, Lahore, Pakistan.
Sana
Sherjeel
S
D015897:Comorbidity; D005260:Female; D006801:Humans; D008297:Male; D009369:Neoplasms / Q000453:epidemiology / Q000401:mortality / Q000628:therapy*; D010154:Pakistan / Q000453:epidemiology; D012042:Registries; D012959:Socioeconomic Factors; D015996:Survival Rate