Incidence and Trends of Prostate Cancer in Karachi South, 1995- 2002


Introduction: Cancer prostate (CaP) is a commonly diagnosed cancer in western men, but there is sparseinformation about the demographics of this malignancy in Pakistan. The study objective was to provide anoverview of CaP in Karachi, Pakistan. Methodology: Epidemiological data of 282 incident CaP cases registeredat Karachi Cancer Registry (KCR) during 1st January 1995 to 31st December 2002 were reviewed. Incidenceand trends were studied in 2 time periods, 1995-7 and 1998-2002.
Results: In 1995-7, CaP accounted forapproximately 3.4% of the cancers in males and ranked 8th in hierarchy with an age standardized incidencerate (ASR) world and crude incidence rate (CIR) per 100,000 of 6.0 and 2.8 respectively. During 1998-2002, CaPaccounted 4.6% of the cancers, ranked 4th with an ASR world and CIR per 100,000 of 10.1 and 4.4. Thus anapproximate 60% increase was observed between 1995 and 2002. Mean ages of the patients were 67.0 and 67.4years. Age-specific curves showed a gradual increase in risk from the fifth decade onwards. A marginal downstaging was also observed in period 2, more apparent in the more educated Mohajir and Punjabi ethnicities.
Conclusion: Karachi falls into a low risk region for CaP, with a rapidly increasing incidence and a marginaldown staging. The probable reasons for the lower incidence are a low life expectancy, lack of availability oraccessibility to health care and lack of public awareness. Implementation of CaP screening and public healtheducation is a necessity today. The low incidence of CaP in Pakistan may be an artefact!