Is Kelantan Joining the Global Cancer Epidemic? - Experience from Hospital Universiti Sains Malaysia; 1987-2007

Objective: To determine the trend of cancer cases in one major hospital in Kelantan over a 20 year periodfrom 1987 to 2007 and to speculate the change in trend due to the socio-economic and other health status in thestate. Methodology: All data on clinically diagnosed cancer cases in Hospital Universiti Sains Malaysia [HUSM]were retrieved from the hospital medical records. The cancers were classified according to ICD10 and scrutinizedto avoid duplicate or more entries. The increment in cancer incidence was calculated based on total numbers ofcancer cases per each 5-6 year period.
Results: A total of 12,228 solid cancers were diagnosed during the period.There is an increment of 20.1% for 1991-1996 from 1987-1990 period, 67.4% for 1997-2001 from 1991-1996period and 305.9% for 2002-2007 from the 1997-2001 period. The rise was steep in the last 5-6 years. Afterexcluding referred cases from states outside Kelantan, the increments were 20.1%, 67.4% and 143.6% for theconsecutive 5-6 year periods. The predominant rising trends were seen for cancers of the female organs, digestivetract and endocrine organs.
Conclusion: Cancer cases in HUSM are showing a rising trend, associated withincreasing prevalence of smoking, obesity and diabetes in the community served by the hospital. Since HUSMis the only hospital managing cancer in the state of Kelantan, to reduce cancer incidence in the state, life-styleissues need to be addressed.