Cancer treatment in Pakistan: challenges & obstacles.

INTRODUCTION

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.

MATERIALS & 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.

DISCUSSION

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.