The spectrum of cancer in Papua New Guinea. An analysis based on the Cancer Registry 1979-1988

Malignant tumors registered with the Tumour Registry of Papua New Guinea (PNG) from 1958-1988 were analyzed with emphasis on the variation of incidence with time and different regions. Cancer incidence was generally low in PNG. During this period, carcinoma of oral cavity, cervix, breast, and skin, hepatoma, and lymphoma were the most common types of malignant lesions detected. The incidence of carcinoma of the oral cavity has increased. Currently, it is more common in the Highlands region and is associated with the spread of betel nut chewing. A threefold increase in cervical carcinoma registration was observed nationally, with a sixfold increase in the Highlands region; this was attributed both to social changes and improved registration. The incidence of breast cancer has doubled, in keeping with better registration, but there is little interregional variation. The decline in registrations of hepatocellular carcinoma is artifactual. PNG is a high-incidence area for Burkitt lymphoma, but Hodgkin disease is rare. Both Burkitt and other non-Hodgkin lymphomas are uncommon in the Highlands. A decline in the incidence of squamous carcinoma of skin was observed that was associated with improved control of tropical ulcers. The incidence of stomach cancer is falling. The registered cancer incidence in PNG is low, even when compared with that in native people from other Pacific nations, such as Fijians and New Caledonian Melanesians. Preventive measures have been hitherto ineffective, with the exception of squamous carcinoma of skin.