Profile of cancer in Riyadh Armed Forces Hospital

The relative frequency of malignant disease varies with sex, age, race and geographic location. The frequency differs among the developed and developing countries. A review of the first 5000 histologically confirmed malignancies seen at the Riyadh Armed Forces Hospital Oncology Department confirmed differences from those encountered elsewhere. With the absence of a National Cancer Registry, only relative frequencies can be reported. In this series, gastrointestinal tract cancers were the most frequent, at nearly 18%, with high relative frequency of cancers of the liver and esophagus. Colorectal malignancies were less frequent than in the West. Lymphoma was the second most frequent malignancy at 13% with 2.5:1 ratio of non-Hodgkin lymphoma to Hodgkin disease. In both groups, poor prognostic histological varieties were more frequent than in the West. Breast cancer was the most frequent malignancy in females, accounting for 24% of all female cancers, in spite of the infrequency of the traditional risk factors of nulliparity, late age of first pregnancy, late age of menopause, and high dietary fat consumption. Two-thirds of patients with breast cancer were premenopausal. Other malignancies encountered at a higher frequency than in developed countries include hepatocellular carcinoma and nasopharyngeal cancer. This high relative frequency could be related to the high incidence of viral hepatitis and Epstein-Barr virus infections, respectively. The high relative frequency of oral cavity cancers is presumed to be due to chewing Qat and Shama. Thyroid cancer relative frequency was just over 5%, with a high predominance in females. No obvious etiological factors are identified. The relative frequency of bronchogenic cancer is low at 5%. This is likely to increase with the progressive rise in the habit of cigarette smoking. Skin cancer, on the other hand, is low, presumably due to the traditional dress covering the entire body and the head.