Roohullah, Khursheed M A, Muhammad Ayub Shah, Zainullah Khan, Haider S W, Burdy G M, Kamran S, Farah Khan.
An alarming occurence of esophageal cancer in Balochistan.
Pak J Med Res Jan ;44(2):101-4.

Objective: To evaluate the prevalence, geographical features and disease characteristics of Cancer of Esophagus in patients registered at Centre for Nuclear Medicine and Radiotherapy (CENAR). Patients and Methods: From January 1991 to Dec 2001 832 cases of esophageal cancer were seen at CENAR Hospital Quetta. Only cases confirmed by Histopathology and for whom the esophagus was the primary site of tumor were included in the study. The mean age of the patients was 50 + 13year) The geographical background and disease characteristics were elaborated, by calculating statistical ratios and percentages of various demographic variables, in different subgroups of patients. Results: Cancer of esophagus is 3rd commonest tumor (11.3% of total registered cases) and on average, the annual proportion of esophageal cancer constitutes a figure of 11 cases per hundred patients diagnosed at CENAR Hospital. It is third common tumor in male and 4th common in female, with Male to female ratio of 1.37. It is about 1.33 times more common in Balochistan than in Afghanistan. Naswar and beetle nut chewing (31%), malnutrition (56%) and Alcohol (13 %) were among the common risk factors present in this study population. About 90% of the cases were of Squamous cell variety and 85% of the patients were diagnosed when disease has progressed to stage ¾.and upto 60 % cases involve lower third of esophagus. Forty percent of the patients were in 4th decade of life at time of diagnosis. Conclusion: The areas that surround CENAR Hospital in Balochistan Province seem to be a high-risk belt for esophageal cancer. It is also common in Afghanistan and Peshawar. Naswar and beetle nut chewing along with malnutrition and alcohol might be important contributory risk factors.

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