Patterns of Cancer Frequency in Balochistan: Regional Perspectives and Implications for Cancer Control.
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OBJECTIVE: To evaluate the distribution of cancers across different age groups among residents of Balochistan from 2021 to 2024 and compare these patterns with those observed in other provinces of Pakistan. STUDY DESIGN: An observational study. Place and Duration of the Study: Pathology-based cancer registry at the Section of Histopathology, Department of Pathology and Laboratory Medicine, Aga Khan University Hospital, Karachi, Pakistan, and Department of Pathology, Aria Institute of Medical Sciences, Quetta, Pakistan, from January 2021 to December 2024. METHODOLOGY: Newly diagnosed, biopsy-confirmed malignant cases received from Quetta and other cities of Balochistan through the Aga Khan University Hospital laboratory network and the collaborating Institute over four years from the cancer registry and one year from the other institute were analysed. Patients were grouped by age and gender into children (0-14 years), adolescents (15-19 years), and adults (≥20 years). Duplicate records were removed through systematic verification. Categorical variables were evaluated using frequencies and percentages. RESULTS: Out of 16,342 biopsy specimens, 5,145 (31.5%) were malignant. There were 52% (n = 2,659) male and 48% (n = 2,486) female cases. Adults accounted for 93% of cases, while children and adolescents accounted for 7%. Among a total of 2,438 adult males, oesophageal cancer was most frequent (425, 17.4%), followed by stomach (351, 14.4%) and colorectal cancers (225, 9.2%). Out of the total 2,351 adult females, breast cancer was the leading malignancy (526, 22.4%), followed by oesophageal (434, 18.5%) and colorectal cancers (133, 5.7%). In younger groups, brain tumours and lymphomas predominated. CONCLUSION: Marked predominance of oesophageal cancer in both genders highlights substantial regional variation. Overall, the predominance of gastrointestinal cancers suggests the presence of region-specific environmental risk factors. KEY WORDS: Cancer registry, Balochistan, Oesophageal cancer, Colorectal cancer.