CancerIncidenceinPeninsularMalaysia2003 2005x1x

Cancer Incidence in
Peninsular Malaysia
2003-2005
Edited by:
Dr Gerard Lim Chin Chye

Dr Sanjay Rampal
Dato’ Dr Halimah Yahaya
National Cancer Registry

NATIONAL CANCER REGISTRY ACKNOWLEDGES
GRANTS FROM:
Ministry of Health, Malaysia

AND SUPPORT FROM:
Majlis Kanser Nasional

National Cancer Council
Design & Printing by : Konsep Niaga (+603) 2148 6413
Cancer Incidence in
Peninsular Malaysia,
2003-2005
The Third Report of the

National Cancer Registry,
Malaysia
Edited by
Gerard Lim Chin Chye
Sanjay Rampal
Halimah Yahaya
Ministry of Health Malaysia

January 2008
© National Cancer Registry, Malaysia
Published by:
This report is copyrighted. However it may be freely reproduced without the permission of
NCR. Acknowledgment would be appreciated and the suggested citation is:
GCC Lim, S Rampal, Y Halimah (Eds). Cancer Incidence in Peninsular Malaysia,
2003 - 2005. National Cancer Registry. Kuala Lumpur 2008.
The National Cancer Registry report is also published electronically on:

Jabatan Kesihatan Awam, MOH : http://www.cancer.gov.my
MAKNA : http://www.makna.org.my
College of Radiology, Academy of Medicine : http://www.radiologymalaysia.org
College of Pathology, Academy of Medicine : http://www.acadmed.org.my
Malaysian Oncological Society : http://www.malaysiaoncology.org
2003-2005
TABLE OF CONTENTS Page
CONTENTS i
CONTENTS i
ABBREVIATIONS xiii
FOREWORD BY THE MINISTER OF HEALTH, MALAYSIA 1
FOREWORD BY THE DIRECTOR GENERAL OF HEALTH, MALAYSIA 2
ACKNOWLEDGEMENTS 3
NATIONAL CANCER REGISTRY PARTICIPATING CENTRES 4
ADVISORY COMMITTEE 8
EXPERT PANEL 9
NATIONAL CANCER REGISTRY UNIT 14
EXECUTIVE SUMMARY 15
1.0 NATIONAL CANCER REGISTRY 19
1.1 Background 19
1.2 Objectives 19
1.3 Operations of the National Cancer Registry 19
1.4 Sponsors Of The NCR 20
2.0 MALAYSIA AND ITS POPULATION 21
2.1 Geography 21
2.2 Population Of Peninsular Malaysia 22
2.3 Infrastructure 23
2.4 Socioeconomic Status 23
2.5 Health Status and Facilities 24
3.0 METHODS 25
3.1 Evaluation of the Quality of NCR Data 32
4.0 CANCER INCIDENCE IN MALAYSIA 2003-2005 38
4.1 Overall Cancer Incidence 38
4.2 Cancer Incidence by Site 40
4.3 Cancer Incidence by Site, Ethnicity and Sex 43
4.4 Cancer Incidence by Site, Age and Sex 45
5.0 SELECTED CANCER SITES 2003-2005 61
5.1 TONGUE (ICDO: C01-C02) 61
5.2 SALIVARY GLAND (ICDO: C07-C08) 64
5.3 MOUTH (ICDO: C03-C06) 67
5.4 NASOPHARYNX (ICDO: C11) 71
5.5 OESOPHAGUS (ICDO: C15) 77
5.6 STOMACH (ICDO: C16) 80
5.7 LARGE BOWEL (ICDO: C18-C21) 83
5.8 LIVER (ICDO: C22) 87
5.9 GALLBLADDER (ICDO: C23-C24) 90
CONTENTS i
2003-2005
TABLE OF CONTENTS Page
5.10 PANCREAS (ICDO: C25) 93

5.11 NOSE and SINUSES (ICDO: C30-C31) 99
5.12 LARYNX (ICDO: C32) 103
5.13 LUNG (ICDO: C33-C34) 106
5.14 BONE (ICDO: C40-C41) 111
5.15 OTHER SKIN 117
5.16 MELANOMA 120
5.17 FEMALE BREAST (ICDO: C50) 125
5.18 CERVIX UTERI (ICDO: C53) 131
5.19 CORPUS UTERI (ICDO: C54) 134
5.20 OVARY (ICDO: C56-C57) 137
5.21 PROSTATE (ICDO: C61) 143
5.22 BLADDER (ICDO: C67) 145
5.23 KIDNEY and OTHER URINARY ORGANS (ICDO: C64, C65, C66, C68) 148
5.24 BRAIN and OTHER NERVOUS SYSTEM (ICDO: C70-C72) 153
5.25 THYROID (ICDO: C73) 156
5.26 LYMPHOMA 161
5.26.1 Hodgkin’s Lymphoma 164
5.26.2 Non Hodgkin’s Lymphoma 166
5.27 LEUKAEMIA 171
5.27.1 Lymphatic Leukaemia 174
5.27.2 Myeloid Leukaemia 176
REFERENCES 179
ii CONTENTS
2003-2005
LIST OF TABLES Page
Table 2.2.1: Age, sex and ethnic distribution of the population of Peninsular Malaysia, 23
2004
Table 2.4.1: Malaysia: Percentage Distribution of Employed Persons by Occupation 23
Table 2.5.1: Perinatal, neonatal, infant and maternal mortality rate for Malaysia, 2004 24
Table 4.1.1: Cancer Incidence per 100,000 population (CR) and Age-standardized 38
incidence (ASR), by sex, Malaysia 2003-2005
Table 4.1.2: Cancer Incidence per 100,000 population (CR) by age and sex, 38
Peninsular Malaysia 2003-2005
incidence (ASR), by ethnicity and sex, Peninsular Malaysia 2003-2005
Table 4.1.4: Age specific Cancer Incidence per 100,000 population, by ethnicity and 39
sex, Peninsular Malaysia 2003-2005
incidence (ASR), by site and sex, Peninsular Malaysia 2003-2005
Table 5.1.1: Tongue Cancer Incidence per 100,000 population (CR) and Age- 61
standardized incidence (ASR), by sex and ethnicity, Peninsular Malaysia
2003-2005
Table 5.1.2: Tongue Age specific Cancer Incidence per 100,000 population, by 61
ethnicity and sex, Peninsular Malaysia 2003-2005
Table 5.1.3: Number of Tongue cases by subsite, Peninsular Malaysia 2003-2005 62
Table 5.1.4: Number (%) of Tongue cases by morphology, Peninsular Malaysia 2003- 62
2005
Table 5.2.1: Salivary Gland Cancer Incidence per 100,000 population (CR) and Age- 64
2003-2005
Table 5.2.2: Salivary Gland Age specific Cancer Incidence per 100,000 population, by 64
Table 5.2.3: Number (%) of Salivary Gland cases by morphology, Peninsular Malaysia 65
2003-2005
Table 5.2.4: Number of Salivary Gland cases by subsite, Peninsular Malaysia 2003- 66
2005
Table 5.3.1: Mouth Cancer Incidence per 100,000 population (CR) and Age- 67
2003-2005
Table 5.3.2: Mouth Cancer Incidence per 100,000 population (CR) and Age- 67
standardized incidence (ASR), by ethnicity and sex, Peninsular Malaysia
2003-2005
Table 5.3.3: Number of Mouth cases by subsite, Peninsular Malaysia 2003-2005 68
Table 5.3.4: Number (%) of Mouth cases by morphology, Peninsular Malaysia 2003- 69
2005
CONTENTS iii
2003-2005
LIST OF TABLES Page
Table 5.4.1: Nasopharynx Cancer Incidence per 100,000 population (CR) and Age- 71
2003-2005
Table 5.4.2: Nasopharynx Age specific Cancer Incidence per 100,000 population, by 71
Table 5.5.1: Oesophagus Cancer Incidence per 100,000 population (CR) and Age- 77
2003-2005
Table 5.5.2: Oesophagus Age specific Cancer Incidence per 100,000 population, by 77
Table 5.5.3: Number of Oesophagus cases by subsite, Peninsular Malaysia 2003-2005 78
Table 5.5.4: Number (%) of Oesophagus cases by morphology, Peninsular Malaysia 78
2003-2005
Table 5.6.1: Stomach Cancer Incidence per 100,000 population (CR) and Age- 80
2003-2005
Table 5.6.2: Stomach Age specific Cancer Incidence per 100,000 population, by 80
Table 5.6.3: Number of Stomach cases by subsite, Peninsular Malaysia 2003-2005 81
Table 5.6.4: Number (%) of Stomach cases by morphology, Peninsular Malaysia 2003- 81
2005
Table 5.7.1: Large Bowel Cancer Incidence per 100,000 population (CR) and Age- 83
2003-2005
Table 5.7.2: Large Bowel Age specific Cancer Incidence per 100,000 population, by 83
Table 5.7.3: Number of Large Bowel cases by subsite, Peninsular Malaysia 2003-2005 84
Table 5.7.4: Number (%) of Large Bowel cases by morphology, Peninsular Malaysia 85
2003-2005
Table 5.8.1: Liver Cancer Incidence per 100,000 population (CR) and Age- 87
2003-2005
Table 5.8.2: Liver Age specific Cancer Incidence per 100,000 population, by ethnicity 87
and sex, Peninsular Malaysia 2003-2005
Table 5.8.3: Number (%) of Liver cases by morphology, Peninsular Malaysia 2003- 88
2005
Table 5.9.1: Gallbladder Cancer Incidence per 100,000 population (CR) and Age- 90
2003-2005
Table 5.9.2: Gallbladder Age specific Cancer Incidence per 100,000 population, by 90
Table 5.9.3: Number of Gallbladder cases by subsite, Peninsular Malaysia 2003-2005 91
Table 5.9.4: Number (%) of Gallbladder cases by morphology, Peninsular Malaysia 91
2003-2005
Table 5.10.1: Pancreas Cancer Incidence per 100,000 population (CR) and Age- 93
2003-2005
iv CONTENTS
2003-2005
LIST OF TABLES Page
Table 5.10.2: Pancreas Age specific Cancer Incidence per 100,000 population, by 93
ethnicity and sex,LIST OF Malaysia
Peninsular TABLES2003-2005 Page
Table 5.10.3: Number of Pancreas cases by subsite, Peninsular Malaysia 2003-2005 94
Table 5.10.2: Pancreas Age specific Cancer Incidence per 100,000 population, by 93
Table 5.10.4: Number
ethnicity(%)
and of
sex,Pancreas
Peninsularcases by morphology,
Malaysia 2003-2005 Peninsular Malaysia 94
2003-2005
Table 5.10.3: Number of Pancreas cases by subsite, Peninsular Malaysia 2003-2005 94
Table 5.11.1: Nose and Sinuses Cancer Incidence per 100,000 population (CR) and 99
Table 5.10.4: Number (%) of Pancreas
Age-standardized incidence cases
(ASR),bybymorphology, Peninsular
sex and ethnicity, Malaysia
Peninsular 94
2003-2005
Malaysia 2003-2005
Table5.11.2:
Table 5.11.1: Noseand
Nose and Sinuses
Sinuses AgeCancer Incidence
specific per 100,000
Cancer Incidence population
per 100,000 (CR) and
population, 9999
Age-standardized incidence (ASR), by
by ethnicity and sex, Peninsular Malaysia 2003-2005sex and ethnicity, Peninsular
Malaysia 2003-2005
Table 5.11.3: Number of Nose and Sinuses cases by subsite, Peninsular Malaysia 100
Table 5.11.2: Nose and Sinuses Age specific Cancer Incidence per 100,000 population, 99
2003-2005
by ethnicity and sex, Peninsular Malaysia 2003-2005
Table 5.11.4: Number (%) of Nose and Sinuses cases by morphology, Peninsular 101
Table 5.11.3: Number2003-2005
Malaysia of Nose and Sinuses cases by subsite, Peninsular Malaysia 100
2003-2005
Table 5.12.1: Larynx Cancer Incidence per 100,000 population (CR) and Age- 103
Table 5.11.4: Number (%)incidence
standardized of Nose(ASR),
and Sinuses
by sex and cases by morphology,
ethnicity, Peninsular
Peninsular Malaysia 101
Malaysia
2003-2005 2003-2005
Table5.12.2:
Table 5.12.1: LarynxAge
Larynx Cancer
specificIncidence per 100,000
per 100,000 (CR)byand
population, Age-
ethnicity 103
103
standardized incidence (ASR),
and sex, Peninsular Malaysia 2003-2005by sex and ethnicity, Peninsular Malaysia
2003-2005
Table 5.12.3: Number of Larynx cases by subsite, Peninsular Malaysia 2003-2005 104
Table 5.12.2: Larynx Age specific Cancer Incidence per 100,000 population, by ethnicity 103
and sex,(%) of LarynxMalaysia
Peninsular cases by morphology, Peninsular Malaysia 2003-
2003-2005 104
2005
Table 5.12.3: Number of Larynx cases by subsite, Peninsular Malaysia 2003-2005 104
Table 5.13.1: Lung Cancer Incidence per 100,000 population (CR) and Age- 106
of Larynx(ASR),
cases by
by sex
morphology, Peninsular Malaysia 2003- 104
standardized and ethnicity, Peninsular Malaysia
2005
2003-2005
Table5.13.2:
Table 5.13.1: LungAge
Lung Cancer
specificIncidence per 100,000
population, Age-
ethnicity 106
106
and sex, Peninsular Malaysia 2003-2005 by sex and ethnicity, Peninsular Malaysia
2003-2005
Table 5.13.3: Number of Lung cases by subsite, Peninsular Malaysia 2003-2005 107
Table 5.13.2: Lung Age specific Cancer Incidence per 100,000 population, by ethnicity 106
and sex,(%) of Lung Malaysia
Peninsular cases by2003-2005
2005
Table 5.13.3: Number of Lung cases by subsite, Peninsular Malaysia 2003-2005 107
Table 5.14.1: Bone Cancer Incidence per 100,000 population (CR) and Age- 111
standardized of Lung (ASR),
cases byby morphology, Peninsular
Peninsular 2003-
Malaysia 107
2005
2003-2005
Table5.14.2:
5.14.1: BoneAge Cancer 111
Table Bone specificIncidence per 100,000
population, Age-
ethnicity 111
and sex, Peninsular Malaysia 2003-2005 by sex and ethnicity, Peninsular Malaysia
2003-2005
Table 5.14.3: Number of Bone cases by subsite, Peninsular Malaysia 2003-2005 112
Table 5.14.2: Bone Age specific Cancer Incidence per 100,000 population, by ethnicity 111
and sex,(%) of BoneMalaysia
Peninsular cases by2003-2005
2005
Table 5.14.3: Number of Bone cases by subsite, Peninsular Malaysia 2003-2005 112
Table 5.15.1: Other Skin Cancer Incidence per 100,000 population (CR) and Age- 117
standardized of Bone (ASR),
cases byby morphology, Peninsular
Peninsular 2003-
Malaysia 113
2005
2003-2005
Table5.15.2:
Table 5.15.1: OtherSkin
Other SkinAge
Cancer Incidence
specific Cancer per 100,000perpopulation
Incidence (CR) and Age-
100,000 population, by 117
117
standardized incidence (ASR), by sex
ethnicity and sex, Peninsular Malaysia 2003-2005and ethnicity, Peninsular Malaysia
2003-2005
Table 5.15.3: Number of Other Skin cases by subsite, Peninsular Malaysia 2003-2005 118
Table 5.15.2: Other Skin Age specific Cancer Incidence per 100,000 population, by 117
Table 5.15.4: Ten most and
ethnicity common of OtherMalaysia
sex, Peninsular Skin cases by morphology, Peninsular
2003-2005 118
Malaysia 2003-2005
Table 5.15.3: Number of Other Skin cases by subsite, Peninsular Malaysia 2003-2005 118
Table 5.15.4: Ten most common of Other Skin cases by morphology, Peninsular 118
Malaysia 2003-2005
v
CONTENTS
v
2003-2005
LIST OF TABLES Page
Table 5.16.1: Melanoma Cancer Incidence per 100,000 population (CR) and Age- 120
LIST (ASR),
standardized incidence OF TABLESby sex and ethnicity, Peninsular Malaysia Page
2003-2005
Table5.16.2:
5.16.1: MelanomaAge Cancer Incidence 120
Table Melanoma specific Cancer per 100,000perpopulation
Incidence 100,000 (CR) and Age-
population, by 120
ethnicity and sex, Peninsular Malaysia 2003-2005 and ethnicity, Peninsular Malaysia
2003-2005
Table 5.16.3: Number of Melanoma cases by subsite, Peninsular Malaysia 2003-2005 121
Table 5.16.2: Melanoma Age specific Cancer Incidence per 100,000 population, by 120
Table 5.17.1: Female Breast
ethnicity and sex,Cancer Incidence
Peninsular per 100,000
Malaysia population (CR) and Age-
2003-2005 125
standardized incidence (ASR), by ethnicity, Peninsular Malaysia 2003-
Table 5.16.3: Number of Melanoma cases by subsite, Peninsular Malaysia 2003-2005 121
2005
Table5.17.2:
5.17.1: FemaleBreast
BreastAgeCancer Incidence 125
Table Female specific Cancer per 100,000
Incidence perpopulation (CR) and Age-
ethnicity, Peninsular Malaysia 2003-2005 by ethnicity, Peninsular Malaysia 2003-
2005
Table 5.17.3: Number (%) of Female Breast cases by morphology, Peninsular Malaysia 126
Table 5.17.2: Female Breast Age specific Cancer Incidence per 100,000 population, by 125
2003-2005
ethnicity, Peninsular Malaysia 2003-2005
Table 5.18.1: Cervix Uteri Cancer Incidence per 100,000 population (CR) and Age- 131
Table 5.17.3: Number (%) incidence
of Female (ASR),
Breast cases by morphology, Peninsular 126
standardized by ethnicity, Peninsular MalaysiaMalaysia
2003-
2003-2005
2005
Table5.18.2:
5.18.1: CervixUteri
UteriAgeCancer Incidence 131
Table Cervix specific Cancer per 100,000perpopulation
2005
Table 5.18.3: Number (%) of Cervix Uteri cases by morphology (WHO), Peninsular 132
Table 5.18.2: Cervix Uteri Age specific Cancer Incidence per 100,000 population, by 131
Malaysia 2003-2005
Table 5.19.1: Corpus Uteri Cancer Incidence per 100,000 population (CR) and Age- 134
of Cervix(ASR),
Uteri cases by morphology 132
standardized by ethnicity, Peninsular(WHO), Peninsular
Malaysia 2003-
Malaysia
2005 2003-2005
Table5.19.2:
5.19.1: CorpusUteri
UteriAge
Cancer Incidence 134
Table Corpus specific Cancer per 100,000perpopulation
2005
Table 5.19.3: Number (%) of Corpus Uteri cases by morphology (WHO), Peninsular 135
Table 5.19.2: Corpus 2003-2005
Uteri Age specific Cancer Incidence per 100,000 population, by 134
Malaysia
Table 5.20.1: Ovary Cancer Incidence per 100,000 population (CR) and Age- 137
of Corpus(ASR), Uteri cases by morphology 135
standardized by ethnicity, Peninsular(WHO), Peninsular
Malaysia 2003-
Malaysia
2005 2003-2005
Table5.20.2:
5.20.1: OvaryAgeCancer 137
Table Ovary specificIncidence per 100,000
per 100,000 (CR)
population, and Age-
by ethnicity, 137
standardized incidence
Peninsular Malaysia 2003-2005 (ASR), by ethnicity, Peninsular Malaysia 2003-
2005
Table 5.20.3: Number (%) of Ovary cases by morphology (WHO), Peninsular Malaysia 139
Table 5.20.2: Ovary Age specific Cancer Incidence per 100,000 population, by ethnicity, 137
2003-2005
Table 5.21.1: Prostate Cancer Incidence per 100,000 population (CR) and Age- 143
Table 5.20.3: Number (%) incidence
of Ovary cases 139
standardized (ASR),bybymorphology (WHO), Peninsular
ethnicity, Peninsular MalaysiaMalaysia
2003-
2003-2005
2005
Table5.21.2:
5.21.1: Prostate Age
Cancer Incidence 143
Table Prostate specific Cancerper 100,000per
Incidence population
100,000 (CR) and Age-
population, by 143
2005
Table 5.21.3: Number (%) of Prostate cases by morphology, Peninsular Malaysia 2003- 144
Table 5.21.2: Prostate Age specific Cancer Incidence per 100,000 population, by 143
2005
Table 5.22.1: Bladder Cancer Incidence per 100,000 population (CR) and Age- 145
of Prostate casesbybysex
standardized (ASR), and ethnicity, Peninsular Malaysia
2005
2003-2005
Table5.22.2:
5.22.1: Bladder AgeCancer Incidence 145
Table Bladder specific Cancerper 100,000per
Incidence population
100,000 (CR) and Age-
population, by 145
ethnicity and sex, Peninsular Malaysia 2003-2005 and ethnicity, Peninsular Malaysia
2003-2005
Table 5.22.2: Bladder Age specific Cancer Incidence per 100,000 population, by 145
vi
vi CONTENTS
vi
2003-2005
LIST OF TABLES Page
Table 5.22.3: Number (%) of Bladder cases by morphology, Peninsular Malaysia 2003- 146
2005 LIST OF TABLES Page
Table 5.23.1: Kidney and Other Urinary Organs Cancer Incidence per 100,000 148
Table 5.22.3: Number (%) of Bladder cases by morphology, Peninsular Malaysia 2003- 146
population (CR) and Age-standardized incidence (ASR), by sex and
2005
Table 5.23.1: Kidney and Other Urinary Organs Cancer Incidence per 100,000 148
Table 5.23.2: Kidney and Other Urinary Organs Age specific Cancer Incidence per 148
100,000 population, by ethnicity and sex, Peninsular Malaysia 2003-2005
Table 5.23.3: Number of Kidney and Other Urinary Organs cases by subsite, Peninsular 149
Table 5.23.2: Kidney and Other Urinary Organs Age specific Cancer Incidence per 148
Malaysia 2003-2005
Table 5.23.4: Number (%) of Kidney and Other Urinary Organs cases by morphology, 149
Table 5.23.3: Number of Kidney and Other Urinary Organs cases by subsite, Peninsular 149
Malaysia 2003-2005
Table 5.24.1: Brain and Other Nervous System Cancer Incidence per 100,000 153
Table 5.23.4: Number (%) of Kidney and Other Urinary Organs cases by morphology, 149
Table 5.24.1: Brain and Other Nervous System Cancer Incidence per 100,000 153
Table 5.24.2: Brain and Other Nervous System Age specific Cancer Incidence per 153
Table 5.24.3: Number of Brain and Other Nervous System cases by subsite, Peninsular 154
Table 5.24.2: Brain and Other Nervous System Age specific Cancer Incidence per 153
Malaysia 2003-2005
Table 5.24.4: Number (%) of Brain and Other Nervous System cases by morphology, 154
Table 5.24.3: Number of Brain and Other Nervous System cases by subsite, Peninsular 154
Malaysia 2003-2005
Table 5.25.1: Thyroid Cancer Incidence per 100,000 population (CR) and Age- 156
Table 5.24.4: Number (%) of Brain and Other Nervous System cases by morphology, 154
2003-2005
Table 5.25.1: Thyroid Cancer Incidence per 100,000 population (CR) and Age- 156
Table 5.25.2: Thyroid Age specific Cancer Incidence per 100,000 population, by 156
2003-2005
Table 5.25.3: Number (%) of Thyroid cases by morphology, Peninsular Malaysia 2003- 157
Table 5.25.2: Thyroid Age specific Cancer Incidence per 100,000 population, by 156
2005
Table 5.26.1: Lymphoma Cancer Incidence per 100,000 population (CR) and Age- 161
Table 5.25.3: Number (%) of Thyroid cases by morphology, Peninsular Malaysia 2003- 157
2005
2003-2005
Table 5.26.1: Lymphoma Cancer Incidence per 100,000 population (CR) and Age- 161
Table 5.26.2: Lymphoma Age specific Cancer Incidence per 100,000 population, by 161
2003-2005
Table 5.26.3: Number of Lymphoma cases by subsite, Peninsular Malaysia 2003-2005 162
Table 5.26.2: Lymphoma Age specific Cancer Incidence per 100,000 population, by 161
Table 5.26.4: ethnicity
Number and (%) sex, Peninsular cases
of Lymphoma Malaysia
by 2003-2005
morphology, Peninsular Malaysia 163
2003-2005
Table 5.26.3: Number of Lymphoma cases by subsite, Peninsular Malaysia 2003-2005 162
Table 5.26.1.1: Hodgkin Lymphoma Cancer Incidence per 100,000 population (CR) and 164
Table 5.26.4: Number (%) of Lymphoma cases by morphology, Peninsular Malaysia 163
Age-standardized incidence (ASR), by sex and ethnicity, Peninsular
2003-2005
Malaysia 2003-2005
Table 5.26.1.1: Hodgkin Lymphoma Cancer Incidence per 100,000 population (CR) and 164
Table 5.26.1.2: Hodgkin Lymphoma Age specific Cancer Incidence per 100,000 164
Age-standardized incidence (ASR), by sex and ethnicity, Peninsular
population (CR) by sex, Peninsular Malaysia 2003-2005
Malaysia 2003-2005
Table 5.26.2.1: Non Hodgkin Lymphoma Cancer Incidence per 100,000 population (CR) 166
Table 5.26.1.2: Hodgkin Lymphoma Age specific Cancer Incidence per 100,000 164
and Age-standardized incidence (ASR), by sex and ethnicity, Peninsular
Malaysia 2003-2005
Table 5.26.2.1: Non Hodgkin Lymphoma Cancer Incidence per 100,000 population (CR) 166
Table 5.26.2.2: Non Hodgkin Lymphoma Age specific Cancer Incidence per 100,000 166
and Age-standardized incidence (ASR), by sex and ethnicity, Peninsular
Malaysia 2003-2005
Table 5.26.2.2: Non Hodgkin Lymphoma Age specific Cancer Incidence per 100,000 166
vii
CONTENTS vii
vii
2003-2005
LIST OF TABLES Page
Table 5.27.1: Leukaemia Cancer Incidence per 100,000 population (CR) and Age- 171
LIST OF
standardized incidence TABLES
(ASR), by sex and ethnicity, Peninsular Malaysia Page
2003-2005
Table
Table 5.27.1:
5.27.2: Leukaemia
Leukaemia AgeCancer Incidence
specific CancerperIncidence
100,000 per
population
100,000(CR) and Age-
population, by 171
171
standardized incidence (ASR), by sex and ethnicity,
ethnicity and sex, Peninsular Malaysia 2003-2005 Peninsular Malaysia
2003-2005
Table 5.27.1.1: Lymphatic Leukaemia Cancer Incidence per 100,000 population (CR) and 174
Table 5.27.2: Leukaemia Age specific
Age-standardized incidenceCancer
(ASR),Incidence
by sexperand100,000 population,
ethnicity, by
Peninsular 171
ethnicity and sex,
Malaysia 2003-2005 Peninsular Malaysia 2003-2005
Table
Table 5.27.1.1:
5.27.1.2: Lymphatic
Lymphatic Leukaemia
LeukaemiaCancerAge Incidence per 100,000
specific Cancer population
Incidence per (CR) and
100,000 174
174
Age-standardized incidence
population, by ethnicity (ASR),
and sex, by sex
Peninsular and ethnicity,
Malaysia 2003-2005Peninsular
Malaysia 2003-2005
Table 5.27.2.1: Myeloid Leukaemia Cancer Incidence per 100,000 population (CR) and 176
Table 5.27.1.2: Lymphatic Leukaemia
Age-standardized Age (ASR),
incidence specific byCancer
sex andIncidence
ethnicity,perPeninsular
100,000 174
population, by ethnicity
Malaysia 2003-2005 and sex, Peninsular Malaysia 2003-2005
Table
Table 5.27.2.1:
5.27.2.2: Myeloid
Myeloid Leukaemia
LeukaemiaCancer
Age Incidence per 100,000
specific Cancer population
Incidence per (CR) and
100,000 176
176
Age-standardized incidence (ASR), by sex and ethnicity,
population, by ethnicity and sex, Peninsular Malaysia 2003-2005 Peninsular
Malaysia 2003-2005
Table 5.27.2.2: Myeloid Leukaemia Age specific Cancer Incidence per 100,000 176
population, by ethnicity and sex, Peninsular Malaysia 2003-2005
viii
viii CONTENTS
viii
2003-2005
LIST OF FIGURES Page
Figure 2.2.1: Age and sex distribution of the population of Peninsular Malaysia 2004 22
Figure 2.2.2: Ethnicity in Peninsular Malaysia, 2004 22
Figure 2.5.1: Most common causes of death in Malaysia government hospitals, 2003- 24
2005
Figure 3.1: Flow Chart for Overall Operations of the NCR 25
Figure 3.2: Flow Chart for Receiving data 27
Figure 3.3: Flow Chart for Data Management Process 28
Figure 4.2: Ten most frequent cancers, Peninsular Malaysia 2003-2005 40
Figure 4.2.1(a): Ten most frequent cancers in males, Peninsular Malaysia 2003-2005 40
Figure 4.2.1(b): Ten most frequent cancers in females, Peninsular Malaysia 2003-2005 40
Figure 4.3.1(a): Ten most frequent cancers in males by ethnic groups, Peninsular 43
Malaysia 2003-2005
Figure 4.3.1(b): Ten most frequent cancers in females by ethnic groups, Peninsular 44
Malaysia 2003-2005
Figure 4.4.1(a): Ten most frequent cancers in males by age groups, Peninsular Malaysia 45
2003-2005
Figure 4.4.1(b): Ten most frequent cancers in females by age groups, Peninsular Malaysia 46
2003-2005
Figure 5.1.1: Tongue Age specific Cancer Incidence per 100,000 population by sex, 62
Figure 5.1.2: Tongue International comparisons – Age-standardized Incidence per 63
100,000 population by sex, Peninsular Malaysia 2003-2005
Figure 5.2.1: Salivary Gland Age specific Cancer Incidence per 100,000 population by 65
Figure 5.2.2: Salivary Gland International comparisons – Age-standardized Incidence 66
per 100,000 population by sex, Peninsular Malaysia 2003-2005
Figure 5.3.1: Mouth Age specific Cancer Incidence per 100,000 population by sex, 68
Figure 5.3.2: Mouth International comparisons – Age-standardized Incidence per 70
Figure 5.4.1: Nasopharynx Age specific Cancer Incidence per 100,000 population by 72
Figure 5.4.2: Nasopharynx International comparisons – Age-standardized Incidence per 73
Figure 5.5.1: Oesophagus Age specific Cancer Incidence per 100,000 population by 78
Figure 5.5.2: Oesophagus International comparisons – Age-standardized Incidence per 79
Figure 5.6.1: Stomach Age specific Cancer Incidence per 100,000 population by sex, 81
Figure 5.6.2: Stomach International comparisons – Age-standardized Incidence per 82
Figure 5.7.1: Large Bowel Age specific Cancer Incidence per 100,000 population by 84
CONTENTS ix
2003-2005
Figure 5.7.2: Large Bowel International comparisons – Age-standardized Incidence per 86

Figure 5.8.1: Liver Age specific Cancer Incidence per 100,000 population by sex, 88
Figure 5.8.2: Liver International comparisons – Age-standardized Incidence per 89
Figure 5.9.1: Gallbladder Age specific Cancer Incidence per 100,000 population by sex, 91
Figure 5.9.2: Gallbladder International comparisons – Age-standardized Incidence per 92
Figure 5.10.1: Pancreas Age specific Cancer Incidence per 100,000 population by sex, 94
Figure 5.10.2: Pancreas International comparisons – Age-standardized Incidence per 95
Figure 5.11.1: Nose and Sinuses Age specific Cancer Incidence per 100,000 population 100
by sex, Peninsular Malaysia 2003-2005
Figure 5.11.2: Nose and Sinuses International comparisons – Age-standardized 102
Incidence per 100,000 population by sex, Peninsular Malaysia 2003-2005
Figure 5.12.1: Larynx Age specific Cancer Incidence per 100,000 population by sex, 104
Figure 5.12.2: Larynx International comparisons – Age-standardized Incidence per 105
Figure 5.13.1: Lung Age specific Cancer Incidence per 100,000 population by sex, 107
Figure 5.13.2: Lung International comparisons – Age-standardized Incidence per 108
Figure 5.14.1: Bone Age specific Cancer Incidence per 100,000 population by sex, 112
Figure 5.14.2: Bone International comparisons – Age-standardized Incidence per 114
Figure 5.15.1: Other Skin Age specific Cancer Incidence per 100,000 population by sex, 118
Figure 5.15.2: Other Skin International comparisons – Age-standardized Incidence per 119
Figure 5.16.1: Melanoma Age specific Cancer Incidence per 100,000 population by sex, 121
Figure 5.16.2: Melanoma International comparisons – Age-standardized Incidence per 122
Figure 5.17.1: Female Breast Age specific Cancer Incidence per 100,000 population, 127
Figure 5.17.2: Female Breast International comparisons – Age-standardized Incidence 127
Figure 5.18.1: Cervix Uteri Age specific Cancer Incidence per 100,000 population, 132
Figure 5.18.2: Cervix Uteri International comparisons – Age-standardized Incidence per 133
x CONTENTS
2003-2005
Figure 5.19.1: Corpus Uteri Age specific Cancer Incidence per 100,000 population, 135
Peninsular Malaysia
LIST OF 2003-2005
FIGURES Page
Figure 5.19.2: Corpus Uteri International comparisons – Age-standardized Incidence 136
Figure 5.19.1: Corpus Uteripopulation
per 100,000 Age specific Cancer
by sex, Incidence
Peninsular per 2003-2005
Malaysia 100,000 population, 135
Figure 5.20.1: Ovary Age specific Cancer Incidence per 100,000 population, Peninsular 138
Figure 5.19.2: Corpus
MalaysiaUteri International comparisons – Age-standardized Incidence
2003-2005 136
Figure 5.20.2: Ovary International comparisons – Age-standardized Incidence per 138
Figure 5.20.1: Ovary Age
100,000 specific Cancer
population Incidence per
by sex, Peninsular 100,000
Malaysia population, Peninsular
2003-2005 138
Malaysia 2003-2005
Figure 5.21.1: Prostate Age specific Cancer Incidence per 100,000 population, 144
Figure 5.20.2: Ovary International
Peninsular comparisons – Age-standardized Incidence per
Malaysia 2003-2005 138
Figure 5.21.2: Prostate International comparisons – Age-standardized Incidence per 144
Figure 5.21.1: Prostate Age specific
100,000 population by sex,Cancer Incidence
Peninsular Malaysiaper 100,000 population,
2003-2005 144
Figure 5.22.1: Bladder Age specific Cancer Incidence per 100,000 population by sex, 146
Figure 5.21.2: Prostate
PeninsularInternational comparisons – Age-standardized Incidence per
Malaysia 2003-2005 144
Figure 5.22.2: Bladder International comparisons – Age-standardized Incidence per 147
Figure 5.22.1: Bladder
100,000 Age specific
population byCancer Incidence
sex, Peninsular per 100,000
Malaysia population by sex,
2003-2005 146
Figure 5.23.1: Kidney and Other Urinary Organs Age specific Cancer Incidence per 150
Figure 5.22.2: Bladder International
100,000 population comparisons
by sex, Peninsular– Malaysia
Age-standardized
2003-2005Incidence per 147
Figure 5.23.2: Kidney and Other Urinary Organs Age specific Cancer Incidence per 150
Figure 5.23.1: Kidney
100,000and Other Urinary
population, Organsand
by ethnicity Agesex,
specific CancerMalaysia
Peninsular Incidence per
2003- 150
100,000
2005 population by sex, Peninsular Malaysia 2003-2005
Figure
Figure 5.23.2:
5.24.1: Kidneyand
Brain andOther
OtherNervous
Urinary System
Organs Age
Age specific
specific Cancer
Cancer Incidence
Incidence per
per 150
155
100,000 population,byby
100,000 population ethnicity
sex, and Malaysia
Peninsular sex, Peninsular
2003-2005Malaysia 2003-
2005
Figure 5.24.2: Brain and Other Nervous System International comparisons – Age- 155
Figure 5.24.1: Brain and Other
standardized Nervousper
Incidence System
100,000Agepopulation
specific Cancer Incidence
by sex, per
Peninsular 155
100,000
Malaysiapopulation
2003-2005by sex, Peninsular Malaysia 2003-2005
Figure
Figure 5.24.2:
5.25.1: Brain
Thyroidand
AgeOther Nervous
specific CancerSystem International
Incidence per 100,000comparisons – Age-
population by sex, 155
157
standardized Incidence per
Peninsular Malaysia 2003-2005 100,000 population by sex, Peninsular
Malaysia 2003-2005
Figure 5.25.2: Thyroid International comparisons – Age-standardized Incidence per 158
Figure 5.25.1: Thyroid
100,000 Age specific
population byCancer IncidenceMalaysia
sex, Peninsular per 100,000 population by sex,
2003-2005 157
Figure 5.26.1: Lymphoma Age specific Cancer Incidence per 100,000 population by 162
Figure 5.25.2: Thyroid International
sex, Peninsular comparisons
Malaysia 2003-2005 – Age-standardized Incidence per 158
Figure 5.26.1.1: Hodgkin Lymphoma Age specific Cancer Incidence per 100,000 164
Figure 5.26.1: Lymphoma
population byAge
sex,specific Cancer
Peninsular Incidence
Malaysia per 100,000 population by
2003-2005 162
Figure 5.26.1.2: Hodgkin Lymphoma International comparisons – Age-standardized 165
Figure 5.26.1.1: Hodgkin
Incidence Lymphoma
per 100,000Age specificby Cancer
population IncidenceMalaysia
2003- 164
population
2005 by sex, Peninsular Malaysia 2003-2005
Figure
Figure 5.26.1.2:
5.26.2.1: Hodgkin Lymphoma
Non Hodgkin Lymphoma International comparisons
Age specific – Age-standardized
Cancer Incidence per 100,000 165
166
Incidence per 100,000 population by sex,
population by sex, Peninsular Malaysia 2003-2005Peninsular Malaysia 2003-
2005
Figure 5.26.2.2: Non Hodgkin Lymphoma International comparisons – Age-standardized 167
Figure 5.26.2.1: Non Hodgkin
Incidence per Lymphoma Age specific
100,000 population Cancer
by sex, Incidence
Malaysia 2003- 166
population
Figure
Figure:5.26.2.2:
5.27.1 Non Hodgkin
Leukaemia AgeLymphoma International
specific Cancer comparisons
Incidence per 100,000 – Age-standardized
population by 167
172
Incidence per 100,000 population
sex, Peninsular Malaysia 2003-2005 by sex, Peninsular Malaysia 2003-
2005
Figure: 5.27.2 Leukaemia International comparisons – Age-standardized Incidence per 173
Figure: 5.27.1 Leukaemia Age specific
100,000 population Cancer
by sex, Incidence
Peninsular per 2003-2005
Malaysia 100,000 population by 172
Figure: 5.27.2 Leukaemia International comparisons – Age-standardized Incidence per 173
xi
CONTENTS xi
xi
2003-2005
Figure 5.27.1.1: Lymphatic Leukaemia Age specific Cancer Incidence per 100,000 175
population byLIST OF FIGURES
sex, Peninsular Malaysia 2003-2005 Page
Figure: 2.27.1.2: Lymphoid Leukaemia International comparisons – Age-standardized 175
Figure 5.27.1.1: Lymphatic Leukaemia
Incidence per 100,000 Age specific
population by Cancer IncidenceMalaysia
2003- 175
population
Figure: 2.27.1.2:
Figure 5.27.2.1: Lymphoid Leukaemia Age
Myeloid Leukaemia International
specific comparisons – Age-standardized
Cancer Incidence per 100,000 175
177
Incidence per 100,000 population by sex, Peninsular
population by sex, Peninsular Malaysia 2003-2005 Malaysia 2003-
2005
Figure: 2.27.2.2: Myeloid Leukaemia International comparisons – Age-standardized 178
Figure 5.27.2.1: Myeloid
Incidence Leukaemia
per 100,000Age specific
population Cancer
by sex, Incidence
Malaysia 2003- 177
population
Figure: 2.27.2.2: Myeloid Leukaemia International comparisons – Age-standardized 178
Incidence per 100,000 population by sex, Peninsular Malaysia 2003-
2005
xii
xii CONTENTS
xii
2003-2005
Abbreviations
Abbreviations
ASR
ASR Age-standardized
Age-standardized Incidence
Incidence Rate
Rate
CR
CR Crude Incidence
Crude Incidence Rate
Rate
CRC
CRC Clinical
Clinical Research
Research Centre
Centre
CRU
CRU Cancer Registry Unit
Cancer Registry Unit
CumR
CumR Cumulative
Cumulative Risk
Risk
HMIS
HMIS Hospital
Hospital Management Information
Management Information System
System
IACR
IACR International
International Association
Association of
of Cancer
Cancer Registry
Registry
IARC
IARC International
International Agency
Agency for
for Cancer
Cancer Research
Research
IC
IC Identification
Identification Card
Card
ICD
ICD International
International Classification of
Classification of Disease,
Disease, WHO
WHO
th
ICD
ICD -10
-10 International
International Classification
Classification of
of Diseases 10 Edition
Diseases 10
th
Edition
ICD-O
ICD-O International
International Classification
Classification of Disease for Oncology, WHO
of Disease for Oncology, WHO
MOH
MOH Ministry
Ministry of
of Health,
Health, Malaysia
Malaysia
NCR
NCR National Cancer Registry
QC
QC Quality
Quality Control
Control
SDP
SDP Source
Source Data
Data Provider
Provider or
or Producer
Producer
SOP
SOP Standard
Standard Operating
Operating Procedure
Procedure
USA
USA United States of America
United States of America
WHO
WHO World
World Health
Health Organization
Organization
NSCLC
NSCLC Non
Non Small Cell Lung
Small Cell Lung Carcinoma
Carcinoma
xiii
xiii
ABBREVIATIONS xiii
2003-2005
xiv
2003-2005
FOREWORD BY THE MINISTER OF HEALTH, MALAYSIA 1

2003-2005
2 FOREWORD BY THE DIRECTOR GENERAL OF HEALTH, MALAYSIA

2003-2005
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

 
               


              

 


              

 
              

          
          
           

           

 
 
 
 
 
 
 
 
 
  
ACKNOWLEDGEMENTS
2003-2005





  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
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  
NATIONAL CANCER REGISTRY PARTICIPATING CENTRES
2003-2005
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
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 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
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  

2003-2005
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
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 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
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  

2003-2005

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 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
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  
2003-2005

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 
 

 

 

 

 

 

 
 
 
 
 
 
 
 
 

 
 
 
 
 
 
 

 
 

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  
ADVISORY COMMITTEE
2003-2005
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
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               

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
 
             

 
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
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 
 
 
 
 
 
 
 



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  
EXPERT PANEL
2003-2005

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 
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  

  
  

  

  

  

  

  

  

  
  

  

  

  

  

  

  

  

  

  
 
  

  

 

  
10 EXPERT PANEL
2003-2005



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 

  

  

  
  

  
  
  

  
  

  

  

  

  

  

  

  

  

  
  

  

  

  

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  
EXPERT PANEL 11
2003-2005

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 
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  

  

  
  

  

  

  

  
 
  


  

  

  

  

  

  

  
  

  

  

  

  

  


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  
12 EXPERT PANEL
2003-2005

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 
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  

  

  

  

  

  

  

  
 
  

  

  

  

  

  

  

  
  
  

  

  

  

  

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EXPERT PANEL 13
2003-2005
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
 
 
 
 
 
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
 
 
 
 

 

 

 
 
 
 
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14 NATIONAL CANCER REGISTRY UNIT
2003-2005
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
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TheThirdReportoftheNCRdescribesthemorbidityburdenofcancerfrom1stJanuary2003to31st
December2005.Thisreportismainlyadescriptivereportofthedatacollectedfortheaboveperiod
togetherwithadetailedanalysisoftopographyandmorphology,interpretationandcomparisonofthe
saiddata.
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In 2003, 2004 and 2005, NCRreceived 42,963, 48,549 and 46,048 notifications respectively from
various hospitals, laboratories and clinics, both public and private, making a total of 137,560
notifications. This report includes 75,735 incident cases from the whole of Malaysia with 67,792
incidentcasesreportedfromPeninsularMalaysia.
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This report has the advantage of a large source population that produces precise incidence
estimates.Asummaryofthedataforthewholecountry(PeninsularandEastMalaysia)ispresented
inTable4.1.1.However,thedetailedanalysisis presentedforPeninsularMalaysia.Welimitedthe
presentation of the detailed analyses, as the ascertainment rate for Peninsular is more confidently
determined. The information derived from this report is representative of the cancer burden to
MalaysianslivinginPeninsularMalaysia.
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In this report, comparisons between groups within and outside the country were based on Age
SpecificRatesinordertoovercomethepossibleextraneouseffectofdifferencesinagecomposition
ofthevariousgroups.
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Female breast cancer is presented on its own as in previous reports while noting that male breast
cancer contributed a further 257 cases. The figures for bone cancer, liver cancer and brain cancer
werecomparabletointernationalfigures,thusreflectingthequalityoftheexpertinput,asmetastases
tothesesiteswereconsciouslyexcludedfrombeingreportedasprimarytumoursfromthesesites.
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The main contributors of the data, the Source Data Providers (SDP) has increased over the years.
ThetotalnumberofactiveSDPsincreasedfrom141in2002to193in2005.However,somecancers
may still be underreported even though the numbers of SDPs had been increased to include
radiologists,chestphysicians,surgeons,gastroenterologists.
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A total of 67,792 new cancers cases were diagnosed among Malaysians in Peninsular Malaysia in
the years 2003  2005, comprising 29,596 males (43.7%) and 38,196 females (56.3%). The annual
cruderateformaleswas100.2per100,000populationand132.1per100,000forfemales;whereas
the age standardized incidence rate for all cancers was 136.9 per 100,000 males, and 156.4 per
100,000females.
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In comparison with the second NCR report for 2003, the figures for this report were similar. For
instance,ethnicvariationsweresimilartotheNCRSecondReport2003.Overall,thisreportshowed
thattheChinesepopulationhadthehighestCRof174.1per100,000malesand218.1per100,000
females. This was followed by the Indians who had CR of 89.6 per 100,000 males and 150.7 per
100,000 females. The Malays had relatively lower CR of 60.2 per 100,000 males and 82.6 per
100,000females.
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A similar ethnic variation was seen in the Penang Cancer Registry Report 1999  2003.  In the
PenangReport,theChinesehadaCRof169.2per100,000malesand217.7per100,000females;
followedbytheIndianswithaCRof85.7per100,000malesand147.2per100,000females;withthe
MalayshavingaCRof60.6per100,000malesand79.0per100,000females.
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In this report, the cumulative lifetime risk for Malaysians in Peninsular Malaysia developing cancer
was14.8%formalesand15.9%forfemales.Thistranslatestoanestimatedriskof1in7males,and
1in6femalesdevelopingcancerintheirlifetime.
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2003-2005

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In this third report, cancers from the colon and rectum are grouped together as coming from one
cancer site. This is to standardize the report for comparison to other national and international
reports.
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ThemostfrequentcancerinMalaysianswasbreastcancer(18.0%)followedbylargebowelcancer
(11.9%)andlungcancer(7.4%).Thetenmostfrequentcancersinmalesandfemalesarepresented
inFigures4.2.1(a)and4.2.1(b)andtheaccompanyingtables.

Amongst males, large bowel cancer (14.5%; ASR 20.9) was the most frequent cancer followed by
cancers of the lung (12.2%; ASR 18.1), nasopharynx (7.8%; ASR 9.2), prostate (7.3%; ASR 12.0),
leukaemia (6.5%; ASR 7.0) and lymphoma (6.2%; ASR 7.7). In females, the most frequent cancer
was breast cancer (31.3%; ASR 47.4), followed by cancers of the cervix uteri (10.6%; ASR 16.1),
large bowel(9.9%; ASR16.8),ovary(4.3%;ASR6.4),leukaemia(3.7%;ASR 5.2)and lung(3.6%;
ASR6.2).




Generally, the incidence of cancers was reported more in males than females in most countries.
However the male to female (M:F) sex ratio in this report was 1: 1.3. A similar trend was noted in
earlierNCRreports.Consistentwithotherregionalregistries,therewaspredominanceoffemalesto
malesincancersofthethyroidasseenbyaM:Fratioof1:3.

Thevariationofthetenmostfrequentcancerincidencebysexandmajorethnicgroupsisshownin
Figure 4.3.1(a) and 4.3.1(b) and the accompanying tables. Overall, this report showed that the
ChinesehadsignificantlyhigherASRper100,000populationof182.9(males)and201.5(females),
compared with the Indians (ASR of 134.4 in males and 186.3 in females) and the Malays (ASR of
89.6 in males and 106.4 in females). The following estimates of cancers are presented as a
proportiontothetotalsubgroupandasanASRper100,000populationforcomparisonpuposes.

AmongstMalaymales,largebowelcancer(12.6%;ASR12.3)wasthemostcommoncancerfollowed
by leukaemia (11.2%; ASR 7.2), lung cancer (11.1%; ASR 11.2), lymphoma (9.0%; ASR 7.4) and
prostatecancer(6.6%;ASR7.7).

Large bowel cancer was also the leading cause of cancer in Chinese males (16.9%; ASR 31.5)
followedbycancersofthelung(14.2%;ASR26.8),nasopharynx(10.7%;ASR17.0),prostate(7.8%;
ASR15.8)andstomach(5.9%;ASR11.3).

In Indian males, the most frequent cancers were large bowel (11.5%; ASR 15.7), prostate (8.7%;
ASR14.8),stomach(8.0%;ASR11.9),lung(7.0%;ASR9.9)andlymphoma(6.4%;ASR6.9)

The most frequent cancers for Malay females are cancers of the breast (33.6%; ASR 34.9), large
bowel(8.2%;ASR9.7),cervixuteri(8.1%;ASR8.7),Leukaemia(6.0%;ASR5.3)andovary(5.0%;
ASR5.2).

In the Chinese females, the most frequent cancers were cancers of the breast (30.3%; ASR 59.9),
largebowel(12.8%;ASR26.2),cervixuteri(11.8%;ASR23.2),lung(5.1%;ASR10.6)andstomach
(3.8%;ASR7.7).

AmongsttheIndianfemalesbreastcancer(31.2%;ASR54.2)wasfollowedbycancersofthecervix
uteri(8.8%;ASR16.4),mouth(6.5%;ASR14.5),largebowel(6.3%;ASR12.9)andcorpusuteri
(4.0%;ASR8.0).
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16
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16 EXECUTIVE SUMMARY
2003-2005
For most tumour sites, Chinese had the highest ASR except for the following cancers: lymphoma
(ASR highest in Malay males and females); lymphatic leukemia (ASR highest in Malay and Indian
males,andMalayfemales);myeloidleukemia(ASRhighestinMalaymales,Indianfemales);larynx
(highestinIndianmalesandfemales);mouth(highestinIndianmalesandfemales);tongue(highest
in Indian males and females); oesophagus (highest in Indian males and females); bone (highest in
Indianfemales);corpusuteri(highestinIndianfemales);brainandnervoussystem(highestinIndian
females),thyroid(highestinMalaymales).

In tumour sites not mentioned in the previous paragraph, Malays had the lowest ASR among the
major ethnic groups. For stomach cancer, Malay males and females had an incidence much lower
thantheothermajorethnicgroups.Inthemouth,Chinesehadthelowestamongfemales,although
amongmalestheMalayshadthelowestASR.InNasopharyngealcancer,Indianmalesandfemales
hadthelowestASR.

The other surprising finding in this report was the high ranking of leukemia amongst Malay Males.
However,thiswasconsistentwiththeKelantanCancerRegistryReport19992003wherebyleukemia
was the third most frequent cancer among all Males, and second highest among Malay Males.By
contrast, in the Penang Cancer Registry 19992003, leukemia featured eighth among males and
eighthamongfemales.

An unexpected finding is that prostate cancer was the secondmost common cancer in Indian
males.ProstatecancerrankedfourthamongmalecancersinMalaysia.Interestingly,theagespecific
incidencerateinChinese(ASR15.8)andIndians(ASR14.8)inMalaysiawerehigherthanthosein
Taiwan(ASR11.9),HongKong(ASR8.6)andMumbai(ASR7.4).ThisfindingforMalaysianIndian
males could be due to chance variation in a smaller sample compared to the other major ethnic
groups. However, in Singapore Indians, the numbers of cases reported for lung and prostate were
very close (68 and 65 respectively), with the ASR for these two organs being 10.0 and 9.9 in this
populationin Singapore. The ASRforprostatecancerin MalaysianIndians(14.8per 100,000)was
higher than that reported for Indians in the Singapore Cancer Registry and various other Indian
CancerRegistries.




ThevariationincancerincidencebyageandsexispresentedinFigures4.4.1(a)and4.4.1(b)andin
detailintheaccompanyingtable.Thefollowingestimatesofcancersarepresentedasaproportionto
thetotalsubgroupandasCRper100,000populationforcomparison.

Themostfrequentcancersinmalechildrenchildren(014years)wereleukaemias(47.6%,CR7.7),
brain cancers (11.2%, CR 1.8), lymphomas (9.5%, CR 1.5), cancer of kidneys (3.9%,; CR 0.6) and
thebones(3.7%;CR0.6).

Similarly, in female children aged 014 years, the most frequent cancers are leukemia(45.4%; CR
5.8),brain(13.3%;CR1.7),lymphoma(6.2%,CR0.8),bones(4.3%;CR0.5)andkidneys(3.6%;CR
0.5).
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In the age group of young male adults (1549 years old), the common cancers were nasopharynx
(15.9%; CR 7.7), large bowel (10.7%, CR 5.2), lymphomas (9.6%; CR 4.7), leukaemias (9.2%; CR
4.4)andlung(6.6%;CR3.2).

Inwomenaged1549years,thecommoncancerswerebreast(39.1%;CR37.8),cervixuteri(13.5%;
CR13.1),largebowel(5.4%;CR5.3),ovary(5.2%;CR5.1)andthyroid(4.9%;CR4.7).

In older subjects (50  69 years), cancers of the large bowel (16.6%; CR 63.4), lung (15.4%; CR
58.7), prostate (7.2%; CR 27.3), nasopharynx (7.1%; CR 27.2) and lymphoma (5.3%; CR 20.0)
predominatedinmen.Whereasthemostfrequentcancerinwomenaged5069werebreast(31.9%,
CR149.3), largebowel(11.1%;CR52.0), cervixuteri(10.1%;CR 47.1),lung(4.5%;CR20.9)and
corpusuteri(4.5%;CR20.9).






2003-2005
Intheoldestgroup(aged≥70years),themostcommoncancersinmenwerelargebowel(17.4%:CR
177.2),prostate(16.5%:CR167.7),lung(14.6%:CR147.6),stomach(7.3%:CR74.4)andbladder
(5.3%: CR 54.3). While in women aged ≥ 70 years, the most frequent cancers were large bowel
(20.0%; CR 133.7), breast (15.7%; CR 105.1), cervix uteri (6.9%; CR 46.2), lung (6.6%; CR 44.2),
stomach(6.3%;CR42.5).
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


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18
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18 EXECUTIVE SUMMARY
2003-2005


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 
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TheMalaysianNationalCancerRegistry(NCR)isaservicesupportedbyMinistryofHealth,Malaysia
(MOH)tocollectinformationaboutcancerincidenceinMalaysia.Thisinformationisvitalinplanning
andevaluationofcancerservicesbythegovernementalagencies,NonGovernementalOrganizations
(NGO),privateprovidersandtheindustry.

InNovember2001,theHonorableMinisterofHealthMalaysiadirectedtheClinicalResearchCentre
(CRC) to establish a National Cancer Registry (NCR). Following this directive, the NCR’s Sponsor
Groupwasformed.ThemembershipcomprisedofOncologist,Pathologist,Haematologist,Paediatric
Oncologist,HeadoftheCancerResearchCentreintheInstituteofMedicalResearch,Directorofthe
Disease Control Division and the Director of the Medical Development Division.  In April 2002, the
NCR obtained approval from the Director General of Health to setup its operations and was
subsequentlyawardedaMedicalResearchGrantgrantinJune2002bytheDeputyDirectorGeneral
ofHealth(Research&TechSupport).
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Administratively, the NCR began as one of the seven clinical registries under the umbrella of the
ClinicalResearchCentre, MinistryofHealth.In2005,astheregistry‘matured’theadministrationof
the registry was handed over to the Department of Radiotherapy and Oncology, Hospital Kuala
Lumpur. In response to the call by the Director General of Health for a single Cancer Registry in
Malaysia,theDivisionofPublicHealth(DPH)hastakenoverthemanagementoftheNCRfrom2007
onwards. This is timely as the DPH is in the midst of expanding its cancer registration system at a
nationallevel.Itishopedthatwithasinglemanagementsystem,theregionalregistriesalongwiththe
national registry would be able to produce national data more effectively and efficiently. This will
providethemuchneededimpetusforfurtherdevelopmentofcancerprogrammesandinitiatives.
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

TheobjectivesofNationalCancerRegistryareto:
1. Determine the disease burden attributable to cancer by quantifying the magnitude of cancer
 morbidityandmortality,anditsgeographicandtemporaltrendsinMalaysia.
2. Identify subgroups in the population at high risk of cancer to whom cancer prevention effort
 shouldbetargeted.
3. Stimulate and facilitate epidemiological research on cancer with respect to cancer etiology,
 diagnosisandprognosis.
4. Evaluatecancertreatment,controlandpreventionprogramme.
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


TheNCRreceiveddatavoluntarilyoncancerincidencemainlyfromindividualdoctorswhoprovided
cancer diagnostic services or who cared for cancer patients. Information on cancer incidence was
alsoextractedusingthetheMinistryofHealth’sHospitalInformationSystem.
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NATIONAL CANCER REGISTRY 19
2003-2005
ThedaytodayoperationsoftheNCRcanbecategorizedastwoessentialcomponents:
a.   These are the daytoday administration, site and data management
 operationsofaRegistry.Itentailsgeneraladministrationoftheregistry,initiatingandmaintaining
 siteparticipationintheregistry,dataacquisition,datastorage,dataprocessing(datatransmittal,
 review, coding, cleaning, query, reconciling, transferring and archiving), data quality assurance,
 andperiodicsitemonitoringandretraining.



b. Anelectronicdatabaseserverwasusedtostorethedataand
 a database application was used to automate most of the work processes involved in data
 management. The database management system required routine administration, maintenance
 andcontinuingdevelopmentandenhancementtomeetthedynamicneedsofthisregistry.
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

Oncology,HaematologyandPathologyservices,MOH
DivisionofDiseaseControl,PublicHealthDepartment,MOH
MedicalDevelopmentDivision,MOH
CancerResearchCentre,InstituteforMedicalResearch,MOH
ClinicalResearchCentre,HospitalKualaLumpur,MOH
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
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20
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20 NATIONAL CANCER REGISTRY
2003-2005





2
MalaysiaislocatedintheSouthEastAsianregionandcoversanareaof329,961km .Itsharesits
borderswithSingapore,Thailand,IndonesiaandBrunei.TheSouthChinaSeaseparatesWestand
East Malaysia; West Malaysia being a peninsular region of the Asian Continent whereas East
Malaysia is located on the Island of Borneo. There are a total of 13 states and three Federal
Territoriesasfollows:

 PeninsularMalaysia
 NorthernRegion:Perlis,Kedah,Penang,Perak
 EastCoastRegion:Kelantan,Terengganu,Pahang
 CentralRegion:Selangor,FederalTerritoryofKualaLumpurandFederalTerritoryof
Putrajaya
 SouthernRegion:NegeriSembilan,Malacca,Johor

 EastMalaysia
 Sarawak
 Sabah
 FederalTerritoryofLabuan

Malaysia enjoys an equatorial climate. It is hot and humid throughout the year with an average
o
temperatureof27 Candanannualrainfallthatexceeds2000mm.Therainyseasonsareinfluenced
bythemonsoontradewinds.






MALAYSIA AND ITS POPULATION 21
2003-2005


The age distribution of Malysia is dynamic over the years and the country currently experiences a
highbirthratewithadeclineofthedeathrates.Theagepyramidstillhasalargebasebuttheelderly
proportion is increasing. The age and sex distribution of the population of Peninsular Malaysia is
showninFigure2.2.1.Malaysiaisamultiethniccountry,withtheMalaysbeingthemajorityfollowed
bytheChinese,Indians,IndigenousgroupsandOrangAsli.Agraphicalrepresentationoftheethnic
distributioninPeninsularMalaysiaisshowninFigure2.2.2.




75+ 116300 155300

7074 109200 129200
6569 172400 189700
6064 242900 239300
5559 329000 314300
5054 454200 441500
4549 548800 539200

4044 604300 608800 Female
3539 659200 668200 Male
3034 676400 682100

2529 737900 736000
2024 886300 866400
1519 996500 957500
1014 1044400 983600
59 1105000 1037900
04 1158700 1089500
1500000 1000000 500000 0 500000 1000000 1500000







9% 2%
27%
62%
Malay Chinese Indian Others

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
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
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22
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22 MALAYSIA AND ITS POPULATION
2003-2005

Thisreportcoversincidentcancercasesfrom2003to2005.Thustheage,sexandethnicdistribution
in 2004 can be used to represent the average age, sex and ethnic distribution of the study base
(averagedistributionofthedenominatorusedforincidentratecalculation).

ThetotalpopulationofPeninsularMalaysiain2004was19.5millionwhichconsistedof9.84million
(50.5%)malesand9.64million(49.5%)females.Therewere12.0million(61.5%)Malays,5.2million
(26.7%)Chineseand1.8million(9.2%)Indians.


 
     
 
       
 
04 799,100 753,300 231,900 214,800 93,000 89,600 1,158,700 1,089,500 12,000
59 743,100 700,000 240,200 221,100 91,800 88,500 1,105,000 1,037,900 10,000
1014 707,300 669,600 227,000 207,300 8,600 82,900 1,044,400 983,600 9,000
1519 658,600 637,600 228,900 213,700 87,400 83,300 996,500 957,500 9,000
2024 566,500 559,000 216,700 206,300 81,700 79,800 886,300 866,400 8,000
2529 433,800 442,000 205,400 197,100 73,600 75,400 737,900 736,000 8,000
3034 384,100 396,200 200,600 194,600 69,600 72,000 676,400 682,100 6,000
3539 376,900 387,400 200,400 196,700 67,300 68,900 659,200 668,200 6,000
4044 339,400 346,100 192,500 187,500 62,300 63,800 604,300 608,800 6,000
4549 300,600 299,700 182,100 173,400 56,900 58,100 548,800 539,200 6,000
5054 243,700 240,800 158,700 148,600 45,300 46,300 454,200 441,500 5,000
5559 171,400 167,600 124,500 113,300 28,700 29,200 329,000 314,300 4,000
6064 124,000 125,500 96,400 89,900 19,500 20,900 242,900 239,300 4,000
6569 88,000 99,800 68,800 70,800 13,500 17,000 172,400 189,700 3,000
7074 55,500 67,100 44,200 49,800 8,100 10,800 109,200 129,200 2,000
75+ 63,500 79,900 41,800 63,400 8,900 10,200 116,300 155,300 2,000
         
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
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Infrastructure such as roads, public transportation and telecommunication in Malaysia are well
developed.Thereisgoodcoverageforelectricityandwatercoverage.
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


ThemainoccupationsinMalaysiaof2004areshownin

 
 
Legislators,seniorofficialsandmanagers 8.6%
Professionals 5.6%
Techniciansandassociateprofessionals 12.1%
Clericalworkers 9.3%
Serviceworkersandshopandmarketsalesworkers 14.8%
Skilledagriculturalandfisheryworkers 13.2%
Craftandrelatedtradeworkers 11.7%
Plantandmachineoperatorsandassemblers 14.1%
Elementaryoccupations 10.7%


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
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MALAYSIA AND ITS POPULATION 23

2003-2005


Since independence, the health status of Malaysia has been enhanced by improved socio
economicalstatus,healthinfrastructureandservices.Thefollowingstatisticsarepresentedfor2004
unlessstatedotherwiseasitrepresentsanaverageofthe20032005period.

Lifeexpectancyatbirthwas70.4yearsand76.2yearsinMalaysianmalesandfemalesrespectively.
InfantMortalityRatewas5.9per1000livebirthswhereasMaternalMortalityRatewas0.3per1000
livebirths (Table 2.5.1). The doctor to population ratio was 1:1402 and there were 119 government
hospitals, 6 nonMOH government hospitals, 218 private hospitals, 859 MOH health clinics, 1924
MOH rural clinics, 93 MOH maternal and child health clinics, 165 mobile clinics and 1969 dental
clinics.Governmenthospitalsandprivatehospitalsprovided28,966and10,542bedsrespectively.




 
Perinatalmortalityrate* 6.8
Maternalmortalityrate* 0.3
Infantmortalityrate* 5.9
Neonatalmortalityrate* 3.8
*Per1000livebirths




WithMalaysiansenjoyingbetterhealthstatuscurrentlycomparedwiththeirpredecessors,itwasthen
no surprise that malignant neoplasm ranked among its top five causes of death in the years 2003
2005.



18
16.54
15.63
16 15.1
14.41 14.52 14.31
14
12
10.11
9.34 9.54
10
8.27 8.4 8.19
8
6.29 6.07
5.67
6
0
2003 2004 2005
Septicaemia HeartDiseases M alignantNeo plasms Cerebro vascularDiseases A ccident

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24
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24 MALAYSIA AND ITS POPULATION
2003-2005





 
 
 







 

 








 


 




 
 
 
 
 

 
 
 
 

 
 

 
 
 



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

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
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METHODS 25
2003-2005


              
             


       


             
       



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
            

         


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    

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
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               
           
           


            




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                

              





                













26 METHODS
2003-2005


 



   



 


  



 




 


 
















            






METHODS 27
2003-2005



  




  

 


 



 
 


















               

 

 
 
 

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            
              

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
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28 METHODS
2003-2005

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
             
             
             


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
       
            



             
           

             
            
              

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            

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
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




             
 
               
                
 
             
 


          




              





               






METHODS 29
2003-2005

 



• 
           
         

• 
•              
            

• 
•               





             
              


               


                








 ∑ 
   =



 ∑  =





              




           

               

             




                  






30 METHODS
2003-2005



 

 ∑  =

   


∑  =









                







 
  ∑  
  =





 





























METHODS 31
2003-2005






             


                



             



              


                 





             








             

• 
• 
• 

• 


• 

•             
            

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
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32 METHODS
2003-2005

• 

•              
               
              

•             
            

• 





• 

• 
• 
•               

              


• 
• 


• 


• 
• 
• 


• 


• 
            

•              
           







              
            
           


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


METHODS 33
2003-2005
 


                
    




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
 
   
  
    
    
    
    
    
    
    
    
    
    
    
    
    
    
    
    
    
    
    
    
    
    
    
    
    
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
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34 METHODS
2003-2005
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
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              

             
              
    
                   
             
      
                


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
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
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 
 
 
 
 

             



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
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             


















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

METHODS 35
2003-2005
 


     

  
     
        

        
        
        
       

       
        
        
        
        
        
        
        
        
       

       
        
        
        
        
       

       
        
        
        
        
        
        
        
        
        
        
        
        
        
        
        
        

 
 
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




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36 METHODS
2003-2005
     

  
     
        

        
        

        
        
        
        
        
        
        
        
        
        
        
        
        
        
        
        
        
        
        
        
        
        
        
        
        
        
        

       

        

       

        

       

        

 
 









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METHODS 37
2003-2005





          

      
 
       
       
       
 
       
       
       
 
       
       
       


           

  
      
      
      
      
      
      
      
      
      
















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
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38 CANCER INCIDENCE IN MALAYSIA 2003-2005
2003-2005
         

  


          
            
            
            


           

   
          
          
          
          
          
          
          




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CANCER INCIDENCE IN MALAYSIA 2003-2005 39
2003-2005



 

  
  
 

 

 

 
 
 
 
          
 
  
 



  
  
  
 
  
 
  
 
 
 
              
 



 

  
 

   
  
  
 
  
 
 
       
       
 








  
  
           
 
                  
                  
                  
                  
                  
                  
                  
                  
                  
                  
                 
                 
 
                  
                  
                  
                  
                  
                 
 
                  
                  
                  
                 
 
                  
                  
                  
                  
                  
                 
                  
                 
                 
                 
 
                  
                  
                 
                 
                  
                  
                 
                 
                  
                 



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CANCER INCIDENCE IN MALAYSIA 2003-2005


41
2003-2005


42


2003-2005
  
  
           
 
                  
                 
                 
                  
                  
                  
                  
                  
                  
                  
                  
                  
                  
                  
                  
        


                  
          
                  
                  
                  
      
                  
                  
                  
                 
 
                  
               
                  
                  
 
                  
                  
                  
                  
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          


 
 
 
 
 
 
 
 
 
 
       



 
  
 
 
 
 
 
 
 
 
       



 

  
 
 
 
 
 
 
 
 
       


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

 
 
 
 
 
 
 
 
 
 
       



 
 
 
 
 
 
 
 
 
 
       



 
 
 
 
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  
 
 
 
 
 
       


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            
              


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

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 

  
        

       

        
        
        


 

   
          

         

          
          
          
          

         

          
          
          
          
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



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
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 
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BUCCAL CAVITY 61
2003-2005


  




 
 
 
 
 

   
  
   
  




   
     
     
     
     

    

     
     
     

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
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
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 
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62 BUCCAL CAVITY
2003-2005



 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
   


 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
   

 

BUCCAL CAVITY 63
2003-2005



            
          
 
          



             



 

 
  
        

       

        
        
        




   
          

         

          
          
          
          

         

          
          
          
          














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  
64 BUCCAL CAVITY
2003-2005


 

 



 











   
   
      


 
 
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
  
BUCCAL CAVITY 65
2003-2005

 
   
     
     
     
     
     
     





 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
    


 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
    


  
66 BUCCAL CAVITY
2003-2005



            

             





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                

             

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            
          
               

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 

  
        

       

        
        
        
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 

   
          

         

          
          
          
          

         

          
          
          
          






  
BUCCAL CAVITY 67
2003-2005


   

 





              
 




 
   
     
     
     
     
     
     
     

    

     
     
     
     
     

    

     
     
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  
68 BUCCAL CAVITY
2003-2005

 
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
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  
BUCCAL CAVITY 69
2003-2005



 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
    


 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
    




  
70 BUCCAL CAVITY
2003-2005





               


                 
              



                 




 

 
  
        

       

        
        
        


 

   
          

         

          
          
          
          

         

          
          
          
          











  
NASOPHARYNX 71
2003-2005





 

  





















 



 




 


 
 
    

    





  
72 NASOPHARYNX
2003-2005



 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
    


 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
    

  
NASOPHARYNX 73
2003-2005
74
SELECTED CANCER SITES 2003-2005
2003-2005







 
 
 
 
 
    
75
2003-2005
76
2003-2005



               
             








           




                 



              
              
              



 

 
  
        

       

        
        
        


 

   
          

         

          
          
          
          

         

          
          
          
          



DIGESTIVE SYSTEM 77
2003-2005


 
 

 
 
 
 
 
 
 

   
          



   
     
     
     
     
     
     
     
     



   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   



78 DIGESTIVE SYSTEM
2003-2005



 
 
 
 
 
 
 
 
 
 
 
 
    


 
 
 
 
 
 
 
 
 
 
 
 
    

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






DIGESTIVE SYSTEM 79
2003-2005



              







              



              
               
                
              
             



 

  
        

       

        
        
        


 

   
          

         

          
          
          
          

         

          
          
          
          









80 DIGESTIVE SYSTEM
2003-2005



 













 
       

       




   
     
     
     
     
     
     
     
     
     
     
     



   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
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


DIGESTIVE SYSTEM 81
2003-2005
   
   
   
   
   
   
   
   
   
   





 
 
 
 
 
 
 
 
 
 
 
 
    


 
 
 
 
 
 
 
 
 
 
 
 
    

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



82 DIGESTIVE SYSTEM
2003-2005






           














            
              
             


               
               



 

 
  
        

       

        
        
        


 

   
          

         

          
          
          
          

         

          
          
          


DIGESTIVE SYSTEM 83
2003-2005






 
  






 


 


  


  

  
 
    
   
 
  



   
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
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
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84 DIGESTIVE SYSTEM
2003-2005


   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
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DIGESTIVE SYSTEM 85
2003-2005



 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
        


 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
       











86 DIGESTIVE SYSTEM
2003-2005

 

      
                 









 

  
        

       

        
        
        


 

   
          

         

          
          
          
          

         

          
          
          
          


















DIGESTIVE SYSTEM 87
2003-2005


  


 







 
 

   
       
 

 



   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   



88 DIGESTIVE SYSTEM
2003-2005



 
 
 
 
 
 
 
 
 
 
 
 
 
      


 
 
 
 
 
 
 
 
 
 
 
 
 
    












DIGESTIVE SYSTEM 89
2003-2005



              


                



              





 

  
        

       

        
        
        


 

   
          

         

          
          
          
          

         

          
          
          
          
















90 DIGESTIVE SYSTEM
2003-2005


 







        




   
     
     
     
     
     
     
     



   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   



DIGESTIVE SYSTEM 91
2003-2005



 
 
 
 
 
 
 
 
 
 
 
 
     


 
 
 
 
 
 
 
 
 
 
 
 
     










92 DIGESTIVE SYSTEM
2003-2005



               

              


               





  
        

       

        
        
        




   
          

         

          
          
          
          

         

          
          
          
          




















DIGESTIVE SYSTEM 93
2003-2005
 
 
   
 
   
 
 
 
 
       

       




   
     
     
     
     
     
     
     
     
     
     



   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   


94 DIGESTIVE SYSTEM
2003-2005
 
 

 
 
 
 
 
 
 
 
 
 
 
 
     


 
 
 
 
 
 
 
 
 
 
 
 
     











DIGESTIVE SYSTEM 95
2003-2005
96
LARYNX
 2003-2005









  
  
  

LARYNX 97
2003-2005
98
LUNG
2003-2005




                 

                


               

              

               

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

 
  
        

       

        
        
        
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

   
          

         

          
          
          
          

         

          
          
          
          
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
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NOSE, SINUSES, LARYNX AND LUNGS 99
2003-2005


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 
 
 
 
 
 
 
 
 
 
               
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
 
   
     
     
     
     
     
     
     
     
     
     
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
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100 NOSE, SINUSES, LARYNX AND LUNGS
2003-2005
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

   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   

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









2003-2005
 
 

 
 
 
 
 
 
 
 
 
 
 
 
    


 
 
 
 
 
 
 
 
 
 
 
 
    

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
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2003-2005



             



              

              
                







  
        

       

        
        
        




   
          

         

          
          
          
          

         

          
          
          
          
















2003-2005
 
 
 
   









 
 

   
         
 



   
     
     
     
     
     
     
     
     



   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   



2003-2005
 
 

 
 
 
 
 
 
 
 
 
 
 
 
 
 
         


 
 
 
 
 
 
 
 
 
 
 
 
 
 
   









2003-2005


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
              
              



                
                  



              


            






  
        

       

        
        
        
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

   
          

         

          
          
          
          

         

          
          
          
          
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
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2003-2005


 
 

 


 



 
           
  
 


   
     
     
     
     
     
     
     
     
     
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
    
    
    
    
    
    
    
    
    
    
    
    
    
    
    
    
    
    
    
    


2003-2005
 
 

 
 
 
 
 
 
 
 
 
 
 
 
 
 
    


 
 
 
 
 
 
 
 
 
 
 
 
 
 
    

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

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 2003-2005
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






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  
OTHER SKIN 109

2003-2005
110
MELANOMA
2003-2005


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



               


               
              
             


           

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


  
        

       

        
        
        




   
          

         

          
          
          
          

         

          
          
          
          

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
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BONE AND CONNECTIVE TISSUE 111
2003-2005



   

 

 
 
 
 
 
             

 



   
     
     
     
     
     
     
     

     
     
     
     
     
     

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
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

112 BONE AND CONNECTIVE TISSUE
2003-2005


   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   


















BONE AND CONNECTIVE TISSUE 113

2003-2005
 
 

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
    


 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
    



114 BONE AND CONNECTIVE TISSUE
 2003-2005









  
   
FEMALE BREAST 115

2003-2005
116
FEMALE BREAST
2003-2005










              


           





  
        

       

        
        
        
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

   
          

         

          
          
          
          

         

          
          
          
          

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
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SKIN AND MELANOMA 117
2003-2005
 
 
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 











 
 

   
 
 
   
  


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

   
     
     
     
     
     
     
     
     
     
     
     

    

     
     
     
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

  
  
  
  
  
  
  
  
  
  
  
  
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
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118 SKIN AND MELANOMA
2003-2005
 
 

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
     



 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
     

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
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2003-2005




                
              


                

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


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

  
        

       

        
        
        
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

   
          

         

          
          
          
          

         

          
          
          
          
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
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2003-2005
 
 
 
 

  


 
 
 
 
 
             

 



   
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     

    


    

     
     
     
     
     
     
     
     
     
     
     



2003-2005
 
 

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
     



 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
     






 2003-2005








  

CORPUS UTERI 123

2003-2005
124
OVARY
2003-2005
* Editorial Note: Singapore estimates in the above write-up are based on Singapore Cancer Registry Report
No. 6, Trends In Cancer Incidence in Singapore 1968-2002 (Reference 10); whereas Singapore estimates for
Figure 5.17.2 are based on Cancer Incidence in Five Continents (Reference 4).
FEMALE BREAST 125

2003-2005
126 FEMALE BREAST

2003-2005
 
 






 
 
 
 

 
          
 


 
 

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
    




FEMALE BREAST 127
2003-2005
128
PROSTATE
2003-2005









  
  
  

PROSTATE 129
2003-2005
130
BLADDER
2003-2005




                  



                




              



           





 
    

   

    
    
    




   
          

         

          
          
          
          
















FEMALE GENITAL ORGANS 131
2003-2005


 
 
 
 
 
 
 
              
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
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

  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
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
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132 FEMALE GENITAL ORGANS
2003-2005
 
 
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
 
 
 
 
 
 
 
 
 
 
 
 
 
   

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





2003-2005


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
                   
     
              
          

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                
                   
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              

               
               

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

 
    

   

    
    
    




   
          

         

          
          
          
          


2003-2005


 
 
 
 
 
 
 
       
       




  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  






2003-2005
 
 

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
     






































2003-2005



             


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                  
               
              
                     


                



        





 
    

   

    
    
    




   
          

         

          
          
          
          

















2003-2005
 
 
 
 
 
 
 
 
 
             

 

 
 

 
 
 
 
 
 
 
 
 
 
 
 
    







2003-2005

 
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  






2003-2005
140
 2003-2005







  
  
 
 

SELECTED CANCER SITES 2003-2005 141

2003-2005
142
2003-2005



                


             


                





             
             


               





 
    

   

    
    
    




   
          

         

          
          
          
          
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PROSTATE, BLADDER, KIDNEY AND OTHER URINARY ORGANS 143
2003-2005



 





   

   

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
   
   
   
   
   
   
   
   
   
   
   
   
   
   
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 
 

 
 
 
 
 
 
 
 
 
 
 
     


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144 PROSTATE, BLADDER, KIDNEY AND OTHER URINARY ORGANS
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2003-2005
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

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              
                 

                

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

               
             



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

  
        

       

        
        
        




   
          

         

          
          
          
          

         

          
          
          
          










2003-2005
 
 
 
   
 


 
 
 
 
 
               
 



   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   


2003-2005

 
 


 
 
 
 
 
 
 
 
 
 
 
 
           


 
 
 
 
 
 
 
 
 
 
 
 
   










2003-2005




                

                 








             
              










  
        

       

        
        
        




   
          

         

          
          
          
          

         

          
          
          
          






2003-2005


   
     
     
     
     
     
     
     




   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   





2003-2005
 
 
 
 

 



 
 
 
 
 
              

 


 
 
 

 
 
 
 
 
 
 
 
 
 
 
 
 
 
     


 
 
 
 
 
 
 
 
 
 
 
 
 
 
    




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 2003-2005
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



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 

 


2003-2005
152
2003-2005
 
  
 


             
             


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
            

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                 
             
              






  
        

       

        
        
  

     

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

   
          

         

          
          
          
          

         

          
          
          
          
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BRAIN AND OTHER NERVOUS SYSTEM, THYROID 153
2003-2005
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

   
     
     
     
     
     
     
     
     
     
     
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

  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
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154 BRAIN AND OTHER NERVOUS SYSTEM, THYROID

2003-2005
 
 
   
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 

 
 
 
 
 
      

         
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 
 
 

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
    


 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
    

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
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2003-2005
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

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

               





                  

                

            








  
        

       

        
        
        




   
          

         

          
          
          
          

         

          
          
          
          








2003-2005
 
 
   
   
 
 
 
 
 
      



      




   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   




2003-2005
 
 


 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
     



 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
    




2003-2005







   
 
 


2003-2005
160
2003-2005



          
                


           


              


             
    



                   






  
        

       

        
        
        




   
          

         

          
          
          
          

         

          
          
          
          






LYMPHOMA 161
2003-2005
 
 
 
  


 



 
 

  
 
    
 


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            
            
            

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
   
     
     
     
     
     
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
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162 LYMPHOMA
2003-2005
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
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   







LYMPHOMA 163
2003-2005



                   


             
             
             




 
 
  
        

       

        
        
        



 
   

        

         
         
         
         
         
         
         
         


 
  
   
 
 


 
 
 
 
 
               




164 LYMPHOMA
2003-2005
 
 

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
    


 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
    











LYMPHOMA 165
2003-2005






 
 
 
  
        

       

        
        
        


 
 
   

        

         
         
         
         
         
         
         
         


 
 
 
   




 
 
 
 
 
      
 
       




166 LYMPHOMA
2003-2005
 
 

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
    


 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
    



LYMPHOMA 167
2003-2005
168
 2003-2005







   
 
 


2003-2005
170
2003-2005





               


              






 
  
        

       

        
        
        



 
   
          

         

          
          
          
          

         

          
          
          

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











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
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LEUKAEMIA 171
2003-2005
 
  

 







 
 
 

 
 
 
 
 
 
  


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
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172 LEUKAEMIA
2003-2005

 

 
 
 
 
 
 
 
 
 
 
 
 
             


 
 
 
 
 
 
 
 
 
 
 
 
         

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LEUKAEMIA 173
2003-2005


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                



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
              


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         
 
 
  
        

       

        
        
        
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 
 
   
          

         

          
          
          
          

         

          
          
          
          
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
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174 LEUKAEMIA
2003-2005
 
 
 
   
 

 
 
 
 
 
               
 



 

 
 
 
 
 
 
 
 
 
 
 
 
        


 
 
 
 
 
 
 
 
 
 
 
 
    


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LEUKAEMIA 175
2003-2005
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

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


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

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


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
 
 
 
  
        

       

        
        
        

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 
 
   
          

         

          
          
          
          

         

          
          
          
          
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
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176 LEUKAEMIA
2003-2005
 
 

 



 
 
 
 
 
 

   
  
 
 
  




LEUKAEMIA 177
2003-2005



 

 
 
 
 
 
 
 
 
 
 
 
 
      


 
 
 
 
 
 
 
 
 
 
 
 
    



178 LEUKAEMIA
2003-2005
REFERENCES
1) First Report of the National Cancer Registry. Cancer Incidence in Malaysia 2002. Lim,
GCC and Halimah, Y. National Cancer Registry. Kuala Lumpur 2003.
2) 2nd Report of the National Cancer Registry. Cancer Incidence in Malaysia 2003. Lim,
GCC and Halimah, Y. National Cancer Registry. Kuala Lumpur 2004.
3) International Classification of Diseases for Oncology 3rd edition. Fritz. A., Percy. C.,
Jack. A., Shanmugaratnam, K., Sobin, L., Parkin, D. M. and Whelan, S. World Health
Organization, Geneva, 2000.
4) Cancer Incidence in Five Continents Volumes I to VIII. Parkin, D.M., Whelan, S.L., Ferlay,
J. and Storm, H. IARC CancerBase No 7, Lyon, 2005.
5) Malaysia, Year Book of Statistics 2006. Department of Statistics, Malaysia, 2006.
6) Health Facts 2002. Planning and Development Division (Information and Documentation
System Unit), Ministry of Health Malaysia, 2004.
10) Trends In Cancer Incidence in Singapore 1968-2002. A Seow, W P Koh, K S Chia,

L M Shi, H P Lee, K Shanmugaratnam (editors). Singapore Cancer Registry Report
No. 6. Singapore Cancer Registry, 2004.
11) Penang Cancer Report 1999-2003. Bina Rai, S., Devaraj, T., Aishah, K., Rokiah, M. and
Nor Asikin, A.K. Penang Cancer Registry, 2005.
12) Kelantan Cancer Registry Report 1999-2003. Fauziah, M.N., Hamizah, M.S., Norazmi, A.,
and Lila, P.M.M. Kelantan Cancer Registry, 2006.
13) Epidemiology of Cancer in Sarawak 1996-2000. Ooi, CH., Kiyu, A., Yao, SK., Helli, B.,
Mastulu, W. and Assan, J. Sarawak Cancer Registry, Sarawak Health Department, Sarawak.
2005.
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180
REFERENCES

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Cancer Incidence in

Dr Gerard Lim Chin Chye

National Cancer Registry

Ministry of Health, Malaysia

Majlis Kanser Nasional

The Third Report of the

National Cancer Registry

Ministry of Health Malaysia

The National Cancer Registry report is also published electronically on:

TABLE OF CONTENTS Page

TABLE OF CONTENTS Page

5.10 PANCREAS (ICDO: C25) 93

LIST OF TABLES Page

Table 2.4.1: Malaysia: Percentage Distribution of Employed Persons by Occupation 23

Table 5.1.3: Number of Tongue cases by subsite, Peninsular Malaysia 2003-2005 62

Table 5.3.3: Number of Mouth cases by subsite, Peninsular Malaysia 2003-2005 68

LIST OF TABLES Page

LIST OF TABLES Page

LIST OF TABLES Page

LIST OF TABLES Page

LIST OF TABLES Page

LIST OF FIGURES Page

LIST OF FIGURES Page

Figure 5.7.2: Large Bowel International comparisons – Age-standardized Incidence per 86

LIST OF FIGURES Page

LIST OF FIGURES Page

FOREWORD BY THE MINISTER OF HEALTH, MALAYSIA 1

2 FOREWORD BY THE DIRECTOR GENERAL OF HEALTH, MALAYSIA

NATIONAL CANCER REGISTRY PARTICIPATING CENTRES 

 NATIONAL CANCER REGISTRY PARTICIPATING CENTRES

  

75+ 116300 155300

4044 604300 608800 Female

3539 659200 668200 Male

3034 676400 682100

1500000 1000000 500000 0 500000 1000000 1500000

Malay Chinese Indian Others

MALAYSIA AND ITS POPULATION 23

Septicaemia HeartDiseases M alignantNeo plasms Cerebro vascularDiseases A ccident

     

        

     

        

        

  

CANCER INCIDENCE IN MALAYSIA 2003-2005

CANCER INCIDENCE IN MALAYSIA 2003-2005

       

       

       

       

       

       

CANCER INCIDENCE IN MALAYSIA 2003-2005 45

46 CANCER INCIDENCE IN MALAYSIA 2003-2005

NOSE, SINUSES, LARYNX AND LUNGS 101

OTHER SKIN 109

BONE AND CONNECTIVE TISSUE 113

FEMALE BREAST 115

     

     

     

CORPUS UTERI 123

NATIONAL CANCER REGISTRY PARTICIPATING CENTRES

NATIONAL CANCER REGISTRY PARTICIPATING CENTRES