*Corresponding author: [email protected]T he Sultanate of Oman is located in the Southeastern corner of the Arabian Peninsula. It has a coastal line extending almost 1700 km from the Strait of Hormuz in the north to the borders of Yemen, overlooking three seas; the Arabian Gulf, Gulf of Oman, and the Arabian Sea. e country borders Saudi Arabia and the UAE in the west, Yemen in the south, the Strait of Hormuz in the north, and the Arabian Sea in the east. ere are a number of scattered Omani islands in the Arabian Sea; the most important are Masirah and Al Halaniyat. e total area of Oman is approximately 309 500 km 2 and it is the second largest country in the Arabian Peninsula. Oman is composed of varying topographic areas consisting of plains, wadis (dry river beds), and mountains. e most important area is the plain overlooking the Gulf of Oman and the Arabian Sea with an area of about 3% of the total area. e mountain ranges occupy almost 15% of the total land of Oman and are inhabited by about 5% of the population. e remaining area is mainly sand, wadis, and desert (about 82% of the total area). e climate differs from one area to another; it is hot and humid in the coastal areas in summer, hot and dry in the interior with the exception of higher mountains and Dhofar governorate, which enjoy a moderate climate throughout the year. Oman is administratively divided into 11 governorates with 62 Wilayats. ese are Muscat, Dhofar, Musandam, A’Dakhiliyah, Al Buraymi, A’Sharqiyah South and North, Al Batinah South and North, A’Dhahirah, and Al Wasta [Figure 1]. Population structure The estimated mid-year population in1996 was 2 135 853 of which 1 593 769 were Omanis and 542 084 were Non-Omanis. e Omani population shows a sex ratio of 963 females per 1000 males. About 16.0% of the population is under-5 years and 45.0% is under-15 years. Only 3.0% of the total Omani population is above the age of 65 years. While, the estimated mid-year population in 2015 was 4 159 102 of which 2 344 946 were Omanis and 1 814 156 were Non-Omanis. e Omani population showed a sex ratio of 979 females per 1000 males. About 14.9% of the population were under-5 years and 35.7% were under-15 years. e population above 65 years increased to 4.3% [Figure 2]. Oman national cancer registry e Oman National Cancer Registry was established in 1985 as a hospital-based registry. Only cases treated in tertiary hospitals were registered. In 1996, with the establishment of the department of Non-Communicable Diseases Surveillance and supplement Oman Medical Journal [2019], Vol. 34, No. 4: 361-387 Twenty-year Trends of Cancer Incidence in Omanis, 1996–2015 Najla A. Al-Lawati 1 , Bassim J. Al-Bahrani 2 , Shadha S. Al-Raisi 1 and Jawad A. Al-Lawati 1 * 1 Directorate General of Primary Health Care, Ministry of Health, Muscat, Oman 2 National Oncology Centre, Royal Hospital, Muscat, Oman MUSCAT Al BURAYMI MUSANDAM AL BATINAH A’DHAHIRAH A’ DAKHILIYAH A’ SHARQIYAH AL WASTA DHOFAR Figure 1: Diagrammatic map of the Sultanate of Oman.
The Sultanate of Oman is located in the Southeastern corner of the Arabian Peninsula. It has a coastal line extending almost 1700 km from the Strait of
Hormuz in the north to the borders of Yemen, overlooking three seas; the Arabian Gulf, Gulf of Oman, and the Arabian Sea. The country borders Saudi Arabia and the UAE in the west, Yemen in the south, the Strait of Hormuz in the north, and the Arabian Sea in the east. There are a number of scattered Omani islands in the Arabian Sea; the most important are Masirah and Al Halaniyat.
The total area of Oman is approximately 309 500 km2 and it is the second largest country in the Arabian Peninsula. Oman is composed of varying topographic areas consisting of plains, wadis (dry river beds), and mountains. The most important area is the plain overlooking the Gulf of Oman and the Arabian Sea with an area of about 3% of the total area. The mountain ranges occupy almost 15% of the total land of Oman and are inhabited by about 5% of the population. The remaining area is mainly sand, wadis, and desert (about 82% of the total area). The climate differs from one area to another; it is hot and humid in the coastal areas in summer, hot and dry in the interior with the exception of higher mountains and Dhofar governorate, which enjoy a moderate climate throughout the year.
Oman is administratively divided into 11 governorates with 62 Wilayats. These are Muscat, Dhofar, Musandam, A’Dakhiliyah, Al Buraymi, A’Sharqiyah South and North, Al Batinah South and North, A’Dhahirah, and Al Wasta [Figure 1].
Population structureThe estimated mid-year population in1996 was 2 135 853 of which 1 593 769 were Omanis and 542 084 were Non-Omanis. The Omani population shows a sex ratio of 963 females per 1000 males. About 16.0% of the population is under-5 years
and 45.0% is under-15 years. Only 3.0% of the total Omani population is above the age of 65 years. While, the estimated mid-year population in 2015 was 4 159 102 of which 2 344 946 were Omanis and 1 814 156 were Non-Omanis. The Omani population showed a sex ratio of 979 females per 1000 males. About 14.9% of the population were under-5 years and 35.7% were under-15 years. The population above 65 years increased to 4.3% [Figure 2].
Oman national cancer registryThe Oman National Cancer Registry was established in 1985 as a hospital-based registry. Only cases treated in tertiary hospitals were registered. In 1996, with the establishment of the department of Non-Communicable Diseases Surveillance and
supplement Oman Medical Journal [2019], Vol. 34, No. 4: 361-387
Twenty-year Trends of Cancer Incidence in Omanis, 1996–2015Najla A. Al-Lawati 1, Bassim J. Al-Bahrani2, Shadha S. Al-Raisi1 and Jawad A. Al-Lawati1*1Directorate General of Primary Health Care, Ministry of Health, Muscat, Oman2National Oncology Centre, Royal Hospital, Muscat, Oman
MUSCAT
Al BURAYMI
MUSANDAM
AL BATINAH
A’DHAHIRAH
A’ DAKHILIYAH A’ SHARQIYAH
AL WASTA
DHOFAR
Figure 1: Diagrammatic map of the Sultanate of Oman.
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Control, the cancer registry was transferred and started functioning under the Directorate General of Primary Health Care. New cancer notification forms were developed and distributed to all regional hospitals and institutions. In 2000, the registration form was simplified, printed, and distributed to all institutions that could potentially report cancer cases. Three trained cancer registrars are responsible for data collection, coding, and data entry of all reported cases.
M ET H O D S
1. Data collectiona) Active collectionActive collection involves the registry personnel visiting different sources and abstracting data on cancer registry forms. Being the largest tertiary center for diagnosis and treatment of cancer, registrars visit the Royal Hospital twice a week and abstract data on the notification forms. Similarly, other tertiary hospitals like Khoula Hospital and Al-Nahdha Hospital are visited once a month.
Data on patients undergoing chemotherapy and radiotherapy treatments are also collected from the National Oncology Centre which was established
within the Royal Hospital in November 2004. Data of patients diagnosed with cancer abroad are traced through oncology out-patient registers at the Royal Hospital, and subsequently, data are extracted from their case notes. Detailed list of patients sent abroad for cancer treatment through the Ministry of Health system are obtained from the department of Treatment Abroad.
b) Passive reportingCancer notification was made mandatory in 2001 through a Ministerial Decision (4/2001). When a case of cancer is diagnosed, the attending physician of the relevant specialty or the medical records department at the regional hospital completes the notification forms and sends them to the registry. Other institutions like the Armed Forces Hospital and Sultan Qaboos University Hospital have similar passive reporting. In 2017, the above Ministerial Decision was updated (222/2017) to include all health (Civil or Military) institutions in Oman including private hospitals. These institutions are frequently visited by the cancer registrars for data extraction of patients diagnosed in them.
2. Data-coding, entry, and validity checksUntil 2001, all cancer cases were coded using
Figure 2: Population pyramid, Oman, 1996 and 2015.
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International Classification of Diseases for Oncology (ICDO-2) with topography ‘C’ and morphology ‘M’ codes. Initially, data were entered using CanReg3 software, (International Agency for Research on Cancer (IARC), lyon, France). Subsequently, CanReg4 software and ICDO-3 were used in 2003. Duplicate entries were checked by this software to avoid the same case being registered more than once. In 2016, the registry software was upgraded to CanReg5 (version 00.40).1 For this report, we used CanReg5 (version 00.42). Validity checks were performed for consistency between site/histology, gender/site, and age/site/histology combinations using the same version.
3. Completeness of data reportingData are obtained from all hospitals with histopathology/cytology and hematology laboratories (Royal, Al-Nahdha, Khoula, Sultan Qaboos University, and Sohar Hospitals) from copies of patients' reports diagnosed with cancer to the registry. Since the mid of 2001, Sultan Qaboos University and Armed Forces Hospitals histopathology laboratories have also started sending reports.
Since the establishment of the new National Oncology Centre, chemotherapy and radiotherapy weekly logs are included in data collection of all patients attending these two modalities of treatments. Monthly hospital admission and discharge lists sent from all tertiary and regional hospitals to the Registry office to extract data of patients admitted for or discharged with a diagnosis of cancer and patients status are updated in the Registry (alive/dead).
A list of all cancer patients attending for chemotherapy sessions in all tertiary hospitals is also obtained. Details of missing data are sought from all of the above sources so that the registry can be updated.
4. Data analysisThe analysis below is limited to Omani nationals in the ONCR database. Non-Omanis working in Oman represent a skewed population from a wide range countries from all over the world, making determination of denominator for the calculation of incidence rates among them a complex exercise.
The data was first checked for consistency and validity using CanReg5 (version 00.42, build1566 (IARC 2008).1 Frequency distribution and incidence tables were generated for Omani subjects, using this
software. Data for individual cancers were then exported to CSV format to Stata software (version 14.2, Stata Corporation, TX, USA) for analysis of incidence by region, gender and morphology, and topography. Bar diagrams and graphs are generated using Excel version 2013 (Microsoft Corporation).
The average annual incidence and crude rates for the entire 20 years period were generated using CanReg5. The total average incidence and crude rates were calculated manually using Excel. Average of mid-year population of the years 2005 and 2006 were used to estimate crude rates and age-standardized rates were calculated using the World Standard Population of Segi.2
Population denominators used for the calculations of incidence rates (by 5-year age group, gender, and region) were obtained from the Ministry of Health’s Annual Health Reports.3
5. Age-standardized rate (ASR)Age-standardized rates (ASRs) were obtained using the World Standard Population of Segi2 to adjust the crude incidence rates (CRs) and to remove the confounding effect of age [Table 1]. These rates could be used for comparison purposes with other rates where the same Segi population was used such as the World Health Organization’s agency, IARC, in its periodic publication Cancer Incidence in Five Continents.4
Table 1: Age structure of the World Standard Population of Segi.2
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Comparison between the cancer incidence in 1996 and 2015In 1996, the total registered cases among Omanis were 787 (445 males and 342 females), and the CR for all cancer among Omanis was 49.4 per 100 000 (54.8 per 100 000 for males and 43.7 per 100 000 for females). The ASR was 95.0 per 100 000 (106.1 per 100 000 for males and 82.8 per 100 000 for females). While in 2015, the total registered cases among Omanis were 1632 (760 males and 872 females) and the CR for all cancer among Omanis was 69.7 per 100 000 (64.2 per 100 000 for males and 75.1 per 100 000 for females). The ASR was 105.0 per
100 000 (101.0 per 100 000 for males and 109.0 per 100 000 for females) [Table 2 and Figure 3].
If we consider the CR of 49.4 per 100 000 people for 1996 to continue at same rate then it would be expected that the total cases in 2015 would be 1158 cases. However, the total cases were 1632 cases which means that the incidence rate has increased. There was a rise in the CR by 41% between 1996 and 2015. This increase was higher (37.9%) between 2010 and 2015 compared to 2.3% 1996–2010.
There appears to be a true increase in the incidence of cancer in Oman which may be attributed to population aging. In 1996, about
Table 2: Comparison of frequency, crude and age-standardized rates of cancer cases by gender, Oman, 1996–2015.
Gender Frequency Percentage (%) Crude rates Age-standardized rates
Figure 3: Frequancy of cancer cases by gender, Oman, 1996–2015.
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16.0% of the population were under-5 years, 45.0% were under-15 years, and only 3.0% were above the age of 65 years. In 2015, the proportion of under-5 years were 14.9%, under-15 years reached 37.5% while the proportion of peopled aged 65 and above increased to 4.3%.
life expectancy in Oman has also increased from 72.0 years at birth in 1996 to 76.4 years in 2015. This rise in cancer incidence cases may be attributed to a number of factors, mainly the improvement in health care services over the past five decades including the introduction of an early detection program for breast cancer, the advanced in diagnostic and treatment modalities, and better public awareness about the cancer by non-governmental associations (introduced mammogram mobile unit as an outreach program into various regions of Oman). Other factors that might explain the increase in the incidence rates is the epidemiologic transition due to the rapid socioeconomic changes resulting in an increase in unhealthy lifestyles (tobacco use and its easy availability, physical inactivity, and unhealthy food habits).
Cancer incidence in Oman, 1996–2015 Between January 1996 and December 2015, there were 21 002 newly diagnosed cases of cancer among Omanis, of which 10 723 (55.1%) were in men
and 10 279 (48.9%) in women. On average, 1050 cases were reported annually in Oman. The average annual crude incidence rate was 55.1 per 100 000 males versus 54.2 per 100 000 females. The average annual ASRs were 105.2 and 96.3 per 100 000 males and females, respectively. The average annual CRs were 55.1 per 100 000 Omani males and 54.2 per 100 000 Omani females. The average annual world ASRs were 105.2 and 96.3 per 100 000 Omani males and females, respectively [Table 2].
Overall, there was an observed gradual decline in the trend of average annual ASR for Omani male over the 20-year period. On the other hand, the trend of average annual ASR for Omani females increased gradually over the same period [Figure 4]. The average annual age-specific incidence rates were observed to increase dramatically with advancing age in both sexes [Figure 5].
Tables 3 and 4 illustrate the frequency of incidence cases by age group and gender in Omanis for the period 1996–2015. While, tables 5 and 6 demonstrate ASRs in Omani males and females for the same period. Additionally, tables 7 and 8 show ASR by year, from 1996 to 2015, respectively.
Common cancer among OmanisOver the 20-year period (1996–2015), breast cancer
Figure 4: Age-standardized incidence rates (ASRs) of cancers among Omanis by year, 1996–2015.
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was the leading cancer among Omanis followed by non-Hodgkin's lymphoma, leukemia, colorectal, and thyroid [Table 9].
1) Breast cancerBreast Cancer was the leading cancer among males and females in Oman and accounted for 10.9% of
total malignancies [Table 9]. This malignancy has quadrupled in Oman in 2015 (n = 217) compared to 1996 (n = 53) [Figure 6].
Between 1996 and 2015, there were 2280 cases of breast cancer reported in Oman: 2181 in women and only 99 in men. The ASR for breast cancer in Omani women was 20.8 per 100 000 females with
0
100
200
300
400
500
600
700
800 FemaleMale
75+7065605550454035302520151050
Age, years
Incide
nce r
ate pe
r 100
000
Figure 5: Average annual age-specific incidence rates of cancers by gender and age among Omanis, 1996–2015.
Figure 6: Trends of breast cancer in both genders by year.
O M A N M E D J, V O l 3 4 , N O 4 , J U lY 2 0 1 9
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Tabl
e 3:
Fre
quen
cy o
f inc
iden
t cas
es o
f can
cer i
n m
ales
by t
opog
raph
y/m
orph
olog
y and
age g
roup
, Om
an, 1
996–
2015
.
Site
All
ages
Age
U
NK
0-5-
10-
15-
20-
25-
30-
35-
40-
45-
50-
55-
60-
65-
70-
75+
(%)
ICD
(10t
h)
lip
240
00
00
00
02
02
23
22
56
0.2
C00
Tong
ue10
10
00
00
30
52
1019
2012
153
39
1.0
C01
-02
Mou
th11
40
00
01
32
49
1212
1311
1710
1010
1.1
C03
-06
Saliv
ary g
land
s36
00
02
04
11
42
13
38
13
30.
3C
07-0
8To
nsil
130
00
00
00
11
21
22
30
01
0.1
C09
Oth
er o
roph
aryn
x22
01
00
00
10
03
13
42
32
20.
2C
10N
asop
hary
nx10
10
02
27
97
37
1118
810
58
31
1.0
C11
Hyp
opha
rynx
280
21
01
02
11
04
44
42
11
0.3
C12
-13
Phar
ynx u
nspe
cifie
d10
00
00
00
00
01
22
10
12
10.
1C
14O
esop
hagu
s20
90
00
00
02
01
713
1915
4332
3542
2.0
C15
Stom
ach
960
00
00
24
218
2137
5284
100
190
126
156
168
9.3
C16
Smal
l int
estin
e43
00
00
00
02
24
14
511
47
30.
4C
17C
olon
473
00
11
37
1825
3642
5365
5158
4928
364.
6C
18R
ectu
m30
10
00
01
109
1512
1824
4032
4836
2729
2.9
C19
-20
Anu
s45
00
00
00
01
14
75
77
14
80.
4C
21li
ver
544
010
32
14
66
1026
3260
8510
269
6662
5.3
C22
Gal
lbla
dder
etc.
760
00
00
00
13
37
912
108
1112
0.7
C23
-24
Panc
reas
209
00
00
00
21
411
1430
2434
3324
322.
0C
25N
ose,
sinus
es et
c.31
00
01
22
02
02
46
12
32
40.
3C
30-3
1la
rynx
130
00
00
00
03
511
1422
1219
1413
171.
3C
32Tr
ache
a, br
onch
us. a
nd lu
ng72
00
00
20
37
514
2844
8181
149
101
108
977.
0C
33-3
4O
ther
thor
acic
org
ans
390
11
01
33
04
01
42
61
48
0.4
C37
-38
Bone
147
05
1427
2618
127
93
35
29
32
21.
4C
40-4
1M
elan
oma o
f ski
n42
00
21
00
11
11
45
47
55
50.
4C
43O
ther
skin
434
03
44
38
1210
1215
2331
4363
6066
774.
2C
44M
esot
helio
ma
180
00
00
00
00
10
33
13
34
0.2
C45
Kap
osi s
arco
ma
570
01
02
35
56
24
65
64
53
0.6
C46
Con
nect
ive a
nd so
ft tis
sue
175
017
1412
1820
147
107
812
118
62
91.
7C
47,C
49Br
east
990
00
00
02
17
713
1215
157
713
1.0
C50
O M A N M E D J, V O l 3 4 , N O 4 , J U lY 2 0 1 9
368 Na jl a A . A l -l awat i , et a l . 369Na jl a A . A l -l awat i , et a l .
Site
All
ages
Age
U
NK
0-5-
10-
15-
20-
25-
30-
35-
40-
45-
50-
55-
60-
65-
70-
75+
(%)
ICD
(10t
h)
Peni
s6
00
00
00
00
00
11
11
00
20.
1C
60Pr
osta
te99
80
10
22
00
14
717
5294
196
182
199
241
9.7
C61
Testi
s12
00
132
010
2523
1511
93
23
01
12
1.2
C62
Oth
er m
ale g
enita
l org
ans
50
00
00
10
11
00
00
10
01
0C
63K
idne
y23
60
276
31
39
714
1820
3015
2523
1520
2.3
C64
Ren
al p
elvi
s4
00
00
00
00
00
01
00
20
10
C65
Ure
ter
40
00
00
00
00
00
10
21
00
0C
66Bl
adde
r59
00
31
11
26
1024
1935
6261
8983
7911
45.
7C
67O
ther
urin
ary o
rgan
s6
01
00
00
00
00
02
01
11
00.
1C
68Ey
e52
015
10
22
01
22
12
57
27
30.
5C
69Br
ain,
ner
vous
syst
em40
40
5142
3126
2119
2324
1826
3225
2118
1710
3.9
C70
-72
Thyr
oid
242
00
02
921
2930
2022
2218
1725
127
82.
4C
73A
dren
al g
land
460
303
30
12
00
00
32
01
10
0.4
C74
Oth
er en
docr
ine
100
11
01
10
02
11
10
00
10
0.1
C75
Hod
gkin
dise
ase
384
011
4339
3942
3034
2814
2726
1411
104
123.
7C
81N
on-H
odgk
in's
lym
phom
a93
20
2842
2548
3753
4452
6467
8078
8774
8073
9.1
C82
-85,
C96
Imm
unop
rolif
erat
ive d
iseas
es5
00
00
00
00
10
00
20
00
20
C88
Mul
tiple
mye
lom
a17
70
00
01
14
20
612
2328
3322
2025
1.7
C90
lym
phoi
d le
ukae
mia
443
010
488
4952
249
124
1013
175
1913
1311
4.3
C91
Mye
loid
leuk
aem
ia32
00
3813
1018
1924
1925
1818
2112
2320
1626
3.1
C92
-94
leuk
aem
ia u
nspe
cifie
d80
09
79
128
25
22
25
84
22
10.
8C
95M
yelo
prol
ifera
tive d
isord
ers (
MPD
)15
00
10
00
11
10
21
31
11
20.
1M
PDM
yelo
dysp
lasti
c syn
drom
es (M
DS)
50
10
00
10
00
00
00
20
01
0M
DS
Oth
er an
d un
spec
ified
(O&
U)
438
016
33
62
129
1422
2646
4973
4763
474.
3O
&U
All
sites
(All)
10 72
30
388
296
231
296
312
331
339
413
502
674
986
982
1465
1110
1131
1267
104
All
All
sites
but
C44
(Allb
C44
)10
289
038
529
222
729
330
431
932
940
148
765
195
593
914
0210
5010
6511
9010
0A
llbC
44
UN
K: u
nkow
n; IC
D: I
nter
natio
nal C
lassifi
catio
n of D
iseas
es, 10
th re
vision
.
Tabl
e 3:
Fre
quen
cy o
f inc
iden
t cas
es o
f can
cer i
n m
ales
by t
opog
raph
y/m
orph
olog
y and
age g
roup
, Om
an, 1
996–
2015
. -co
ntinued
O M A N M E D J, V O l 3 4 , N O 4 , J U lY 2 0 1 9
368 Na jl a A . A l -l awat i , et a l . 369Na jl a A . A l -l awat i , et a l .
Tabl
e 4:
Fre
quen
cy o
f inc
iden
t cas
es o
f can
cer i
n fe
mal
es b
y top
ogra
phy/
mor
phol
ogy a
nd ag
e gro
up, O
man
, 199
6–20
15.
Site
All
ages
Age
U
NK
0-5-
10-
15-
20-
25-
30-
35-
40-
45-
50-
55-
60-
65-
70-
75+
(%)
ICD
(1
0th)
lip
120
10
10
00
01
11
11
11
12
0.1
C00
Tong
ue50
00
10
01
13
44
96
75
43
20.
5C
01-0
2M
outh
640
00
01
01
23
33
135
147
48
0.6
C03
-06
Saliv
ary g
land
s43
01
10
36
33
44
28
32
11
10.
4C
07-0
8To
nsil
00
00
00
00
00
00
00
00
00
0.0
C09
Oth
er o
roph
aryn
x7
00
00
00
01
00
11
10
20
10.
1C
10N
asop
hary
nx48
00
00
54
24
78
65
21
12
10.
5C
11H
ypop
hary
nx17
00
00
00
00
24
10
13
04
20.
2C
12-1
3Ph
aryn
x uns
peci
fied
50
00
00
00
02
01
00
10
01
0.1
C14
Oes
opha
gus
134
00
00
00
11
23
413
1130
1623
301.
3C
15St
omac
h51
20
01
11
103
1320
3740
7162
8850
6253
5.1
C16
Smal
l int
estin
e28
00
00
00
10
03
42
23
27
40.
3C
17C
olon
376
00
03
48
1219
2328
3851
4057
2824
413.
8C
18R
ectu
m23
20
00
01
35
1221
2715
3134
2521
2314
2.3
C19
-20
Anu
s23
00
00
00
10
21
05
32
15
30.
2C
21li
ver
245
08
01
14
35
79
1839
3241
2925
232.
5C
22G
allb
ladd
er et
c.90
00
00
00
02
411
89
1017
1110
80.
9C
23-2
4Pa
ncre
as12
60
00
00
11
23
610
1918
318
1314
1.3
C25
Nos
e, sin
uses
etc.
230
10
11
00
21
04
13
31
32
0.2
C30
-31
lary
nx29
00
00
00
11
16
02
53
43
30.
3C
32Tr
ache
a, br
onch
us, a
nd lu
ng22
90
10
01
13
49
813
3229
3929
2733
2.3
C33
-34
Oth
er th
orac
ic o
rgan
s18
08
00
10
11
02
01
11
00
20.
2C
37-3
8Bo
ne94
02
723
1810
103
33
28
11
00
30.
9C
40-4
1M
elan
oma o
f ski
n34
00
01
00
42
13
46
13
24
30.
3C
43O
ther
skin
332
01
31
62
107
1120
2932
4042
3638
543.
3C
44M
esot
helio
ma
30
00
00
00
00
01
00
01
01
0.0
C45
Kap
osi s
arco
ma
170
00
00
00
01
60
03
32
11
0.2
C46
Con
nect
ive a
nd so
ft tis
sue
120
027
49
77
107
69
124
52
13
71.
2C
47-4
9Br
east
2181
00
00
225
9518
427
529
029
730
922
917
510
989
102
21.9
C50
Vulv
a24
00
00
01
00
12
21
34
15
40.
2C
51Va
gina
300
10
01
02
01
12
51
57
13
0.3
C52
O M A N M E D J, V O l 3 4 , N O 4 , J U lY 2 0 1 9
370 Na jl a A . A l -l awat i , et a l . 371Na jl a A . A l -l awat i , et a l .
Tabl
e 4:
Fre
quen
cy o
f inc
iden
t cas
es o
f can
cer i
n fe
mal
es b
y top
ogra
phy/
mor
phol
ogy a
nd ag
e gro
up, O
man
, 199
6–20
15.
-continued
Site
All
ages
Age
U
NK
0-5-
10-
15-
20-
25-
30-
35-
40-
45-
50-
55-
60-
65-
70-
75+
(%)
ICD
(1
0th)
Cer
vix u
teri
550
00
00
01
1028
5368
7173
6164
3252
375.
5C
53C
orpu
s ute
ri20
60
00
10
13
79
1518
2427
4524
1814
2.1
C54
Ute
rus u
nspe
cifie
d86
01
00
00
24
88
1310
811
68
70.
9C
55O
vary
463
01
415
2735
3327
1536
4044
3748
2840
334.
7C
56O
ther
fem
ale g
enita
l org
ans
100
00
01
01
01
13
01
01
10
0.1
C57
Plac
enta
230
00
01
26
31
34
21
00
00
0.2
C58
Kid
ney
204
040
73
24
710
119
1228
1620
188
92.
1C
64R
enal
pel
vis
10
00
00
00
00
00
00
00
01
0.0
C65
Ure
ter
40
00
00
00
00
10
10
00
11
0.0
C66
Blad
der
204
02
00
12
66
111
1612
2127
2824
472.
1C
67O
ther
urin
ary o
rgan
s2
00
00
00
00
00
01
00
01
00.
0C
68Ey
e45
020
41
20
01
12
12
04
03
40.
5C
69
Brai
n, n
ervo
us sy
stem
281
036
3428
2418
1614
1416
1917
1316
64
62.
8C
70-7
2
Thyr
oid
1035
00
37
4710
614
515
013
311
310
874
4045
1930
1510
.4C
73A
dren
al g
land
420
245
01
22
12
11
11
01
00
0.4
C74
Oth
er en
docr
ine
30
00
10
01
01
00
00
00
00
0.0
C75
Hod
gkin
dise
ase
225
04
1721
2230
2315
713
167
1813
77
52.
3C
81N
on-H
odgk
in's
lym
phom
a60
10
2727
1623
3240
2829
3343
6448
8335
3043
6.0
C82
-85,
C
96Im
mun
opro
lifer
ativ
e dise
ases
30
00
00
00
00
11
00
00
01
0.0
C88
Mul
tiple
mye
lom
a12
30
00
00
00
13
46
2214
2518
1317
1.2
C90
lym
phoi
d le
ukae
mia
275
010
153
2713
99
71
67
64
106
97
2.8
C91
Mye
loid
leuk
aem
ia24
40
1611
1824
1715
1816
1615
1612
1810
139
2.5
C92
-94
leuk
aem
ia u
nspe
cifie
d77
014
1014
54
21
24
11
35
42
50.
8C
95M
yelo
prol
ifera
tive d
isord
ers (
MPD
)7
00
00
10
00
00
00
01
14
00.
1M
PDM
yelo
dysp
lasti
c syn
drom
es (M
DS)
50
01
02
00
00
00
00
00
02
0.1
MD
SO
ther
and
unsp
ecifi
ed (O
&U
)41
00
173
29
49
1322
3032
5029
5342
5441
4.1
O&
UA
ll sit
es (A
ll)10
279
035
419
619
525
835
050
061
374
589
095
611
3090
710
9066
270
373
010
3A
llA
ll sit
es b
ut C
44 (A
llbC
44)
9947
035
319
319
425
234
849
060
673
487
092
710
9886
710
4862
666
567
610
0A
llbC
44
UN
K: u
nkow
n; IC
D: I
nter
natio
nal C
lassifi
catio
n of D
iseas
es, 10
th re
vision
.
O M A N M E D J, V O l 3 4 , N O 4 , J U lY 2 0 1 9
370 Na jl a A . A l -l awat i , et a l . 371Na jl a A . A l -l awat i , et a l .
Tabl
e 5:
Age
-stan
dard
ized
inci
denc
e rat
es (A
SRs)
per
100
000
popu
latio
n of
canc
er in
mal
es b
y top
ogra
phy/
mor
phol
ogy a
nd ag
e gro
up, O
man
, 199
6–20
15.
Site
All
ages
Age
U
NK
0-5-
10-
15-
20-
25-
30-
35-
40-
45-
50-
55-
60-
65-
70-
75+
Cru
de
rate
(%)
CU
M
0-74
ASR
ICD
(1
0th)
lip
240
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.2
0.0
0.4
0.4
0.8
0.7
0.9
3.1
3.0
0.1
0.2
0.03
0.3
C00
Tong
ue10
10
0.0
0.0
0.0
0.0
0.1
0.0
0.4
0.2
1.4
3.6
4.5
3.2
4.9
1.3
1.9
4.5
0.5
1.0
0.1
1.1
C01
-02
Mou
th11
40
0.0
0.0
0.0
0.0
0.1
0.1
0.3
1.0
1.7
2.3
2.9
3.0
5.5
4.3
6.2
5.0
0.6
1.1
0.1
1.2
C03
-06
Saliv
ary g
land
s36
00.
00.
00.
10.
00.
20.
10.
10.
40.
30.
20.
70.
82.
60.
41.
91.
50.
20.
30.
040.
3C
07-0
8To
nsil
130
0.0
0.0
0.0
0.0
0.0
0.0
0.1
0.1
0.3
0.2
0.4
0.5
1.0
0.0
0.0
0.5
0.1
0.1
0.01
0.1
C09
Oth
er o
roph
aryn
x22
00.
00.
00.
00.
00.
00.
10.
00.
00.
40.
20.
71.
10.
71.
31.
21.
00.
10.
20.
030.
2C
10N
asop
hary
nx10
10
0.0
0.1
0.1
0.3
0.4
0.4
0.2
0.7
1.6
3.4
1.8
2.7
1.6
3.4
1.9
0.5
0.5
1.0
0.09
0.9
C11
Hyp
opha
rynx
280
0.1
0.0
0.0
0.0
0.0
0.1
0.1
0.1
0.0
0.8
0.9
1.1
1.3
0.9
0.6
0.5
0.1
0.3
0.03
0.3
C12
-13
Phar
ynx u
nspe
cifie
d10
00.
00.
00.
00.
00.
00.
00.
00.
00.
10.
40.
40.
30.
00.
41.
20.
50.
10.
10.
010.
1C
14O
esop
hagu
s20
90
0.0
0.0
0.0
0.0
0.0
0.1
0.0
0.1
1.0
2.5
4.3
4.1
14.0
13.6
21.6
20.9
1.1
2.0
0.3
2.4
C15
Stom
ach
960
00.
00.
00.
00.
10.
20.
11.
42.
25.
310
.018
.927
61.9
53.7
96.3
83.6
4.9
9.3
1.4
10.9
C16
Smal
l int
estin
e43
00.
00.
00.
00.
00.
00.
00.
20.
20.
60.
20.
91.
43.
61.
74.
31.
50.
20.
40.
10.
5C
17C
olon
473
00.
00.
00.
00.
10.
31.
01.
93.
86.
110
.214
.613
.818
.920
.917
.317
.92.
44.
60.
54.
8C
18R
ectu
m30
10
0.0
0.0
0.0
0.0
0.4
0.5
1.1
1.3
2.6
4.6
9.0
8.7
15.6
15.3
16.7
14.4
1.6
2.9
0.4
3.2
C19
-20
Anu
s45
00.
00.
00.
00.
00.
00.
00.
10.
10.
61.
31.
11.
92.
30.
42.
54.
00.
20.
40.
10.
5C
21li
ver
544
00.
40.
10.
10.
00.
20.
30.
51.
13.
86.
113
.523
33.2
29.4
40.8
30.9
2.8
5.3
0.8
6.0
C22
Gal
lbla
dder
etc.
760
0.0
0.0
0.0
0.0
0.0
0.0
0.1
0.3
0.4
1.3
2.0
3.2
3.3
3.4
6.8
6.0
0.4
0.7
0.1
0.8
C23
-24
Panc
reas
209
00.
00.
00.
00.
00.
00.
10.
10.
41.
62.
76.
76.
511
.114
.114
.815
.91.
12.
00.
32.
4C
25N
ose,
sinus
es et
c.31
00.
00.
00.
00.
10.
10.
00.
20.
00.
30.
81.
30.
30.
71.
31.
22.
00.
20.
30.
030.
3C
30-3
1la
rynx
130
00.
00.
00.
00.
00.
00.
00.
20.
51.
62.
74.
93.
26.
26.
08.
08.
50.
71.
30.
21.
4C
32Tr
ache
a, br
onch
us, a
nd
lung
720
00.
00.
00.
10.
00.
10.
40.
41.
54.
08.
418
.221
.948
.543
.066
.748
.33.
77.
01.
18.
2C
33-3
4
Oth
er th
orac
ic o
rgan
s39
00.
00.
00.
00.
00.
10.
20.
00.
40.
00.
20.
90.
52.
00.
42.
54.
00.
20.
40.
040.
4C
37-3
8Bo
ne14
70
0.2
0.6
1.1
1.0
0.8
0.7
0.5
1.0
0.4
0.6
1.1
0.5
2.9
1.3
1.2
1.0
0.8
1.4
0.07
0.8
C40
-41
Mel
anom
a of s
kin
420
0.0
0.1
0.0
0.0
0.0
0.1
0.1
0.1
0.1
0.8
1.1
1.1
2.3
2.1
3.1
2.5
0.2
0.4
0.1
0.4
C43
Oth
er sk
in43
40
0.1
0.2
0.2
0.1
0.3
0.7
0.8
1.3
2.2
4.4
7.0
11.6
20.5
25.6
40.8
38.3
2.2
4.2
0.6
4.6
C44
Mes
othe
liom
a18
00.
00.
00.
00.
00.
00.
00.
00.
00.
10.
00.
70.
80.
31.
31.
92.
00.
10.
20.
030.
2C
45K
apos
i sar
com
a57
00.
00.
00.
00.
10.
10.
30.
40.
60.
30.
81.
31.
42.
01.
73.
11.
50.
30.
60.
10.
5C
46
O M A N M E D J, V O l 3 4 , N O 4 , J U lY 2 0 1 9
372 Na jl a A . A l -l awat i , et a l . 373Na jl a A . A l -l awat i , et a l .
Site
All
ages
Age
U
NK
0-5-
10-
15-
20-
25-
30-
35-
40-
45-
50-
55-
60-
65-
70-
75+
Cru
de
rate
(%)
CU
M
0-74
ASR
ICD
(1
0th)
Con
nect
ive a
nd so
ft tis
sue
175
00.
60.
60.
50.
70.
90.
80.
51.
11.
01.
52.
73.
02.
62.
61.
24.
51.
01.
70.
11.
2C
47,C
49
Brea
st99
00.
00.
00.
00.
00.
00.
10.
10.
71.
02.
52.
74.
14.
93.
04.
36.
50.
51.
00.
11.
1C
50Pe
nis
60
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.2
0.2
0.3
0.3
0.0
0.0
1.0
0.03
0.1
0.01
0.1
C60
Pros
tate
998
00.
00.
00.
10.
10.
00.
00.
10.
41.
03.
311
.725
.463
.877
.512
312
05.
19.
71.
511
.6C
61Te
stis
120
00.
50.
10.
00.
41.
11.
21.
11.
21.
30.
60.
40.
80.
00.
40.
61.
00.
61.
20.
10.
6C
62O
ther
mal
e gen
ital
orga
ns5
00.
00.
00.
00.
00.
00.
00.
10.
10.
00.
00.
00.
00.
30.
00.
00.
50.
030.
00.
00.
0C
63
Kid
ney
236
01.
00.
20.
10.
00.
10.
50.
51.
52.
63.
86.
74.
18.
19.
89.
310
.01.
22.
30.
22.
2C
64R
enal
pel
vis
40
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.2
0.0
0.0
0.9
0.0
0.5
0.02
0.0
0.01
0.0
C65
Ure
ter
40
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.2
0.0
0.7
0.4
0.0
0.0
0.02
0.0
0.01
0.1
C66
Blad
der
590
00.
10.
00.
00.
00.
10.
30.
82.
62.
76.
713
.916
.529
35.4
48.8
56.8
3.0
5.7
0.8
6.5
C67
Oth
er u
rinar
y org
ans
60
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.4
0.0
0.3
0.4
0.6
0.0
0.03
0.1
0.01
0.1
C68
Eye
520
0.6
0.0
0.0
0.1
0.1
0.0
0.1
0.2
0.3
0.2
0.4
1.4
2.3
0.9
4.3
1.5
0.3
0.5
0.1
0.4
C69
Brai
n, n
ervo
us sy
stem
404
01.
91.
71.
21.
00.
91.
01.
72.
62.
65.
07.
26.
86.
87.
710
.55.
02.
13.
90.
32.
9C
70-7
2Th
yroi
d24
20
0.0
0.0
0.1
0.4
0.9
1.6
2.3
2.1
3.2
4.2
4.0
4.6
8.1
5.1
4.3
4.0
1.2
2.4
0.2
2.0
C73
Adr
enal
gla
nd46
01.
10.
10.
10.
00.
00.
10.
00.
00.
00.
00.
70.
50.
00.
40.
60.
00.
20.
40.
020.
3C
74O
ther
endo
crin
e10
00.
00.
00.
00.
00.
00.
00.
00.
20.
10.
20.
20.
00.
00.
00.
60.
00.
10.
10.
010.
1C
75H
odgk
in d
iseas
e38
40
0.4
1.8
1.6
1.5
1.8
1.6
2.6
3.0
2.0
5.2
5.8
3.8
3.6
4.3
2.5
6.0
2.0
3.7
0.2
2.4
C81
Non
-Hod
gkin
's ly
mph
oma
932
01.
11.
71.
01.
91.
62.
93.
35.
59.
212
.818
.021
.128
.331
.549
.436
.34.
89.
11.
08.
3C
82-8
5,
C96
Imm
unop
rolif
erat
ive
dise
ases
50
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.1
0.0
0.0
0.0
0.5
0.0
0.0
0.0
1.0
0.03
0.0
0.0
0.0
C88
Mul
tiple
mye
lom
a17
70
0.0
0.0
0.0
0.0
0.0
0.2
0.2
0.0
0.9
2.3
5.2
7.6
10.7
9.4
12.4
12.4
0.9
1.7
0.2
2.0
C90
lym
phoi
d le
ukae
mia
443
04.
03.
62.
02.
11.
00.
50.
90.
41.
42.
53.
81.
46.
25.
58.
05.
52.
34.
30.
22.
6C
91M
yelo
id le
ukae
mia
320
01.
50.
50.
40.
70.
81.
31.
42.
72.
63.
44.
73.
27.
58.
59.
912
.91.
63.
10.
32.
5C
92-9
4le
ukae
mia
uns
peci
fied
800
0.3
0.3
0.4
0.5
0.3
0.1
0.4
0.2
0.3
0.4
1.1
2.2
1.3
0.9
1.2
0.5
0.4
0.8
0.1
0.5
C95
Mye
lopr
olife
rativ
e di
sord
ers (
MPD
)15
00.
00.
00.
00.
00.
00.
10.
10.
10.
00.
40.
20.
80.
30.
40.
61.
00.
10.
10.
020.
1M
PD
Tabl
e 5:
Age
-stan
dard
ized
inci
denc
e rat
es (A
SRs)
per
100
000
popu
latio
n of
canc
er in
mal
es b
y top
ogra
phy/
mor
phol
ogy a
nd ag
e gro
up, O
man
, 199
6–20
15.
-continued
O M A N M E D J, V O l 3 4 , N O 4 , J U lY 2 0 1 9
372 Na jl a A . A l -l awat i , et a l . 373Na jl a A . A l -l awat i , et a l .
Site
All
ages
Age
U
NK
0-5-
10-
15-
20-
25-
30-
35-
40-
45-
50-
55-
60-
65-
70-
75+
Cru
de
rate
(%)
CU
M
0-74
ASR
ICD
(1
0th)
Mye
lody
spla
stic
synd
rom
es (M
DS)
50
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.7
0.0
0.0
0.5
0.03
0.0
0.0
0.0
MD
S
Oth
er an
d un
spec
ified
(O
&U
)43
80
0.6
0.1
0.1
0.2
0.1
0.7
0.7
1.5
3.2
5.0
10.3
13.3
23.8
20.0
38.9
23.4
2.3
4.3
0.6
4.6
O&
U
All
sites
(All)
10 72
30
14.8
12.0
9.2
11.7
13.5
1825
.743
.972
.512
922
226
647
747
369
963
155
.110
412
.410
5.0
All
All
sites
but
C44
(A
llbC
44)
10 28
90
14.7
11.9
9.1
11.6
13.1
17.3
24.9
42.6
70.3
125
215
254
457
447
658
593
52.9
100
11.9
101.
0A
llbC
44
UN
K: u
nkow
n; C
UM
: cum
ulat
ive; I
CD: .I
nter
natio
nal C
lassifi
catio
n of D
iseas
es, 10
th re
vision
.
Tabl
e 5:
Age
-stan
dard
ized
inci
denc
e rat
es (A
SRs)
per
100
000
popu
latio
n of
can
cer i
n m
ales
by t
opog
raph
y/m
orph
olog
y and
age g
roup
, Om
an, 1
996–
2015
. -co
ntinued
Tabl
e 6:
Age
-stan
dard
ized
inci
denc
e rat
es (A
SRs)
per
100
000
popu
latio
n of
canc
er in
fem
ales
by t
opog
raph
y/m
orph
olog
y and
age g
roup
, Om
an, 1
996-
2015
.
Site
All
ages
Age
U
NK
0-5-
10-
15-
20-
25-
30-
35-
40-
45-
50-
55-
60-
65-
70-
75+
Cru
de
rate
(%)
CU
M
0-74
ASR
ICD
(1
0th)
lip
120
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.1
0.1
0.2
0.2
0.3
0.4
0.5
0.7
1.0
0.1
0.1
0.01
0.1
C00
Tong
ue50
00.
00.
00.
00.
00.
00.
10.
20.
40.
61.
61.
31.
91.
81.
92.
01.
00.
30.
50.
060.
5C
01-0
2M
outh
640
0.0
0.0
0.0
0.0
0.0
0.1
0.2
0.3
0.4
0.5
2.8
1.4
4.9
3.4
2.7
4.0
0.3
0.6
0.08
0.7
C03
-06
Saliv
ary g
land
s43
00.
00.
00.
00.
10.
30.
20.
20.
40.
60.
41.
70.
80.
70.
50.
70.
50.
20.
40.
030.
3C
07-0
8To
nsil
00
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
C09
Oth
er o
roph
aryn
x7
00.
00.
00.
00.
00.
00.
00.
10.
00.
00.
20.
20.
30.
01.
00.
00.
50.
040.
10.
010.
1C
10N
asop
hary
nx48
00.
00.
00.
00.
20.
20.
10.
30.
71.
11.
11.
10.
50.
40.
51.
30.
50.
30.
50.
040.
4C
11H
ypop
hary
nx17
00.
00.
00.
00.
00.
00.
00.
00.
20.
60.
20.
00.
31.
10.
02.
71.
00.
090.
20.
020.
2C
12-1
3Ph
aryn
x uns
peci
fied
50
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.2
0.0
0.2
0.0
0.0
0.4
0.0
0.0
0.5
0.03
0.1
0.0
0.0
C14
Oes
opha
gus
134
00.
00.
00.
00.
00.
00.
10.
10.
20.
40.
72.
83.
010
.67.
715
.214
.90.
71.
30.
21.
6C
15St
omac
h51
20
0.0
0.0
0.0
0.0
0.4
0.2
1.0
2.1
5.1
7.2
15.2
16.7
31.0
24.0
41.1
26.3
2.7
5.1
0.7
5.7
C16
Smal
l int
estin
e28
00.
00.
00.
00.
00.
00.
10.
00.
00.
40.
70.
40.
51.
11.
04.
62.
00.
20.
30.
040.
3C
17C
olon
376
00.
00.
00.
10.
20.
40.
71.
52.
43.
96.
810
.910
.820
.113
.515
.920
.42.
03.
80.
43.
9C
18R
ectu
m23
20
0.0
0.0
0.0
0.0
0.1
0.3
0.9
2.2
3.7
2.7
6.6
9.2
8.8
10.1
15.2
7.0
1.2
2.3
0.3
2.4
C19
-20
O M A N M E D J, V O l 3 4 , N O 4 , J U lY 2 0 1 9
374 Na jl a A . A l -l awat i , et a l . 375Na jl a A . A l -l awat i , et a l .
Site
All
ages
Age
U
NK
0-5-
10-
15-
20-
25-
30-
35-
40-
45-
50-
55-
60-
65-
70-
75+
Cru
de
rate
(%)
CU
M
0-74
ASR
ICD
(1
0th)
Anu
s23
00.
00.
00.
00.
00.
00.
10.
00.
20.
10.
01.
10.
80.
70.
53.
31.
50.
10.
20.
030.
3C
21li
ver
245
00.
30.
00.
00.
00.
20.
20.
40.
71.
23.
28.
48.
614
.513
.916
.611
.41.
32.
50.
32.
7C
22G
allb
ladd
er et
c.90
00.
00.
00.
00.
00.
00.
00.
20.
41.
51.
41.
92.
76.
05.
36.
64.
00.
50.
90.
11.
0C
23-2
4Pa
ncre
as12
60
0.0
0.0
0.0
0.0
0.0
0.1
0.2
0.3
0.8
1.8
4.1
4.9
10.9
3.8
8.6
7.0
0.7
1.3
0.2
1.5
C25
Nos
e, sin
uses
etc.
230
0.0
0.0
0.0
0.0
0.0
0.0
0.2
0.1
0.0
0.7
0.2
0.8
1.1
0.5
2.0
1.0
0.1
0.2
0.03
0.2
C30
-31
lary
nx29
00.
00.
00.
00.
00.
00.
10.
10.
10.
80.
00.
41.
41.
11.
92.
01.
50.
20.
30.
040.
3C
32Tr
ache
a, br
onch
us, a
nd
lung
229
00.
00.
00.
00.
00.
00.
20.
31.
01.
12.
36.
97.
813
.713
.917
.916
.41.
22.
30.
32.
6C
33-3
4
Oth
er th
orac
ic o
rgan
s18
00.
30.
00.
00.
00.
00.
10.
10.
00.
30.
00.
20.
30.
40.
00.
01.
00.
090.
20.
010.
1C
37-3
8Bo
ne94
00.
10.
31.
00.
70.
40.
60.
20.
30.
40.
41.
70.
30.
40.
00.
01.
50.
50.
90.
030.
5C
40-4
1M
elan
oma o
f ski
n34
00.
00.
00.
00.
00.
00.
20.
20.
10.
40.
71.
30.
31.
11.
02.
71.
50.
20.
30.
040.
3C
43O
ther
skin
332
00.
00.
10
0.2
0.1
0.6
0.5
1.2
2.8
5.2
6.9
10.8
14.8
17.3
25.2
26.8
1.8
3.3
0.4
3.6
C44
Mes
othe
liom
a3
00.
00.
00.
00.
00.
00.
00.
00.
00.
00.
20.
00.
00.
00.
50.
00.
50.
020.
00.
00.
0C
45K
apos
i sar
com
a17
00.
00.
00.
00.
00.
00.
00.
00.
10.
80.
00.
00.
81.
11.
00.
70.
50.
090.
20.
020.
2C
46C
onne
ctiv
e and
soft
tissu
e12
00
1.1
0.2
0.4
0.3
0.3
0.6
0.5
0.6
1.2
2.2
0.9
1.4
0.7
0.5
2.0
3.5
0.6
1.2
0.1
0.8
C47
,C49
Brea
st21
810
0.0
0.0
0.0
0.1
1.1
5.3
14.1
29.3
40.2
53.3
66.2
61.8
61.7
52.4
5950
.711
.521
.92.
220
.8C
50Vu
lva
240
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.1
0.3
0.4
0.2
0.8
1.4
0.5
3.3
2.0
0.1
0.2
0.04
0.3
C51
Vagi
na30
00.
00.
00.
00.
00.
00.
10.
00.
10.
10.
41.
10.
31.
83.
40.
71.
50.
20.
30.
040.
3C
52C
ervi
x ute
ri55
00
0.0
0.0
0.0
0.0
0.0
0.6
2.2
5.6
9.4
12.7
15.6
16.5
22.6
15.4
34.5
18.4
2.9
5.5
0.7
5.7
C53
Cor
pus u
teri
206
00.
00.
00.
00.
00.
00.
20.
51.
02.
13.
25.
17.
315
.911
.511
.97.
01.
12.
10.
32.
3C
54U
teru
s uns
peci
fied
860
0.0
0.0
0.0
0.0
0.0
0.1
0.3
0.9
1.1
2.3
2.1
2.2
3.9
2.9
5.3
3.5
0.5
0.9
0.1
0.9
C55
Ova
ry46
30
0.0
0.2
0.6
1.1
1.6
1.8
2.1
1.6
5.0
7.2
9.4
1016
.913
.526
.516
.42.
44.
70.
54.
2C
56O
ther
fem
ale g
enita
l or
gans
100
0.0
0.0
0.0
0.0
0.0
0.1
0.0
0.1
0.1
0.5
0.0
0.3
0.0
0.5
0.7
0.0
0.1
0.1
0.01
0.1
C57
Plac
enta
230
0.0
0.0
0.0
0.0
0.1
0.3
0.2
0.1
0.4
0.7
0.4
0.3
0.0
0.0
0.0
0.0
0.1
0.2
0.01
0.2
C58
Kid
ney
204
01.
60.
30.
10.
10.
20.
40.
81.
21.
22.
26.
04.
37.
08.
65.
34.
51.
12.
10.
21.
8C
64R
enal
pel
vis
10
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.5
0.01
0.0
0.0
0.0
C65
Ure
ter
40
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.1
0.0
0.2
0.0
0.0
0.0
0.7
0.5
0.02
0.0
0.01
0.0
C66
Tabl
e 6:
Age
-stan
dard
ized
inci
denc
e rat
es (A
SRs)
per
100
000
popu
latio
n of
canc
er in
fem
ales
by t
opog
raph
y/m
orph
olog
y and
age g
roup
, Om
an, 1
996–
2015
. -co
ntinued
O M A N M E D J, V O l 3 4 , N O 4 , J U lY 2 0 1 9
374 Na jl a A . A l -l awat i , et a l . 375Na jl a A . A l -l awat i , et a l .
Site
All
ages
Age
U
NK
0-5-
10-
15-
20-
25-
30-
35-
40-
45-
50-
55-
60-
65-
70-
75+
Cru
de
rate
(%)
CU
M
0-74
ASR
ICD
(1
0th)
Blad
der
204
00.
10.
00.
00.
00.
10.
30.
50.
11.
52.
92.
65.
79.
513
.515
.923
.31.
12.
10.
32.
3C
67O
ther
urin
ary o
rgan
s2
00.
00.
00.
00.
00.
00.
00.
00.
00.
00.
00.
20.
00.
00.
00.
70.
00.
010.
00.
00.
0C
68Ey
e45
00.
80.
20.
00.
10.
00.
00.
10.
10.
30.
20.
40.
01.
40.
02.
02.
00.
20.
50.
030.
3C
69Br
ain,
ner
vous
syst
em28
10
1.4
1.4
1.2
1.0
0.8
0.9
1.1
1.5
2.2
3.4
3.6
3.5
5.6
2.9
2.7
3.0
1.5
2.8
0.2
1.9
C70
-72
Thyr
oid
1035
00.
00.
10.
31.
94.
88.
111
.514
.215
.719
.415
.910
.815
.99.
119
.97.
55.
510
.40.
77.
6C
73A
dren
al g
land
420
1.0
0.2
0.0
0.0
0.1
0.1
0.1
0.2
0.1
0.2
0.2
0.3
0.0
0.5
0.0
0.0
0.2
0.4
0.01
0.2
C74
Oth
er en
docr
ine
30
0.0
0.0
0.0
0.0
0.0
0.1
0.0
0.1
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.02
0.0
0.0
0.0
C75
Hod
gkin
dise
ase
225
00.
20.
70.
90.
91.
31.
31.
20.
71.
82.
91.
54.
94.
63.
44.
62.
51.
22.
30.
21.
6C
81N
on-H
odgk
in's
lym
phom
a60
10
1.1
1.1
0.7
0.9
1.4
2.2
2.2
3.1
4.6
7.7
13.7
13.0
29.3
16.8
19.9
21.4
3.2
6.0
0.6
5.4
C82
-85
,C96
Imm
unop
rolif
erat
ive
dise
ases
30
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.1
0.2
0.0
0.0
0.0
0.0
0.0
0.5
0.02
0.0
0.0
0.0
C88
Mul
tiple
mye
lom
a12
30
0.0
0.0
0.0
0.0
0.0
0.0
0.1
0.3
0.6
1.1
4.7
3.8
8.8
8.6
8.6
8.4
0.7
1.2
0.2
1.5
C90
lym
phoi
d le
ukae
mia
275
04.
02.
21.
10.
50.
40.
50.
50.
10.
81.
31.
31.
13.
52.
96.
03.
51.
52.
80.
11.
6C
91M
yelo
id le
ukae
mia
244
00.
60.
50.
71.
00.
80.
81.
41.
72.
22.
73.
43.
26.
34.
88.
64.
51.
32.
50.
21.
8C
92-9
4le
ukae
mia
uns
peci
fied
770
0.6
0.4
0.6
0.2
0.2
0.1
0.1
0.2
0.6
0.2
0.2
0.8
1.8
1.9
1.3
2.5
0.4
0.8
0.1
0.5
C95
Mye
lopr
olife
rativ
e di
sord
ers (
MPD
)7
00.
00.
00.
00.
00.
00.
00.
00.
00.
00.
00.
00.
00.
40.
52.
70.
00.
040.
10.
020.
1M
PD
Mye
lody
spla
stic
synd
rom
es (M
DS)
50
0.0
0.0
0.0
0.1
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
1.0
0.03
0.1
0.0
0.0
MD
S
Oth
er an
d un
spec
ified
(O
&U
)41
00
0.7
0.1
0.1
0.4
0.2
0.5
1.0
2.3
4.2
5.7
10.7
7.8
18.7
20.2
35.8
20.4
2.2
4.1
0.5
4.3
O&
U
All
sites
(All)
10 27
90
14.1
8.3
8.1
10.6
15.7
27.8
47.1
79.3
124
172
242
245
384
318
466
363
54.2
103
10.8
96.3
All
All
sites
but
C44
(A
llbC
44)
9947
014
.08.
18
10.4
15.6
27.3
46.5
78.1
121
166
235
234
369
301
441
336
52.5
100
10.4
92.7
Allb
C44
UN
K: u
nkow
n; C
UM
: cum
ulat
ive; I
CD: I
nter
natio
nal C
lassifi
catio
n of D
iseas
es, 10
th re
vision
.
Tabl
e 6:
Age
-stan
dard
ized
inci
denc
e rat
es (A
SRs)
per
100
000
popu
latio
n of
canc
er in
fem
ales
by t
opog
raph
y/m
orph
olog
y and
age g
roup
, Om
an, 1
996–
2015
. -co
ntinued
O M A N M E D J, V O l 3 4 , N O 4 , J U lY 2 0 1 9
376 Na jl a A . A l -l awat i , et a l . 377Na jl a A . A l -l awat i , et a l .
Tabl
e 7:
Age
-stan
dard
ized
inci
denc
e rat
es p
er 1
00 00
0 po
pulat
ion
in m
ales
by t
opog
raph
y/m
orph
olog
y and
year
, Om
an, 1
996–
2015
.
Site
1996
1997
1998
1999
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
2013
2014
2015
ICD
(1
0th)
lip
0.2
0.5
0.7
0.7
0.5
0.4
0.2
0.0
0.8
0.3
0.5
0.0
0.1
0.0
0.3
0.4
0.1
0.2
0.0
0.0
C00
Tong
ue1.
30.
90.
31.
21.
30.
70.
70.
90.
81.
01.
51.
31.
20.
70.
80.
90.
72.
10.
82.
1C
01-0
2M
outh
1.6
1.1
1.6
1.0
0.8
0.6
1.5
0.9
3.0
1.9
0.3
1.1
1.3
1.7
0.7
1.7
1.2
0.6
1.3
0.6
C03
-06
Saliv
ary g
land
s0.
30.
31.
30.
00.
20.
30.
50.
11.
80.
00.
00.
10.
30.
20.
50.
00.
30.
40.
20.
5C
07-0
8To
nsil
0.0
0.2
0.0
0.2
0.0
0.3
0.0
0.0
0.3
0.2
0.5
0.6
0.2
0.0
0.2
0.0
0.0
0.1
0.0
0.2
C09
Oth
er o
roph
aryn
x0.
00.
00.
00.
00.
50.
00.
00.
70.
80.
80.
40.
00.
30.
20.
20.
40.
00.
20.
20.
4C
10N
asop
hary
nx0.
91.
70.
80.
41.
51.
30.
30.
40.
71.
00.
60.
91.
51.
10.
80.
80.
30.
31.
31.
4C
11H
ypop
hary
nx0.
60.
30.
20.
40.
20.
10.
70.
22.
30.
00.
00.
00.
30.
70.
00.
00.
00.
00.
10.
3C
12-1
3Ph
aryn
x uns
peci
fied
0.2
0.2
0.0
0.0
0.0
0.0
0.0
0.3
0.3
0.0
0.0
0.3
0.0
0.2
0.0
0.2
0.0
0.1
0.1
0.2
C14
Oes
opha
gus
3.7
2.9
2.6
2.6
2.4
2.6
2.8
2.1
3.7
3.5
3.2
2.6
1.3
2.1
4.0
2.3
1.8
1.5
2.2
1.3
C15
Stom
ach
11.7
14.6
13.5
13.9
1313
.411
.97.
811
.916
.213
10.1
8.8
13.1
7.5
13.9
11.3
8.1
9.0
5.7
C16
Smal
l int
estin
e0.
20.
20.
20.
30.
20.
40.
60.
00.
00.
40.
00.
50.
00.
50.
41.
10.
40.
60.
71.
6C
17C
olon
2.7
2.8
3.5
1.5
3.0
2.4
3.1
3.2
4.7
5.8
5.8
5.1
4.4
4.9
6.3
6.8
7.3
6.7
6.3
7.0
C18
Rec
tum
1.5
3.4
2.5
1.8
1.1
31.
63.
11.
64.
53.
73.
02.
44.
82.
15.
54.
14.
43.
15.
0C
19-2
0A
nus
0.8
0.0
0.2
0.6
0.3
1.2
0.8
0.7
0.9
0.3
0.3
0.5
0.5
0.2
0.3
0.7
0.6
0.6
0.3
0.3
C21
live
r5.
94.
17.
89.
56.
16.
83.
05.
08.
49.
84.
64.
78.
04.
34.
26.
45.
54.
58.
05.
9C
22G
allb
ladd
er et
c.0.
00.
90.
51.
01.
20.
50.
70.
71.
72.
30.
51.
80.
91.
01.
31.
90.
30.
80.
50.
9C
23-2
4Pa
ncre
as2.
32.
81.
31.
72.
33
0.5
1.4
4.1
2.3
1.9
1.2
2.3
2.4
3.4
3.7
2.7
3.7
2.2
2.7
C25
Nos
e, sin
uses
etc.
0.2
0.6
0.2
0.7
0.5
0.0
0.0
0.3
0.8
0.6
0.4
0.9
0.1
0.2
0.2
0.7
0.0
0.0
0.0
0.2
C30
-31
lary
nx1.
91.
12.
71.
01.
20.
40.
41.
73.
32.
92.
51.
31.
10.
82.
71.
61.
11.
21.
01.
1C
32Tr
ache
a, br
onch
us, a
nd lu
ng7.
513
.08.
413
.18.
89.
96.
86.
910
.68.
38.
211
.27.
67.
86.
311
.25.
07.
38.
06.
9C
33-3
4
Oth
er th
orac
ic o
rgan
s1.
00.
80.
20.
20.
60.
50.
20.
10.
70.
10.
60.
30.
10.
70.
01.
20.
00.
20.
40.
1C
37-3
8Bo
ne0.
71.
31.
10.
80.
70.
20.
70.
91.
60.
90.
30.
50.
31.
01.
41.
80.
70.
70.
80.
6C
40-4
1M
elan
oma o
f ski
n0.
50.
90.
30.
00.
21.
00.
40.
31.
10.
30.
00.
30.
50.
80.
60.
70.
40.
70.
20.
3C
43O
ther
skin
7.7
6.9
5.8
3.1
3.4
3.8
5.4
4.1
5.0
5.4
5.1
5.9
5.7
6.2
5.2
4.8
3.7
4.5
3.2
3.1
C44
Mes
othe
liom
a0.
00.
00.
40.
40.
20.
20.
00.
30.
00.
00.
30.
30.
30.
00.
00.
90.
10.
20.
30.
2C
45K
apos
i sar
com
a0.
61.
70.
01.
30.
20.
50.
80.
70.
00.
50.
70.
50.
50.
50.
31.
40.
10.
60.
00.
1C
46C
onne
ctiv
e and
soft
tissu
e1.
42.
01.
61.
02.
01.
30.
91.
52.
00.
80.
60.
41.
20.
51.
40.
90.
70.
91.
01.
9C
47,C
49Br
east
0.5
1.0
0.6
0.7
0.7
1.4
0.8
1.1
1.0
1.7
1.8
0.9
0.1
1.4
2.0
1.3
1.4
0.8
1.8
0.9
C50
O M A N M E D J, V O l 3 4 , N O 4 , J U lY 2 0 1 9
376 Na jl a A . A l -l awat i , et a l . 377Na jl a A . A l -l awat i , et a l .
Site
1996
1997
1998
1999
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
2013
2014
2015
ICD
(1
0th)
Peni
s0.
00.
20.
00.
00.
00.
00.
00.
00.
00.
20.
00.
0.0.
30.
00.
30.
00.
00.
00.
10.
1C
60Pr
osta
te10
.812
.911
.412
9.0
10.6
7.3
6.9
11.2
12.3
8.7
16.1
12.3
13.1
12.8
17.0
13.5
13.7
12.7
13.3
C61
Testi
s0.
60.
50.
50.
50.
20.
70.
90.
71.
00.
50.
70.
50.
70.
50.
50.
70.
40.
60.
80.
9C
62O
ther
mal
e gen
ital o
rgan
s0.
00.
00.
00.
00.
00.
00.
00.
00.
50.
00.
00.
00.
10.
10.
00.
00.
00.
00.
00.
1C
63K
idne
y1.
61.
91.
31.
62.
61.
21.
22.
91.
72.
51.
21.
42
3.9
4.1
2.6
2.2
2.2
3.6
2.7
C64
Ren
al p
elvi
s0.
30.
00.
00.
00.
00.
00.
00.
00.
00.
00.
00.
70.
00.
00.
00.
00.
00.
00.
00.
2C
65U
rete
r0.
00.
00.
00.
00.
00.
30.
00.
00.
00.
00.
30.
00.
00.
00.
00.
00.
20.
00.
00.
2C
66Bl
adde
r8.
37.
55.
86.
63.
84.
44.
14.
85.
97.
77.
58.
86.
96.
78.
98.
76
7.8
8.3
6.6
C67
Oth
er u
rinar
y org
ans
0.0
0.0
0.2
0.3
0.1
0.0
0.2
0.0
0.0
0.0
0.6
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
C68
Eye
1.5
1.0
0.8
0.6
0.3
0.3
0.0
0.8
0.9
1.1
0.5
1.1
0.3
0.1
0.0
0.2
0.1
0.2
0.0
0.2
C69
Brai
n, n
ervo
us sy
stem
2.4
4.0
3.8
2.9
3.0
4.4
3.2
3.2
4.1
2.8
1.5
2.4
1.8
3.4
2.6
2.8
3.5
2.3
3.2
2.1
C70
-72
Thyr
oid
1.9
2.2
1.3
1.7
1.1
2.8
1.6
3.2
1.6
2.0
0.9
1.1
2.0
1.7
0.6
2.4
2.0
2.4
3.2
2.7
C73
Adr
enal
gla
nd0.
00.
10.
00.
10.
20.
10.
00.
30.
20.
20.
40.
10.
00.
30.
70.
30.
70.
30.
40.
3C
74O
ther
endo
crin
e0.
00.
20.
00.
10.
00.
20.
00.
00.
30.
00.
10.
10.
00.
10.
00.
00.
00.
10.
20.
0C
75H
odgk
in d
iseas
e1.
92.
23.
42.
22.
73.
02.
42.
43.
52.
32.
21.
63.
01.
71.
83.
53.
02.
22.
62.
3C
81N
on-H
odgk
in's
lym
phom
a8.
98.
69.
59.
07.
97.
37.
19.
911
.39.
47.
87.
49.
77.
57.
610
.97.
57.
28.
38.
6C
82-
85,C
96Im
mun
opro
lifer
ativ
e dise
ases
0.2
0.0
0.2
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.3
0.0
0.0
0.3
0.0
0.0
0.0
0.1
C88
Mul
tiple
mye
lom
a1.
33.
82.
01.
62.
42.
11.
40.
83.
13.
51.
22.
92.
52.
21.
81.
82.
22.
11.
51.
4C
90ly
mph
oid
leuk
aem
ia1.
62.
41.
92.
52.
52.
62.
43.
33.
82.
32.
51.
72.
53.
62.
65.
31.
71.
63.
32.
3C
91M
yelo
id le
ukae
mia
1.0
2.0
2.9
1.9
2.9
1.8
1.9
3.1
1.9
2.6
3.5
3.8
3.3
1.9
2.0
4.3
2.4
2.0
2.4
2.7
C92
-94
leuk
aem
ia u
nspe
cifie
d1.
30.
50.
60.
80.
61.
21.
21.
10.
60.
40.
10.
40.
20.
30.
20.
30.
20.
70.
10.
0C
95M
yelo
prol
ifera
tive d
isord
ers
(MPD
)0.
00.
00.
30.
20.
00.
00.
20.
10.
00.
10.
20.
70.
30.
30.
50.
10.
00.
00.
00.
1M
PD
Mye
lody
spla
stic s
yndr
omes
(M
DS)
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.3
0.0
0.0
0.0
0.6
0.0
0.0
0.0
0.1
0.1
MD
S
Oth
er an
d un
spec
ified
(O
&U
)6.
37.
47.
25.
26.
85.
35.
34.
19.
04.
65.
85.
44.
15.
03.
15.
94.
02.
71.
12.
2O
&U
All
sites
(All)
106
124
112
109
99.4
105
85.7
92.8
135
127
103
113
104
111
104
141
99.3
100
105
101
All
All
sites
but
C44
(Allb
C44
)98
.411
710
610
696
101
80.3
88.7
130
121
9810
797
.910
498
.513
695
.695
.710
297
.7A
llbC
44
ICD
: .Int
erna
tiona
l Clas
sifica
tion o
f Dise
ases,
10th
revis
ion.
Tabl
e 7:
Age
-stan
dard
ized
inci
denc
e rat
es p
er 1
00 00
0 po
pulat
ion
in m
ales
by t
opog
raph
y/m
orph
olog
y and
year
, Om
an, 1
996–
2015
. -co
ntinued
O M A N M E D J, V O l 3 4 , N O 4 , J U lY 2 0 1 9
378 Na jl a A . A l -l awat i , et a l . 379Na jl a A . A l -l awat i , et a l .
Tabl
e 8:
Age
-stan
dard
ized
inci
denc
e rat
es p
er 1
00 00
0 po
pulat
ion
in fe
mal
es b
y top
ogra
phy/
mor
phol
ogy a
nd ye
ar, O
man
, 199
6–20
15.
Site
1996
1997
1998
1999
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
2013
2014
2015
ICD
(10t
h)
lip
0.0
0.0
0.4
0.0
0.0
0.0
0.0
0.2
0.2
0.0
0.3
0.4
0.5
0.0
0.0
0.0
0.3
0.0
0.0
0.2
C00
Tong
ue1.
70.
20.
00.
90.
50.
00.
10.
40.
30.
20.
40.
50.
30.
30.
81.
00.
50.
21.
00.
7C
01-0
2M
outh
0.4
2.0
0.2
1.0
0.4
0.4
0.1
0.7
0.6
0.6
0.3
1.3
0.8
1.5
0.9
0.7
0.5
0.9
1.1
0.4
C03
-06
Saliv
ary g
land
s0.
00.
10.
50.
40.
20.
30.
01.
20.
80.
40.
70.
40.
20.
30.
20.
60.
10.
20.
20.
4C
07-0
8To
nsil
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
C09
Oth
er o
roph
aryn
x0.
00.
00.
00.
00.
00.
00.
00.
60.
30.
70.
00.
30.
00.
00.
00.
00.
00.
10.
00.
0C
10N
asop
hary
nx0.
30.
40.
20.
80.
20.
00.
60.
70.
10.
00.
20.
21.
00.
60.
40.
60.
30.
10.
30.
6C
11H
ypop
hary
nx0.
00.
40.
40.
40.
20.
40.
20.
50.
50.
00.
70.
30.
30.
00.
00.
00.
00.
00.
10.
0C
12-1
3Ph
aryn
x uns
peci
fied
0.0
0.0
0.0
0.0
0.0
0.3
0.0
0.0
0.0
0.0
0.0
0.1
0.3
0.0
0.0
0.2
0.0
0.1
0.0
0.0
C14
Oes
opha
gus
2.2
3.0
4.4
3.3
2.1
1.7
1.1
0.9
2.1
1.9
23.
11.
72.
41.
11.
21.
60.
40.
50.
6C
15St
omac
h7.
27.
18.
27.
05.
74.
46.
84.
310
.610
.17.
15.
14.
16.
05.
55.
14.
84.
55.
52.
9C
16Sm
all i
ntes
tine
0.5
0.3
0.3
0.0
0.0
0.7
0.5
0.0
0.6
0.4
0.3
0.0
0.6
0.3
0.2
0.5
0.5
0.5
0.0
0.2
C17
Col
on2.
11.
63.
11.
02.
42.
42.
12.
44.
03.
53.
04.
64.
34.
82.
84.
67.
24.
17.
06.
2C
18R
ectu
m1.
11.
62.
10.
02.
01.
52.
22.
62.
01.
22.
72.
51.
92.
64.
13.
22.
53.
73.
43.
0C
19-2
0A
nus
0.0
0.0
0.0
0.0
0.2
0.0
0.1
0.5
0.4
0.7
0.5
0.6
0.3
0.3
0.6
0.6
0.0
0.0
0.3
0.2
C21
live
r0.
63.
63.
24.
13.
12.
51.
71.
91.
92.
22.
51.
21.
73.
83.
62.
02.
22.
74.
83.
7C
22G
allb
ladd
er et
c.1.
31.
21.
11.
40.
81.
40.
30.
51.
21.
11.
81.
31.
51.
40.
61.
11.
30.
71.
00.
7C
23-2
4Pa
ncre
as0.
80.
82.
41.
21.
31.
80.
70.
83.
02.
01.
00.
31.
61.
01.
31.
91.
52.
61.
81.
5C
25N
ose,
sinus
es et
c.0.
00.
20.
50.
00.
30.
10.
80.
30.
00.
40.
00.
30.
01.
10.
30.
20.
00.
00.
10.
3C
30-3
1la
rynx
0.5
0.2
0.4
0.0
0.4
0.5
0.4
0.3
0.2
0.2
0.8
0.3
0.0
0.8
0.1
0.0
0.2
0.4
0.2
0.5
C32
Trac
hea,
bron
chus
, an
d lu
ng4.
12.
81.
62.
12.
03.
21.
02.
23.
52.
43.
61.
63.
03.
41.
83.
63.
62.
72.
52.
7C
33-3
4
Oth
er th
orac
ic o
rgan
s0.
00.
40.
00.
10.
00.
00.
00.
30.
00.
10.
00.
40.
50.
00.
10.
10.
40.
00.
10.
1C
37-3
8Bo
ne0.
41.
10.
20.
60.
40.
40.
20.
30.
80.
70.
80.
10.
10.
10.
30.
91.
01.
30.
50.
0C
40-4
1M
elan
oma o
f ski
n0.
41.
20.
20.
10.
90.
00.
10.
20.
50.
00.
10.
50.
50.
40.
40.
60.
20.
20.
00.
5C
43O
ther
skin
3.4
2.6
2.9
5.4
4.8
3.3
1.5
2.5
4.0
4.0
4.1
2.1
5.0
4.8
5.2
3.9
3.4
3.9
3.0
4.3
C44
Mes
othe
liom
a0.
00.
00.
00.
00.
20.
00.
00.
00.
00.
00.
00.
00.
00.
00.
00.
00.
00.
00.
10.
2C
45K
apos
i sar
com
a0.
00.
00.
20.
90.
40.
00.
20.
60.
00.
00.
00.
20.
70.
40.
30.
00.
00.
20.
00.
0C
46
O M A N M E D J, V O l 3 4 , N O 4 , J U lY 2 0 1 9
378 Na jl a A . A l -l awat i , et a l . 379Na jl a A . A l -l awat i , et a l .
Site
1996
1997
1998
1999
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
2013
2014
2015
ICD
(10t
h)
Con
nect
ive a
nd so
ft tis
sue
1.0
1.9
0.3
1.1
1.5
0.6
1.0
0.3
1.9
0.7
0.8
0.7
0.7
0.2
0.3
0.2
1.2
0.7
0.5
1.1
C47
,C49
Brea
st13
.613
.813
.213
.915
.416
.015
.013
.625
.622
.323
.523
.225
.023
.325
.028
.124
.225
.122
.226
.9C
50Vu
lva
0.2
0.7
0.0
0.4
0.3
0.3
0.2
0.8
1.0
0.0
1.0
0.3
0.0
0.0
0.2
0.0
0.3
0.3
0.0
0.0
C51
Vagi
na0.
00.
40.
60.
00.
60.
20.
50.
00.
40.
11.
50.
00.
80.
00.
00.
10.
70.
10.
70.
2C
52C
ervi
x ute
ri6.
66.
67.
26.
37.
35.
73.
87.
58.
07.
46.
86.
07.
12.
87.
46.
14.
24.
04.
84.
7C
53C
orpu
s ute
ri0.
50.
20.
90.
20.
81.
51.
81.
73.
42.
22.
32.
83.
23.
53.
26.
02.
22.
82.
93.
6C
54U
teru
s uns
peci
fied
2.3
1.8
1.0
1.1
0.0
1.4
0.7
0.6
0.6
0.4
0.5
0.8
1.4
0.4
0.7
1.2
0.7
0.7
1.1
1.1
C55
Ova
ry1.
93.
87.
87.
05.
84.
53.
73.
63.
15.
35.
05.
63.
42.
63.
73.
73.
03.
74.
64.
3C
56O
ther
fem
ale g
enita
l or
gans
0.0
0.0
0.0
0.0
0.0
0.0
0.2
0.0
0.1
0.0
0.5
0.8
0.0
0.0
0.0
0.0
0.0
0.3
0.0
0.2
C57
Plac
enta
0.0
0.1
0.3
0.6
0.8
0.3
0.0
0.1
0.1
0.0
0.2
0.1
0.0
0.2
0.0
0.4
0.1
0.0
0.0
0.2
C58
Kid
ney
2.3
1.2
1.7
1.0
1.8
2.2
0.7
2.2
0.6
2.0
0.8
1.2
4.0
1.7
1.5
3.1
1.2
2.3
2.0
2.3
C64
Ren
al p
elvi
s0.
00.
00.
00.
00.
00.
00.
00.
00.
00.
30.
00.
00.
00.
00.
00.
00.
00.
00.
00.
0C
65U
rete
r0.
00.
00.
00.
00.
00.
20.
00.
00.
00.
30.
00.
00.
00.
00.
20.
00.
20.
00.
00.
0C
66Bl
adde
r2.
42.
91.
63.
41.
52.
32.
82.
04.
82.
94.
82.
72.
82.
01.
82.
01.
51.
42.
01.
6C
67O
ther
urin
ary o
rgan
s0.
00.
00.
00.
00.
00.
00.
00.
00.
00.
00.
00.
20.
00.
00.
00.
00.
20.
00.
00.
0C
68Ey
e0.
70.
40.
70.
90.
20.
20.
30.
20.
70.
50.
30.
40.
20.
30.
40.
40.
20.
20.
10.
0C
69Br
ain,
ner
vous
syst
em1.
32.
73.
02.
41.
93.
21.
11.
22.
51.
42.
21.
71.
91.
43.
02.
20.
91.
22.
01.
8C
70-7
2Th
yroi
d7.
07.
46.
85.
94.
37.
06.
35.
94.
86.
66.
95.
75
6.7
5.2
9.1
7.7
12.2
10.3
14.3
C73
Adr
enal
gla
nd0.
00.
70.
30.
20.
50.
30.
10.
30.
10.
00.
30.
00.
40.
10.
00.
40.
30.
20.
10.
3C
74O
ther
endo
crin
e0.
00.
00.
00.
00.
00.
10.
00.
00.
00.
00.
00.
00.
00.
00.
00.
00.
10.
00.
10.
0C
75H
odgk
in d
iseas
e2.
10.
70.
52.
01.
90.
81.
21.
60.
61.
70.
71.
52.
61.
81.
43.
31.
02.
21.
51.
6C
81N
on-H
odgk
in's
lym
phom
a3.
16.
43.
93.
35.
45.
14.
55.
410
.06.
04.
56.
05.
85.
77.
97.
44.
55.
44.
07.
1C
82-8
5,C
96
Imm
unop
rolif
erat
ive
dise
ases
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.2
0.2
C88
Mul
tiple
mye
lom
a1.
22.
71.
92.
52.
70.
50.
21.
51.
71.
52.
30.
80.
91.
61.
51.
01.
61.
41.
01.
5C
90ly
mph
oid
leuk
aem
ia1.
01.
32.
01.
01.
31.
71.
31.
72.
31.
82
1.5
2.4
1.1
1.7
1.5
1.9
1.6
2.1
1.9
C91
Mye
loid
leuk
aem
ia1.
51.
91.
01.
92.
51.
80.
92.
12.
11.
31.
31.
72.
12.
12.
92
1.7
1.7
2.3
2.2
C92
-94
Tabl
e 8:
Age
-stan
dard
ized
inci
denc
e rat
es p
er 1
00 00
0 po
pulat
ion
in fe
mal
es b
y top
ogra
phy/
mor
phol
ogy a
nd ye
ar, O
man
, 199
6–20
15.
-continued
O M A N M E D J, V O l 3 4 , N O 4 , J U lY 2 0 1 9
380 Na jl a A . A l -l awat i , et a l . 381Na jl a A . A l -l awat i , et a l .
infiltrating ductal carcinoma as the most frequent histopathological type accounting for 73.9% of all breast cancer [Figure 7].
2) Non-Hodgkin's lymphoma Non-Hodgkin's lymphoma (NHl) is the second most common malignancy among Omanis and accounted for 7.3% of total malignancies. There was an increase of 96.8% in the total of NHl cases reported in Oman in 2015 (n = 122) compared to 1996 (n = 62) [Figure 8].
Between 1996 and 2015, there were 1533 cases of NHl reported in Oman: 932 in men and 601 in women [Table 9]. The world ASR by gender were 8.3 cases per 100 000 Omani males and 5.4 cases per 100 000 females. Figure 9 shows the morphology of NHl reported over past 20 years in both genders.
3) Leukemialeukemia is the third most common malignancy among Omanis and accounted for 6.8% of total malignancies in both genders [Table 9]. The total number of leukaemia cases reported in Oman was more than doubled in 2015 (n = 97) compared to 1996 (n = 43) [Figure 10].
Between 1996 and 2015, there were 1439 cases of leukemia reported in Oman: 843 in men and 596 in women [Table 5 and 6]. The ASR by gender were 5.6 cases per 100 000 Omani males and 3.9 cases per 100 000 females. lymphoid leukaemia accounted for 50% of all leukaemia followed by myeloid leukaemia 39.0% and unspecified leukaemia 11.0%.
4) Colorectal cancerColorectal cancer is the fourth most common malignancy among Omanis and accounted for 6.6% of total malignancies [Table 9]. There was an increase of more than four folds in the total cases of colorectal cancer reported in Oman in 2015 (n = 148) compared to 1996 (n = 28) [Figure 11].Si
te19
9619
9719
9819
9920
0020
0120
0220
0320
0420
0520
0620
0720
0820
0920
1020
1120
1220
1320
1420
15IC
D (1
0th)
Mye
lopr
olife
rativ
e di
sord
ers (
MPD
)0.
40.
00.
50.
00.
00.
00.
00.
30.
00.
40.
00.
40.
30.
00.
00.
00.
00.
00.
00.
0M
PD
Mye
lody
spla
stic
synd
rom
es (M
DS)
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.4
0.5
0.0
0.0
0.0
0.0
0.0
0.0
0.0
MD
S
Oth
er an
d un
spec
ified
(O
&U
)6.
78.
78.
96.
64.
53.
85.
44.
47.
16.
56.
67.
32.
62.
92.
03.
71.
52.
62.
22.
0O
&U
All
sites
(All)
82.8
97.1
97.4
92.7
90.2
86.6
73.9
83.5
120
105
108
101
104
97.4
100
115
92.9
99.6
100
109
All
All
sites
but
C44
(A
llbC
44)
79.4
94.5
94.6
87.3
85.4
83.3
72.4
81.1
116
101
104
98.8
99.4
92.6
95.2
111
89.5
95.7
97.4
104
Allb
C44
ICD
: Int
erna
tiona
l Clas
sifica
tion o
f Dise
ases,
10th
revis
ion.
Tabl
e 8:
Age
-stan
dard
ized
inci
denc
e rat
es p
er 1
00 00
0 po
pulat
ion
in fe
mal
es b
y top
ogra
phy/
mor
phol
ogy a
nd ye
ar, O
man
, 199
6–20
15.
-continued
Table 9: Five most common cancer among Omanis (males and females), 1996–2015.
O M A N M E D J, V O l 3 4 , N O 4 , J U lY 2 0 1 9
380 Na jl a A . A l -l awat i , et a l . 381Na jl a A . A l -l awat i , et a l .
Between 1996 and 2015, there were 1382 cases of colorectal cancer reported in Oman: 774 in men and 608 in women. The ASR by was 8 per 100 000 and 6.3 cases per 100 000 males and females, respectively [Table 5 and 6]. Adenocarcinoma was the most frequent histopathological type accounting for 77% of all colorectal cancer [Figure 12].
5) Thyroid cancerThyroid cancer is the fifth most common malignancy
among Omanis and accounted for 6.1% of all malignancies [Table 9]. There was a four-fold increase in the total cases of thyroid cancer reported in Oman in 2015 (n = 164) compared to 1996 (n = 39) [Figure 13].
Between 1996 and 2015, there were 1277 cases of thyroid cancer reported in Oman: 242 in men and 1035 in women. The ASR by gender were 2.0 cases per 100 000 Omani males and 7.6 cases per 100 000 females [Tables 5 and 6]. Papillary carcinoma was the
Figure 8: Trends of non-Hodgkin's lymphoma among Omanis, 1996–2015.
O M A N M E D J, V O l 3 4 , N O 4 , J U lY 2 0 1 9
382 Na jl a A . A l -l awat i , et a l . 383Na jl a A . A l -l awat i , et a l .
most frequent histopathological type accounting for 83.0% of all thyroid cancer [Figure 14].
Five common cancer in Omani male Between 1996 and 2015, prostate cancer was
observed to be the leading malignancy in Omani males (998 new cases), followed by cancers of the stomach, NHl, leukemia, and colorectal. Table 10 summarizes the five most common cancers in Omani male in three different periods 1996–2005, 2006–2015, and over 20 years 1996–2015.
1) Prostate cancerProstate cancer was the leading cancer in Omani males between 1996 and 2015 and accounting for 9.3% of all incident cases in males with an average annual ASR of 11.6/100 000 people [Tables 5 and 10]. Prostate cancer incidence continued to rise slowly over the years; the lowest ASR (6.9/100 000) was reported in 2003 and the highest (17.0/100 000) in 2011 [Table 7]. Age-specific incidence among males begins in the age group 40–45 year and steadily rises to peak in the in the age group 70–74 year [Table 5].
2) Stomach cancerStomach cancer was the second most common cancer in Omani males between 1996 and 2015 and accounting for 8.9% of all incident cancers in males with an average annual ASR of 10.9 /100 000 male [Table 5]. The trend of stomach cancer incidence had declined over the years; the lowest ASR (5.7/100 000) was reported in 2015 and the highest
Figure 10: Trends of leukemia in both genders, Oman, 1996–2015.
Table 10: Frequency of the five common cancer among males in Oman.
Topography Frequency
Years 1996–2005Stomach 492Non-Hodgkin's lymphoma 431Leukemia 385Prostate 382Lung 360
Years 2006–2015Prostate 616Colorectal 534Non-Hodgkin's lymphoma 501Stomach 468Leukemia 458
Years 1996–2015Prostate 998Stomach 960Non-Hodgkin's lymphoma 932Leukemia 843Colorectal 774
O M A N M E D J, V O l 3 4 , N O 4 , J U lY 2 0 1 9
382 Na jl a A . A l -l awat i , et a l . 383Na jl a A . A l -l awat i , et a l .
(16.2/100 000) in 2005 [Table 7 and Figure 15]. Age-specific incidence among males begins in the 4th decade of life and steadily rises to a peak in the 7th
decade [Table 5].
3) Non-Hodgkin's lymphomaNHl is the third most common male cancer and accounted for 8.7% of all incident cancer cases in Omani males[Table 10]. The average annual ASR was 8.3/100 000 male [Table 5]. There was a minor
decrease in the ASR trend is observed from 1996 to 2015; the lowest ASR (7.1/100 000) was reported in 2002 and the highest (11.3/100 000) in 2004 [Table 4]. Age-specific incidence among males begins in the 30–35 year age group and gradually rises to peak in the 65–70 year age group.
4) Leukemialeukemia is the fourth most common cancer in males and accounted for 7.9% of all incident cancers in males with an average annual ASR of 5.6/100 000 male [Table 5]. The trend of leukaemia incidence has increased slowly over the years; the lowest ASR (3.9/100 000) was reported in 1996 and the highest (9.9/100 000) in 2011 [Table 7]. Age-specific incidence among males begins in the first decade of life and gradually rises to peak in the fifth decade [Table 5].
5) Colorectal cancerColorectal cancer is the fifth most common cancer in males and accounted for 7.2% of all incident cancers in males with an average annual ASR of 8.0/100 000 male [Figure 16]. The trend of colorectal cancer incidence continued to rise steadily over the years; the lowest ASR (3.3/100 000) was reported in 1999 and the highest (12/100 000) in 2015 [Table 7]. Age-specific incidence among males begins rising in
Figure 11: Trends of colorectal cancer among Omanis, 1996–2015.
Mucinous adenocarcinoma 4.0%
Mucin-producing adenocarcinoma 3.0%
Neoplasm, malignant 4.0% Signet ring cell carcinoma 1.0%
Carcinoid Tumour 1.0%
Neuroendocrine carcinoma 1.0%
Carcinoma, NOS* 6.0%
Others 3.0%
Adenocarcinoma, NOS* 77.0%
Figure 12: Morphology of colorectal cancer in Omani males, 1996–2015.
O M A N M E D J, V O l 3 4 , N O 4 , J U lY 2 0 1 9
384 Na jl a A . A l -l awat i , et a l . 385Na jl a A . A l -l awat i , et a l .
in the 25–30 year age group and steadily rises to peak in the 60–65 year age group [Table 5].
Five common cancer in Omani female Between 1996 and 2015, breast cancer was the leading malignancy in Omani females with 2181 new cases, followed by cancers of the, thyroid, colorectal, NHl, and leukemia. Table 11 summarizes the five most common cancers among Omani female in
three different periods 1996–2005, 2006–2015, and finally over 20 years 1996–2015.
1) Breast cancerBreast cancer was by far the most common cancer among Omani females and accounted for 21.2%
Figure 13: Trends of thyroid cancer among Omanis, 1996–2015.
Other specified carcinoma 3.0%
Unspecified carcinoma 3.0%
Unspecified malignant neoplasm 2.0%
Medullary carcinoma 1.0%
Follicular carcinoma 8.0%
Pappillary carcinoma 83.0%
Figure 14: Morphology of thyroid cancer among Omani females, 1996–2015.
Table 11: Frequency of five most common cancer among Omani females.
Topography Frequency
Years 1996–2005Breast 706Thyroid 339Cervix 267Stomach 263Leukemia 256
Years 2006–2015Breast 1475Thyroid 696Colorectal 442Non-Hodgkin's lymphoma 346Leukemia 340
Years 1996–2015Breast 2181Thyroid 1035Colorectal 608Non-Hodgkin's lymphoma 601Leukemia 596
O M A N M E D J, V O l 3 4 , N O 4 , J U lY 2 0 1 9
384 Na jl a A . A l -l awat i , et a l . 385Na jl a A . A l -l awat i , et a l .
of all incident cases between 1996 and 2015, with an average annual ASR of 20.8/100 000 women [Table 6]. Its incidence has increased over the past 20-year period [Figure 17]. The lowest ASR (13.2/100 000) was noted in 1998 and the highest (26.9/100 000) was in 2015 [Table 8]. The age-specific incidence rates among female begins to rise in
the second to third decades of life with steadily rises to peak in the fourth and fifth decade years [Table 6].
2) Thyroid cancerThyroid cancer was the second most common female cancer between 1996 and 2015 and accounted for 10.0% of all incident cancer cases in Omani female,
Figure 16: Age-standardized incidence rates (ASRs) for colorectal cencer in Omani males, 1996–2015.
O M A N M E D J, V O l 3 4 , N O 4 , J U lY 2 0 1 9
386 Na jl a A . A l -l awat i , et a l . 387Na jl a A . A l -l awat i , et a l .
with an average annual ASR of 7.6/100 000 people [Figure 18].
Thyroid cancer incidence continued to rise steadily over the years; the ASR was lowest (4.3/100 000) in 2000 and highest (14.3/100 000) in 2015 [Table 8]. Cases were seen in females as young as 15 years of age,
and incidence was found to increase with age, with peaks at 30–45 years and at 65–70 years [Table 6].
3) Colorectal cancerColorectal cancer is the third most common cancer in females and accounted for 5.9% of all incident
Figure 18: Age-standardized incidence rates (ASRs)for thyroid cancer in Omani females, 1996–2015.
O M A N M E D J, V O l 3 4 , N O 4 , J U lY 2 0 1 9
386 Na jl a A . A l -l awat i , et a l . 387Na jl a A . A l -l awat i , et a l .
cancers in females with an average annual ASR of 7.3/100 000 female [Figure 19].
The trend of colorectal cancer incidence continued to rise steadily over the years; the lowest ASR (1/100 000) was reported in 1999 and the highest (10/100 000) in 2014 [Table 8]. Age-specific incidence among females begins in the 30–35 year age group and steadily rises to peak in the 50–60 year age group [Table 6].
4) Non-Hodgkin's lymphomaNHl is the fourth most common female cancer and accounted for 5.8% of all incident cancer cases in Omani females [Table 11]. The average annual ASR was 5.4/100 000 female [Table 6]. There was a gradual increase in the ASR from 1996 to 2015; the lowest ASR (3.1/100 000) was reported in 1996 and the highest (7.1/100 000) in 2015 [Table 8]. Age-specific incidence among females begins in the 30–35 year age group and gradually rises to peak in the 55–60 year age group [Table 6].
5) Leukemialeukemia is the fifth most common cancer in females and accounted for 5.8% of all incident cancers in females with an average annual ASR of 3.9/100 000 female [Table 6]. The trend of leukaemia incidence
has slowly increased over the years; the lowest ASR (2.8/100 000) was reported in 1996 and the highest (5.6/100 000) in 2003 [Table 8]. Age-specific incidence among females begins in the 0–10 year age group and gradually rises to peak in the 55–60 year and 70–75 age group [Table 6].
r efer ences
1. International Association of Cancer Registries. CanReg5: software for cancer registries [13 May 2019]. Available from: http://www.iacr.com.fr/index.php?option=com_content&view=category&layout=blog&id=68&Itemid=445.
2. Segi M. Cancer mortality for selected sites in 24 countries (1950-57). Department of Public Health, Tohuku University of Medicine. Nagoya: Japan; 1960.
3. Ministry of Health, Oman. Annaul Health Reports [7 May 2019]. Available from: https://www.moh.gov.om/en/web/statistics/annual-reports.
4. Ferlay J, Colombet M, Bray F. Cancer Incidence in Five Continents, CI5plus: IARC CancerBase No. 9 [13 May 2019]. Available from: http://ci5.iarc.fr/Default.aspx.
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