Saudi Cancer Registry Research Articles

Demographic and clinical characteristics associated with advanced stage colorectal cancer: a registry-based cohort study in Saudi Arabia

BackgroundIn Saudi Arabia, approximately one-third of colorectal cancer (CRC) patients are diagnosed at an advanced stage. Late diagnosis is often associated with a worse prognosis. Understanding the risk factors for late-stage presentation of CRC is crucial for developing targeted interventions enabling earlier detection and improved patient outcomes.MethodsWe conducted a retrospective cohort study on 17,541 CRC patients from the Saudi Cancer Registry (1997–2017). We defined distant CRCs as late-stage and localized and regional CRCs as early-stage. To assess risk factors for late-stage CRC, we first used multivariable logistic regression, then developed a decision tree to segment regions by late-stage CRC risk, and finally used stratified logistic regression models to examine geographical and sex variations in risk factors.ResultsOf all cases, 29% had a late-stage diagnosis, and 71% had early-stage CRC. Young (< 50 years) and unmarried women had an increased risk of late-stage CRC, overall and in some regions. Regional risk variations by sex were observed. Sex-related differences in late-stage rectosigmoid cancer risk were observed in specific regions but not in the overall population. Patients diagnosed after 2001 had increased risks of late-stage presentation.ConclusionOur study identified risk factors for late-stage CRC that can guide targeted early detection efforts. Further research is warranted to fully understand these relationships and develop and evaluate effective prevention strategies.

A Comprehensive Two-Decade Analysis of Lymphoma Incidence Patterns in Saudi Arabia.

Background: Lymphomas account for approximately 10% of all cancer cases among the Saudi population. Even when separated, Hodgkin lymphoma (HL) and non-Hodgkin lymphoma (NHL) are in the top ten most commonly diagnosed cancers among Saudi men and women. Despite the substantial cost of HL and NHL to public health, the resources to assess their impact are insufficient. This study provides a two-decade detailed assessment of lymphoma incidence trends in the Saudi population. Methods: Analysis of the Saudi Cancer Registry (SCR) data for various incidence metrics from 2001 to 2020 was conducted. Joinpoint regression analysis was further performed to investigate temporal trends globally and by age group, gender, and administrative region. Results: HL cases grew by 174.1%, whereas NHL cases increased by only 80% for that time period. The HL overall Age-Standardized Incidence Rate (ASR) increased by 100% for both genders combined but remained unchanged for NHL. The median age at diagnosis for HL (20-30 years) and NHL (46-57 years) was lower than in many other nations. Our model identified increasing trends for HL with annual percentage changes (APCs) of 2.94% (CI: 2.2-3.7) and 3.67% (CI: 2.6-4.7) for males and females, respectively. The rise was mainly among young groups under 40. On the contrary, the NHL cohort revealed notable declining tendencies. We discovered alarming rates of HL in Saudi Arabia's APC (2.23% for males and 3.88% for females) and ASR compared to other Western countries. Overall, the majority of the patients presented with advanced-stage disease at a younger age and with slight male predominance. Conclusions: The overall incidence of lymphoma (especially HL) has been rising among Saudis. Implementation of secondary and tertiary prevention measures, as well as management of modifiable risk factors, is warranted.

An Observational Analysis on the Epidemiological Status of Gastric Cancer Prevalence in the Saudi Population

Abstract Introduction: Gastric cancer, also called stomach cancer, is one of the most fatal cancers with widespread global prevalence, despite declining incidences and mortality rates in the past decade. The data for the study are gathered from the Saudi Cancer Registry, created and maintained by the National Health Information Center, used to undertake the observational analysis on the epidemiological status of gastric cancer prevalence, a cohort-based epidemiological research on stomach cancer. The study examined the age-standardized incidence rates (ASIRs) and crude incidence rates (CIRs) of stomach cancer as per the different anthropometric parameters, such as age group, diagnostic year, and administrative districts, among Saudi inhabitants to analyze the gastric cancer prevalence, distribution, and trends. The study highlights consumption of high salt, high red meat, and highly processed food as some of the major causes of stomach cancer prevalence in Saudi Arabia. Materials and Methods: The data were analyzed using SPSS version 2.0 and GraphPad Prism software, which included the Kruskal–Wallis, sex ratio, t-test, and detailed statistics information. Saudi documented 1972 and 1296 instances of stomach cancer in both sexes, respectively, between 2006 and 2016. Results: The highest mean numbers and percentage of gastric cancer cases were found among men and women over 75 years old, meanwhile men and women aged between 0 and 19 years showed lowest percentage of gastric cancer cases. The greatest mean CIR (2.4) was found in males in Asir, followed by Najran and Makkah (2.1). CIRs of stomach cancer cases in Saudi women decreased somewhat. The highest CIR was 1.5 in 2007, followed by 1.4 in 2011 and 2014, respectively. The highest mean ASIR was observed among both sexes in the Najran and Northern regions. Males and females in Asir and Riyadh, respectively, had the highest mean CIR. Conclusion: In the present study, Saudi males had a modest increase in CIRs and a drop in ASIRs of gastric cancer in males and females, whereas females had a slight decrease in CIRs. Between 2006 and 2016, the mean ASIR in males and females in Riyadh and the Northern area was the highest.

Incidence of Malignant Peripheral Nerve Sheath Tumor in Saudi Arabia: A Registry-based Descriptive Analysis

Background: Malignant peripheral nerve sheath tumors (MPNSTs) refer to malignant tumors in the cells of the peripheral nerve or nerve sheath. This study was conducted to report the incidence and provide an overview of MPNSTs in Saudi Arabia due to the rarity and lack of studies on MPNSTs in the country. Methods: This retrospective cohort study of MPNSTs included all patients diagnosed with MPNSTs in Saudi Arabia between 2010 and 2020. The data was collected from the Saudi Cancer Registry (SCR) and was analyzed using John&amp;apos;s Macintosh Project (JMP) statistical software. Results: Twenty-five total with 25 MPNST cases were included in this study. The annual incidence in Saudi Arabia is 0.076 per million people. Of the patients, 15 were males (60.00%), and the median age was 36 (15–47) years. In this study, all 25 cases were diagnosed based on histopathology of the primary lesions (100.00%). For the sites of the lesions, the trunk and lower limbs were the most reported sites with six cases (24.00%) each. Regarding tumor grading, the majority had an unknown grade (18 cases, 72.00%), followed by grade II (moderately differentiated) in four cases (16.00%). Lastly, for tumor extension, 12 cases (48.00%) were localized, whereas only one case (4.00%) was distally metastasized. Conclusion: This study revealed a low incidence of MPNSTs in Saudi Arabia, providing information on gender distribution, age, geographical distribution, tumor site, grading, and tumor extension.

Prostate cancer among Saudis: a registry review.

Policy makers in Saudi Arabia greatly rely on published studies to make major public health decisions. Prostate cancer (PCa) studies in Saudi Arabia are either outdated or limited to local regions. The authors aim to analyze the Saudi Cancer Registry to determine the incidence of PCa across all regions of the Kingdom and the risk factors of poor prognosis in the population. Patients diagnosed with primary PCa from 1 January 2008 to 31 December 2017 were included in the study from the Saudi Cancer Registry. Incidence rates and risk factors for poor survival were calculated. A total of 3607 PCa patients were retrieved. PCa incidence rates ranged from 0.2 to 1.4 per 100000. Most of the patients were aged 60 and older (86.5%; n=3120), married (97%; n=3497) and lived in the central region (38.1%; n=1375). The mean age at diagnosis was 71.1 (10.8) years. Over half of all tumors were poorly differentiated (64.2%; n=2317), and localized (60.4%; n=2180). The all-time metastasis rate reached 31.4% (n=1131). The lowest mean survival was in those with distant metastasis (P=0.039). Age groups, marital status, tumor morphology, place of residency, and grade were not proven to significantly influence survival. The high metastasis rate and evidence of a greater incidence of newly diagnosed metastatic PCa indicate that the idea of select screening for certain high-risk populations is not farfetched. The authors encourage the promotion of awareness regarding PCa risk factors and screening to optimize prognosis and minimize late presentations and high metastasis rates.

Beyond the norm: exploring the uncommon squamous cell carcinoma of the prostate using a Saudi tumor registry

Background: Squamous cell carcinoma (SCC) of the prostate has limited treatment choices and portends a dismal prognosis with an average survival time of ~14-months. This study provides a descriptive overview of SCC of the prostate in Saudi Arabia. Materials and Methods: A retrospective cohort study of patients diagnosed with prostatic SCC between 1 January 2008 and 31 December 2017. Information on demographic and tumor characteristics and the survival of patients was collected from the Saudi Cancer Registry. Survival was depicted through Kaplan–Meier plots. Fisher’s exact test was used to assess the association between categorical variables and death, while a Wilcoxon rank sum test was applied for numerical variables. Results: Out of a larger subset of 3607 patients, 16 patients were diagnosed with prostatic SCC, of which half resided in the Central region (50.0%) and most (81.2%) were aged greater than or equal to 60 years. Most patients (62.6%) had poorly differentiated (grade III, 43.8%) lesions, and 50% of cases were metastatic at diagnosis. 62.5% of patients died, all residing in the Eastern and Central regions. Regional extension (75.0%) and distant metastasis (87.5%) were significantly associated with death compared to localized lesions (0.0%) (P=0.022). The 5-year survival rate in our study was 33%. Conclusion: The present study is the first to describe the characteristics of prostatic SCC in Saudi Arabia. Our results are consistent with prior studies showing that prostatic SCC is often high-grade and metastatic at diagnosis, conferring a poor prognosis.

Comprehensive Retrospective Analysis of Colorectal Cancer Incidence Patterns in Saudi Arabia.

Colorectal cancer (CRC) is the commonest cancer in Saudi males and the third most common in Saudi females. Although CRC represents a major public health challenge, the resources to evaluate its burden are inadequate. This study aims to elucidate the magnitude of CRC incidence trends in the Saudi population by age, gender, and administrative region. Data for multiple incidence measures were analyzed from the Saudi Cancer Registry (SCR) retrospectively from 2001 to 2018. Temporal trends were further analyzed by age group, gender, administrative region, and globally using joinpoint regression analysis. The number of CRC cases climbed by 335.6% and the disease increased by 56.4% to comprise 12.2% of all cancers cases. The age-standardized incidence rate (ASR) increased by 152% overall, and the median age at diagnosis peaked at 60 and 58 years for males and females, respectively. Riyadh and the Eastern Region had the highest ASR for both genders, peaking at 21.8 and 19.2 for males and 17.4 and 16.5 for females per 100 K population. Our prediction model identified growing trends with annual percentage changes (APCs) of 4.59% in males (CI: 3.1-6.1) and 3.91% among females (CI: 2.4-5.5). Males above 75 years had the highest APC (7.9%, CI: 5.3-10.7), whereas the highest APC among females was found in the age group 70-74 (5.4%, CI: 2.8-8). Globally, APC was the highest for both genders compared to selected countries. CRC incidence is increasing alarmingly in Saudi Arabia and is projected to continue. There is a need for better screening strategies, preventative measures, and awareness-building.

A decade in focus: mixed germ cell tumors with choriocarcinoma components

Introduction: This 10-year registry review aimed to investigate the clinical behaviour and outcomes of mixed germ cell tumours with choriocarcinoma components, a rare and aggressive subtype of testicular cancer, in Saudi Arabia. The study explores the demographic characteristics of affected patients, tumour profiles, and the mortality rate associated with this malignancy. Methods: Utilizing data from the Saudi Cancer Registry, the authors identified 33 cases of mixed germ cell tumours with choriocarcinoma components among 1001 testicular cancer cases recorded between 2008 and 2017. Demographic information, including age, marital status, region of residency, year of diagnosis, and 10-year survival status, were collected. Tumour factors, such as the basis of diagnosis, origin site, behaviour, grade, extension, and laterality, were also analyzed. Results: The majority of cases (78.8%) occurred in the young age group (18–45 years), and most tumours (97%) originated in normally descended testes. Grade IV (undifferentiated anaplastic) tumours and distant metastasis were present in 45.5% of patients. All cases exhibited malignant tumour behaviour. The overall mortality rate was 15%, with a mean time from diagnosis to death of 7.72 months (range: 0.5–21.5 months). Conclusion: Mixed germ cell tumours with choriocarcinoma components are rare and tend to affect younger populations. These tumours demonstrate aggressive clinical behaviour, with a significant proportion presenting with high-grade lesions and metastasis at diagnosis. The observed mortality rate underscores the poor prognosis associated with this malignancy. Our study provides essential insights into the clinical characteristics of this rare tumour subtype in the Saudi Arabian population, emphasizing the need for further research to identify prognostic factors and optimize management strategies for affected patients.

Epidemiology of gastric cancer in Saudi Arabia from 2004 to 2017.

Gastric cancer (GC), a prevalent disease which globally affects both men and women, was predicted by the International Agency for Research on Cancer in 2020 to have an age-standardized incidence rate (ASIR) in Saudi Arabia of 2.7 per 100,000 individuals for all ages and sexes (ranked 15th), and an age-standardized mortality rate of 2.1 per 100,000 individuals (ranked 12th). The present retrospective study aimed to investigate the prevalence of GC across all administrative regions in Saudi Arabia. Specifically, the present study sought to examine the incidence of diagnosed cases, age-specific incidence rates, crude incidence rates (CIRs) and ASIRs adjusted for age, year and region. To meet this aim, this retrospective descriptive epidemiological analysis was conducted on all cases of GC recorded in the Saudi Cancer Registry (SCR) between January 2004 and December 2017. The collected data were subjected to a range of statistical analyses (using SPSS version 20.0), including descriptive analyses, independent sample t-tests, the Kruskal-Wallis test and sex ratio analysis. In the SCR, a total of 4,066 cases of GC were recorded between 2004 and 2017. The regions with the highest overall ASIRs of GC for both men and women were found to be Riyadh, Najran and the Eastern Region, with rates ranging from 2.2-4.0 per 100,000 individuals. Conversely, Jazan had the lowest ASIRs, with rates of 1.5 and 0.5 per 100,000 individuals for men and women, respectively. The overall ASIRs of GC were found to be significantly higher in men compared with women, with a ratio of 2.8 per 100,000 individuals (P<0.05). In conclusion, the present study has revealed that, between 2004 and 2017, there was a slight decrease in the values of both CIR and ASIR of GC in Saudi Arabia.

A Retrospective Study of Ocular Cancer in Saudi Arabia: 25-Year Analysis.

Ocular malignancies are uncommon among eye diseases; however, they jeopardize both vision and life. The main objective of this study was to use to describe the epidemiology of eye and ocular adnexa malignancies across different ages and sex. The King Khaled University institutional review board approved this study. Data on ocular cancer were retrieved from the Saudi Cancer Registry between 1994 and 2018. The registry collected important patient information such as demographic information (age, gender, and nationality), clinical details, and tumor classification. The total number of cases with ocular cancer diagnosed was 1051 cases. The highest number was recorded in Riyadh (35.39%, n=372), followed by Makkah (16.93%, n=178). The incidence was higher in the 0-4 years' age group (55.21%), and it got down as people got older. The data also revealed differences in the number of reported cases over time, as well as in the representation of eye cancer cases by gender and nationality. While many ocular cancer pathologies were seen, with "Retinoblastoma, not otherwise specified" being the most common (53.32%), the incidence rates for males and females remained largely stable over time. The study emphasizes the need for continued monitoring, research, and analysis of potential of epidemiology of ocular cancer occurrence in Saudi Arabia. Identifying the geographical distribution and age pattern of Ocular malignancies have the potential to assist healthcare authorities and policymakers in developing precise strategies to reduce, recognize at an early stage, and successfully manage this condition.

Malignant testicular tumors in children: overview on 10years of Saudi Cancer Registry.

The aim of this study was to identify epidemiological and histopathological patterns of pediatric testicular tumor (TT) in Saudi population over 10years. Retrospective data extracted from the Saudi Cancer Registry for Saudi children diagnosed with TT from 2008 to 2017. The data collected included patient's factors as age, year of diagnosis, survival status, and tumor factors as basis of diagnosis, origin of the tumor, histopathological group and subtype, and tumor behavior, stage, and laterality. A total of 115 patients with a median age of 14 (IQR 1.5-17) were included. The primary tumor site was a normal descended testis in 98.3% (115). Yolk sac tumor was the most common 28.2% (33), followed by embryonal carcinoma in 27.4% (32) and mixed germ-cell tumors in 23.1% (27). Kaplan-Meier analysis revealed significant association between survival and the stage of the tumor (p = 0.002). However, there was a lack of significant association between survival and age groups, histopathological groups, and histopathological subtypes (p = 0.541, p = 0.609, and p = 0.733, respectively). The overall mortality rate of TT 5.2% with all deaths caused by non-seminomatous germ-cell tumor diagnosed with stage 3. The median age of the patients was 14years. Yolk sac tumors were the most common while testicular choriocarcinomas were the least in incidence. No increase in the incidence of TT was seen and the mortality rate over the 10-year period was 5.2%. Shorter survival was associated with higher tumor stage.

The Incidence Rate of Non-Hodgkin’s Lymphoma in Saudi Arabia: An Observational Descriptive Population Based Epidemiological Study from the Saudi Cancer Registry (2006–2016)

Introduction: Non-Hodgkin’s lymphoma (NHL) consists of several hematologic malignancies arising from B, T lymphocytes or natural killer lymphocytes, and nearly 85–90% originates from B lymphocytes. This current study illustrates frequency of diagnosed NHL cases, age-standardized incidence rate (ASIR) and crude incidence rate (CIR) by age group, year of diagnosis and administrative regions for identifying the distribution, pattern and real condition of NHL in Saudi Arabia.&#x0D; Methodology: In this study, an epidemiological analysis of NHL cases is conducted on registered cases between 2006 and 2016 from Saudi cancer registry (SCR). For statistical analysis, t-test, sex ratio, Kruskal–Wallis and descriptive statistics were performed by SPSS version 20.0.&#x0D; Results: A total of 8019 NHL cases were documented from reported from January 2006 to December 2016. Among males, Riyadh region had the highest overall ASIR at 7.9 followed by Eastern region at 6.9 per 100,000 males and lowest overall ASIRs were observed in Jazan and Hail region at 3.5, and the Northern region at 3.9 per 100,000 males. The highest overall ASIR among females was reported in the Riyadh region at 6.9 and Eastern region at 5.2 per 100,000 females and lowest overall ASIR was documented in the Jazan region at 2.2, followed by Hail at 2.4. The overall age-standardized incidence sex ratio of NHL was found to be 1.3 per100,000 in Saudi Arabia. &#x0D; Conclusion: This study concluded an increase in crude incidence rates and age-standardized incidence rates NHL among Saudi population. Highest overall ASIRs for NHL among males and females from 2006 to 2016 were documented in Riyadh and Eastern region. While, lowest overall ASIRs among males and females were documented in the Jazan and Hail region.

Major salivary gland carcinoma in KSA: A 10-year nationwide retrospective study of 571 cases

ObjectivesMajor salivary gland carcinoma (MSGC) comprises a morphologically diverse group of rare tumours with different clinical behaviours, and epidemiology findings in the literature substantially vary by geographic location. The aim of this study was to conduct a comprehensive analysis of the incidence rates, anatomical sites, and histological subtypes of different salivary gland malignancies in the population of KSA. MethodsThis retrospective cohort study included patients diagnosed with MSGC in KSA from 2008 to 2017, on the basis of the demographic characteristics and histological data retrieved from the Saudi Cancer Registry database. Malignant lesions were identified according to the International Classification of Diseases for Oncology, Third Edition (ICD-O-3) codes. ResultsSalivary gland malignancies were diagnosed in 571 patients (50.10% males and 49.90% females) over the course of 10 years. The parotid gland was the site of origin in 69.9% of cases. The most common histological type was mucoepidermoid carcinoma (29.1%). Over a decade, the incidence rate ranged from (0.15–0.24) per 100,000 inhabitants. The peak incidence of salivary gland malignancies was observed in the fourth, fifth, and sixth decades of life (17.5%, 18.2%, and 16.8%, respectively). ConclusionCompared with that in other parts of the world, the incidence of MSGC is significantly lower in KSA, with 0.15–0.24 cases per 100,000 people each year. However, the clinical manifestations of carcinoma of the salivary glands in KSA are similar to those described worldwide.

An unusually high prevalence of isolated prostatic ductal adenocarcinoma among Saudi patients: A registry-based study.

We conduct a secondary analysis on the demographics, tumor characteristics, survival, and risk factors for mortality among patients with prostatic ductal adenocarcinoma (PDA) in the Kingdom of Saudi Arabia (KSA). This is a registry-based retrospective study that included all patients diagnosed with prostate cancer in the KSA. The data were collected from the Saudi Cancer Registry, which collects tumor data from all private, military, and health ministry hospitals in Saudi Arabia through five regional offices. Among 3607 prostate cancer patients detected during the specified period, 209 (5.8%) had ductal adenocarcinoma. The median interquartile range age of patients was 72.0 years (64.0-78.0). Adenocarcinoma lesions were malignant among all the patients. Grade III tumors were most frequently apparent lesions (61.2%), followed by Grade II tumors (26.3%), Grade I tumors (7.2%), and Grade VI tumors (5.3%). A total of 33 patients died, representing 15.8% of the whole sample. The 1-year survival rate was 78.1%. More than a third of patients who were residing in the Western region deceased (38.0%), whereas no deaths were reported in other regions with a statistically significant difference based on regions (P < 0.001). To the best of our knowledge, this is the first registry-based study to investigate PDA in the KSA; these efforts were done to further understand this deadly condition and to further enhance patient care in the KSA.

Prostatic adenocarcinoma with transitional cell features among the Saudi Arabian population: a registry review.

A retrospective cohort study was conducted on all Saudi patients diagnosed with adenocarcinoma of the prostate with transitional cell features. The data was collected from the Saudi Cancer Registry, which collects tumor data from all private, military, and Health Ministry hospitals in Saudi Arabia through five regional offices. Out of 3608 patients, only 16 (0.44%) had adenocarcinoma with transitional cell features. All the tumors under investigation were malignant and constituted. Only 6.2% of the tumors were well-differentiated, 43.8% were moderately differentiated, and 50.0% were poorly differentiated. Among the included patients, 56.3% of the patients (n=9) died. There were no significant factors associated with death among patients, including the demographic and tumor-related variables. To the authors' knowledge, this is the first study describing the prevalence of adenocarcinoma with transitional cell features and its characteristics in Saudi Arabia. The authors have demonstrated that this rare subtype may be more prevalent than what was originally believed. It is necessary for future studies to assess the effectiveness of various treatment modalities to combat it. Furthermore, identifying risk factors - if any - may be crucial in the prevention of its development among men worldwide.

Testicular Cancer in Saudi Arabia Between 2004 and 2017.

This study examines the epidemiology related to testicular cancer (TC) in the administrative regions of Saudi Arabia by looking at not only the percentage/ frequency of diagnosed cases, but also the crude incidence rate, age-specific incidence rate, and age-standardized incidence rate stratified by the age group, diagnosis year, and regions. From 2004 to 2017, descriptive epidemiological research was carried out across all TC cases registered under the Saudi Cancer Registry (SCR). Descriptive statistics as well as the Kruskal-Wallis test, together with SPSS (version 20.0) were used to evaluate the data. The SCR received 1114 reports of TC diagnoses between January 2004 and December 2017. TC was diagnosed most frequently in Saudi men aged 15-44 years. In terms of Saudi men, Jouf, Tabuk, Hail, and the Northern region reported the highest age-specific incidence rate (ASIR) of TC at 1.1 per 100,000 men. Alternatively, Baha, Jazan, and Riyadh had the lowest overall ASIR of TC (0.1 and 0.3 per 100,000 men, respectively). The ASIR of TC exceeded its previous levels by twofold. The likelihood of TC was five times higher in Jouf, Tabuk, Hail, and Northern regions than in Baha and Jazan. In Saudi Arabia, the ASIRs of TC doubled between 2004 and 2017. TC was most frequently diagnosed in younger Saudi men. Jouf, Tabuk, Hail, and Northern regions of Saudi Arabia had the highest incidence of TC among Saudi men, whereas Baha, Jazan, and Riyadh had the lowest incidence.

The estimating level of awareness and knowledge of colorectal cancer among general population in Al-Ahsa Region, Saudi Arabia

Background: Colorectal cancer (CRC) is a type of cancer that affects the colon. Globally, CRC is one of the most common types of cancer in the world among both genders. The east of Saudi Arabia, Al Ahsa, is reported by the Saudi Cancer Registry to have the highest incidence. This study aimed to assess the knowledge and awareness of CRC signs and symptoms among the general population in Alahsa, Saudi Arabia. Methods: A cross-sectional study was conducted from August 2022 to February 2023, utilizing a survey based on a previous study by Bakry et al. The sample size was 384 participants, with data collected through an online Google questionnaire. This survey covered demographics, CRC awareness, knowledge, and risk factors. Result: 385 out of 457 of the participants which is represented as 84% answered the questionnaire correctly. The majority were males, aged over 45, residing in the Al Hassa region, with over half having university education or degrees. In addition, most participants were married, and over 80% had heard of CRC. Twelve individuals had been diagnosed with CRC, and 91 had a family history of the disease. Surprisingly, more than 90% of participants demonstrated excellent knowledge of CRC. The correlation analysis indicated that younger participants were more aware of CRC (p = 0.042), but no significant associations were found between excellent awareness levels and gender, educational level, or marital status. Conclusion: There is an excellent level of awareness of CRC signs and symptoms among the general population in Alahsa. This reflects the excellent knowledge and education among the general population. Leading us to expect early medical help if anyone experiences CRC symptoms.

Outcome of Advanced Stage Diffuse Large B-Cell Lymphoma; Experience from Saudi Arabia

Background Diffuse large B-cell lymphoma (DLBCL) is one of the most common subtypes of non-hodgkin lymphoma, and an aggressive cancer of B-cells. As per the Saudi Cancer Registry, the reported DLBCL prevalence in Saudi Arabia is 15(22.7%) in males and 3(13%) in females (1). CHOP (cyclophosphamide, doxorubicin, vincristine, and prednisone) is the standard of care (2), however, the outcome had displayed significant improvement with rituximab addition. The treatment adjustment is required as per the International Prognostic Index (IPI), based on a patient's profile (age and the associated risk factors)(3,4). There is high mortality in relapsed and refractory cases. The overall survival 0.40 (95% CI, 0.27-0.61), and the progression free survival 0.40 (95% CI, 0.27-0.61) had improved with the addition of rituximab. Methods A retrospective cohort study was employed in year 2016 for patients diagnosed with DLBCL during 2008-2018. The patients were followed up for five years from the treatment till the outcome death or survival. The collected data included demographics, clinical characteristics, ECOG status, Ann Arbor stage, bulky disease, spleen/ extra-nodal involvement, disease status, received line of therapies, and the outcome. Study was approved by the institutional ethical committee (RC14/076). Results A total of 145 consecutive patients were enrolled. The median age was 67 (20-111) years. Little more than half of the sample 80(55%) were males. The B-symptoms were positive in 42(46%). Almost two-thirds 103(71%) had ANN Arbor stage III or IV. 19(22%) had three or more co-morbidities. 58(50.43%) patients had a high-intermediate/ high IPI risk category. Chemotherapy/ Immunotherapy was most common mode of therapy 140(96%), followed by radiotherapy 20(14%). 9(6%) had received stem cell transplantation. First line of therapy was received by 134(92%), followed by second line of therapy19(13%), third line of therapy and above in 9(6.2%). 95(71%) patients had received R-CHOP as a first line of therapy, followed by R-CVP 15(11%), ABVD 3(2.24%), R-bendamustine 2(1.5%), Rituximab 2(1.5%), and others 17(12.68%). The mid treatment evaluation using PET was negative in 16(28%), and post therapy PET evaluation was negative in 44(51%). The five years overall survival was 78%, and five years progression free survival was 74% (figure 1). Conclusion Despite the advanced and high-risk presentation in the majority of patients diagnosed with DLBCL, the 5-year overall survival and progression free survival appears similar or better than what has been reported in literature. This can be attributed to the individualization of therapy based on clinical stage and risk factors. Figure 1View largeDownload PPTFigure 1View largeDownload PPT Close modal

Breast Cancer Incidence Patterns in the Saudi Female Population: A 17-Year Retrospective Analysis.

Background and Objectives: Breast cancer is considered the most commonly diagnosed type of cancer among women globally and in Saudi Arabia. This study aimed to assess breast cancer incidence patterns and trends among the Saudi female population. Materials and Methods: Breast cancer incidence parameters were obtained from the Saudi Cancer Registry (SCR). The data were retrospectively analyzed for the period from 2001 to 2017 to investigate changes in incidence rates. Temporal trends were also analyzed through joinpoint regression analysis and were dissected by age groups and administrative regions. Results: During the specified period, breast cancer jumped by 55% to constitute 30.9% of all cancer cases among Saudi females. The median age at diagnosis increased to reach 51 years at the end of that period, with an overall increase of 6.3%. The overall Age-Standardized Incidence Rate (ASR) escalated by 151.7% from 11.8/100,000 to 29.7/100,000 population for that period. The Eastern region noticeably had the highest ASR and peaked at 52.2/100,000 population. The joinpoint analysis of the ASR showed increased trends, with an annual percent change (APC) of 5.13% (p &lt; 0.05, [95% CI 4-6.3]). An age-specific analysis was also performed and showed that the age group 70-74 years had the highest trend (APC 10.2%, [95% CI 7.2-13.4], p &lt; 0.05). Region-specific analysis revealed that the Jouf region had the highest trend among the regions (APC 8.8%, [95% CI 3.7-14.2], p &lt; 0.05). Conclusions: Our analysis indicates increased breast cancer incidence in Saudi Arabia with an alarming pace. With the existing trend, it is expected that Saudi Arabia will continue to display an increase in breast cancer incidence. Long-term preventive measures and more effective screening strategies are warranted to alleviate the burden of the disease.

Brain Tumors in Saudi Arabia: An Observational and Descriptive Epidemiological Analysis.

Introduction: Brain tumors are one of the major causes of death and morbidity around the world. A prospective existential retrospective observational population-cohort study based on the comprehensive research work on brain tumors in the Saudi population was conducted, with statistics drawn from the Saudi Cancer Registry data collected and published by the Ministry of Health, Saudi Arabia, which is a national document prepared and maintained by the National Health Information Center, from 2006 to 2016. For the analysis of the brain tumor distribution and trends in Saudi Arabian inhabitants, the current study outlined the brain tumor incident rates in the age-standardized incidence rates (ASIRs) and crude incidence rates (CIRs) in the inhabitants of Saudi Arabia by distinct age cohorts, the year of diagnosis, and the core administrative regions of Saudi Arabia. Method: Statistical tools, such as GraphPad Prism and SPSS 2.0, were used for the analyses of the t-test, Kruskal–Wallis test, and descriptive statistics, including the sex ratio and other demographic features. Between 2006 and 2016, Saudi Arabia recorded 1854 and 1293 cases of brain tumors in males and females, respectively. Results: The highest percentage and mean number of brain tumor cases were recorded among males and females in the age group 0–4 years, and the lowest proportion of brain tumor cases were reported among males and females in the higher age group (55–69 years). The highest mean CIR and ASIR were found in the male and female populations of the Riyadh region, and the highest CIR and ASIR sex ratios were found in the Baha and Naj regions of Saudi Arabia, respectively. Males in the Jazan region had the lowest average CIRs and ASIRs. The Baha and Jazan regions of Saudi Arabia recorded the lowest mean CIR and ASIR among females. Conclusion: The Riyadh region had the most significant increases in ASIRs and CIRs for brain tumors in males and females from 2006 to 2016, whereas the Jazan region had the least significant changes in the ASIRs in males and females.