THE HISTOPATHOLOGICAL SPECTRUM OF MALIGNANT NEOPLASMS AT A TERTIARY CARE CENTER IN KHYBER PAKHTUNKHWA, PAKISTAN: A FOUR-YEAR HOSPITAL-BASED TUMOR-REGISTRY ANALYSIS
DOI:
https://doi.org/10.52764/jms.26.34.3.5Abstract
Background and Objective: Population-representative cancer data remain scarce for Khyber Pakhtunkhwa, Pakistan's northwestern province, which receives cross-border referrals from Afghanistan. We analyzed four years of confirmed malignancies at a tertiary-care center to characterize the spectrum of malignancies presenting to the center by site, age, sex, and geography.
Methods: We retrospectively analyzed consecutive malignant cases entered into the institutional tumor register from 2021 to 2024, each with a histopathological diagnosis, coded tumor topography, and, when recorded, age, sex, and district of residence. Because a hospital register lacks a population denominator, we limited the analysis to case-series comparisons using chi-square, Fisher exact, Mann-Whitney U, and Kruskal-Wallis tests.
Results: Among 1,062 confirmed malignancies, the mean age was 50.8 years (standard deviation 19.1), and 52.4 percent were female (p=0.118); men were older (median 55.5 versus 51 years, p<0.001). The ten most frequent sites accounted for 70.3 percent of cases, led by central nervous system tumors (14.2 percent), pleural and other intrathoracic sites (8.5 percent), breast (7.8 percent), urinary bladder (7.6 percent), skin (7.2 percent), esophagus (7.0 percent), and colon-rectum (6.1 percent). Site distribution differed by sex (p<0.001), with urinary bladder malignancy more frequent among male than female cases (odds ratio 3.45, 95 percent confidence interval 1.98-6.00; q<0.001). Central nervous system tumors made up half of all pediatric cases, compared with 12.2 percent of adult cases (odds ratio 7.18, 95 percent confidence interval 4.11-12.53). Most patients (95.2 percent) resided in the province, with 59.6 percent from Peshawar.
Conclusions. This series shows a cancer spectrum led by central nervous system, breast, urinary-tract, aerodigestive and skin malignancies, supporting the case for a population-based registry and decentralized diagnostic capacity.
Keywords: Hospital-Based Tumor Registry; Histopathology; Epidemiology; Pakistan; Khyber Pakhtunkhwa; Tumor Topography Classification
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Copyright (c) 2026 Shahida Tasneem, Muhammad Nawaz Khan, Sundas Tariq, Syed Shayan Shah
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