KARACHI, July 16: Breast cancer is the most frequent malignancy among women in Pakistan. It constitutes 15% of all cancers and are registered a decade earlier among local women as compared to their counterparts in the western countries.

A countrywide hospital-based surveys conducted during the years 1995-2001 revealed breast cancer to be closely followed by skin, ovary, leukemia, cervix, lymph node, colorectal, gall bladder, thyroid and bone cancers.

Apart from environmental factors which play significant role in the etiology of cancer, the diet consumed by patients, particularly those suffering from breast cancers, was found to be rich in saturated animal fat and low in total protein.

The studies further suggested that genetic factors might also be playing an important role in the frequency of breast cancer and Pakistani women might be at a higher risk on account of their genetic constitution.

During the case control study a large number of healthy women were also interviewed. It showed that breast cancer was equally prevalent in the rural and the urban areas, although the majority of the women affected belonged to the lower socio-economic classes.

Ovarian cancer, another of the cancers frequently inflicting Pakistani women, was registered as one of the commonest causes of gynaecological cancer deaths in the country. 34.4 per cent of these ovarian tumours were benign while 65.6 per cent were malignant.

Only 15.1 per cent local women reporting ovarian carcinoma were nulliparous, 14.3 per cent with benign tumours were nulliparous and over half of these women (57.3 per cent) had four or more children.

Another retrospective study reporting a five-year experience of 107 patients with ovarian cancer found most of these patients multiparous, aged between 19 to 39 years, presenting with low abdominal pain, pelvic mass, vague G.I.T symptoms and bleeding per vaginal.

A significant percentage of patients with ovarian carcinoma gave a history of breast cancer. It was also concluded that patients with ovarian cancer were younger and had more advanced disease.

The majority (78 per cent) of patients over 40 had cancer of epithelial origin while the majority (63 per cent) of patients under 40 had benign tumours.

The frequency of mucinous tumours of the ovary in Pakistani females was higher than that of India and two-thirds of the ovarian cancers had spread widely beyond surgical treatment at a time of presentation.

Delayed referral has emerged as the major cause for high rate of morbidity and mortality.—APP