ORIGINAL ARTICLE OPEN ACCESS Journal of the College of Physicians and Surgeons Pakistan 2023, Vol. 33(06):625-632 625 National Cancer Registry of Pakistan: First Comprehensive Report of Cancer Statistics 2015-2019 Aamer Ikram 1 , Shahid Pervez 2 , Muhammad Tahir Khadim 3 , Muhammad Sohaib 4 , Hafeez Uddin 5 , Farhana Badar 6 , Ahmed Ijaz Masood 7 , Zafar I. A. Khattak 8 , Saima Naz 1 , Tayyaba Rahat 1 , Nighat Murad 1 , Farah Naz Memon 1 , Sumera Abid 1 , Faiza Bashir 1 , Ibrar Rafique 1 , Muhammad Ayaz Mustafa 1 , Roshan Kumar 1 and Aisha Shafiq 4 1 Health Research Institute, National Institutes of Health, Islamabad, Pakistan 2 Karachi Cancer Registry, Karachi, Pakistan 3 Air University, Islamabad, Pakistan 4 Pakistan Atomic Energy Commission Cancer Registry, Islamabad, Pakistan 5 Armed Forces Institute of Pathology Cancer Registry, Rawalpindi, Pakistan 6 Punjab Cancer Registry, Lahore, Pakistan 7 Nishtar Medical University Hospital Cancer Registry, Multan, Pakistan 8 Shifa International Hospital Islamabad Cancer Registry, Islamabad, Pakistan ABSTRACT Objective: To compile a comprehensive national cancer registry report of Pakistan by merging and analysing cancer registration data received from major functional cancer registries in various parts of Pakistan. Study Design: Observational study. Place and Duration of the Study: Health Research Institute (HRI), National Institutes of Health (NIH), Islamabad, from 2015-2019. Methodology: Data from major cancer registries which included ‘Punjab Cancer Registry (PCR), ‘Karachi Cancer Registry (KCR)’, ‘Pakistan Atomic Energy Commission (PAEC) Cancer Registry’, Armed Forces Institute of Pathology (AFIP) Cancer Registry, Nishtar Medical University Hospital Multan (NMH), and Shifa International Hospital, Islamabad (SIH) registries were pooled, cleared, and analysed at HRI. Results: A total of 269,707 cancer cases were analysed. Gender-wise 46.7% were males and 53.61% were females. As per province-wise distribution, 45.13% of cases were from Punjab, 26.83% from Sindh, 16.46% from Khyber Pakhtunkhwa (KP), and 3.52% from Baluchistan. Both genders combined, ‘breast cancer’ 57633 (21.4%) was the most common cancer. In males, the top-5 cancers in order of frequency/perce- natages were ‘oral’ 14477 (11.6%), ‘liver’ 8398 (6.73%), colorectal 8024 (6.43%), ‘lung’ 7547 (6.05%) and ‘prostate’ 7322 (5.87% cancers). In females, causes of the top-5-cancers included ‘breast’ 56250 (38.8%), ‘ovary’ 8823 (6.09%), ‘oral’ 7195 (4.97%), ‘cervix’ 6043 (4.17%), and ‘colorectal’ 4860 (3.36%) cancers. In children ‘Leukemia’ 1626 (14.50%) and in adolescents ‘Bone’ 880 (14%) were the leading malignancies. Conclusion: Breast cancer is the most common cancer in females touching epidemic proportions while ‘oral cancer’ which is the leading cancer in males ranks third in frequency in females. Like ‘oral cancer’ which shows a strong correlation with chewing, other common cancers in Pakistan including liver cancer, lung cancer, and cervical cancer are also largely preventable as showed a strong correlation with hepatitis B and C, smoking, and high-risk human papillomavirus. Key Words: National Cancer Registry, Health Research Institute - NIH, Islamabad, Pakistan. How to cite this article: Ikram A, Pervez S, Khadim MT, Sohaib M, Uddin H, Badar F, et al. National Cancer Registry of Pakistan: First Comprehensive Report of Cancer Statistics 2015-2019. J Coll Physicians Surg Pak 2023; 33(06):625-632. INTRODUCTION Pakistan presently comprises of four provinces with Punjab being the most populous (53% population), Sindh next (24% Popula- tion), KP (15% population) and Baluchistan (6% population) in addi- tion to Islamabad capital territory, Pakistan administered Kashmir, and Gilgit-Baltistan. Correspondence to: Dr. Nighat Murad, Chief Research Officer, Focal Person, National Cancer Registry, Health Research Institute, National Institute of Health (NIH), Islamabad, Pakistan E-mail: nighat.murad.hri@nih.org.pk, ncr.hri@nih.org.pk ..................................................... Received: April 10, 2023; Revised: May 12, 2023; Accepted: May 17, 2023 DOI: https://doi.org/10.29271/jcpsp.2023.06.625 Pakistan is a low-income developing country with a GDP of US$ 376.49 billion and a per capita income of US$ 1658 (177 th world- wide). The current life expectancy is 67.79 years while 64% are younger than 30 years, with 29% aged between 15-29 years. Approximately 40% of Pakistan is urban with M: F approximately 1.033 i.e., 1033 males per 1000 females. Pakistan’s current GDP allocation on health is 3% about half of the minimum as per the recommendation of WHO. 1 In the developed world, cancer is becoming the leading cause of death as life expectancy has increased and morbidity and mortalityduetoheartdiseaseshasmarkedlyreduced.However, presently, the major burden of cancer is seen in Asia, Africa, and Latin America. Among these, Asia-Pacific or Indo-Pacific regions stand out since it is home for four out of the five most populous countries of the world namely China, India, Indonesia, and Pakistan. Many low-income countries in the Asia-Pacific region