Overview of Cancer Registration Research in the Asian Pacific from 2008-2013

Population based cancer registration provides an essential base for cancer control, providing information not only on incidenc and survival but also facilitating confirmation of effective of interventions, including screening, and both analytical and clinical epidemiology. Hospital-based registries and even pathology-based registries also can make impottant contributions, even in high resource countries like Japan (Higashi et al., 2013). The major international resources for descriptive epdemiology of cancer are provided by the International Agency for Cancer Research (IARC)/WHO through Globocan (Ferlay et al., 2010) and Cancer Incidence in Five Continents (Curado et al., 2007). To provide concrete evidence of the necessity of cancer registries to national cancer control programs, timely publication of results in the international literature, especially when freely accessible, is also of paramount importance (Moore et al., 2013). The present review aims to provide an update of cancer registraion research in the Asian Pacific in the five year period from 2008-2013, concentrating on publications indexed through PubMed/Medline.


Introduction
Population based cancer registration provides an essential base for cancer control, providing information not only on incidenc and survival but also facilitating confirmation of effective of interventions, including screening, and both analytical and clinical epidemiology. Hospital-based registries and even pathology-based registries also can make impottant contributions, even in high resource countries like Japan (Higashi et al., 2013). The major international resources for descriptive epdemiology of cancer are provided by the International Agency for Cancer Research (IARC)/WHO through Globocan (Ferlay et al., 2010) and Cancer Incidence in Five Continents (Curado et al., 2007). To provide concrete evidence of the necessity of cancer registries to national cancer control programs, timely publication of results in the international literature, especially when freely accessible, is also of paramount importance (Moore et al., 2013). The present review aims to provide an update of cancer registraion research in the Asian Pacific in the five year period from 2008-2013, concentrating on publications indexed through PubMed/Medline.

Overview of Cancer Registration Research in the Asian Pacific from 2008-2013 Malcolm A Moore
Central Asia (Moore et al., 2010a), South-West Asia (Salim et al., 2010), South Asia (Moore et al., 2010b), mainland South-East Asia (Moore et al., 2010c), peninsular and island South-East Asia (Moore et al., 2010d), the Pacific Islands (Moore et al., 2010e) and North-East Asia (Long et al., 2010). These papers covered available data for the existence of cancer registies, population based data from CIV IX (Curado et al., 2007) and from papers published in the literature, with pictorial display of the most important cancers. Globocan 2002 data on mortality and incidence were employed for comparison with population-based findings and to generate mortality/incidence ratios (Moore and Sobue, 2010).
As a cooperative effort within Eastern Asia, general information and quality of data of cancer registration at each participating registry and five-year relative survival rates were generated for cancer of the stomach, colorectum, liver, lung, breast and cervix by Tanaka et al. (2009).
In the remainder of this section the focus is on regions and individual countries regarding published data on general registry coverage. Other sections concern individual organ sites and pediatric cases.

Western and Central Asia
In addition to the review of Moore et al. (2010a) (see Figures 1 and 2) an earlier paper was published regarding the status of non-communicable disease research in Central Asia (Moore et al., 2009?). In males lung or stomach cancer were the most common in males in Globocan 2002, along with urinary bladder or oesophageal cancer. In females, breast was unequivocally number one,, with the exception of Tadjikistan, followed by cervical only in those countries of Central Asia with a history of membership of the USSR. Otherwise oesophageal or stomach appear of importance.
Turkey: A nationwide study showed rates/100,000 to be highest for lung (60.3), followed by prostate (22.8), bladder (19.6), stomach (16.3) and colo-rectal (15.4) cancers in males and breast (33.7) followed by colorectal (11.5), stomach (8.8), thyroid (8.8) and lung (7.7) in females (Eser et al., 2010). Most striking findings about cancer incidence in the provinces were the high incidence rates for stomach and esophageal cancers in Erzurum and high stomach cancer incidence rates in Trabzon for both sexes (Eser et al., 2010). In cases younger than 65 years were breast, larynx, digestive system, skin and hematopoietic-reticuloendothelial system whereas the skin, digestive system and the urogenital system were more common in cases older than 65 years (Kilciksiz et al., 2012). Between 2002 and 2005 the average rate of increase for men comes about 9.7%, which is higher than 8.6% for women leading to the widening of incidence gap between man and women (Yilmaz et al., 2011).
Iran: Activities regarding cancer registry and cancer data in Iran since the early seventies were reviewed by Mohageghi and Mosavi-Jarrahi (2010). I The five leading primary sites in males were liver, stomach, lung, esophagus, and colon/rectum; whereas in females Asian Pacific Journal of Cancer Prevention, Vol 14, 2013 4463 DOI:http://dx.doi.org/10.7314/APJCP.2013.14.8.4461 Overview of Cancer Registration Research in the Asian Pacific from 2008-2013 they were liver, cervix, stomach, esophagus and breast . In Isfahan, lung, stomach, breast and prostate all increased over the period 2001-2010 (Moradpour and Fatemi, 2013). This confirmed earlier findings for increase with most frequent cancers being gastrointestinal in men and breast in women (Mokarian et al., 2011). Similarly in Gholestan, stomach, colorectal, and breast cancers increasing while esophageal decreasing (Roshandel et al., 2012). Incidence of cancers in the elderly population increases with age (Akbari et al., 2011).
Regarding regional variation, counties in provinces Ardebil, Mazandaran and Kordestan have higher risk than other counties (Maracy et al., 2012). The incidence of cancer was higher in some regions of Tehran which appeared to be mainly determined by socio-economic position rather than dietary intake (Rasaf et al., 2012;Rohani-Rasaf et al., 2013). Breast, colorectal, prostate and bladder ASR ascended across socioeconomic position groups, while cervical and skin cancers in women indicate an aggregation in lower SEP groups (Rohani- Rasaf et al., 2012). n Fars the 5 most frequent cancers in women were breast (13 per 100,000), stomach (4.4 per 100,000), lung and bronchus (2.9 per 100,000), uterus (2.7 per 100,000), and colon and rectum (2.6 per 100,000); and in men, the 5 most frequent types were stomach (9.2 per 100,000), bladder (6.8 per 100,000), lung and bronchus (6.3 per 100,000), lymphocytic leukemia (4.1 per 100,000), and skin melanoma (3.8 per 100,000) (Masoopour et al., 2011)An association has been reported between spatial distribution of common malignancies and soil lead concentration in Isfahan, Iran (Rashidi et al., 2012) Concerning quality of data, sensitivity rate of all cancer cases was 83.9% and that of Population-based Cancer Registry Center was 52%, 93.1% considering both resources, so that using two resources and the capture-recapture method rather than a single resource may be a more reliable method to estimate the number of cancer cases (Ghojazadeh et al., 2013). The cancer registry program in Fars province (southern Iran) was considered satisfactory in terms of completeness of coverage and information about age, but deficient in recording patient personal details and the error level for cancer encoding was unacceptably high, suggesting the need for enhancing hardware and software resources, education and motivation in all public and private sectors involved in the cancer registry program (Lankarani et al., 2013).
Kazakhstan: Trends in incidence of cancers in under study were different, the most marked reduction in cancer of esophagus is established (T=-6.1%) and revealed the high increase in breast cancer (T=+6.7%). In the dynamics the trend of malignant disease in general tended to decrease (T=-0.5%) (Igissinov et al., 2011a). Esophageal cancer and lung cancer had a tendency to increase with "aging", while in other cases "juvenation" was noted (Igissinov et al., 2011b).
Siberia: Lung cancer, breast cancer, colorectal cancer, non-melanoma skin cancer, and gastric cancer are the most prevalent cancer forms in Kemerovo Region, with no differences in cancer mortality between 2001-2005(Kutikhin et al., 2012.

Arab Countries
Comparison of many countries were made by Salim et al. (2009; and by Al-Hamdan et al. (2009), with lung or urinary bladder, and prostate common in males and breast in females (see Figure 2). The agestandardized incidence of all malignancies per 100,000 in both sexes was found to be highest in Qatar followed by Bahrain, Kuwait, Oman, UAE and Saudi Arabia. Paediatric cancer ranged from 9.5% of total cancers in Saudi Arabia and UAE to 4.0% in Bahrain. In males, the most prevalent cancers vary, with lung, urinary bladder or liver in first place, while for females throughout the region breast cancer is the greatest problem. In both sexes, non-Hodgkins lymphomas and leukemias are relatively frequent, along with thyroid cancer in certain female populations. Adenocarcinomas of the breast, prostate and colorectum appear to be increasing Salim et al., 2009) In all countries, the mean age at diagnosis was higher in males than females; cancer of the lung and prostate were commonest among males, and cancer of breast and thyroid among females. Cancer registries in North Africa (Morocco, Algeria, Tunisia, Libya, Egypt) have recently increased, currently serving 9.7% of the total regional population, with lung, breast, colon, and prostate as common (Zanetti et al., 2010).
Bahrain: Men had a higher ASR for most cancer types, and the most common type of cancer was lung for males (35.2), followed by bladder (14.5) and prostate (14.3), and breast for females (46.8), followed by lung (12.2) and ovary (7.7) (Alsayyad and Hamadeh, 2008).
Egypt: Incidence of all common cancers Gharbiah was higher among men than women and urban incidence was higher than rural incidence for all cancer sites, and especially for prostate and uterus (Dey et al., 2011).
Kuwait: ASR of colorectal cancer among Kuwaiti males increased by about 5 fold over the last 33 years and ranked the 1st most frequent site, 2003-2007, prostate cancer 3 fold and non Hodgkin's lymphoma (NHL) and leukemia 1.5 to 2 fold, while lung cancer incidence declined to similar rates as observed in the early 70s and 80s (Elbasmi et al., 2010). For Kuwaiti females breast cancer had the highest incidence increasing 3 fold and colorectal cancer 4 fold, and NHL and leukemia increased by 2-2.5 fold (Elbasmi et al., 2010).
Oman: Incidence of cancer is lower than in some Gulf countries and many developed countries, stomach cancer, non-Hodgkin lymphoma and leukemia being the three commonest cancers in males and breast, thyroid and cervical cancers in females (Nooyi and Al-Lawati, 2011 Yemen: Among males, leukemia was the first followed by NH lymphoma, Hodgkin's disease, brain and liver. In females, breast was the first, then leukemia, NH lymphoma, thyroid and brain cancer, with age group dependence in both genders (Basaleem et al., 2010).

South Asia
Comparison of countries within South Asia were made by Moore et al. (2010c), oral and lung cancer generally being most common in males and breast followed by cervival in females, except in Pakistan where oral is again very prevalent (Figure 3).
India: During the year 2001, nearly 0.80 million new cancer cases were estimated in the country and since this can be expected to increase to 1.22 million by 2016 as a result of change in size and composition of population, existing treatment facilities for cancer control in-terms of radiotherapy and financial allocation are woefully inadequate . Time trend analysis suggested a significant decreasing trend in the case of cervix in Bangalore and Delhi registries, while the registries of Bhopal, Chennai and Mumbai did not show any significant changes. However, in the case of breast cancer, a significant increasing trend was observed in Bhopal, Chennai and Delhi registries with Bangalore and Mumbai registries demonstrating no such significant changes (Takiar and Srivastav, 2008) Overall, the incidence the total number of new cases in males will increase from 0.589 million in 2011 to 0.934 million by the year 2026. The leading sites of cancers in males are lung, oesophagus, larynx, mouth, tongue and in females breast and cervix uteri (D'Souza et al., 2013a). The results revealed that an estimated 0.44 million died due to cancer during the year 2011, while 0.51 million and 0.60 million persons are likely to die from cancer in 2016 and 2021 Among women, cancer of the breast, cervical and ovary account for 34 percent of all cancer deaths. The leading sites of cancer mortality in males are lung, oesophagus, prostrate and stomach. (D'Souza et al., 2013b). There are numerous difficulties in the conduct of a population-based survival study in the context of developing countries, including India. Loss to follow-up is a typical problem encountered, causing biased estimates. In view of this difficulty with the classical approach, the objective of this study was to propose an indirect methodology for the study of survival. The proposed methodology is based on life table techniques and uses current data on incidence and mortality from the disease (Dhar et al., 2009). A prospective cohort study of cancer may be feasible in some centers in India with active follow-up to supplement registry data, with inclusion of cancers diagnosed at private institutions, unique identifiers for individuals, and computerized medical information to improve cancer registries (Mathew et al., 2011). Based on the pooled figures and the relative changes, the emerging new cancers are prostate (140%), liver (112%) and mouth (95%) (Takiar and Vijay, 2011), breast cancer contributed to the maximum % change (38%), followed by ovarian (8.0%), the emerging new cancers were corpus uteri (187%), gallbladder (162.1%) and lung cancer (136.1%) (Takiar and Vijay, 2010). Under the conditions that prevail in India, active follow-up of cancer patients yields the most reliable estimates of cancer survival rates, otherwise overestimate (Swaminathan et al., 2008).
In the Allahabad region of North India, oral and oropharyngeal malignancies are the commonest malignancies in men, while in females carcinoma of cervix and breast are the most frequent (Mehrotra et al., 2008) Barshi rural (Jayant et al., 2010). In Sikkim, the overall AARs were 89.4 and 99.4 per 100,000 person-years in males and females, respectively, with incidence rates highest amongst the Bhutia group (Verma et al., 2012). In urban Delhi lung (ASR: 13.8 per 100,000) followed by oral cavity (ASR: 11.4), prostate (ASR: 9.0) and larynx (ASR: 7.9). In females, breast (ASR: 30.2 per 100,000) was the most common site of cancer, followed by cervix uteri (ASR: 17.5), ovary (ASR: 8.5) and gallbladder Manoharan et al., 2009). In rural Delhi, oral cavity (ASR: 8.0 per 100000) followed by lung (ASR: 6.5), larynx (ASR: 4.0) and bladder (ASR: 4.1). In females cervix uteri (ASR: 10.3 per 100,000) was the most common site of cancer followed by breast (ASR: 7.8), gallbladder (ASR: 3.5) and ovary (ASR: 3.3) (Manoharan et al., 2010). About 26.6% increase is expected in the registered number of cancer cases in five cities and 52.7% increase is projected for Delhi which would mean highest number of cases (Marimuthu, 2008). In Chennai, the incidence of cervical cancer is projected to drop by 46% and oesophageal cancer by 21% decline in 2015, while a 100% increase in future thyroid cancer incidence 42% increase in prostate cancer is predicted . Barshi Rural Cancer Registry prevalence of smoking compared to Mumbai was low (9.9% vs 23.6%) and the incidence of smoking dependent cancers viz., cancers of oropharynx, larynx and lung were significantly low (P< 0.05). However, although the proportion of tobacco chewers is higher in Barshi compared to Mumbai, the incidence rates for cancer of hypopharynx and oral cancer which are predominantly chewing dependent did not show higher rate than in Mumbai (Thorat et al., 2009). Dindigul Ambilikkai Cancer Registry (DACR) covering rural population of 2 million, common cancers among men were stomach (5.6), mouth (4.2) and esophagus (3.7). Cervical cancer (22.1) was ranked at the top among women followed by breast (10.9) and ovary (3.3) lesser by at least two folds and 5-year survival were on par or lower than Chennai for most cancers .
Nepal: Overall the most common site in males was the lung, followed by the oral cavity and stomach, while the first three in females were cervix uteri, breast and lung. Shifts in the the main cancers were noted with different ages, with leukemias and lymphomas in young individuals replaced by lung, oral and stomach in middle age and lung, stomach and larynx in the oldest category of males. In females the shift was to breast in young women, then cervix in middle age followed by lung in the very aged Pradhananga et al., 2009) Pakistan: Karachi, in males the five most frequent malignancies were head and neck (32.6%), lung (15%), gastrointestinal tract (GIT) (6.9%), lymphoma (6.1%), and bone and soft tissue (4.9%). In females breast cancer was the most common cancer accounting for 38.2% followed by head and neck (15.1%), cervical (5.5%), ovarian (4.9%) and GIT cancer (4.9%) respectively (Hanif et al., 2009).In Multan, the common tumours in males, were leukaemia, prostate cancer, urinary bladder cancer, skin cancer and lymphomas and in females they were leukaemia, breast cancer, skin cancer, gallbladder cancer and lymphomas (Atique et al., 2008). In Dir (North West Frontier) the leading cancers were lymph/blood, and cancers of the digestive system, skin and breast (Zeb et al., 2008).

South-East Asia
In two overviews, Moore et al. (2010c;2010d) evidence was summarized for cancer epidemiology, lung and liver being most common in males and cervical an breast, along with liver, in females of the mainland countries ( Figure 4). In peninsular and island SE Asia, lung and stomach or coloorectal and prostate were the most common in males and breast with cervix, lung or colorectal in females ( Figure 5).
Indonesia: Data from the population-based cancer registry in Jakarta Province showed the leading cancers among females in 2005-2007 to be breast cancer, cervical cancer, ovarian cancer, colorectal cancer and among males are bronchus and lung cancer, colorectal cancer, liver cancer, pharyngeal cancer, and prostate cancer. The leading childhood cancers are leukaemia and retinoblastoma (Wahidin et al., 2012).
Philippines: From 1980-2002 overall incidence increased in both sexes. Among males, lung cancer was the leading cancer and reached a peak in 1988-92. Colorectal and prostate cancers showed rising trends and became more common than liver cancer, with stable incidence over time. Stomach cancer incidence fell steeply. Among females, there was a steady increase in incidence of breast cancer  increasing trends were found for breast, 5% annual change, lung (0.5%) and colorectal (1.5%) cancers. Decreasing trends were found for cancers of the liver (-1.2%) and cervix (-1.9%). Among males, increasing trends were found for lung cancer (0.5%), whereas liver cancer rates have been decreasing (-1.0%) Medina et al., 2010).
Singapore: Increased incidence is most marked in colorectal, breast and prostate cancers, mirroring the most common cancers seen in other developed countries. The eradication of infectious disease such as hepatitis B, through the implementation of the hepatitis B immunization programme in 1985, has led to the decline in liver cancer (Lim et al., 2012;Teo and Soo, 2013) Similar to western societies, the incidence of proximal gastric cancer is increasing (Deans et al., 2011). In the 10-year period, 52.9% of patients with cancer had died in the hospital, 30.3% died at home and 10.7% in in-patient hospice .
Thailand: In Chiang Mai, the most common cancers by relative frequency are cancers of the lung, cervix, liver, breast, and non-Hodgkin's lymphoma (Kamnerdsupaphon et al., 2008) The distribution of patients were (a) 32% from Chiang Mai, (b) 42% from nearby provinces of Lampoon, Phayao, and Chiang Rai, (c) 20.4% from other northern provinces, and (d) 1.2% from other parts of the country.

Australasia
Moore et al. population in Fiji, the data are atypical. In females, they were breast and lung and otherwise cervix.
Australian Aborigines: Estimates of cancer incidence, mortality and survival in aboriginal people from NSW, Australia, Mean annual cancer incidence in NSW Aboriginal people was estimated to be 660 per 100,000 and 462 per 100,000, 9% and 6% higher than all NSW males and females respectively, mortality being 68% and 73% higher (Morrell et al., 2012).
Easter Island: Most cases of cervical cancer occurred in women of Rapa Nui ethnicity, while most skin cancers were found in non-Rapa Nui people (Rius et al., 2013) Guam: Chamorros (the indigenous people of the Mariana Islands) on Guam had a slightly lower total cancer incidence rate than the total U.S. population (406.8/100,000 vs. 478.6 U.S.) but high age-adjusted incidence rates for cancers of the mouth and pharynx (24.4 vs. U.S. 10.7), nasopharynx (13.9 vs. 0.6 U.S.), liver (13.2 vs. 5.2 U.S.), and cervix (Haddock et al., 2013) New Zealand: Undercounting of Māori, Pacific and Asian events on cancer registration data, relative to census data, throughout 1981-2004 (Shaw et al., 2009). Stage completeness differs widely by cancer site, partly explained by patient, service and/or cancer related factors (Gurney et al., 2013). Colorectal and lung cancers were more likely to be fatal for people living in deprived areas, while breast and prostate cancers had adverse survival chances if they lived distant from a cancer centre (Haynes et al., 2008). Significant increases in past cancer risk associated with increasing soil arsenic in socioeconomically disadvantaged areas and demonstrate the robustness of the geospatial approach (Pearce et al., 2012).

North-East Asia
In one overview, Lone et al. (2010) summarized epidemiological data for China, Mongolia, Korea and Japan, lung and stomach cancers being most common in males overall, together with liver, while prostate and colorectal predominated in Chinese and Japanese in Hawaii. In females, breast and lung were one and two in China but breast and stomach elsewhere, except again in Hawaii where number two was colorectal (Figure 7).
China: Data from 104 registries covering 85,470,522 people (57,489,009 in urban areas and 27,981,513 in rural areas) showed lung, gastric, colorectal, liver, esophageal and pancreatic cancers, with encephalomas and lymphomas to be the order of frequency in males, and breast and cervical cancer in females . Main cancers in rural areas were cancers of the stomach, followed by esophageal cancer, lung cancer, liver cancer and colorectal cancer, whereas the main cancer in urban areas was lung cancer, followed by liver cancer, gastric cancer and colorectal cancer 2013a;2013b). China registration facing some problems and challenges, such as no stable groups of registrars, shortage of training opportunities, poor data quality, insufficient utilization and lack of multidisciplinary mechanisms, so that the cancer registration system still needs to be enhanced and improved . In the 20 year-period 1989-2008, incidence of gastric cancer, liver cancer and esophageal cancer still keep gradually increasing, while lung cancer, female breast cancer, colorectal cancer and cervical cancer are markedly going up . Cancer registration data are representative at the country level and for urban areas, they may not reflect real cancer burden in rural areas, particularly with some cancer types (Li and Chen, 2009  lowest and female breast cancer the highest. 5-year relative survival rates for major cancer sites ranged from 18% to 85%, with liver cancer showing the lowest and again female breast cancer the highest. Female cancer patients had higher relative survival than males across the 5-year follow up period, with a sex difference of nearly 15% (Lei et al., 2010). Cancer incidence among adolescents and young adults in urban Shanghai, 1973Shanghai, -2005 in males whereas they increased in females .
Korea: The incidence rate of all cancers found using claims data was 363.1 per 100,000 people, which is very similar to the 361.9 per 100,000 rate of the national cancer registry (Seo et al., 2012). On a national level, linking registry data with clinical, drug safety, financial, or drug utilization databases allows analyses of associations between utilization and outcomes (Soon et al., 2013  all combined sources and were not statistically different between the two radiation exposed non-exposed groups (Song et al., 2012). The 10-year RSRs for all cancers combined improved from 29.5% and 50.5% during 1993-1998 to 39.2% and 58.9% during 1999-2007 in Korean men and women, respectively (Lee et al., 2010) The incidence rate for all cancer combined showed an annual increase of 2.8% from 1999 to 2007 . Database of Seoul regional cancer registry has a key role for the method to estimate the valid nationwide cancer statistics in Korea with using the population-based cancer registries' databases (Anonymous, 2009). Compared with the ASRs in 1993, the ASRs in 2002 increased for colorectum (58.4% for men, 27.1% for women), prostate (81.5%), breast (58.3% for women), thyroid (141% for women), and bronchus/lung (15.4% for women). The ASRs for stomach (-18.7% for men, -20.7% for women) and uterine cervix cancer (-39.7%) had decreased (Shin et al., 2008).
Mongolia: The most common cancers are those with a primary site of liver, stomach and esophagus, for which cases fatality rates are high in all populations .

Japan: The Center for Cancer Control and Information
Services at the National Cancer Center supports the management of the hospital-based cancer registry by providing training for tumor registrars and by developing and maintaining the standard software and continuing communication, which includes mailing lists, a customizable web site and site visits. Data from the cancer care hospitals are submitted annually to the Center, compiled, and distributed as the National Cancer Statistics Report (Higashi et al., 2013).
General, age-period cohort model data were published by Utada et al. (2010). Cohort effects influenced by longterm risk factors were prominently observed for every site, decrease in stomach and liver cancer cases being related to reduction in risk factor prevalence (Ito et al., 2011). Survival for uterine cancer, prostate cancer, testis cancer, lymphoma and leukemia was much lower in Japan than in other countries, but for cancers of the esophagus, stomach, colon, liver and gallbladder were better (Matsuda et al., 2011).
In Fukui, while incidence and mortality of stomach cancer significantly decreased in both sexes those for breast and prostate cancers were significantly increased, along with mortality for liver and lung cancers in both sexes (Hattori et al., 2010).

Breast
In Egypt, incidence rate of breast cancer was three to four times higher in urban areas than in rural areas (60.9/10(5)-year for urban areas versus 17.8/10(5)-year for rural areas; IRR=3.73, 95% CI=3.30, 4.22) with highest rates seen in more developed districts of Tanta and El-Mehalla (Dey et al., 2010a). Urban ER+ incidence rate (per 100,000 women) was 2-4 times (IRR = 3.36, 95% CI = 4.84, 2.34) higher than rural incidence rate. (Dey et al., 2010b). In Saudi Arabia, the annual percentage incidence of malignant breast cancer steadily increased by 4.8%, from an annual rate of 23.5% in 2000 to 47.2% in 2007 (Al- Rikabi and Husain, 2012). Saudi Arabia national registry, relative survival rates at one, three and five years were 96%, 83% and 65%, respectively (Hamdan et al., 2011). In Aden, early breast cancer (stages I-II) occurred in 47%, and late breast cancer (stages III-IV) in 51.5%, with invasive ductal carcinoma was the commonest pathology (89.3%) Harhra and Basaleem, 2012) Between the years 2004 and 2010, breast cancer represented 22% of all cancers registered in women in Sanaa, with 71% aged 50 or younger at the time of diagnosis (El-Zaemey et al., 2012). Despite Omani breast cancer patients continuing to present with advanced breast cancer, survival rates have significantly improved (Kumar et al., 2011). In the Lebanon registry, the age-standardized incidence rate per 100,000 was estimated at 71.0. for 2004 (Lakkis et al., 2010). In Jordan, registry of 838 women included, half were diagnosed between the ages 40 and 59 years, the overall Kaplan-Meier 5-year survival rate being 59.3% (Arkoob et al., 2010).
In Kazakhstan, increasing trends over time in almost all areas, a direct strong correlation between the degree of contamination with high pollution emissions in the atmosphere from stationary sources and the incidence of breast cancer being found (Bilyalova et al., 2012).
In Iran, the standardized mortality ratios for breast cancer patients at 5, 10 and 15 year intervals after diagnosis were 6.74 (95% CI, 5.5-8.2), 6.55 (95%CI, 5-8.1) and 1.26 (Haghighat et al., 2012). Totally, Iran 28.2%of the patients were younger than 40 years old and 36.8% had the included criteria for familial breast cancer (Sabokdar et al., 2012). Both the frailty and Cox proportional hazard model emphasize that early detection improves survival in Iran (Faradmal et al., 2013). survival rate of male breast cancer inn Iran is relatively lower than that in western countries . Online registry of breast cancer is country's requirement because this system not only delivers services for laboratories, pharmacies and all physicians for their patients' follow up and monitoring, but also provides ability to access and analyze collected data for managers and experts Iran (Zare et al., 2012). Ardabil largest proportion being grade II (30.6%), but very many belonged to grades III and IV (40.5%) slight increase over the period studied (Fouladi et al., 2012). Using life table analysis, the overall relative 5-year survival rate was found to be 51% (Fouladi et al., 2011) In the 5-year period 1996-2000, here were 2421 cases recorded in the 5 registries, with an age-standardized incidence rate (ASR) of 16.2 per 100,000 person-years (Sadjadi et al., 2009). The ASR of breast cancer was significantly lower in females from Turkmen ethnicity and those from rural areas (Taheri et al., 2012) In Pakistan, less than 1% were at Stage 0 and 10%, 32%, 35% and 23% were at Stage I, II, III and IV respectively (Khokher et al., 2002). Rawapindi, most frequent age group was 26-30 years (78.6%), the most common histological tumour type was invasive ductal carcinoma (88.7%), grade 2 (57.1%), followed by grade 3 (29.8%) being the most frequent (Mamoon et al., 2009) With more and more women in rural India becoming educated, one could foresee breast cancer becoming more frequent even in rural areas of India in future . In Chittaranjan total number of female breast cancer cases steadily increasing from 1997 to 2001 and only slightly lower from 2002 to 2004, the majority in the 40-49 year old age group, but percentage mortality gradually decreased from 25.7% in 1997 to 16.8% in 2004 ( Datta et al., 2012). The incidence of breast cancer has increased in Mumbai during last two to three decades, especially among older women (Dikshit et al., 2012).
In South East Asia, Malay ethnicity is independently associated with poorer survival after breast cancer (Bhoo- Pathy et al., 2012). Malaysia and Singapore, 72% percent of the women were Chinese followed by Malays (16%), Indians (8%), and other races (4%) (Pathy et al., 2011) The overall 5-year survival was 59.1%, stage, nodal status and grade of tumour to be independent prognostic factors, whereas ethnicity, age and ER status were not (Mohd Taib et al., 2008). The age-adjusted 5-year relative survival, using period analysis, of Metro Manila residents, Filipino-Americans and Caucasians were 58.6%, 89.6% and 88.3% respectively (Laudico et al., 2009). In Thailand, the disease incidence under age 40 years was relatively low (4.13/105) while the incidence in the age groups 40 and older was very high (39.2/105) (Kotepui and Chupeerach, 2013).
Breast cancer incidence in Mongolia (age standardized 8.0/100,000) is almost a third of rates in China (21.6/100,000), and over five times that of Japan (42.7/100,000) and Russia (43.2/100,000). Rates within Mongolia appear to have increased slightly over the last decade and are higher in urban than rural areas (annual percentage increase of age-standardized rates from 1998 to 2005 was 3.60 and 2.57 %, respectively). The increase in breast cancer incidence with age plateaus at menopause, as in other Asian populations .
The breast cancer incidence has been increasing annually both in urban and rural areas in China from 36.17/100 000 (3920/10 838 355) and 10.39/100 000 (436/4 197 806) in 1998 to 51.24/100 000 (11 302/22 057 787) and 19.61/100 000 (1475/7 522 690) in 2007 . First comprehensive population-based breast cancer epidemiology study in Southern China using the Hong Kong Cancer Registry database (Kwong et al., 2011). After 1990, breast cancer mortality tended to decrease slightly in Hong Kong and Singapore except for women aged 70+. In Taiwan and Japan, in contrast, breast cancer death rates increased throughout the entire study period. Before the 1990s, breast cancer death rates were almost the same in Taiwan and Japan; thereafter, up to 1996, they rose more steeply in Taiwan and then they began rising more rapidly in Japan than in Taiwan after 1996. The most rapid increases in breast cancer mortality, and for all age groups, were in Korea . National Summary of Hospital Cancer Registry 2007 Japan Japanese classification of breast cancer has spoiled the accuracy of pTNM (Teramoto and Tanimizu, 2011). Accurate outcome of an evaluation of breast cancer screening must include the use of a population-based cancer registry for detecting false-negative cases (Suzuki et al., 2008).
Ethnic disparities in breast cancer survival in New Zealand can be attributed to deprivation and differential access to health care rather than differences in breast cancer subtypes (McKenzie et al., 2011). Māori and Pacific women, and those from lower socioeconomic areas, are more likely to present with advanced uterine cancer (Firestone et al., 2012). No straightforward explanation for the relatively high incidence breast amongst Māori is apparent (Cunningham et al., 2010).

Ovarian
Age-standardized ovarian cancer rate in Iran was much lower in comparison with high incidence areas in the world (Arab et al., 2010a). Epithelial tumors displayed the highest age specific incidence rate, followed by germ cell tumors. Serous epithelial tumors were the most common in the epithelial group (Arab et al., 2010b) In Niigata Gynecological Cancer Registry, the ASRs of clear cell, mucinous, and endometrioid adenocarcinomas in the 50+ age group were significantly increased, especially the clear cell adenocarcinoma, approximately threefold from 1. 2 (1983-1989) to 3.5 (2000-2007) per 100,000 females (Yahata et al., 2012). In Australia, the relative risk (95% confidence limit) of ovarian-cancer death reduced to 0.51 (0.46, 0.57) for 1999compared with 1980-1983(Tracey et al., 2009.

Uterine Corpus
Uterine cancer showed the highest urban-rural incidence rate ratio (IRR = 6.07, 95% CI = 4.17, 8.85) . Increase over time in the number of patients with endometrioid uterine adenocarcinomas was noted in Taiwan (Huang et al., 2012) with increasing trends for corpus uterus cancer incidence rates during 2003 -2007 in 32 selected cancer registry areas of China . After breast cancer multivariate analysis revealed that the incidence rate ratio of corpus uteri cancer associated with hormone therapy was 2.53 (Kamigaki and Kawakami 2011).

Thyroid
In Saudi Arabia, thyroid cancer incidence rates have increased exponentially between 2000 and 2010 with significant geographical variation, now the second most common cancer among young Saudi women with a male to female ratio at 0.3:1 (Hussain et al., 2013). Size of young population and social determinants may be important effective elements for differences in survival, which should be taken more into consideration in managing chronic disease such as thyroid cancer (Khayamzadeh et al., 2011) In China both incidence and mortality of thyroid cancer are higher in females than in males, 3.38 and 1.75 times higher in urban than rural areas, the incidence showing annually increase of 14.5% while the mortality increased by 1.42% (Liu et al., 2012). Thyroid cancer has been the leading cancer in women in South Korea since 2003 and is now the fifth most common cancer in men in Gwangju and Jeonnam, (Kweon et al., 2013).

Cervical
Basically high incidence rates were identified in the eastern, central and northern parts of the country and in Almaty . In Pakistan, Karachi a cause of concern is the steadily increasing incidence especially in the younger birth cohorts, the advanced disease at presentation (Bhurgri et al., 2008a). The total ASR in uterine cervical cancer decreased from 25.7 in 1997 to 13.4 in 2008, but the incidence of CIS increased from 7.6 to 15.8 in same period (Boo et al., 2011). In Japan, ther is a significant trend in increasing incidence of invasive cervical cancer for those < 40 years of age (from 4.7 to 13.1), whereas a significant trend of decreasing incidence for the 50+ year age group (Banzai et al., 2011).. Advanced stage at diagnosis was the main determinant of poor survival among the aged cervical cancer patients in Osaka . Second cancers was significantly greater than the general population in cervical cancer patients in Taiwan esophagus, stomach, small intestine, rectum, lung, bone, non-melanoma skin, uterine corpus, vagina/vulva, bladder, kidney, and leukemia .

Hepatocellular Carcinoma
The burden of hepatocellular carcinoma (HCC) has been increasing in Egypt with a doubling in the incidence rate in the past 10 years, attributable to several biological (e.g. hepatitis B and C virus infection) and environmental factors (e.g. aflatoxin, AF) (Anwar et al., 2008) The analysis revealed a higher incidence in males than in females, significant geographic variations among districts, and a higher incidence in Gharbiah than that reported by SEER (Lehman et al., 2008). The iincidence of HCC is not very high in Iran; however, the higher incidence in Kerman and also the lower age of onset mandates further research (Moghaddam et al., 2010).
In Thailand, during 1990Thailand, during -2009, the trends in HCC incidences have been decreasing significantly with the annual percent change of 6.2% per year in males and by 6.5% per year in females (Wiangnon et al., 2012). According to data from the 184 cancer registries through GLOBOCAN 2008, liver cancer incidence in China was ranked the 5th in males, and 6th in females while mortality was ranked 2nd and 5th . During the past 18 years, the overall incidence rate decreased gradually in 11 covered areas in China (Gao et al., 2013). The age-specific incidence and mortality were relatively low among age groups under 30 years but dramatically higher in those aged 80-84 years . The liver cancer mortality in young people in Qidong demonstrates a continuously falling trend . The incidence of HCC in Osaka started to decrease by 2000, mainly because of decreased HCV-related HCC (Tanaka et al., 2008).
Despite declines in the age-adjusted incidence rates of HCC over time, the absolute number of cases increased likely due to the ageing cohort and an increasing prevalence of both hepatitis B and C in Australia (Thein et al., 2011). Hepatitis C was the form of viral hepatitis most common among liver cancer cases on Guam (Haddock et al., 2013).

Cholangiocellular Carcinoma
Age-adjusted incidence rates of intrahepatic cholangiocarcinoma varied by more than 60-fold by region. The highest rates were found in Khon Kaen, Thailand, where 90% of liver tumors were cholangiocarcinomas. The next highest rates were found in the People's Republic of China, followed by the Republic of Korea . The most common type is HCC and the annual incidence of PLC is increasing in Brunei Darussalam, rates being higher in males and Chinese (Chong et al., 2013). For cholangiocellular carcinomas 10 to 12 years there is a rather stable rate in Khon Kaen, Thailand, but the recent decline in incidence may represent a real fall in risk .

Pancreatic Cancer
Over the past decade, incidence of pancreas malignancies has risen steadily in Yazd, Iran (Zahir et al., 2013). In China, there is an increasing trend of pancreatic cancer incidence which was more significant in the rural areas than the slowly increasing trend in the urban areas .

Upper Aero-Alimentary Tract
Oral Cancer There is a need for future analytical studies investigating specific risk factors of heads and neck in Egypt (Attar et al., 2010). Comparing the two time intervals (1991)(1992)(1993)(1994)(1995)(1996)(1997)(1998)(1999)(2000) and (2001)(2002)(2003)(2004)(2005)(2006)(2007)(2008)(2009)(2010) showed that the ratio of carcinomas and salivary gland tumors had decreased while there was an increase in incidence of sarcomas and lymphomas in Isfahan (Razavi et al., 2012). In Sri Lanka, reversal of betel quid use and smoking must be considered in accounting for declining trends for oral cancer, while increasing rates for oropharyngeal cancer point to other risk factors (Ariyawardana and Warnakulasuriya, 2011). Oral and pharyngeal cancers in Khon Kaen, Thailand, 62.6% were female and 37.4% were male, Eighty five percent of all cases were diagnosed in advanced stage (stage III and IV) Vatanasapt et al., 2011). The incidence and mortality of oral and pharyngeal cancer were low in China from 2003 to 2007 (Hu et al., 2013). In Korea, HPV-related sites (oropharynx) had increased significantly over the period 1999 to 2009 (APC = 2.35%, P = 0.017), particularly in young men (30-59 years, APC = 2.65%, P = 0.031), whereas HPV-unrelated sites such as larynx and hypopharynx decreased markedly in both sexes. Interestingly, tongue cancer was found to have increased gradually (APC = 2.35%, P = 0.003) in both sexes

Nasopharyngeal Cancer
Our results indicate that the survival of NPC patients in Sihui has significantly increased in recent years and this increase is not influenced by patient's sex, age, histologic type, and clinical stage  squamous cell carcinoma (SCC) and adenocarcinoma (AD) incident proportions during 1990-2007 remained relatively stable. Moreover, SCC was the major pathological type, accounting for 70.6 percent of all new cases, while AD were relatively few and accounted for only 2.66 percent throughout the period (Wei and Liang, 2012). markedly decreasing trends of NPC ASIR and ASMR in Hong Kong over the past three decades, results do not support the notion that changes in salted fish consumption had played an important role (Lau et al., 2013). Incidence rates of NPC remained stable during 1993-2007 in Wuhan, a low-risk region in China (Xie et al., 2012). population (ASMW) were 1.04/100,000 and 1.35/100,000, respectively. The incidence and mortality of NPC were higher in males than in females and higher in urban areas than in rural areas. Both age-specific incidence and mortality were relatively low in persons younger than 30 years old, but these rates dramatically increased. Incidence peaked in the 60-64 age group and mortality peaked in the over 85 age group (Xu et al., 2013). Average annual incidence of NPC among Bruneian Chinese males (4.1 per 100,000 persons) DOI:http://dx.doi.org/10.7314/APJCP.2013.14.8.4461 Overview of Cancer Registration Research in the Asian Pacific from 2008-2013 was significantly lower than that for Chinese males from Singapore (15.9) and Peninsular Malaysia (19.6) (Hsien et al., 2009)

Oesophageal
The results demonstrate that the counties in provinces Ardebil, Mazandaran and Kordestan have higher risk than other counties (Asmarian et al., 2013). There is evidence of systematic clustering for esophageal and gastric cancer, lower rates being observed in urban areas, and also in areas of high income (Mohebbi et al., 2011). The prevalence of adenocarcinoma showed an increase to 18.4%. Guilan province may be considered a relatively low incidence region for EC (Mansour-Ghanaei et al., 2012). A significant increasing trend in the incidence rate of adenocarcinoma in Gholestan (Ghasemi-Kebria et al., 2013). EC median survival time reached about 9 months and estimated survival rates in 1, 3, and 5 years following diagnosis were 23%, 15% and 13% (Rasouli et al., 2011). Environmental factors probably are influential in determining the incidence of esophageal cancer in Ardabil (Ahari et al., 2013). In India, whereas oesophageal adenocarcinomas increased sharply in both sex, among men, oesophageal squamous cell cancer rates increased steadily from the mid-1982s onwards a bit decline was observed from 1997, the same trend observed in females (Gopala Krishnappa et al., 2013). Apparent general decrease in the number of EC patients in Kazakhstan (Igissinov et al., 2012a ) with regional variation, tendency for increase in Karaganda (Igissinov et al., 2012b). Burden of esophageal cancer remains high in China, especially for males in rural areas (Chen et al., 2013b). However, over 20 years from 1989 to 2008, esophageal cancer age standardized incidence rate in cancer registration areas decreased with time (Zhao et al., 2012). Mortality decreased over the six years in both genders, although it remained high in the Yanting area (Song et al., 2012). In Japan, estimated average annual percentage change for adenocarcinomas was 4.7% (95% confidence interval: 0.7, 8.9) in men and 6. 0% (2.4, 9.8) in women Japan SCC slight increase (Shibata et al., 2008). Oesophageal adenocarcinoma is increasing in NSW, possible contributing factors include increasing obesity (Stavrou et al., 2009).

Gastric Cancer
The age-adjusted incidence varied by region within Oman, the incidence rates being higher than in most other gulf countries between 1998(Al-Mahrouqi et al., 2011. Incidence rates of gastric cancer in Iran and its six geographical areas during 2000-2005 were increasing from 2.8 in 2000 to 9.1 per 100,000 persons per year in 2005, rising from 4.1 to 13.2 in men (Haldari et al., 2012. Ardabil has the highest rate in Iran and one the highest rates of gastric cardia cancer in the world, with no evidence of decline in incidence since 2000 (Babaei et al., 2010). There is wide geographical variation and high mortality rate of stomach cancer in Iran, 6 fold between north and south (Zendehdel et al., 2012). Survival rate in 15 years following diagnosis was nearly 6% (Fathollahi et al., 2011). Patients with survival of 0.5, 1.5, 2.5, 3.5 and 4.5 years from the time of diagnosis were 46%, 26%, 19%, 15% and 13% respectively (Mehrabian et al., 2010). In Iranians with a high rate of H. pylori infection, age over 50 years, smoking, family history, intestinal metaplasia significant independent risk factors for mortality (Boreiri et al., 2013).
Gastric cancers in Karachi fall into the prototype of a low risk developing country pattern, incidence increasing most marked in males above 40 years of age (Bhurgri et al., 2009b). Sikkim stomach cancers with AARs being 12.6 and 4.7 times higher in the Bhutia group compared with other ethnic groups in males and females, respectively (Verma et al., 2012) The Malaysian National Cancer Registry (NCR) report for the period 2003-2005 showed an incidence of stomach cancer of 2.2 for Malay, 11.3 for Chinese and 11.9 for Indian males per 100,000 population, Malay (1.3), Chinese (7.2) and Indian (7.2) women having rates lower than men (Lim, 2009). Stomach cancer mortality in males in the region of North East in the North Viet Nam (2005-06) was higher than that in Japan (2002) (31.3 versus 28.7 per 100,000) (Ngoan et al., 2008.) 'Cure' fraction from stomach cancer dramatically increased in Osaka, Japan since 1975, partly because of earlier stage at diagnosis, but mostly due to improvement in treatment (Ito et al., 2012). Five-year relative survival for stomach cancer was 60%. Conditional five-year relative survival was 77% one year after diagnosis and 97% five years after diagnosis (Ito et al., 2013).

Colorectal Cancer
Age-specific incidence ratios of colorectal cancer in older people are increasing (Tas and Keskin, 2012a). An increased trend in the incidence of CRC in Jeddah between 2000 and 2006 mirrors the recent trend in Saudi Arabia, 25% presenting with distant metastasis and adenocarcinomas accounting for 72% of cases (Mosli and Al-Ahwal, 2012). The five-year OS for 1994-2004 was 44.6% for patients with CRC, rates by stage being generally lower than the typically reported survival rates (Al-Ahwal et al., 2013). Yemen has seen an increased incidence of colorectal carcinoma, with >70 % of cases in stages III and IV (Hamid et al., 2012). In the Gharbia Registry, colorectal cancer more common in urban (55%) than rural (45%) areas, with a slightly higher incidence than the United States in subjects under age 40 years (Veruttipong et al., 2912).
Colorectal cancer has an increasing trend in the west of Iran (Abdifard et al., 2013). Iran overall ASR in the four years period was 38.0 per 100,000 and was higher for men compared women (Safaee et al., 2012). Colorectal cancer occurs at a younger age among people living in Golestan province, with a high proportion of patients presenting with late stage (Aryaie et al., 2013). In Kerman, the trend in females is increase by 15% and in males by 7% by year 2016 (Roya and Abbas, 2013). A shift to advanced cancer has also been reported in Iran (Ghabeljoo et al., 2011) Among Nepalese young adult cases account for a high incidence (28%) and although right sided colonic cancer has been increasing, the rectum is the commonest site (Kansakar and Singh, 2012). In Pakistan the current low but increasing incidence (especially in men), the younger age and advanced stage of CRC at diagnosis reflects a low risk, unscreened population, but the low CRC incidence may be partly an artifact . In Kelantan, Malaysia, a high proportion of metabolic diseases; hypertension and diabetes type 2 are linked with colorectal carcinomas (Othman and Zin, 2008).
In China, the incidence and mortality of colorectal cancer during 1988-2002 increased by 38.6% and 15.3%, respectively, rates in urban areas being higher than in rural areas, and in males than in females (Lei et al., 2009). the incidence of total CRCs is male dominant, the actual gender difference in CRC incidence in Taiwan is limited to the left side of the colon. . Metachronous colorectal cancer in Taiwan: analyzing 20 years of data from Taiwan Cancer Registry Taiwan co overall and cancer-specific survivals were significantly higher in women than in men (Chou et al., 2013). In Korea the rapid increase in colorectal cancer incidence is mainly attributed to the increase in colon cancer, especially distal, and may be explained by a transition of risk factors for subsites or by the effect of colorectal cancer screening (Shin et al., 2012). In Japan, right colon cancer among men and women recently levelled off, while the rates of left colon and rectal cancers showed a declining trend (Toyoda et al., 2009).
The database will initially recruit all colorectal cancer cases from eight hospitals. The data will be stored on a customized web-based case report form. (Wendy and Radzi, 2008). In New Zealand a left-to right-sided shift in colon cancer limited to women over the age of 65has been noted, with a rapid increase in Māori incidence rates (Shah et al., 2012). Data on colon could be improved by improving the quality of information on stage and subsite provided to the registry (Cunningham et al., 2008). Disease extent was absent for 42% with a systematic bias towards being unknown for cases with locally advanced disease (Stevens et al., 2008) Second primary colorectal cancer was increased during the first 5 years after first diagnosis but remained increased for up to 10 years in females, in patients with right-sided cancers and in patients <60 years at first diagnosis (Ringland et al., 2010). Colon Cancer Family Registries Proximal colon cancer survival differs from survival for distal colon and rectal cancer in a manner apparently dependent on microsatellite instability status. These findings support the premise that proximal colon, distal colon, and rectal cancers are clinicopathologically distinct (Phipps et al., 2013). South Australian Clinical Registry for Metastatic Colorectal Cancer Patients aged ≥80 years with metastatic colorectal cancer are less likely to receive intervention for their disease and have poorer survival (Kumar et al., 2013).

Urinary Bladder
In Turkey, Izmir bladder cancer incidences were quite high, especially for men, and appear to be increasing (Eser et al., 2009). The male age-adjusted incidence rate in Gharbiah Province was 13.65/100,000 person years, with Kotour had the highest age-adjusted IR 28.96/100,000 among males (Fedewa et al., 2009). The incidence of associated bilharziasis decreased from 80% to 50%, with a significant increase in transitional cell carcinoma from 20% to 66%, with a significant decrease in squamous cell carcinoma from 73% to 25% (Salem and Mahfouz, 2012). Bladder cancer tends to appear slightly more often in the elderly and that the tumors tend to have a higher grade of malignancy in the Shiraz region .It tends to be found in the elderly and the male to female ratio is high in Mazandaran (Ahmadi et al., 2012).
Smoking is likely to be the main risk factor in Sri Lanka, under-reporting in rural areas possibly accounting for the low rates (Ranasinghe et al., 2012).

Prostate
In Turkey, prostate cancer has lower incidence rates as compared to western countries but the trend is for rise (Eser et al., 2009). Karachi falls into a low risk region with a rapidly increasing incidence and a marginal down staging (Bhurgri et al., 2009a). Sri Lankan cancer registry data showed a low rate, similar to other South Asian countries, but the actual incidence is probably higher than reported, as seen in densely populated districts and in pathological specimens (Ranasinghe et al., 2011). Singapore, 1998 to 2002, the age-standardised incidence and mortality rates (per 100,000) for prostate cancer among the Chinese were 30.9 (95% CI, 29.1 to 32.8) and 9.6 (95% CI, 8.6 to 10.7), respectively (Chia et al., 2010).

Testicular
Increasing rates of testicular cancer for all ethnic and income groups since 1990s. Maori had higher rates, and Pacific and Asian groups lower rates than European/other men with rate ratios pooled over time (Sarfati et al., 2011)

Larynx
In Kazakhstan, incidence rates of laryngeal cancer demonstrated a tendency to decrease in women (T=-6.7%) this being more pronounced than in men (T=-3.3%) . In China incidence and mortality of larynx cancer were stable from 2003 to 2007 (Du et al., 2012).

Lung
Age-specific incidence ratios of lung cancer in Turkey in older people is increasing (Tas and Keskin, 2012b). In Erzurum the most common histopathological subtype is squamous cell carcinoma, 46.1%, followed by small cell lung carcinoma, 15.7%, Smoking status was found to have a strong correlation with primary lung cancer (p <0.05), and there were significant differences between males and females (p<0.001) (Demirci et al., 2013). In Egypt there was a steady increase in the incidence of mesothelioma from 1998 to 2005 followed by a decline during 2006-2007, possibly attributable to recent strict industrial preventive measures (Aki et al., 2010).
In the Arab world, the estimated numbers of new lung cancer cases in 2008 were 9,537 in ages below 65 for both sexes, and 7,059 cases for ages above 65 and in 2020 there is expected to be 14,788 new lung cancer cases in ages below 65, and 14,788 cases for ages above 65 in both males and females (Salim et al., 2011). The age adjusted rate for males in district Srinagar was 19.3 per 100 000 (Koul et al., 2010).
Mortality rate of lung cancer among residents during the last four decades in Qidong has been increasing remarkably . In Taiwan the 5-year survival rate was 15.9%, with a median survival of 13.2 months stage III (30.0%), and stage IV (54.1%) (Wang et al., 2013). The available data indicate that the prognosis of lung cancer remains very poor and that a high proportion of patients are still diagnosed with advanced disease (Jiwa et al., 2010). In Japan percentages of female patients, cases with adenocarcinoma, stage I or II disease, and tumors sized less than 2 cm have increased (Sawabata et al., 2011). Increased lung cancer risks in New Zealand, including wood workers, metal workers, meat workers, textile workers and drivers (Corbin et al., 2011).

Skin
Increasing incidence of skin cancer in the Islamic Republic of Iran is similar to that reported in other countries (Heidari and Nalafi, 2013). In Malaysia, skin cancer rates among the fairer-skinned Chinese were approximately 3 times higher than in Malays and Indians (Sng et al., 2009).
In Australia, significant decreases in rates of invasive melanoma in the younger age groups on less frequently exposed body sites, providing evidence of the impact of long-running primary prevention campaigns (Youl et al., 2013). In Western Australia the majority of non-melanoma skin cancer deaths were due to squamous cell carcinomas in primary sites associated with significant sun exposure and in older men (Girshik et al., 2008). Outlook for patients with thin invasive melanoma is positive, although continued clinical vigilance is warranted for patients with nodular melanoma and those with the thickest tumors (Green et al., 2012). Cutaneous melanoma is much less common among Maori than among New Zealand Europeans, but Maori have a greater Breslow depth and therefore have a worse prognosis (Hore et al., 2010) Minority ethnicities in New Zealand have a higher than expected risk of thick and more advanced melanoma, with poorer prognosis (Sneyd and Cox, 2009).

Hematological
In the Antalya registry, an increase in the NHL incidence over the years was identified, with a 2.42fold increment found from 1995 to 2005 and a 2.77 fold elevation from 1995 to 2010, use of pesticides increasing1.89 fold over the same period (Yildirim et al., 2013). In Gharbia Registry, we observed NHL incidence pattern similar to that observed for hepatocellular carcinoma because of the possible link to hepatitis C virus for both cancers. Comparison to the published HCs data from Algeria, Cyprus, and Jordan showed the highest NHL rate in Egypt than the other countries (Herzog et al., 2012).
Compared to the Western world, Kuwait had a lower prevalence of follicular lymphoma, a higher prevalence of diffuse large B-cell lymphoma and extranodal presentation, and a high frequency of mycosis fungoides (Ameen et al., 2010). In Gholestan 237 (4.67 %) of cancers were lymphomas (Roshandel et al., 2011). Significant reduction in incidence of chronic myeloid leukemia in India in recent periods might be because of reduced misclassification .The incidence of leukemia was significantly higher in males and residents of rural areas (Rajabli et al., 2013).
The incidence of chronic lymphocytic leukemia in Taiwan, 1986-2005: a distinct increasing trend with birthcohort effect (Wu et al., 2010). In Korea, from 1999 to 2008, the age-standardized incidence rates for hematologic malignancies increased from 10.2 to 13.7, and the annual percentage change was 3.9%, whereas 5-year survival increased from 38. 2% during 19932% during -19952% during to 55.2% during 20042% during -20082% during (Park et al., 2012. Non-Hodgkin lymphoma is an increasingly common cancer in Australia but since the year 2000, mortality has decreased every year by an average of 5.1% per year, whereas incidence has continued to increase at 0.9% (Coory and Gill, 2008). Increased leukaemia risks are associated with certain agricultural, manufacturing, construction and service occupations in New Zealand (McLean et al., 2009)

Nervous
Iran, male predominance of primary malignant brain tumors with an overall incidence of 2.74 per 100,000 person-years, the most common histopathologies being meningioma, astrocytoma, glioblastoma and ependymoma (Jayazeri et al., 2013).

Soft Tissue
Karachi falls into a high risk region for soft tissue sarcomas, observed in a relatively younger population, with a male predominance, high frequency of rhabdomyosarcoma and advanced stage at diagnosis . Taiwan patients with multiple myeloma, especially younger cases, are at a high risk of hematologic malignancies (Tzeng et al., 2013).

Pediatric Cancer
In Turkey, males were more likely to develop CNS tumors (1.65 per 100,000) compared to females (1.21 per 100,000, p<0.01), astrocytic tumors being the most frequent followed by embryonal and ependymal tumors (Beygi et al., 2013). In the West Bank spatial analysis showed a concentration of cancer in metropolitan districts where referral hospitals are based, under registration occurring elsewhere (Bailony et al., 2011). Annual rates of childhood leukaemia in Basrah were similar to those in other countries with a trend towards younger children (Alrudainy et al., 2011). Incidence rates of childhood cancers are relatively high in Golestan province of Iran (Moradi et al., 2010).
In Pakistan, amongst boys, leukemias 1.3, lymphomas and reticuloendothelial neoplasms 1.3, CNS and miscellaneous intracranial/intraspinal tumors 0.7, malignant bone tumors 0.4, and soft tissue sarcomas 0.4; amongst girls, leukemias 0.7, lymphomas and reticuloendothelial neoplasms 0.5, malignant bone tumors 0.3, CNS and miscellaneous intracranial/intraspinal tumors 0.3, and renal tumors 0.3 (Badar et al., 2009). In India, considerable inter-regional variation exists (Arora et al., 2009), rates being higher among boys than girls, with leukemia as the commonest (36.8%) followed by lymphomas (14.8%) and soft tissue tumors (8.0%) (Datta et al., 2010). In West Bengal, retinoblastoma, renal tumours, neuroblastoma and hepatic tumours were higher in children less than five years but lymphoma, leukaemia, bone tumours and central nervous system tumours above that age (Roy et al., 2012). In an earlier study in an Indian registry, the top 5 childhood cancers were the same among boys and girls: leukemias, lymphomas, central nervous system neoplasms, retinoblastomas and renal tumors (Swaminathan et al., 2008). Childhood lymphoma in Khon Kaen province of Thailand lower than in western countries, with trend for increase in boys but decrease in girls (Srina et al., 2010). Childhood osteosarcoma was slightly less than reported for Western countries (Wiromrat et al., 2012). There are a higher proportion of children with retinoblastoma and negligible numbers of pediatric brain tumors in the Yogyakarta Registry .
Survival rate for children aged 0-14 diagnosed with cancer in Shanghai during 2002-2005 was at a medium level, lower than in West (Bao et al., 2012). For Taiwan, leukemia, lymphomas, central nervous system neoplasms and other epithelial neoplasms for males and females accounted for nearly 55% of all types (Chiang et al., 2010) In Osaka the constant decline in mortality in childhood cancer was primarily due to improved survival between the 1970s and 1980s and reduced incidence after the 1990s (Baba et al., 2010) Age-standardized incidence rates (per million) were 144.3 for boys and 93.9 for girls, leukemia being the most frequent (29%) among the 12 diagnostic groups (Sugiyama et al., 2009).
Australian Paediatric Cancer Registry improvements in childhood cancer mortality in Australia are generally encouraging, of concern is the lack of a corresponding decrease in mortality among children with certain types of tumours of the central nervous system during the past decade (Youlden et al., 2012a). Some variation in prognosis by place of residence was present, particularly among leukemia patients (Youlden et al., 2011). Children living in remote or very remote areas were 21% less likely to be diagnosed with cancer compared to children in major cities, mainly due to differences in the incidence of leukemias and lymphomas (Youlden et al., 2012b). There is some evidence of a recent plateau in cancer incidence rates in Australia for boys and older children (Baade et al., 2010)

Future Perspectives
Judging by the more than 300 papers from 2008-2013 cited in the present report, cancer registration research in the Asian Pacific is receiving a reasonable priority. Thus there are basic data for incidence, mortality and survival for the majority of countries, with a large body of information on geographical ethnic and socioeconomic factors. Trends have also been a major focus. It is to be hoped that this will continue, with expansion into new areas like novel applications for development and assessment of cancer control programs, as argued in a recent commentary (Moore, 2013). Opportunities for cancer registries to coordinate with clinicians to promote clinical epidemiology is one other obvious area deserving of future emphasis.