PAKISTAN Cancer Country Profile 2020

BURDEN OF CANCER

Total population (2019) Most common cancer cases (2018)

216,565,317 Incidence Mortality
Breast 19.6% 14.5%
Total # cancer cases Total # cancer deaths
(2018) (2018) Bladder 2.7% 2.2%

173,937 118,442 Cervix uteri 3.2% 3.3%

Colorectum 3.7% 4.2%

Leukaemia 4.1% 4.2%

Premature deaths from NCDs (2016) Lip, oral cavity 10.9% 11.3%

337,006 Lung 5.6% 7.8%

Non-Hodgkin lymphoma 3.4% 4.1%

Cancer as % of NCD premature deaths (2016)
Oesophagus 4.6% 6.4%

23.3% Prostate 2.6% 2.9%

20.0% 0.9% 9.9% 1.7% 4.2% 1.2%

PAFs Tobacco (2017)a Alcohol (2016)a Infections (2012)b Obesity (2012)b UV (2012)c
Occupational risk
(population attributable (2017)a
fractions)
a b c
PAF, cancer deaths PAF, cancer cases PAF, melanoma cases

TRENDS
Estimated past and future trends in total cases per year (breast and lung) Probability of premature death from cancer per year

70,000
62,649
60,000 17.00%

50,000

40,000 12.00%
34,038 34,066
30,000 6.98%
6.62% 6.16%
19,140 6.98% 7.03%
7.00% 6.99%
6.96%
6.90%
6.85%
6.80%
6.75%
6.71%
6.67%
6.64%
6.63% 6.53%
6.50%
6.47%
6.44%
20,000 6.17% 6.41%
6.38%
6.34%
6.31%
6.28%
6.25%
6.22%
6.19%
7.00% 6.02%
5.88%
5.73%
5.58%
5.43%
5.28%
5.14%
4.99%
4.84%
9,771 4.69%
4.54%
10,000 6,800
4.40%
- 2.00%
Breast cancer Lung cancer 2000 2005 2010 2015 2020 2025 2030

2012 2018 2040 Past trends Projected linear trend SDG target

INVESTMENT CASE (2019)

*Lower middle income
At this income level, investing in a package of essential services and scaling-up coverage will:
Costs per year Projected lives saved per year
4.50 12,000
4.00
10,000
3.50
3.00
US$ (per capita)

8,000
2.50
6,000
2.00
1.50 4,000
1.00
2,000
0.50
- 0
2020 2022 2024 2026 2028 2030 2020 2022 2024 2026 2028 2030
 PAKISTAN Cancer Country Profile 2020

HEALTH SYSTEM CAPACITY

a
per 10,000 cancer patients
Availability of population-based cancer
2019 Registration activity WORKFORCE
registry (PBCR)** a
per 10,000 cancer patients
Available staff in Ministry of Health who
Quality of mortality registration*** 2007-2016 No coverage dedicates significant proportion of their 2019 yes
time to cancer
# of external beam radiotherapy # of radiation oncologista 2019 1.8
2019 3.3
(photon,electron)a # of medical physicista 2019 n/a

# of mammographsa 2020 0.9 # of surgeonsa 2012 128.7

# of CT scannersa 2020 17.2 # of radiologista 2019 57.5

a a
# of MRI scanners 2020 4.6 # of nuclear medicine physician 2019 14.4
# of PET or PET/CT scannersa 2020 0.3 # of medical & pathology lab scientistsa 2015 n/a

FORMULATING RESPONSE
# Public cancer centres per 10,000 cancer
Integrated NCD plan 2019 n/a 2019 n/a
patients
Early detection programme/ guidelines for
NCCP (including cancer types) 2019 n/a 2019 0 cancer(s)
4 cancers (breast, cervix, colon, childhood)
MPOWER measures fully implemented and
achieved
2018 2 Pathology services 2019 generally available
generally not
Cancer management guidelines 2019 no Bone marrow transplantation capacity 2019
available
Palliative care included in their operational,
2019 n/a Palliative care availability: generally not
integrated NCD plan 2019
community/home-based care available
# of treatment services (surgery,
2019 2 Availability of opioids* for pain
radiotherapy, chemotherapy) 2015-2017 2
management
Breast cancer screening program 2019 no
*Defined daily doses for statistical purposes (S-DDD) per miliion inhabitants per day

Breast cancer screening program: Starting

age, target population
2019 n/a

GLOBAL INITIATIVES
Elimination of Cervical Cancer Global Initiative for Childhood Cancer
HPV vaccination programme coverage 2018 n/a Annual cancer cases (0-14 years old) 2020 8213

Cervical cancer screening 2019 no Early detection programme/guidelines 2019 no

Screening programme type 2019 n/a Defined referral system 2019 no

Screening programme method 2019 n/a

Annual cancer cases (0-14 years old)
Screening participation rates 2019
n/a
Early detection programme/guidelines 2019 no
Acute lymphoid leukaemia

Defined referral system 2019 no Hodgkin lymphoma

2441
Burkitt lymphoma

4368 CNS, low grade tumours

Retinoblastoma
413

267 Wilms tumour

68
391 265
Other childhood cancer

**The incidence estimates for this country have a high degree of uncertainty because they are not based on population based cancer registry
***The mortality estimates for this country have a high degree of uncertainty because they are not based on any national NCD mortality data