Cancer in the Philippines Vol. V Part 1 Cancer Incidence 2003-2007 C.A. Mapúa, A.V. Laudico, M.R.M. Lumague, M.T.M. Redaniel, T. Patama, E. Pukkala PHILIPPINE CANCER SOCIETY-MANILA CANCER REGISTRY DEPARTMENT OF HEALTH-RIZAL CANCER REGISTRY FINISH CANCER REGISTRY UNIVERSITY OF THE PHILIPPINES MANILA-SURGERY RESEARCH UNIT EDUARDO ABOITIZ FOUNDATION-METRO CEBU CANCER REGISTRY
Table of Contents FOREWORD... iv I. INTRODUCTION... 1 1.1. Population-Based Registries in Metropolitan Manila, Rizal Province, and Metro Cebu... 1 1.2. The Registration Areas... 2 1.3. Socio-demographic, Economic and Health Aspects... 6 II. METHODS... 8 2.1. Data Collection Overview... 8 2.2. Data sources... 8 2.3. Data Management... 8 2.4. Quality Control... 9 2.5. Data Analysis... 9 2.6. Incidence Maps... 13 III. RESULTS AND DISCUSSION... 14 3.1. Data Description... 14 3.2. Leading Cancer Sites... 14 3.3. Overall Cancer Incidence (All Sites)... 20 3.4. Oral Cavity... 27 3.5. Stomach... 34 3.6. Colon... 41 3.7. Rectum... 48 3.8. Liver... 55 3.9. Lung... 62 3.10. Breast... Error! Bookmark not defined. 3.11. Cervix Uteri... 73 3.12. Prostate... 78 3.13. Thyroid... 82 APPENDICES... 89 2007 Population Census by Area, Age Group and Sex... 89 Annual Incidence per 100,000 by Age Group, Male, Manila... 99 Annual Incidence per 100,000 by Age Group, Female, Manila... Error! Bookmark not defined. Annual Incidence per 100,000 by Age Group, Male, Rizal... Error! Bookmark not defined. Annual Incidence per 100,000 by Age Group, Female, Rizal... Error! Bookmark not defined. Annual Incidence per 100,000 by Age Group, Male, Cebu... Error! Bookmark not defined. Annual Incidence per 100,000 by Age Group, Female, Cebu... Error! Bookmark not defined. Comparison of the Most Common Cancer Sites for Five Time Periods... Error! Bookmark not defined. Contributors... Error! Bookmark not defined. Philippine Cancer Society Board of Trustees... Error! Bookmark not defined. Philippine Cancer Society - Manila Cancer Registry... Error! Bookmark not defined. Department of Health - Rizal Cancer Registry... Error! Bookmark not defined. ii
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FOREWORD This monograph presents the fourth volume of the analysis of the incidence of cancer in the populations of Metropolitan Manila, Rizal Province, and Cebu Province in the Republic of the Philippines. The data used are from the three population-based cancer registries, namely the Department of Health-Rizal Cancer Registry, the Philippine Cancer Society-Manila Cancer Registry, and the Eduardo Aboitiz Foundation-Metro Cebu Cancer Registry. It covers the period from 2003 to 2007. Cancer in the Philippines Vol. 5 (CIP5) is now divided into two parts, CIP5 Part 1 Cancer Incidence 2003-2007, and, CIP5 Part 2 Cancer Incidence Trends 1980-2007. In CIP5 Part 1, as in the third volume, the incidence rates for leading cancer sites are presented by age-group, sex and geographic subdivisions (cities/municipalities) of the registration area. These rates are then compared with those from other populations. Also, for the first time, incidence maps are included, provided by the Finnish Cancer Registry. In CIP5 Part 2, a trend analysis for leading cancer sites using joinpoint regression developed by the National Cancer Institute of the United States will be presented, and will also include incidence maps. The entire book was produced using personal computers and computer software, which are widely distributed. Hence, this volume proves that the results of a cancer registry may be summarized into a monograph illustrated by tables and figures with the aid of nothing more complicated than a personal computer. The production of the monograph was generously supported by the Degenerative Disease Office National Center for Disease Prevention and Control of the Department of Health. iv
I INTRODUCTION The Republic of the Philippines which is located in the Southeast Asia region, is an archipelago composed of more than 7,000 islands bounded by the Pacific Ocean and the South China Sea. The country is divided into three main island groups - Luzon, Visayas and Mindanao. Metropolitan Manila and Rizal Province are centrally located in Luzon, which is the second largest island, located in the northern portion of the archipelago. The exact location of these two areas is between latitudes 14 18 and 14 50 North and between longitudes 120 59 and 121 29 West. Metro Cebu is centrally located in the Visayas, located between latitudes 9 25'N and 11 15'N and between longitudes 123 13'E and 124 5'E. Cancer in the Philippines Vol. 5 Part 1 presents an epidemiological profile of the major cancers in Metropolitan Manila and the province of Rizal for the period 1980-2007 and the province of Cebu for the 2003-2007 period. Data from the three population-based registries, the Department of Health-Rizal Cancer Registry (DOH-RCR), the Philippine Cancer Society-Manila Cancer Registry (PCS-MCR), and the Eduardo Aboitiz Foundation-Metro Cebu Cancer Registry (EAF-MCCR) were analyzed in detail with the age standardized rates (ASR) for each area being compared with the ASR for all the areas combined. Comparison with rates from other areas in the world are presented, as well as incidence maps. 1.1. Population-Based Registries in Metropolitan Manila, Rizal Province, and Metro Cebu Until 1987, the DOH-RCR and the PCS-MCR were the only population-based cancer registries in the country. The area covered by these two registries is the most populous and medically sophisticated in the country, enabling a fairly accurate view of cancer incidence to be obtained, and providing a basis for future epidemiological and clinical studies on cancer, as well as valuable inputs to cancer control activities. 1.1.1. The Department of Health - Rizal Cancer Registry (DOH-RCR) The first population-based cancer registry in the country was established in 1974 as one of the activities of the Community Cancer Control Program of the province of Rizal. At that time, Rizal was still composed of 26 municipalities, 12 of which were subsequently incorporated into Metropolitan Manila in 1975. From 1974 to 1979, data collection was entirely passive relying on notification from physicians and hospitals. This system was highly unsatisfactory so that active registration was started in 1980. Research assistants were trained in methods of cancer registration and were assigned to abstract data from hospitals and death certificates. In 1984, the registry started a cooperative effort with the Philippine Cancer Society-Manila Cancer Registry in covering 134 hospitals within the National Capital Region and Rizal Province. Both registries use the same forms and the same method of active data collection. Since 1978, data from the Rizal Cancer Registry have been included in Cancer Incidence in Five Continents (http://www-dep.iacr.fr). Data for 1978-1982 were part of Volume V, 1983-1987 data in Volume VI, 1993-1997 data in Volume VIII, and 2003-2007 data in Volume X. The DOH-RCR is located in the Rizal Medical Center in Pasig City. It was initially funded by the Rizal provincial government but since 1975, funding has been a full responsibility of the Rizal Medical Center. Its present staff consists of a surgical oncologist who heads the registry, two surgeons, two full-time registry clerks, and five part-time cancer registry research assistants (collaborative work with IARC and the Andres Soriano Foundation). 1.1.2. The Philippine Cancer Society - Manila Cancer Registry (PCS-MCR) The first formal cancer registration activity in the Philippines was started in 1959 by the Philippine Cancer Society (PCS) when it established the Central Tumor Registry of the Philippines (CTRP). The CTRP collected data from 26 hospitals, 25 in Metropolitan Manila and one located in Cebu, completely relying on notifications from these hospitals. 1
The CTRP was converted into a population-based registry in 1983. It covered the population of four cities included in the Metropolitan Manila area (Manila, Quezon City, Pasay City and Caloocan City) and was renamed the Philippine Cancer Society-Manila Cancer Registry. One of the first tasks of the PCS-MCR was a retrospective review of records covering the period of 1980-1982 in all hospitals, since prior to 1983 data collection relied solely on passive notification of cases. A review of death certificates was also accomplished. All of the smaller hospitals which were not part of the CTRP network were now included in the PCS-MCR. The DOH-RCR was also able to provide data on cases it had identified among residents of the four cities. Incidence data from the PCS-MCR have been included in vols. VI, VII, VIII, IX and X of Cancer Incidence in Five Continents. The registry is located in the PCS building, and is fully funded by the PCS. The registry staff is composed of four parttime consultants (two surgical oncologists, one of whom heads the registry, and two epidemiologists), one full-time supervisor, and six cancer registry research assistants. 1.1.3. The Eduardo Aboitiz Foundation - Metro Cebu Cancer Registry (EAF-MCCR) The Metro Cebu Cancer Registry (MCCR) was founded in February 1988. Serving the needs of communities in the southern part of the country, it is the third internationally accredited population-based registry outside Metro Manila. The Eduardo J. Aboitiz Cancer Center, a program of Ramon Aboitiz Foundation Inc. is running the Metro Cebu Population-Based Cancer Registry that is located in Cebu, Philippines. The registry is manned by three (3) personnel (1 Project Officer and 2 research staff). The program is fully subsidized by the Ramon Aboitiz Foundation, Inc. being one of the component program of the Eduardo J. Aboitiz Cancer Center. 1.2. The Registration Areas The Republic of the Philippines is part of Southeast Asia, between the Pacific Ocean and the South China Sea (Figure 1.2.1, 1.2.2). The total land area involved in cancer registration in Luzon comprises of 1,944 km 2. The area is in the central part of Luzon Island, bounded by Manila Bay in the West, the province of Bulacan in the North, and the provinces of Cavite and Laguna in the southwest. To the East lies Quezon province. The southern border faces a large lake, the Laguna de Bay (Figures 1.2.3 and 1.2.4). The total area of the Metropolitan Cebu is 1163 km 2, bounded by other Cebu municipalities and cities on the north, west and south, and by the Cebu Strait and Camotes Sea on the east (Figure 1.2.5). Metropolitan Manila, called the National Capital Region (NCR), consists of 16 cities and 1 municipality located in an area of 635 square kilometers. The NCR is the major urban center of the country. The present Rizal province consists of 1 city and 13 municipalities with an area of 1,039 square kilometers and a population that is 75 percent urban (Figure 1.2.6). The DOH-RCR covers the 26 municipalities of the original province of Rizal, encompassing a land area of 1343 km 2, situated between latitudes 14 17 9 and 14 45 51 North and between longitudes 120 57 59 and 121 15 10 West. Of the 12 municipalities that were incorporated into Metro Manila, 6 became cities during 1994 to 1999. Of the fourteen remaining municipalities of Rizal province, one (Antipolo) became a city in 1999, ten (10) are urbanizing and only three are rural. The PCS-MCR covers the four major cities (Manila, Quezon, Pasay, Caloocan) of the National Capital Region (NCR) which is the major urban center of the country. It encompasses a land area of 274.2 km 2 located in the southwest portion of Luzon between latitudes 14 48 23 and 14 31 15 North and between longitudes 14 39 53 and 121 05 20 West. The city of Manila is the capital of the Philippines and is the country s main port, the hub of commerce and trade and the seat of cultural and intellectual activities. The EAF-MCCR covers the cities of Cebu, Mandaue, Lapu-Lapu, Talisay, Naga and the municipalities of Consolacion, Lilo-an, Compostela, Cordova, Minglanilla, Naga and San Fernando (Figure 1.2.7). Metro Cebu is a narrow stretch of land about 220 kilometers from the north to south and about 41 kilometers at its widest portion. It is located between the latitudes 9 25'N and 11 15'N and between longitudes 123 13'E and 124 5'E. The total land area is 5,078 km 2. Hospital 2
coverage includes 26 hospitals (both public and private), 11 local Civil Registries (of each LGU covered) and all oncology clinics in Cebu. Figure 1.2.1. Location of the Republic of the Philippines (http://go.hrw.com/atlas/norm_htm/world.htm). 3
Figure 1.2.2. Location of the Republic of the Philippines in Southeast Asia. Figure 1.2.3. Map of the Republic of the Philippines. 4
Figure 1.2.4. Location of the registration area in Luzon Island. Figure 1.2.5. Location of the registration area in the Visayas. 5
Figure 1.2.6. Map of Metro Manila and Rizal Province. Figure 1.2.7. Map of Metro Cebu. 6
1.3. Socio-demographic, Economic and Health Aspects The population covered by the DOH-RCR, based on the 2007 Census of Population and Housing was 7,116,987, with a male to female ratio of 0.96:1 (Figure 1.3.1). There had been a 21.3% increase compared to the 2000 census. The population was predominantly young (31.7% below 15 years of age and 3.1% 65 years and older). The largest ethnic group was Tagalog (82%) while the second and third largest groups were Bicol (4%) and Bisaya (3%), respectively. The following were the foreign groups noted: American/English (0.025%), Other Foreign (0.018%) and Chinese (0.012%). Eighty percent (80%) were Roman Catholic, 3.2% belonged to Iglesia ni Kristo and 0.17% were Muslims. The population covered by the PCS-MCR, based on the 2007 census, was 5,287,425, representing an increase of 15.2% as compared to that in 2000. As a whole, the population was young, with 30.5% under 15 years of age and only 3.2% 65 years and older (Figure 1.3.2). There were 140 different ethnic groups, the largest of which were Tagalog (69.85%), Bicol (4.27%), Ilocano (4.16%), Bisaya (3.87%) and Waray (2.81%). Among the foreign ethnic groups, the largest were Chinese (0.59%). People of American/English ethnicity and other foreign groups comprised 0.02% and 0.04%, respectively. Roman Catholics comprised 88.8% of the population while 3.2% belonged to Iglesia ni Kristo and 0.6 % were Muslims. Health services in the National Capital Region and the adjacent province of Rizal included four (4) cancer institutes, 168 secondary and tertiary care hospitals, 43 primary care hospitals and 32 clinics of the Department of Health for outpatient consultations. Ten hospitals had radiotherapy facilities. The population covered by the EAF-MCCR, based on the 2007 census was, 2,106,291. There has been a 10.5% increase compared to the 2000 census. One third (32.6%) of the population were under 15 years of age, and only 3.2% were over 65 years old (Figure 1.3.3). The people of Cebu are called Cebuanos and are of Austronesian, Chinese, and Spanish ancestries. The most commonly-used conversational dialect is Cebuano or Visayan, but the medium of instruction in educational institutions and business transactions is English. Other languages used are Filipino/Tagalog, Waray-Waray and Ilonggo. The majority of the Cebuanos are Christians, mostly Roman Catholics and Protestants. Other religions include Islam, Buddhism and Hinduism. Health services in Metro Cebu includes 3 cancer institutes, 29 tertiary and secondary hospitals. Three hospitals had radiotherapy facilities and one has a free standing laboratory. Figure 1.3.1. Population distribution by age and sex, DOH-RCR, 2007. Figure 1.3.2. Population distribution by age and sex, PCS-MCR, 2007. 7
Figure 1.3.3. Population distribution by age and sex, EAF-MCCR, 2007. II METHODS 2.1. Data Collection Overview Although cancer is a notifiable disease, passive collection of cancer data from physicians and hospitals was unsuccessful. Previous experience in the DOH-RCR showed a high degree of under-reporting. Thus data collection shifted to an active search for cases. Registry research assistants, formerly known as cancer registry clerks, were trained to obtain pertinent cancer data from medical records and death certificates. Letters and visits to hospital directors and medical records officers preceded actual data gathering. Data collection from hospitals included the following activities: 1. Case finding or identification of cancer cases who were residents of the catchment area of the registry. A case-finding list was prepared for every hospital data source. These lists were later collated and matched 8
prior to abstracting. Pertinent information obtained by case finding was later integrated into the hospital abstract. 2. Actual abstracting of data from the medical records and completion of the hospital abstract form (Appendix III). Death certificates from the office of the Local Civil Registries were also reviewed. For death certificates, the death certificate abstract form (Appendix IV) was filled out for patients with cancer mentioned as the underlying, immediate or contributory cause of death and whose permanent address was within the catchment area of the registry. The registry staff also visited private oncologists and hematologists to ensure registration completeness. 2.2. Data sources These included the following: 1. Records of hospitals located in the Metropolitan Manila and Rizal areas. Cases were collected from the following data sources: a. Medical records, both inpatient and outpatient b. Pathology records including surgical pathology, cytology, hematology and autopsy reports and logbooks c. Radiotherapy records and logs d. Radiology, ultrasound, nuclear medicine and CT scan reports and logs e. Hospital Tumor registry, if available 2. Death certificates gathered from the offices of the Local Civil Registrar of the municipalities of Metropolitan Manila and the province of Rizal. 2.3. Data Management Data management was done as follows: 1. All documents received at registry were stamped with the proper date. 2. A summary of all cases abstracted in each hospital (the Intake of Cases) was prepared by giving the number of cases collected from a hospital per year and the distribution of cases per hospital by site. 3. A summary of all death certificate abstracts gathered per municipality per year (Intake of Deaths) was likewise prepared, giving the number of deaths from cancer per municipality per year and the distribution of cases by site as well as the cases for follow-back and the hospitals where the follow-back will be made. 4. Both hospital abstract and death certificate abstracts were checked for completeness as well as consistency. Abstracts with missing essential data or with inconsistencies were held in a Suspense File pending completion of data or correction of inconsistencies. 5. To avoid duplication, completed hospital and death certificate abstracts were compared with the following: a. The Master Patient Index File, which was an alphabetical file of all registered cancer cases, including both living and dead cases. b. Prior to Reference Date Cases, which was an alphabetically arranged file of cases diagnosed prior to the reference date of the registry. c. The Site Index File, which was an index file of cases, arranged by primary site. d. In matching the name of patients, allowance was made for errors in spelling (phonetic spelling of names or errors in spelling due to varying degrees of legibility of handwritten records). If there was a similarity of name, the age, sex, residence and diagnosis were compared. e. If the death certificate abstract was not previously registered, this was followed back in the hospital where the patient died, or if the patient died at home, the death certificate abstract was matched with 9
the different case-finding lists from the different hospitals to determine if the case was previously seen in a hospital or not. If the case could not be traced back to a hospital or to the physician who signed the death certificate, the case was then registered under the Death Certificate Only category (DCO). 6. Data were encoded using the IARC/IACR CanReg 4 software, which incorporated checks for consistency and validity of codes. 2.4. Quality Control Quality control was assessed through the following indices: 1. Histologically Verified (HV) Percentage: This was the percentage of cases whose diagnosis was based on histological examination of tissue from a primary site or from a metastatic site. For leukemia, this included examination of the bone marrow. Cases based on cytology or peripheral blood smear were not considered as histologically verified. Cases seen in Radiotherapy Units where the basis for diagnosis indicated were coded under the Clinical Only category. However, since most radiotherapy unit gave irradiation only to histologically verified cases, (with the exception of oncological emergencies), this would have led to the Histologically Verified percentage being an underestimate of the true value. 2. Death Certificate Only (DCO) Percentage: This is the percentage of cases where diagnosis was based solely on information obtained from a death certificate. If this percentage was high, it reflected the degree of underreporting in the registry. The percentages of cases of histologically verified and registered from death certificates only for each time period are shown in Tables 3.1.1 and 3.1.2 in the Results and Discussion part of this paper. 2.5. Data Analysis The calculation of incidence rates was based on the number of new cases registered by the DOH-RCR, PCS-MCR, and the EAF-MCCR for the time periods 1 January 2003 to 31 December 2007. In this fifth volume, analysis of the data included: 1. Average annual crude incidence rates per 100,000 by sex and site for the period covering 2003-2007. 2. Average annual age-specific incidence rates per 100,000 by sex, site and age groups for the period covering 2003-2007. 3. Age-standardized rates (ASR) per 100,000 carried out by the direct method using the world standard population. 4. A detailed analysis of the most frequent malignancies and other sites of interest, including the following: oral cavity, stomach, colon, rectum, liver, lung (bronchus), breast (female), cervix uteri, prostate, and thyroid for the period of 2003-2007. 2.5.1. Population The number of person-years was derived from the 2007 census reported by the National Census and Statistics Office (Appendix I). 2.5.2. Geographic Subdivision As in the previous volume, volume IV calls the different geographical subdivisions (cities/municipalities) by their proper names in order to avoid confusion with the administrative regions used by the Department of Health. The numbering and geographic location of each city/municipality are: 10
PCS-Manila Cancer Registry 1. City of Manila 14 36 N 120 58 E 2. Caloocan City 14 39 N 120 58 E 3. Pasay City 14 34 N 121 00 E 4. Quezon City 14 39 N 121 03 E DOH-Rizal Cancer Registry 5. City of Pasig 14 34 N 121 05 E 6. City of Las Piñas 14 29 N 121 59 E 7. City of Makati 14 34 N 121 02 E 8. City of Antipolo 14 35 N 121 10 E 9. Taguig City 14 32 N 121 04 E 10. City of Parañaque 14 30 N 120 59 E 11. City of Marikina 14 38 N 121 06 E 12. City of Muntinlupa 14 23 N 121 03 E 13. City of Malabon 14 39 N 120 57 E 14. City of Mandaluyong 14 35 N 121 02 E 15. Cainta 14 29 N 121 13 E 16. City of Navotas 14 40 N 120 57 E 17. Taytay 14 33 N 121 08 E 18. Binangonan 14 28 N 121 11 E 19. San Mateo 14 42 N 121 07 E 20. City of San Juan 14 36 N 121 01 E 21. Montalban 14 44 N 121 09 E 22. Tanay 14 30 N 121 17 E 23. Angono 14 32 N 121 09 E 24. Pateros 14 33 N 121 04 E 25. Pililla 14 29 N 121 18 E 26. Morong 14 31 N 121 14 E 27. Cardona 14 29 N 121 13 E 28. Teresa 14 34 N 121 12 E 29. Baras 14 32 N 121 16 E 30. Jala-Jala 14 21 N 121 20 E EAF Metro Cebu Cancer Registry 1. Cebu City 10 17 N 123 54 E 2. Mandaue City 10 19 N 123 55 E 3. Lapu-Lapu City 10 18 N 123 56 E 4. Talisay City 10 15 N 123 50 E 5. Naga City 10 13 N 123 45 E 6. Minglanilla 10 15 N 123 47 E 7. San Fernando 10 09 N 123 42 E 8. Consolacion 10 22 N 123 57 E 9. Lilo-an 10 24 N 123 59 E 10. Compostela 10 26 N 124 00 E 11. Cordova 10 15 N 123 56 E The numbering and geographic locations were used in the production of the site-specific cancer incidence maps (Figures 2.5.1 and 2.5.2) 11
Figure 2.5.1. Map of Metro Manila and Rizal Province showing the number corresponding to each City/Municipality. Figure 2.5.2. Map of Metro Cebu showing the number corresponding to each City/Municipality. 2.5.3. Statistical Methods For comparisons of age-adjusted incidence rates between the different areas, the significance of the difference between the incidence rate for each area, with that for the entire Rizal and Metro Manila (overall) was tested. The method used 12
was the Mantel-Haenszel (M-H) test. The difference in rates was significant at the = 0.05 when M-H is equal to or greater than 1.96. This was indicated by an asterisk (*) in the tables. The M-H test takes into account the possible effect of the differences in the variance of age-groups to the ASR. It takes into consideration the differences in the variance by age-groups. This means that the M-H test underscores the variation between age-specific rates of the groups being compared. The formula for this is illustrated below. where : k K m m M Z 2x x 1x 2x x x 1 the number of cases in agegroup x in the second population the the g the person - years in agegroup the k g x 1 2x K K x total number 2x 1x person - years in x m M x x m 2x x m 2 M of cases in agegroup x total person - years in agegroup agegroup x in the first population x in the second population x 2.6. Incidence Maps The database was sent by the two registries to the Finnish Cancer Registry and consisted of annual number of cases by age-group in each city/municipality for each of the selected sites/sex, and the population of each city/municipality and their individual geographic locations. The ASRs were located using a metric coordinate system called Philippines Zone III. Every city/municipality was shown as a circle, the diameter of which described the order of the male or female populations. The size does not indicate absolute population size differences. There was a relative color scale used for showing the ASRs with 19 colors, ranging from blue and green tints depicting low rates, to red and violet depicting high rates. A step change from one color level to another corresponds to a 10% or 1.1-fold relative change in the ASR. The lower limit of the highest category is therefore always 5.07 times (1.1 17 ) the upper limit of the lowest category. The color scale is fixed so that values of the ASRs can be seen. The map consists of layers, such as area boundaries, titles, scales and circles. The maps were created using a self-developed serverside software which can generate the map outlook. The software used the Mapserver module (http://umn.mapserver.ch/) to handle the map layers and produce a single image. 13
III RESULTS AND DISCUSSION 3.1. Data Description The complete 2003-2007 incidence data for All Sites, generated through the CANREG software of the International Agency for Research on Cancer are included in Appendix II, consisting of four separate Tables. The database used for the computations of this monograph differs slightly but not significantly, because of continuing updating of case files by the two registries. During the period between 2003 and 2007, a total of 77,174 new cases were included in the two registries. There were 32,398 cases among males and 44,776 cases among females, resulting in a male to female ratio of 1 male to every 1.38 females. From the PCS-MCR areas, a total of 39,141 cases were recorded, comprising of 16,437 males and 22,704 females. On the other hand, in the DOH-RCR areas, 38,033 new cases were recorded, 15,961 of which were males while 22,072 were females. Table 3.1.1 shows that in DOH-RCR areas, 67.9 percent of cases among males were histologically verified (HV) while 9.7 percent were registered through death certificates (DCO). Among females, the proportions were 79.1 percent and 6.8 percent, respectively. For the PCS-MCR areas, 64.5 percent of cases among males were histologically verified while this proportion was 75.4 percent among females (Table 3.1.2). The proportion of cases that were identified through death certificates were 8.6 percent in males and 5.9 percent in females. A total of 10,195 new cases were included in EAF-MCCR between 2003 and 2007. There were 4,646 and 5,549 cases among males and females, respectively, with a male to female ratio of 1 male to every 1.19 females. Of the male cases, 35.7% were histologically verified and 26.4% were identified through death certificates (Table 3.1.3). Among females, the proportions of HV and DCO were 50.9% and 19.3%, respectively. 3.2. Leading Cancer Sites 3.2.1. Metro Manila and Rizal Province The ten most common cancer sites in Metro Manila and Rizal Province for the period 2003-2007 are shown in Figures 3.2.1.1, 3.2.1.2 and 3.2.1.3. The rankings based on the proportion of cases from the total in comparison with the previous years are shown in Appendix III. For both sexes, the four most common cancer sites were Breast, Lung, Colon and Liver. Compared to 1998-2002, Breast, and Lung remained in their ranks at 1 st and 2 nd respectively. The following cancers rose to up compared to the previous period: Colon cancer from 5 th to 3 rd, Thyroid from 7 th to 6 th, and Prostate from 10 th to 7 th. On the other hand, Liver moved down from 3 rd to 4 th, Cervix from 4 th to 5 th, Leukemias from 6 th to 8 th and Rectum from 8 th to 9 th. Corpus Uteri was now ranked ten. In men, the four most common cancers were the same as the previous period. However, Prostate rose up from 3 rd to 2 nd while Liver went down to 3 rd from 2 nd. Lung, Colon, Leukemias, and Rectum remained in their ranks at 1 st, 4 th, 5 th and 6 th, respectively. Non-Hodgkin Lymphoma climbed from 10 th to 7 th. Both Nasopharyngeal and Stomach went down one level lower, now ranked 8 th and 9 th respectively. Kidney was now ranked 10 th but Thyroid cancer did not make it to the top 10. For women, the four most common cancer sites were Breast, Cervix, Thyroid and Ovary. Compared to the 1998-2002 period, cancers of the Breast, Cervix Uteri, and Corpus Uteri remained as 1 st, 2 nd, and 7 th, respectively. Thyroid cancer moved up from 6 th to 3 rd, Leukemias from 9 th to 8 th, and Liver from 10 th to 9 th. Cancer of the Ovary descended one level 14
down from 3 rd to 4th, Lung from 4 th to 5 th, and Colon from 5 th to 6 th. Rectum was now ranked 10. Cancer of the Brain and Nervous System did not make it to top 10. Table 3.1.1. Percentage of cases registered with histological confirmation of diagnosis (% HV) or on the basis of information only from a death certificate (% DCO), DOH-RCR, 2003-2007. ICD-10 Site Cases % HV % DCO Male Female Male Female Male Female C00-C06 Oral cavity 227 214 91.2 85.0 4.0 7.5 C07-C08 Salivary glands 82 78 92.7 88.5 0.0 2.6 C11 Nasopharynx 528 273 82.0 81.0 8.0 11.0 C15 Oesophagus 185 68 71.9 69.1 8.6 7.4 C16 Stomach 514 402 74.7 68.7 11.7 14.4 C18 Colon 1184 1130 78.0 77.3 9.0 8.8 C19-C21 Rectum 774 652 90.6 88.2 3.6 3.5 C22 Liver 1583 663 42.8 43.0 19.0 19.3 C25 Pancreas 357 377 56.0 52.3 12.6 12.2 C32 Larynx 326 55 85.0 70.9 4.0 18.2 C33-C34 Lung 3189 1308 51.4 53.5 10.5 8.9 C40-C41 Bone 261 220 58.6 53.6 26.8 30.5 C44 Skin 239 254 93.3 94.5 1.3 2.0 C47, C49 Connective and soft tissue 180 209 87.2 91.4 1.7 1.9 C50 Breast 66 6560 90.9 88.2 7.6 4.9 C53 Cervix uteri 0 2008 90.2 3.6 C54 Corpus uteri 0 1070 94.4 0.7 C55 Uterus unspecified 0 239 44.8 42.3 C56 Ovary 0 1336 75.0 4.4 C51-C52, C57 Other female genital organs 0 89 92.1 0.0 C58 Placenta 0 48 93.8 2.1 C60 Penis 32 0 93.8 3.1 C61 Prostate 1875 0 77.3 10.0 C62 Testis 98 0 88.8 2.0 C64 Kidney 334 203 88.9 81.8 5.1 7.9 C67 Bladder 308 150 89.3 84.7 1.9 4.0 C69 Eye 65 52 93.8 90.4 3.1 1.9 C70-C72 Brain, nervous system 335 274 68.4 60.6 18.5 25.2 C73 Thyroid 341 1477 91.5 93.4 2.6 2.1 C81 Hodgkin disease 67 54 83.6 87.0 7.5 7.4 C82-C85, C96 Non-Hodgkin lymphoma 577 505 81.1 83.8 4.7 4.2 C91 Lymphoid leukaemia 310 219 57.1 56.6 3.2 4.1 C92-94 Myeloid leukaemia 347 382 57.1 60.2 3.5 3.7 C95 Other and unspecified leukemias 195 199 33.3 29.1 20.0 28.6 ALL All sites 15961 22072 67.9 79.1 9.7 6.8 15
Table 3.1.2. Percentage of cases registered with histological confirmation of diagnosis (% HV) or on the basis of information only from a death certificate (% DCO), PCS-MCR, 2003-2007. ICD-10 Site Cases % HV % DCO Male Female Male Female Male Female C00-C06 Oral cavity 239 190 84.5 81.1 6.3 5.8 C07-C08 Lip 72 86 87.5 91.9 0.0 0.0 C09 Tonsil 49 18 85.7 83.3 2.0 0.0 C11 Nasopharynx 544 232 72.2 71.1 4.8 4.3 C15 Oesophagus 193 83 66.3 53.0 5.2 4.8 C16 Stomach 538 437 63.0 62.9 7.1 5.0 C18 Colon 1245 1259 67.9 70.5 8.9 6.4 C19-C21 Rectum 809 698 81.6 82.8 1.5 1.6 C22 Liver 1686 706 19.2 21.5 15.8 16.3 C25 Pancreas 298 334 35.2 30.8 9.1 9.3 C32 Larynx 400 69 81.3 69.6 4.0 10.1 C33-34 Lung 3168 1379 55.3 56.9 9.1 7.0 C40-41 Bone 272 214 47.8 51.9 33.8 32.7 C44 Skin 301 289 95.7 97.2 1.7 1.7 C47, C49 Connective and soft tissue 219 231 96.3 93.5 0.9 1.3 C50 Breast 93 6491 55.9 80.4 4.3 4.4 C53 Cervix uteri 0 1991 82.2 3.5 C54 Corpus uteri 0 1108 92.9 0.5 C55 Uterus unspecified 0 238 31.5 47.9 C56 Ovary 0 1440 66.8 7.8 C51-C52, C57 Other female genital organs 0 90 90.0 2.2 C58 Placenta 0 40 92.5 2.5 C60 Penis 37 0 83.8 0.0 C61 Prostate 1833 0 65.5 10.0 C62 Testis 132 0 85.6 4.5 C64 Kidney 396 221 72.5 71.5 10.6 11.3 C67 Bladder 314 135 85.0 74.1 2.9 3.7 C69 Eye 48 51 83.3 88.2 4.2 2.0 C70-C72 Brain, nervous system 299 259 61.2 57.1 17.4 16.6 C73 Thyroid 372 1579 88.7 95.1 1.6 1.2 C81 Hodgkin disease 66 68 98.5 100.0 1.5 0.0 C82-C85, C96 Non-Hodgkin lymphoma 548 541 78.6 79.1 3.8 4.1 C91 Lymphoid leukaemia 335 254 98.2 95.3 1.8 4.7 C92-C94 Myeloid leukaemia 384 376 96.9 98.1 3.1 1.9 C95 Other and unspecified leukemias 192 214 76.0 71.5 23.4 28.0 ALL All sites 16437 22704 64.5 75.4 8.6 5.9 16
Table 3.1.3. Percentage of cases registered with histological confirmation of diagnosis (% HV) or on the basis of information only from a death certificate (% DCO), EAF-MCCR, 2003-2007. ICD-10 Site Cases % HV % DCO Male Female Male Female Male Female C00-C06 Oral cavity 72 50 54.2 40.0 27.8 38.0 C07-C08 Lip 20 29 65.0 48.3 10.0 13.8 C09 Tonsil 4 1 50.0 100.0 0.0 0.0 C11 Nasopharynx 88 37 34.1 48.6 39.8 32.4 C15 Oesophagus 69 20 40.6 45.0 18.8 15.0 C16 Stomach 131 114 41.2 47.4 17.6 17.5 C18 Colon 381 297 52.8 51.9 14.7 15.8 C19-C21 Rectum 151 95 63.6 69.5 9.9 8.4 C22 Liver 1242 393 17.7 16.3 41.9 40.2 C25 Pancreas 63 88 25.4 27.3 15.9 23.9 C32 Larynx 62 17 46.8 47.1 19.4 17.6 C33-34 Lung 853 475 37.0 38.9 26.6 20.8 C40-41 Bone 119 102 26.9 30.4 45.4 42.2 C44 Skin 37 41 48.6 53.7 16.2 29.3 C47, C49 Connective and soft tissue 33 54 57.6 51.9 6.1 14.8 C50 Breast 17 1462 29.4 59.5 35.3 18.6 C53 Cervix uteri 0 323 60.4 12.7 C54 Corpus uteri 0 260 75.0 3.1 C55 Uterus unspecified 0 198 25.3 60.6 C56 Ovary 0 325 49.5 12.6 C51-C52, C57 Other female genital organs 0 13 61.5 7.7 C58 Placenta 0 26 34.6 3.8 C60 Penis 2 0 50.0 0.0 C61 Prostate 369 0 35.8 28.7 C62 Testis 18 0 33.3 0.0 C64 Kidney 87 49 37.9 40.8 6.9 14.3 C67 Bladder 66 29 56.1 231.0 15.2 20.7 C69 Eye 15 9 40.0 55.6 20.0 0.0 C70-C72 Brain, nervous system 103 99 34.0 33.3 16.5 23.2 C73 Thyroid 141 478 72.3 72.8 7.1 5.2 C81 Hodgkin disease 25 25 64.0 44.0 4.0 12.0 C82-C85, C96 Non-Hodgkin lymphoma 177 162 45.2 48.1 16.4 9.9 C91 Lymphoid leukaemia 109 81 51.4 39.5 6.4 7.4 C92-C94 Myeloid leukaemia 123 117 22.0 31.6 5.7 6.8 C95 Other and unspecified leukemias 69 80 11.6 12.5 40.6 42.5 ALL All sites 4646 5549 35.7 50.9 26.4 19.3 17
Breast Lung Colon Liver Cervix uteri Thyroid Prostate Leukemias Rectum Ovary 6.2 6 5.2 4.9 4.8 4.4 3.7 3.6 11.7 17.1 0 2 4 6 8 10 12 14 16 18 20 22 24 26 28 30 32 Percentage Figure 3.2.1.1. Most common cancer sites, both sexes, Metro Manila and Rizal, 2003-2007. Lung Prostate Liver Colon Leukemias Rectum Non-Hodgkin lymphoma Nasopharynx Stomach Kidney 5.4 4.7 3.5 3.3 3.2 2.3 7.5 11.4 10.1 19.6 0 2 4 6 8 10 12 14 16 18 20 22 24 26 28 30 32 Percentage Figure 3.2.1.2. Most common cancer sites, males, Metro Manila and Rizal, 2003-2007. Breast Cervix uteri Thyroid Ovary Lung Colon Corpus uteri Leukemias Liver Rectum 6.8 6.2 6 5.3 4.9 3.7 3.1 2.9 8.9 29.1 0 2 4 6 8 10 12 14 16 18 20 22 24 26 28 30 32 Percentage Figure 3.2.1.3. Most common cancer sites, females, Metro Manila and Rizal, 2003-2007. 18
3.2.2. Metro Cebu The ten leading cancer sites in Metro Cebu for the period 2003-2007 are shown in Figures 3.2.2.1, 3.2.2.2 and 3.2.2.3. The four leading cancer sites for both sexes were Liver, Breast, Lung and Colon. Cancers of the Thyroid, Prostate, Non-Hodgkin Lymphoma, Ovary, Cervix Uteri, and Corpus Uteri followed the list in descending order. Among males, the four most common cancers were Liver, Lung, Colon and Prostate. Other cancer sites that made it to the top ten were Non-Hodgkin Lymphoma, Thyroid, Rectum, Myeloid Leukemia, Stomach and Bone. Among females, the four leading sites were Breast, Thyroid, Lung, and Liver. The other common cancer sites were Ovary, Cervix Uteri, Colon, Corpus Uteri, Uterus unspecified and Non-Hodgkin lymphoma. Liver Breast Lung Colon Thyroid Prostate Non-Hodgkin lymphoma Ovary Cervix uteri Corpus uteri 3.3 3.1 3 2.9 2.4 6.1 5.8 15.5 13.5 12.3 0 2 4 6 8 10 12 14 16 18 20 22 24 26 28 30 32 Percentage Figure 3.2.2.1. Most common cancer sites, both sexes, Metro Cebu, 2003-2007. Liver Lung Colon Prostate Non-Hodgkin lymphoma Thyroid Rectum Myeloid leukaemia Stomach Bone 3.6 2.9 2.9 2.6 2.4 2.4 7.4 7.1 17.3 25.6 0 2 4 6 8 10 12 14 16 18 20 22 24 26 28 30 32 Percentage Figure 3.2.2.2. Most common cancer sites, males, Metro Cebu, 2003-2007. 19
Breast Thyroid Lung Liver Ovary Cervix uteri Colon Corpus uteri Uterus unspecified Non-Hodgkin lymphoma 8.3 8.1 6.8 5.6 5.3 5 4.4 3.4 2.7 24.8 0 2 4 6 8 10 12 14 16 18 20 22 24 26 28 30 32 Percentage Figure 3.2.2.3. Most common cancer sites, females, Metro Cebu, 2003-2007. 3.3. Overall Cancer Incidence (All Sites) 3.3.1. Metro Manila and Rizal Province The overall (all sites) crude incidence rate for all the areas covered by PCS-MCR and DOH-RCR among males was 104.9 per 100,000 population whereas the overall age-standardized incidence rate was 201.0 per 100,000 population. For females, the overall crude and age-standardized rates were 140.0 per 100,000 and 199.9 per 100,000, respectively. The crude, age-standardized and 5-year age-specific incidence rates for the different areas covered by the registries are shown in tables and corresponding incidence maps. For males (Table 3.3.1.1 and Figure 3.3.1.1), the PCS-MCR had an ASR of 218.2 per 100,000 population that was significantly higher than the overall ASR. Meanwhile, the DOH-RCR had an ASR of 185.9 per 100,000 that was significantly lower. The DOH-RCR Rizal area had an ASR that was significantly lower than the overall (137.7 per 100,000) while there was not enough evidence to say that the ASR for the DOH-RCR Metro Manila area was significantly lower than the overall. The areas with ASRs that were significantly higher than that of the overall were Manila, Quezon City, Las Piñas, Mandaluyong, Parañaque, Pasig and San Juan. On the other hand, the areas with ASRs that were significantly lower than the overall ASR were Caloocan, Marikina, Navotas, Pateros, Taguig, Angono, Antipolo, Baras, Binangonan, Cainta, Cardona, Jala-Jala, Montalban, Morong, Pililla, San Mateo, Tanay, Taytay, and Teresa. For females (Table 3.3.1.2 and Figure 3.3.1.2), the PCS-MCR, likewise, had a significantly higher ASR (214.1 per 100,000) than the overall whereas the DOH-RCR had a significantly lower ASR (187.0 per 100,000). The Rizal areas covered by DOH-RCR similarly exhibited a significantly lower ASR (140.4 per 100,000). The ASR for the DOH-RCR Metro Manila areas was significantly higher than the overall (206.4 per 100,000). The cities/municipalities that showed significantly higher ASRs than the overall were Manila, Pasay, Quezon City, Las Piñas, Makati, Mandaluyong, Parañaque, Pasig and San Juan. Conversely, those that presented significantly lower ASRs were Caloocan, Malabon, Marikina, Navotas, Pateros, Taguig, Angono, Antipolo, Baras, Binangonan, Cainta, Cardona, Jala-Jala, Montalban, Morong, Pililla, San Mateo, Tanay, Taytay and Teresa. For both males and females, highly urbanized areas had higher ASRs while those less developed or with large less urbanized areas such as the case of Caloocan, had significantly lower ASRs. 20
Table 3.3.1.1. Metro Manila and Rizal Province annual incidence rates per 100,000, all sites, male, by age group (years), 2003-2007. Male All Sites (C00-C95) AREAS CASES 0-5- 10-15- 20-25- 30-35- 40-45- 50-55- 60-65- 70-75+ CRUDE RATE ASR WORLD All Areas 32355 20.0 11.4 10.2 13.7 15.8 21.1 34.3 52.3 94.7 156.2 276.0 490.6 751.0 1139.0 1526.0 2197.0 104.9 201.0 1.2 S.E. MANTEL- HAENSZEL TEST PCS-MCR 16452 23.2 12.6 11.1 15.6 16.3 23.1 37.3 60.2 102.4 175.5 297.2 546.4 793.2 1189.4 1688.3 2408.1 114.7 218.2 1.8 9.01 * City of Manila 5719 29.1 17.2 13.1 19.8 21.7 28.5 46.7 72.9 131.7 207.5 373.8 669.5 944.4 1440.8 1777.8 2576.4 143.5 253.3 3.6 17.86 * Caloocan City 2585 18.8 9.6 8.1 12.4 13.5 18.0 31.4 50.0 76.1 151.6 220.5 407.4 528.7 892.2 987.4 1550.8 78.7 152.1 3.3-11.35 * Pasay City 934 19.7 13.3 3.5 5.7 15.3 22.3 32.3 42.2 87.1 133.3 272.6 527.0 729.1 960.1 2107.6 2129.1 98.2 202.6 7.2-0.57 Quezon City 7214 22.5 11.4 12.5 16.1 14.2 22.1 35.2 60.4 100.1 173.6 289.0 536.9 833.9 1197.4 1897.5 2674.3 117.9 228.1 2.9 8.56 * DOH-RCR 15903 17.2 10.4 9.4 12.0 15.4 19.3 31.7 45.4 88.1 139.4 257.6 442.2 714.5 1095.9 1380.9 2006.7 96.4 185.9 1.6-8.48 * Metro Manila 12158 17.6 12.0 10.9 12.6 15.0 21.5 33.2 48.0 98.2 152.5 273.1 494.3 771.7 1222.6 1540.4 2326.6 108.1 206.6 2.0 1.43 City of Las Piñas 1452 24.4 14.3 7.2 10.8 17.0 23.3 34.6 59.6 106.8 145.6 288.0 524.1 846.3 1367.5 1832.8 2352.9 116.5 224.0 6.3 3.46 * City of Makati 1622 16.5 11.4 10.9 11.5 15.5 24.7 34.7 57.0 92.4 159.8 322.1 582.6 853.9 1188.4 1579.3 2274.7 131.2 215.3 5.6 2.70 * City of Malabon 885 9.3 14.0 6.7 10.4 14.8 17.6 36.4 37.4 104.5 143.4 299.5 481.5 614.4 1194.2 1224.0 2359.9 99.7 192.3 7.0-1.54 City of Mandaluyong 859 18.8 5.4 7.6 15.1 20.6 22.4 38.1 46.1 125.5 190.4 275.4 589.0 809.4 1273.7 1520.4 2377.9 120.8 218.2 7.9 2.47 * City of Marikina 1073 18.6 10.8 15.6 15.3 11.2 16.7 40.3 33.6 101.8 135.1 258.5 386.1 676.7 1071.4 1406.5 2040.6 106.2 183.5 5.9-2.99 * City of Muntinlupa 995 22.6 15.7 14.4 12.6 15.3 20.8 27.5 59.5 84.1 156.7 230.0 424.4 743.3 1090.5 1542.5 2124.0 97.5 193.5 6.8-1.34 City of Navotas 531 11.6 13.7 8.0 13.4 8.6 16.0 37.3 59.6 84.1 161.9 268.9 437.4 588.3 869.3 1348.8 1682.5 87.2 168.4 8.1-3.25 * City of Parañaque 1527 19.8 14.6 12.4 11.9 17.5 25.7 28.9 43.7 111.4 178.4 273.6 527.2 837.8 1484.8 1748.4 2979.8 121.6 238.6 6.5 5.12 * City of Pasig 1622 14.2 10.2 13.1 13.6 15.5 20.7 35.5 47.6 108.7 169.8 287.5 531.0 956.7 1346.1 1548.6 2496.1 113.3 224.9 6.0 3.66 * City of San Juan 514 18.6 15.3 12.3 10.9 10.1 33.4 54.9 55.2 108.3 162.9 309.4 579.9 1067.3 1553.4 2280.5 3010.4 181.2 266.0 12.0 5.83 * Pateros 133 17.5 6.0 6.7 20.5 14.6 35.6 25.5 0.0 65.9 161.3 336.7 297.3 553.4 603.8 1055.0 1594.9 89.6 146.3 13.3-3.31 * Taguig City 945 17.4 9.2 10.8 12.2 13.4 18.0 21.9 42.3 70.7 98.2 201.0 427.9 525.4 1074.4 1123.4 1822.0 67.3 160.9 6.1-7.24 * Rizal Province 3745 16.4 7.6 6.6 10.9 16.4 14.0 28.3 39.5 66.1 111.1 222.8 326.0 587.2 804.4 1005.2 1220.2 71.2 137.7 2.5-20.11 * Angono 199 27.0 22.1 0.0 9.1 14.8 10.2 23.0 47.4 120.6 160.1 232.3 427.9 409.2 900.6 1650.2 1284.7 89.0 160.1 12.4-2.56 * Baras 32 10.5 0.0 0.0 0.0 29.3 0.0 19.1 114.1 23.7 0.0 105.1 155.6 299.9 713.4 365.6 483.9 42.9 74.9 14.4-5.39 * Binangonan 322 22.3 4.4 4.7 10.7 19.9 12.7 18.9 31.8 46.8 102.2 151.3 215.3 532.0 541.8 707.4 859.4 57.6 104.1 6.3-10.89 * Cainta 602 8.3 6.3 8.5 14.8 22.2 13.4 26.3 35.1 102.2 108.8 220.2 368.4 780.0 1011.0 1284.4 1963.4 86.2 175.2 7.9-3.98 * Cardona 73 8.4 7.9 16.3 8.8 0.0 0.0 0.0 78.4 29.6 141.6 206.9 309.2 531.4 360.2 855.8 833.3 67.1 107.6 13.4-4.83 * City of Antipolo 1014 14.7 9.1 4.9 10.6 15.3 15.4 35.8 28.4 57.7 119.6 226.1 381.3 635.2 926.5 1277.1 1350.2 69.9 153.3 5.4-8.43 * Jala-Jala 35 12.3 0.0 0.0 27.3 15.8 17.3 0.0 21.1 50.1 29.8 266.2 115.7 373.7 744.7 462.3 324.2 50.4 83.6 14.8-5.02 * Montalban 308 8.1 3.4 11.7 6.9 7.7 19.8 26.3 30.7 70.3 117.4 342.1 286.0 572.9 741.7 679.4 816.2 66.0 123.5 7.7-7.14 * Morong 84 29.2 22.0 29.9 0.0 17.8 9.8 22.9 46.0 68.3 46.9 177.7 158.1 324.5 583.8 877.2 984.9 69.5 104.6 12.0-5.55 * Pililla 74 22.7 0.0 0.0 13.9 0.0 17.2 49.8 53.5 51.5 80.4 179.5 108.7 331.5 612.5 459.6 810.4 53.5 89.8 11.1-6.39 * San Mateo 364 15.8 14.0 11.2 12.0 13.1 21.8 44.8 50.4 64.8 124.5 231.8 424.9 594.5 1037.3 1038.5 1491.4 86.5 159.3 9.1-3.69 * Tanay 128 10.1 3.4 0.0 8.3 10.1 16.6 19.2 34.4 39.3 125.9 253.0 208.2 474.8 433.1 693.6 918.0 56.8 102.8 9.7-7.15 * Taytay 465 29.3 2.7 6.3 14.0 27.8 9.1 22.3 55.4 56.6 120.2 229.5 385.0 650.1 878.2 989.8 1541.3 77.3 153.7 7.9-5.12 * Teresa 45 15.5 15.9 0.0 0.0 0.0 0.0 24.9 49.7 110.0 0.0 88.8 205.4 489.0 371.4 688.5 548.7 45.4 82.6 13.7-5.56 * 21
Table 3.3.1.2. Metro Manila and Rizal Province annual incidence rate per 100,000, all sites, female, by age group (years), 2003-2007. Female All Sites (C00-C95) AREAS CASES 0-5- 10-15- 20-25- 30-35- 40-45- 50-55- 60-65- 70-75+ CRUDE RATE ASR WORLD S.E. MANTEL- HAENSZEL TEST All Areas 44719 13.0 9.9 10.0 12.4 22.0 37.5 72.2 130.0 226.6 332.0 439.0 604.8 699.9 878.2 994.8 1227.3 140.0 199.9 1.0 PCS-MCR 22584 14.2 12.6 10.1 12.9 24.3 38.7 75.9 141.3 239.3 360.4 456.6 643.4 737.3 943.1 1078.9 1354.1 152.0 214.1 1.5 8.32 * City of Manila 8219 14.5 13.3 11.6 15.3 30.2 52.8 106.0 201.4 306.2 473.8 587.8 784.5 879.5 1109.9 1223.7 1356.8 198.3 258.2 2.9 22.55 * Caloocan City 3345 11.5 7.5 9.0 8.2 19.9 30.4 56.7 102.5 194.1 262.6 333.3 453.0 495.7 602.9 680.9 824.4 101.4 147.5 2.7-15.68 * Pasay City 1417 12.4 10.9 13.2 7.0 24.0 31.8 74.8 151.8 230.3 362.1 519.3 633.4 687.9 855.0 1071.2 1486.0 143.5 213.6 6.0 2.45 * Quezon City 9603 15.8 15.5 9.4 14.7 22.6 35.0 67.2 122.3 221.5 336.1 419.5 639.3 761.1 998.9 1154.8 1548.1 149.4 216.0 2.3 5.09 * DOH-RCR 22135 12.1 7.7 9.9 11.9 19.8 36.5 69.0 120.3 215.6 307.3 423.4 570.6 666.2 818.6 915.3 1106.1 129.6 187.0 1.3-7.90 * Metro Manila 17184 13.4 9.1 10.9 13.4 21.8 40.4 75.3 133.0 232.7 336.9 460.4 626.4 739.4 896.7 1022.6 1250.8 145.3 206.4 1.7 3.53 * City of Las Piñas 2029 11.5 5.3 2.5 11.1 18.5 38.8 86.8 125.4 283.5 354.2 490.0 755.3 762.4 941.0 1279.8 1319.3 153.6 224.1 5.3 4.66 * City of Makati 2321 13.6 11.9 13.7 16.1 31.1 51.4 91.9 143.6 222.7 351.9 464.4 626.2 795.0 931.0 1022.6 1234.3 167.8 213.8 4.6 3.51 * City of Malabon 1194 12.9 7.4 14.9 13.4 18.5 32.7 60.2 115.3 208.0 313.8 412.3 617.3 629.9 935.4 835.5 1103.1 134.0 188.1 5.7-2.22 * City of Mandaluyong 1206 17.2 12.8 13.9 9.4 17.3 49.7 63.8 151.2 285.3 325.5 554.5 698.6 733.8 1000.3 881.6 1082.6 158.9 214.7 6.4 2.79 * City of Marikina 1464 12.3 16.2 11.9 13.9 28.8 35.2 79.3 97.4 201.9 319.4 416.9 576.4 581.4 741.2 779.0 1082.0 138.2 179.0 4.8-3.57 * City of Muntinlupa 1388 13.9 9.8 18.2 17.9 13.6 28.4 65.6 98.2 235.3 334.6 439.8 649.5 626.3 823.6 1013.8 1344.4 130.2 198.2 5.7-0.69 City of Navotas 679 13.7 1.5 6.4 6.6 22.1 48.3 74.3 110.0 185.3 305.2 354.6 495.0 634.9 728.0 691.8 995.6 114.1 167.6 6.8-4.26 * City of Parañaque 2309 14.6 7.7 14.4 16.9 19.1 48.4 78.8 183.9 246.8 376.9 499.1 703.0 1045.2 972.9 1373.3 1844.3 171.9 252.3 5.5 10.02 * City of Pasig 2269 13.8 8.0 8.2 12.7 25.3 36.4 86.4 161.6 246.4 362.7 484.5 604.8 754.1 957.8 1249.2 1189.3 150.4 216.8 4.8 3.90 * City of San Juan 725 11.6 12.2 8.5 8.6 34.9 55.3 90.9 163.4 262.1 365.3 543.2 582.6 1071.9 1047.2 1284.7 1950.4 220.4 253.7 9.7 6.41 * Pateros 190 18.7 19.8 13.8 6.4 19.7 34.0 49.9 117.4 158.4 259.3 437.6 476.6 850.5 554.7 482.6 528.9 123.8 157.3 11.7-3.29 * Taguig City 1410 12.2 8.5 8.2 13.4 16.9 33.8 52.5 105.8 196.5 286.2 413.0 511.7 532.5 837.8 712.0 743.6 99.4 163.4 4.8-6.78 * Rizal Province 4951 9.4 5.0 7.9 8.7 14.6 26.3 53.6 91.1 176.1 238.3 335.1 438.4 491.8 632.1 648.0 730.1 94.3 140.4 2.1-22.97 * Angono 251 12.2 0.0 12.9 8.9 9.5 24.0 56.1 83.4 215.7 181.9 303.6 626.9 538.6 847.7 866.6 817.8 111.0 159.2 10.5-3.96 * Baras 40 0.0 0.0 0.0 0.0 15.4 32.5 40.2 59.5 97.9 219.2 188.3 274.3 293.7 282.0 131.9 280.1 55.8 77.7 12.8-5.98 * Binangonan 427 14.3 4.7 5.0 3.6 9.9 18.6 62.7 86.3 124.0 181.8 249.6 300.1 444.9 543.0 432.5 471.9 77.2 109.2 5.6-12.21 * Cainta 873 6.3 8.1 13.1 8.1 18.5 22.1 59.4 104.3 194.1 292.7 376.9 601.1 661.7 835.2 886.3 1073.0 120.7 179.4 6.4-3.71 * Cardona 87 8.8 0.0 0.0 9.3 0.0 0.0 26.9 90.2 93.2 420.8 153.1 357.8 194.5 526.6 666.7 287.2 81.8 104.4 11.5-6.13 * City of Antipolo 1342 10.7 5.1 7.6 9.4 11.5 29.1 48.9 96.5 166.3 241.4 346.0 466.0 521.6 793.5 855.6 879.1 92.4 155.1 4.6-9.92 * Jala-Jala 41 0.0 0.0 13.1 0.0 34.4 18.0 21.0 89.3 208.1 65.2 246.9 111.3 381.7 304.9 159.5 578.0 62.5 84.4 13.8-5.25 * Montalban 400 10.6 3.6 6.3 11.5 12.3 24.2 55.2 87.5 191.3 226.6 378.1 399.4 404.8 570.9 531.8 706.6 88.5 132.8 7.1-7.52 * Morong 125 30.8 7.7 0.0 8.4 45.2 30.1 81.5 126.4 242.3 180.3 305.1 288.1 542.3 371.6 457.8 348.3 105.0 124.8 11.5-4.90 * Pililla 85 0.0 0.0 12.8 0.0 17.0 17.7 31.3 55.3 123.8 166.4 249.8 335.1 290.7 588.9 72.5 510.8 63.9 93.4 10.5-7.09 * San Mateo 451 6.3 6.3 6.9 9.3 27.3 27.3 72.1 96.2 224.9 271.1 355.8 453.8 516.7 419.0 544.0 1010.8 106.3 147.4 7.3-5.52 * Tanay 175 3.6 0.0 7.6 4.3 5.0 56.4 65.3 108.8 108.1 185.8 377.6 476.7 308.0 388.1 583.1 384.3 79.8 115.7 9.1-6.72 * Taytay 584 7.1 7.4 8.1 15.2 15.5 28.0 46.0 77.5 211.4 246.9 394.2 382.7 514.7 558.4 630.4 691.8 96.5 140.9 6.2-7.80 * Teresa 70 17.2 8.5 9.5 11.1 0.0 34.2 12.1 40.3 120.2 257.8 228.5 378.2 372.7 470.2 432.9 437.5 71.9 106.3 13.3-5.37 * 22
Figure 3.3.1.1. Metro Manila and Rizal Province age-standardized incidence rates, all sites, males, 2003-2007. Figure 3.3.1.2. Metro Manila and Rizal Province age-standardized incidence rates, all sites, females, 2003-2007. 23
3.3.2. Metro Cebu For all cities and municipalities covered by EAF-MCCR, the overall crude and age-standardized incidence rates per 100,000 population among males for all sites were 114.0 per 100,000 and 209.6 per 100,000, respectively. Among females, the overall crude incidence rate was 132.4 per 100,000 while the overall age-standardized rate was 196.3 per 100,000. Among males, Cebu City had significantly higher ASR of 295.6 per 100,000 compared with that of overall Metro Cebu (Table 3.3.2.1 and Figure 3.3.2.1). All other areas, such as Mandaue, Lapu-Lapu, Talisay, Naga, Minglanilla, San Fernando, Consolacion, Lilo-an, Compostela, and Cordova had significantly lower ASRs than that of the overall Metro Cebu. Similar to those of males, females in Cebu City had significantly higher ASR of 277.0 per 100,000 compared with that of overall Metro Cebu (Table 3.3.2.2 and Figure 3.3.2.2). Significantly lower ASRs than that of the overall were observed in other cities and municipalities of Metro Cebu. Figure 3.3.2.1. Metro Cebu age-standardized incidence rates, all sites, males, 2003-2007. 3.3.3. Comparison with other Countries Figure 3.3.3.1 shows that the all sites ASR among males was lowest among the Singaporean Indians. A step higher were Malays in Singapore and residents of the DOH-RCR area, followed by residents of EAF-MCCR and PCS-MCR, and the Chinese in Los Angeles (L.A.). Singaporean Chinese and Non-Hispanic Whites in L.A. had even higher ASRs. The highest ASR was observed among the Saarland residents in Germany and the Black population in L.A. This could indicate the influence of varying lifestyles not only between developed and developing countries but also between ethnic and/or economic groups within the same geographic area. Among females (Figure 3.3.3.2) the all sites pattern was similar, with the Saarland population and Blacks and Filipino residents in L.A. having the highest ASRs. The lowest ASR was again observed among the Singaporean Indians. This similarity of the pattern observed in both males and females could indicate that the lifestyle differences that could lead to inter-country and intra-country variations in ASRs may affect both sexes. 24
Table 3.3.2.1. Metro Cebu annual incidence rates per 100,000, all sites, male, by age group (years), 2003-2007. Male All Sites (C00-C95) AREAS CASES 0-5- 10-15- 20-25- 30-35- 40-45- 50-55- 60-65- 70-75+ CRUDE RATE ASR WORLD S.E. MANTEL- HAENSZEL TEST Metro Cebu 5727 18.3 12.7 11.6 16.1 19.7 25.1 46.4 80.0 109.6 187.0 315.3 497.3 818.4 1216.1 1473.0 2017.6 114.0 209.6 2.9 Cebu City 3265 23.7 19.6 16.6 22.5 30.4 37.9 70.3 121.0 167.3 266.8 426.4 664.0 1112.3 1664.7 2131.0 2969.5 170.8 295.6 5.4 15.96 * Mandaue City 614 12.2 8.3 4.1 5.1 14.3 19.3 35.5 74.5 90.2 153.9 264.1 376.1 561.7 1182.1 1506.1 1985.7 81.8 183.1 8.2-4.26 * Lapu-Lapu City 535 22.2 6.1 11.6 14.6 13.3 13.7 32.9 76.6 93.4 165.7 251.0 441.6 700.9 913.1 826.0 1574.1 80.2 163.5 7.7-4.93 * Talisay City 354 23.2 12.3 9.0 18.4 7.7 19.5 22.4 55.7 97.3 122.5 161.2 385.2 788.4 961.7 969.2 1093.8 85.5 151.6 8.6-5.86 * Naga City 153 3.3 3.5 19.1 4.1 4.9 10.7 36.7 18.8 110.8 129.2 234.1 277.0 363.8 528.8 595.9 718.4 58.2 101.3 8.7-9.02 * Minglanilla 189 17.3 13.7 3.4 17.3 23.7 25.0 28.8 68.4 30.6 120.3 218.1 352.8 615.0 664.1 825.4 1091.4 70.9 132.0 10.3-6.53 * San Fernando 122 22.8 5.8 24.4 6.9 8.3 9.4 32.6 59.2 83.8 119.2 239.7 458.6 776.3 559.2 975.6 915.0 90.3 141.2 13.2-4.14 * Consolacion 165 7.7 8.8 0.0 23.8 10.6 21.1 41.7 46.3 55.2 89.5 250.4 372.1 569.7 752.0 1103.3 1463.2 80.4 144.5 12.0-4.86 * Lilo-an 158 17.8 11.8 9.0 14.3 5.1 16.2 6.1 45.3 66.2 127.5 200.6 279.4 345.1 1020.5 1021.9 1102.4 74.5 129.9 10.8-6.11 * Compostela 87 0.0 0.0 9.3 10.2 25.1 24.7 15.0 49.1 138.4 23.8 360.1 384.1 750.0 972.2 879.8 1524.7 93.8 159.9 17.8-2.70 * Cordova 85 0.0 22.3 0.0 0.0 9.7 0.0 71.3 126.4 67.5 107.9 315.1 416.5 353.2 1055.3 1201.1 1242.6 80.2 152.5 17.9-2.60 * Table 3.3.2.2. Metro Cebu annual incidence rates per 100,000, all sites, female, by age group (years), 2003-2007. Male All Sites (C00-C95) AREAS CASES 0-5- 10-15- 20-25- 30-35- 40-45- 50-55- 60-65- 70-75+ CRUDE RATE ASR WORLD S.E. MANTEL- HAENSZEL TEST Metro Cebu 6737 18.1 10.0 12.2 13.3 21.9 40.5 73.4 130.9 221.7 303.2 413.8 560.6 725.4 927.4 1003.3 1105.2 132.4 196.3 2.5 Cebu City 3938 25.8 14.2 14.7 19.5 30.4 54.0 105.5 196.1 308.3 444.9 587.5 809.8 935.0 1284.5 1461.2 1622.8 199.8 277.0 4.5 17.46 * Mandaue City 720 14.1 5.1 5.6 7.9 23.3 32.7 47.1 79.7 154.4 236.1 377.3 429.8 591.2 888.8 808.4 1086.4 95.0 163.2 6.5-5.54 * Lapu-Lapu City 626 15.4 13.0 13.2 9.2 17.8 40.4 63.4 111.4 177.7 217.0 286.9 423.9 571.6 759.7 620.6 876.5 91.3 150.9 6.5-5.84 * Talisay City 438 12.1 10.7 12.4 7.4 17.1 24.5 60.8 100.2 198.5 183.4 355.1 421.0 713.4 650.9 678.8 598.5 101.2 148.4 7.4-5.69 * Naga City 148 10.6 3.7 11.8 8.9 20.2 27.7 69.7 55.6 118.9 131.6 121.1 160.8 339.9 367.9 493.0 546.4 66.4 87.8 7.4-9.49 * Minglanilla 211 18.5 7.6 24.9 11.7 3.0 25.2 23.5 76.5 163.4 247.3 192.4 346.2 495.5 574.6 854.7 549.0 76.5 127.8 9.1-6.61 * San Fernando 110 12.3 0.0 6.4 14.7 36.7 29.8 11.6 101.9 238.8 192.9 42.3 396.5 425.4 599.5 226.8 552.2 84.6 110.0 10.7-5.94 * Consolacion 211 12.4 9.6 5.1 4.6 24.3 15.5 47.2 94.2 199.7 283.2 234.6 455.6 773.2 541.8 820.6 719.0 103.1 151.9 11.0-3.90 * Lilo-an 192 7.5 0.0 4.7 18.4 5.0 46.8 77.0 67.8 52.5 116.8 375.9 308.1 613.7 670.2 724.6 730.4 90.9 130.8 9.9-5.93 * Compostela 62 17.2 0.0 10.0 0.0 12.0 12.5 59.8 119.8 173.3 95.3 118.4 117.9 498.4 457.3 541.2 312.4 67.4 93.2 12.3-5.98 * Cordova 81 22.8 16.1 18.3 9.0 20.2 31.5 36.7 74.5 112.5 156.7 340.3 315.0 349.9 528.6 617.9 398.4 78.2 113.6 13.1-4.63 * 25
Figure 3.3.2.2. Metro Cebu age-standardized incidence rates, all sites, females, 2003-2007. Philippines PCS-MCR Philippines DOH-RCR Philippines EAF-MCCR Singapore Chinese Singapore Indian Singapore Malay Germany Saarland USA Los Angeles Black USA Los Angeles Chinese USA Los Angeles Filipino USA Los Angeles Non-Hispanic White 218.2 185.9 209.6 247.2 132.8 165.4 221.9 278.4 257.0 412.2 398.3 0 50 100 150 200 250 300 350 400 450 ASR (W) Figure 3.3.3.1. Comparison of age-standardized incidence rates with other countries, all sites, males, 2003-2007. 26
Philippines PCS-MCR Philippines DOH-RCR Philippines EAF-MCCR Singapore Chinese Singapore Indian Singapore Malay Germany Saarland USA Los Angeles Black USA Los Angeles Chinese USA Los Angeles Filipino USA Los Angeles Non-Hispanic White 214.1 187.0 196.3 207.5 135.4 169.5 298.4 274.3 188.6 261.3 215.5 0 50 100 150 200 250 300 350 400 450 ASR (W) Figure 3.3.3.2. Comparison of age-standardized incidence rates with other countries, all sites, females, 2003-2007. 3.4. Oral Cavity This group included malignancies of the tongue, gum, floor of the mouth, buccal mucosa, hard and soft palate as well as malignancies of the mouth, not otherwise specified. ICD-10 codes are C01-C06. 3.4.1. Metro Manila and Rizal Province There were a total of 865 new oral cavity cancers recorded between both sexes in the period covering 2003 to 2007 in both PCS-MCR and DOH-RCR. Among these, 460 were males while 405 were females, resulting in a male to female ratio of 1.14. The CR for males was 1.5 while the ASR was 2.8 per 100,000. For females, the CR and ASR were 1.3 per 100,000 and 2.1 per 100,000, respectively. Among males (Table 3.4.1.1 and Figure 3.4.1.1), the PCS-MCR had an ASR of 2.9 per 100,000, while the ASR for DOH-RCR was 2.6 per 100,000. For both, there was not enough evidence to say that the ASRs differed from the overall. The ASR of Rizal Province (2.0 per 100,000) was significantly lower, while the ASR of the DOH-RCR Metro Manila areas was similar with the overall (2.9 per 100,000). The cities of Manila and Pasig had significantly higher ASRs (3.6 per 100,000 and 4.9 per 100,000, respectively) compared with the overall. No case of oral cancer was found in Baras and Teresa during this period. For females (Table 3.4.1.2 and Figure 3.4.1.2), there was not enough evidence to say that the ASRs of PCS-MCR (2.0 per 100,000) and DOH-RCR (2.2 per 100,000) were significantly different from that of the overall. Rizal Province exhibited a significantly lower ASR (2.1 per 100,000), but the same cannot be said of the ASR from the DOH-RCR Metro Manila area (2.1 per 100,000). Only Pasig City had a significantly different ASR (3.5 per 100,000) compared with the overall. Moring and Teresa did not have any case of oral cancer among females for this period. 27
3.4.2. Metro Cebu In the EAF-MCCR areas a total of 149 new cases of oral cavity cancer were recorded for both sexes from 2003 to 2007. Of these new cases, 89 were male and 60 were female, with a male to female ratio of 1.48. The CR and ASR among males were 1.8 per 100,000 and 3.3 per 100,000, respectively (Table 3.4.2.1 and Figure 3.4.2.1). Compared with the overall ASR, Cebu City had a significantly higher ASR of 5.4 per 100,000. No case of oral cavity cancer was diagnosed in Talisay City. Among females, the overall CR was 1.2 per 100,000 while the ASR was 1.8 per 100,000 (Table 3.4.2.2 and Figure 3.4.2.2). Only Naga City had a significantly different ASR (0.4 per 100,000) compared to the overall. 3.4.3. Comparison with other countries Figure 3.4.3.1 shows that the highest male oral cancer rates were observed among Saarland residents, and the Non- Hispanic White residents in L.A and the Singapore Indians. The lowest rates occurred in the Filipino and Chinese residents in L.A. and Singapore Malays. Slightly higher ASRs were seen among Singapore Chinese as well as Philippine residents. These rates could reflect the levels of cigarette smoking and, among the Asian populations, betelquid chewing a couple of decades ago. Among females, Figure 3.4.3.2 shows that the differences were not large, and could indicate that the prevalence of cigarette smoking may have been lower compared to males. The highest ASR was seen among Singapore Indians and may be partly attributable to betel-quid chewing. Figure 3.4.1.1. Metro Manila and Rizal Province age-standardized incidence rates, oral cavity, males, 2003-2007. 28
Table 3.4.1.1. Metro Manila and Rizal Province annual incidence rate per 100,000, oral cavity, male, by age group (years), 2003-2007. Male Oral Cavity (C00-C06) AREAS CASES 0-5- 10-15- 20-25- 30-35- 40-45- 50-55- 60-65- 70-75+ CRUDE RATE ASR WORLD S.E. MANTEL- HAENSZEL TEST All Areas 460 0.0 0.0 0.0 0.0 0.1 0.3 0.4 0.8 1.1 3.8 5.4 8.8 11.9 17.4 17.2 20.0 1.5 2.8 0.1 PCS-MCR 228 0.1 0.0 0.0 0.0 0.1 0.1 0.2 0.5 1.2 4.6 7.3 9.3 15.7 16.4 14.8 17.0 1.6 2.9 0.2 0.77 City of Manila 83 0.0 0.0 0.0 0.0 0.0 0.5 0.0 0.7 1.7 6.5 9.8 10.0 17.3 14.6 25.4 23.2 2.1 3.6 0.4 2.33 * Caloocan City 37 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 1.0 3.6 2.4 7.2 10.9 26.2 4.9 22.1 1.1 2.4 0.4-1.37 Pasay City 17 0.0 0.0 0.0 0.0 1.0 0.0 1.2 0.0 0.0 4.4 11.2 12.7 0.0 49.0 0.0 16.9 1.8 3.3 0.9 0.92 Quezon City 91 0.1 0.0 0.0 0.0 0.0 0.0 0.4 0.7 1.1 4.0 7.6 9.6 19.4 7.5 13.8 11.0 1.5 2.6 0.3 0.00 DOH-RCR 232 0.0 0.1 0.1 0.0 0.1 0.4 0.6 1.1 1.0 3.0 3.7 8.3 8.7 18.3 19.4 22.6 1.4 2.6 0.2-0.71 Metro Manila 177 0.0 0.0 0.1 0.0 0.0 0.5 0.6 1.2 0.9 2.7 4.3 10.7 8.5 23.2 21.3 22.9 1.6 2.9 0.2 0.43 City of Las Piñas 19 0.0 0.0 0.0 0.0 0.0 0.0 1.9 1.1 0.0 3.3 2.0 17.1 8.7 20.6 23.3 0.0 1.5 2.6 0.6 0.01 City of Makati 25 0.0 0.0 0.0 0.0 0.0 0.0 0.0 1.1 2.5 3.0 3.7 20.3 13.0 24.8 37.4 0.0 2.0 3.4 0.7 0.83 City of Malabon 13 0.0 0.0 0.0 0.0 0.0 2.3 0.0 1.6 0.0 4.6 8.4 4.2 0.0 0.0 31.8 36.0 1.5 2.5 0.8-0.09 City of Mandaluyong 9 0.0 0.0 0.0 0.0 0.0 0.0 1.6 0.0 0.0 0.0 3.5 15.5 0.0 11.5 18.1 37.2 1.3 2.3 0.8-0.65 City of Marikina 10 0.0 0.0 0.0 0.0 0.0 0.0 0.0 1.3 1.6 0.0 2.4 3.4 5.1 35.7 0.0 0.0 1.0 1.7 0.6-1.62 City of Muntinlupa 11 0.0 0.0 0.0 0.0 0.0 0.9 0.0 4.0 0.0 0.0 0.0 7.4 11.2 0.0 15.6 34.0 1.1 2.0 0.7-1.01 City of Navotas 12 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 2.8 10.1 8.4 12.7 9.6 0.0 0.0 81.4 2.0 3.7 1.2 1.09 City of Parañaque 23 0.0 0.0 0.0 0.0 0.0 0.8 0.9 1.0 2.6 6.4 4.0 3.0 8.7 35.4 21.9 23.6 1.8 3.4 0.8 0.89 City of Pasig 36 0.0 0.0 0.7 0.0 0.0 0.7 0.8 1.8 0.0 2.9 9.1 19.0 16.0 42.6 20.6 45.0 2.5 4.9 0.9 3.13 * City of San Juan 4 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 46.4 0.0 50.6 1.4 2.4 1.2-0.64 Pateros 2 0.0 0.0 0.0 0.0 0.0 7.1 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 75.4 0.0 1.3 2.1 1.6-0.32 Taguig City 13 0.0 0.0 0.0 0.0 0.0 0.0 0.8 0.0 0.0 0.0 4.1 6.6 10.7 26.4 31.2 17.5 0.9 2.7 0.8-1.00 Rizal Province 55 0.0 0.2 0.0 0.0 0.2 0.2 0.5 0.8 1.3 3.9 2.5 3.0 8.9 7.1 14.8 21.9 1.0 2.0 0.3-2.21 * Angono 2 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 7.1 0.0 0.0 0.0 0.0 0.0 0.0 67.6 0.9 1.8 1.4-0.76 Baras 0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0-1.06 Binangonan 2 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 7.0 0.0 0.0 0.0 0.0 0.0 0.0 0.4 0.4 0.3-2.20 * Cainta 9 0.0 0.0 0.0 0.0 0.0 0.0 0.0 2.0 2.4 2.8 7.1 0.0 8.2 0.0 45.1 26.5 1.3 2.5 1.0-0.39 Cardona 1 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 44.3 0.0 0.0 0.0 0.9 1.8 1.8-0.60 City of Antipolo 17 0.0 0.0 0.0 0.0 0.0 0.8 1.8 0.0 1.2 1.5 1.9 5.9 0.0 22.6 25.5 55.1 1.2 3.0 0.8-0.42 Jala-Jala 1 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 154.1 0.0 1.4 3.1 3.1-0.10 Montalban 1 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 5.9 0.0 0.0 0.0 0.0 0.0 0.2 0.3 0.3-2.16 * Morong 1 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 15.6 0.0 0.0 0.0 0.0 0.0 0.0 0.8 0.9 0.9-0.78 Pililla 2 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 41.4 55.7 0.0 0.0 1.4 3.3 2.4-0.08 San Mateo 7 0.0 2.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 13.8 5.9 18.1 0.0 0.0 0.0 0.0 1.7 2.0 0.8 0.26 Tanay 4 0.0 0.0 0.0 0.0 0.0 0.0 0.0 6.9 0.0 9.7 0.0 0.0 50.0 0.0 0.0 0.0 1.8 3.0 1.6 0.36 Taytay 8 0.0 0.0 0.0 0.0 1.9 0.0 0.0 2.2 2.7 3.3 0.0 0.0 30.0 0.0 0.0 30.2 1.3 2.4 1.0-0.16 Teresa 0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0-1.19 29
Table 3.4.1.2. Metro Manila and Rizal Province annual incidence rate per 100,000, oral cavity, female, by age group (years), 2003-2007. Female Oral Cavity (C00-C06) AREAS CASES 0-5- 10-15- 20-25- 30-35- 40-45- 50-55- 60-65- 70-75+ CRUDE RATE ASR WORLD S.E. MANTEL- HAENSZEL TEST All Areas 405 0.0 0.0 0.0 0.2 0.2 0.2 0.3 0.5 0.8 1.9 2.6 4.1 7.8 13.8 18.1 23.1 1.3 2.1 0.1 PCS-MCR 190 0.0 0.0 0.0 0.2 0.3 0.3 0.3 0.7 0.6 1.5 2.0 4.5 8.8 12.2 12.7 26.9 1.3 2.0 0.2-0.19 City of Manila 57 0.0 0.0 0.0 0.0 0.4 0.2 0.0 0.7 0.0 1.4 3.4 5.7 4.4 13.4 14.4 26.0 1.4 2.0 0.3-0.34 Caloocan City 36 0.0 0.0 0.0 0.3 0.0 0.6 0.8 1.3 0.0 1.2 2.4 4.7 8.1 13.7 10.2 15.3 1.1 1.8 0.3-0.47 Pasay City 11 0.0 0.0 0.0 0.0 0.8 0.0 0.0 0.0 0.0 2.2 0.0 7.8 0.0 22.3 0.0 40.7 1.1 2.0 0.6-0.24 Quezon City 86 0.0 0.0 0.0 0.3 0.3 0.2 0.4 0.4 1.3 1.6 1.2 2.9 13.8 9.1 14.3 30.5 1.3 2.2 0.2 0.33 DOH-RCR 215 0.1 0.0 0.0 0.2 0.1 0.1 0.3 0.3 1.0 2.2 3.1 3.7 7.0 15.2 23.3 19.5 1.3 2.2 0.2 0.18 Metro Manila 154 0.1 0.0 0.0 0.3 0.2 0.0 0.1 0.3 0.7 2.5 3.8 4.4 9.1 14.1 20.3 17.8 1.3 2.2 0.2 0.27 City of Las Piñas 12 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 1.3 0.0 1.8 2.7 15.2 17.2 8.8 6.9 0.9 1.7 0.5-1.02 City of Makati 22 0.0 0.0 0.0 0.0 0.0 0.0 0.8 0.0 0.0 2.7 1.7 5.1 17.1 9.0 18.0 27.2 1.6 2.4 0.5 0.34 City of Malabon 5 0.0 0.0 0.0 1.1 0.0 0.0 0.0 0.0 0.0 2.3 0.0 0.0 0.0 0.0 22.0 8.9 0.6 0.9 0.4-1.95 City of Mandaluyong 11 1.3 0.0 0.0 0.0 0.0 0.0 0.0 0.0 2.2 5.2 3.2 4.7 0.0 17.9 12.2 20.6 1.4 2.1 0.7 0.24 City of Marikina 16 0.0 0.0 0.0 0.9 1.8 0.0 0.0 0.0 0.0 5.5 4.5 3.1 8.5 11.8 16.2 6.7 1.5 2.1 0.5 0.23 City of Muntinlupa 14 0.0 0.0 0.0 0.9 0.0 0.0 0.0 0.0 1.6 0.0 7.0 7.3 5.2 15.8 48.3 0.0 1.3 2.5 0.7 0.53 City of Navotas 6 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 8.8 0.0 17.6 12.3 18.2 0.0 1.0 1.9 0.8-0.44 City of Parañaque 13 0.0 0.0 0.0 0.0 0.0 0.0 0.0 1.0 0.0 0.0 1.9 2.8 7.9 16.9 8.1 26.1 1.0 1.8 0.5-0.87 City of Pasig 30 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 1.1 4.1 5.0 10.0 16.9 9.8 43.6 36.0 2.0 3.5 0.7 2.55 * City of San Juan 8 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 5.4 13.6 0.0 0.0 33.2 20.7 28.7 2.4 3.0 1.1 0.95 Pateros 0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0-1.52 Taguig City 17 0.0 0.0 0.0 0.0 0.0 0.0 0.0 1.9 1.2 4.5 4.0 6.3 0.0 27.9 10.8 19.1 1.2 2.3 0.6 0.80 Rizal Province 61 0.0 0.0 0.0 0.0 0.0 0.2 0.7 0.3 1.6 1.6 1.5 2.2 2.1 17.6 30.8 24.0 1.2 2.1 0.3-0.07 Angono 1 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 10.5 0.0 0.0 0.0 0.0 0.0 0.4 0.5 0.5-1.11 Baras 1 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 93.4 1.4 1.9 1.9 0.05 Binangonan 10 0.0 0.0 0.0 0.0 0.0 0.0 2.3 0.0 0.0 0.0 0.0 13.0 9.1 50.5 19.7 16.9 1.8 3.3 1.1 1.19 Cainta 7 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 2.7 0.0 0.0 0.0 20.9 32.8 27.9 1.0 2.0 0.8-0.55 Cardona 1 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 83.3 0.0 0.9 1.7 1.7-0.46 City of Antipolo 16 0.0 0.0 0.0 0.0 0.0 0.0 0.9 0.0 1.2 0.0 0.0 2.9 4.3 24.2 55.8 16.4 1.1 2.6 0.7 0.23 Jala-Jala 2 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 231.2 3.0 4.6 3.3 1.25 Montalban 5 0.0 0.0 0.0 0.0 0.0 0.0 2.6 0.0 3.8 0.0 6.2 0.0 0.0 17.3 0.0 23.6 1.1 1.7 0.8-0.04 Morong 0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0-1.38 Pililla 1 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 16.6 0.0 0.0 0.0 0.0 0.0 0.0 0.8 1.0 1.0-0.53 San Mateo 6 0.0 0.0 0.0 0.0 0.0 2.5 0.0 0.0 3.9 0.0 5.9 0.0 0.0 17.5 0.0 44.9 1.4 2.1 0.9 0.35 Tanay 3 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 16.6 10.3 0.0 0.0 0.0 0.0 0.0 0.0 1.4 1.6 0.9 0.20 Taytay 7 0.0 0.0 0.0 0.0 0.0 0.0 0.0 2.2 0.0 0.0 0.0 0.0 0.0 0.0 76.4 32.9 1.2 2.3 0.9-0.01 Teresa 1 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 21.5 0.0 0.0 0.0 0.0 0.0 0.0 1.0 1.3 1.3-0.17 30
Figure 3.4.1.2. Metro Manila and Rizal Province age-standardized incidence rates, oral cavity, females, 2003-2007. Figure 3.4.2.1. Metro Cebu age-standardized incidence rates, oral cavity, males, 2003-2007. 31
Table 3.4.2.1. Metro Cebu annual incidence rate per 100,000, oral cavity, male, by age group (years), 2003-2007. Male Oral Cavity (C00-C06) AREAS CASES 0-5- 10-15- 20-25- 30-35- 40-45- 50-55- 60-65- 70-75+ CRUDE RATE ASR WORLD S.E. MANTEL- HAENSZEL TEST Metro Cebu 89 0.0 0.0 0.0 0.2 0.0 0.2 0.5 1.9 1.0 6.1 4.5 7.2 14.3 15.6 15.8 42.1 1.8 3.3 0.4 Cebu City 57 0.0 0.0 0.0 0.0 0.0 0.0 1.4 3.1 1.8 8.7 5.5 11.5 28.4 21.0 32.0 65.6 3.0 5.4 0.7 2.73 * Mandaue City 5 0.0 0.0 0.0 0.0 0.0 0.0 0.0 1.9 0.0 6.2 4.1 0.0 9.5 0.0 0.0 0.0 0.7 1.1 0.5-1.84 Lapu-Lapu City 9 0.0 0.0 0.0 1.5 0.0 1.5 0.0 2.1 0.0 7.4 0.0 6.8 10.8 15.2 0.0 24.6 1.3 2.5 0.9-0.37 Talisay City 0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0-2.76 * Naga City 2 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 9.2 0.0 16.3 0.0 0.0 0.0 0.0 0.8 1.2 0.9-1.36 Minglanilla 2 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 33.2 0.0 49.6 0.8 2.0 1.4-1.18 San Fernando 2 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 20.0 0.0 0.0 0.0 0.0 61.0 1.5 2.2 1.6-0.46 Consolacion 4 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 7.9 0.0 13.2 18.6 0.0 39.6 0.0 0.0 1.9 3.1 1.6 0.12 Lilo-an 4 0.0 0.0 0.0 0.0 0.0 0.0 0.0 6.5 0.0 9.8 13.4 0.0 0.0 0.0 53.8 0.0 1.9 2.7 1.4-0.02 Compostela 3 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 88.4 0.0 179.4 3.2 6.2 3.7 0.84 Cordova 1 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 138.1 0.9 2.8 2.8-0.55 Table 3.4.2.2. Metro Cebu annual incidence rate per 100,000, oral cavity, male, by age group (years), 2003-2007. Female Oral Cavity (C00-C06) AREAS CASES 0-5- 10-15- 20-25- 30-35- 40-45- 50-55- 60-65- 70-75+ CRUDE RATE ASR WORLD S.E. MANTEL- HAENSZEL TEST Metro Cebu 60 0.2 0.2 0.0 0.0 0.0 0.2 0.5 0.9 2.6 0.4 3.3 3.0 8.4 2.8 15.3 24.8 1.2 1.8 0.2 Cebu City 28 0.0 0.0 0.0 0.0 0.0 0.5 1.4 1.6 3.6 0.0 3.9 3.5 9.8 3.3 18.3 18.4 1.4 2.0 0.4 0.53 Mandaue City 8 0.0 0.0 0.0 0.0 0.0 0.0 0.0 2.0 2.5 0.0 0.0 0.0 8.7 0.0 33.7 40.7 1.1 2.1 0.8 0.13 Lapu-Lapu City 7 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 2.9 0.0 0.0 0.0 0.0 12.3 35.5 47.0 1.0 2.2 0.8 0.07 Talisay City 4 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 6.2 8.6 11.9 0.0 0.0 18.7 0.9 1.5 0.8-0.49 Naga City 2 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 3.4 0.0 0.0 0.0 0.0 0.0 9.1 0.3 0.4 0.3-2.29 * Minglanilla 1 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 28.9 0.4 0.6 0.6-1.14 San Fernando 2 6.2 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 32.7 0.0 0.0 0.0 1.5 2.0 1.5 0.12 Consolacion 2 0.0 4.8 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 27.6 0.0 0.0 0.0 1.0 1.6 1.2-0.26 Lilo-an 3 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 8.8 0.0 26.8 0.0 0.0 0.0 0.0 0.0 1.4 1.9 1.1 0.13 Compostela 1 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 62.5 1.1 1.2 1.2-0.21 Cordova 2 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 39.4 0.0 0.0 0.0 79.7 1.9 3.2 2.2 0.71 32
Figure 3.4.2.2. Metro Cebu age-standardized incidence rates, oral cavity, females, 2003-2007. Philippines PCS-MCR Philippines DOH-RCR Philippines EAF-MCCR Singapore Chinese Singapore Indian Singapore Malay Germany Saarland USA Los Angeles Black USA Los Angeles Chinese USA Los Angeles Filipino USA Los Angeles Non-Hispanic White 1.2 2.9 2.6 3.3 2.9 2.4 2.1 4.8 5.6 6.3 8.0 0 1 2 3 4 5 6 7 8 9 10 ASR (W) Figure 3.4.3.1. Comparison of age-standardized incidence rates with other countries, oral cavity, males, 2003-2007. 33
Philippines PCS-MCR Philippines DOH-RCR Philippines EAF-MCCR Singapore Chinese Singapore Indian Singapore Malay Germany Saarland USA Los Angeles Black USA Los Angeles Chinese USA Los Angeles Filipino USA Los Angeles Non-Hispanic White 2.0 2.2 1.8 1.0 1.2 2.4 2.2 1.9 1.6 2.5 3.7 0 1 2 3 4 5 6 7 8 9 10 ASR (W) Figure 3.4.3.2. Comparison of age-standardized incidence rates with other countries, oral cavity, females, 2003-2007. 3.5. Stomach 3.5.1. Metro Manila and Rizal Province There were a total of 1,971 new cases of stomach cancer recorded in PCS-MCR and DOH-RCR from 2003 to 2007. Of these, 1084 were males while 887 were females giving a sex ratio of 1.22. The CR for males was 3.5 per 100,000 whereas the ASR was 7.2 per 100,000. For females it was 2.8 per 100,000 (CR) and 4.5 per 100,000 (ASR). For males, there was not enough evidence to say that the ASR of 8.1 per 100,000 population for PCS-MCR and 6.5 per 100,000 for DOH-RCR were significantly higher than the overall (Table 3.5.1.1 and Figure 3.5.1.1). The ASR of Rizal Province (4.2 per 100,000) was significantly lower, while there was not enough evidence to say that the ASR of the DOH-RCR Metro Manila area was also significantly higher (7.5 per 100,000). Among males, Manila had an ASR that was significantly higher than the overall. On the other hand, the areas with ASRs that were significantly lower than the overall ASR were Caloocan City, City of Marikina, Binangonan, City of Antipolo, and Tanay. No cases were reported from the municipalities of Jala-Jala, Morong and Teresa. For females (Table 3.5.1.2 and Figure 3.5.1.2) there was not enough evidence to say that the ASR of PCS-MCR (5.0 per 100,000) and that of DOH-RCR (4.1 per 100,000) were significantly different than the overall. The same conclusions could be said of the ASRs from the DOH-RCR Metro Manila areas (4.5 per 100,000) and Rizal Province (3.0 per 100,000). City of Manila had a significantly higher ASR (6.3 per 100,100), while those with significantly lower ASRs were Caloocan and Taytay. No case was recorded in Teresa. 3.5.2. Metro Cebu A total of 276 new cases of stomach cancer were recorded for both sexes in the period 2003 to 2007 by the EAF- MCCR. Of these new cases, 142 were male and 134 were female, with a male to female ratio of 1.06. The CR and ASR among males were 2.8 per 100,000 and 5.6 per 100,000, respectively. Among females, the CR was 2.6 per 100,000 while the ASR was 4.2 per 100,000. Among males, Cebu City had an ASR of 8.1 per 100,000 which was significantly higher than the overall Metro Cebu (Table 3.5.2.1 and Figure 3.5.2.1). On the other hand, the ASR of 2.5 per 100,000 observed in Lapu-Lapu City was significantly lower. 34
Among females, the ASRs observed in Cebu City and Talisay City were significantly higher than the overall Metro Cebu (Table 3.5.2.2 and Figure 3.5.2.2). No cases of stomach cancer were seen in San Fernando, Compostela, and Cordova. 3.5.3. Comparison with other countries The highest ASR of male stomach cancer was observed among Singapore Chinese, followed by residents of Saarland, Germany (Figure 3.5.3.1). The rates observed among Philippine residents were not too different from the other Asian populations and Filipino residents of L.A. There seems to be a global trend of decreasing incidence of stomach cancer, and the rate observed among the Singaporean Chinese could be the residual effects of higher levels of lifestyle and environmental risk factors. Figure 3.5.3.2 shows that the female Singaporean Chinese also had the highest ASR but was only half of that observed among their male counterparts. The lowest rates were seen among Non-Hispanic White residents in L.A. and Malays in Singapore. The rest had fairly comparable rates. Figure 3.5.1.1. Metro Manila and Rizal Province age-standardized incidence rates, stomach cancer, males, 2003-2007. 35
Table 3.5.1.1. Metro Manila and Rizal Province annual incidence rate per 100,000, stomach, male, by age group (years), 2003-2007. Male Stomach (C16) AREAS CASES 0-5- 10-15- 20-25- 30-35- 40-45- 50-55- 60-65- 70-75+ CRUDE RATE ASR WORLD S.E. MANTEL- HAENSZEL TEST All Areas 1084 0.0 0.0 0.0 0.1 0.2 0.5 0.6 1.4 2.2 5.7 11.4 17.7 24.9 40.1 61.9 93.2 3.5 7.2 0.2 PCS-MCR 555 0.1 0.0 0.0 0.2 0.1 0.6 0.7 1.3 2.4 6.0 11.4 19.0 25.3 44.7 65.0 119.3 3.9 8.1 0.4 1.76 City of Manila 199 0.0 0.0 0.0 0.8 0.2 0.7 0.9 0.7 2.1 6.0 15.9 19.0 37.2 54.3 85.9 138.9 5.0 9.9 0.7 3.67 * Caloocan City 81 0.0 0.0 0.0 0.0 0.3 0.0 0.4 2.5 0.5 4.2 11.1 13.1 10.9 26.2 29.2 104.9 2.5 5.5 0.7-2.49 * Pasay City 34 0.0 0.0 0.0 0.0 0.0 0.0 1.2 0.0 1.8 0.0 14.1 29.7 38.0 49.0 16.9 135.2 3.6 8.1 1.5 0.42 Quezon City 241 0.1 0.0 0.0 0.0 0.0 0.8 0.8 1.3 3.8 7.9 8.0 20.4 22.3 46.8 73.5 110.1 3.9 8.1 0.6 1.48 DOH-RCR 529 0.0 0.0 0.0 0.1 0.2 0.4 0.4 1.6 2.0 5.5 11.4 16.7 24.6 36.1 59.0 69.7 3.2 6.5 0.3-1.67 Metro Manila 420 0.0 0.0 0.0 0.1 0.3 0.4 0.6 1.3 2.2 5.9 13.7 18.8 28.6 41.8 66.5 82.7 3.7 7.5 0.4 0.76 City of Las Piñas 46 0.0 0.0 0.0 0.0 0.8 0.0 1.0 4.4 1.4 8.2 14.0 11.4 34.9 41.2 81.7 24.8 3.7 6.9 1.1 0.24 City of Makati 54 0.0 0.0 0.0 0.0 0.0 0.0 0.0 2.1 3.8 3.0 14.9 29.0 17.3 37.1 93.4 66.5 4.4 7.4 1.1 0.24 City of Malabon 37 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 6.8 19.6 24.9 18.6 69.7 63.6 126.1 4.2 9.0 1.6 1.02 City of Mandaluyong 26 0.0 0.0 0.0 0.0 0.0 1.3 0.0 1.8 2.3 5.7 21.2 20.7 7.5 11.5 36.2 130.0 3.7 6.6 1.4-0.12 City of Marikina 27 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 3.2 1.9 12.1 3.4 25.4 28.6 46.1 61.1 2.7 5.1 1.0-2.04 * City of Muntinlupa 31 0.0 0.0 0.0 0.0 0.0 0.9 0.0 0.0 0.0 7.7 0.0 22.1 50.3 27.7 77.9 51.0 3.0 6.8 1.3-0.60 City of Navotas 20 0.0 0.0 0.0 0.0 0.0 0.0 2.1 0.0 2.8 3.4 8.4 25.4 19.3 45.8 107.9 54.3 3.3 7.3 1.8-0.07 City of Parañaque 50 0.0 0.0 0.0 0.9 0.0 1.6 0.0 1.0 1.3 6.4 12.0 18.3 39.3 49.5 54.6 94.6 4.0 8.1 1.2 0.76 City of Pasig 63 0.0 0.0 0.0 0.0 0.7 0.0 0.8 0.9 3.5 8.7 18.2 21.7 32.0 42.6 72.3 123.7 4.4 9.1 1.2 1.90 City of San Juan 15 0.0 0.0 0.0 0.0 0.0 3.3 0.0 0.0 5.4 6.3 15.9 0.0 16.2 92.7 0.0 126.5 5.3 7.7 2.1 0.28 Pateros 4 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 26.9 0.0 0.0 0.0 0.0 75.4 79.7 2.7 4.7 2.5-0.83 Taguig City 47 0.0 0.0 0.0 0.0 0.7 0.0 2.4 1.9 2.4 3.0 16.2 23.0 37.5 52.8 62.4 87.6 3.3 8.5 1.4 1.32 Rizal Province 109 0.0 0.0 0.0 0.0 0.0 0.4 0.0 2.1 1.6 4.6 6.5 12.0 15.7 23.1 41.4 37.5 2.1 4.2 0.4-4.80 * Angono 8 0.0 0.0 0.0 0.0 0.0 5.1 0.0 0.0 7.1 8.9 22.1 16.5 0.0 0.0 132.0 0.0 3.6 5.8 2.3 0.00 Baras 2 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 35.0 0.0 0.0 118.9 0.0 0.0 2.7 5.3 4.0-0.43 Binangonan 10 0.0 0.0 0.0 0.0 0.0 0.0 0.0 9.8 0.0 0.0 0.0 6.7 29.0 0.0 52.4 0.0 1.8 3.1 1.1-2.16 * Cainta 14 0.0 0.0 0.0 0.0 0.0 0.0 0.0 2.0 2.4 2.8 10.7 5.3 8.2 13.1 45.1 79.6 2.0 4.4 1.3-1.95 Cardona 3 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 17.7 0.0 0.0 44.3 0.0 0.0 104.2 2.8 4.9 2.9-0.65 City of Antipolo 25 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 1.2 1.5 3.9 17.7 13.6 37.7 38.3 55.1 1.7 4.6 1.0-2.74 * Jala-Jala 0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0-1.65 Montalban 11 0.0 0.0 0.0 0.0 0.0 2.5 0.0 2.8 0.0 4.5 11.8 17.3 13.0 21.2 64.7 0.0 2.4 4.4 1.4-1.10 Morong 0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0-2.30 Pililla 5 0.0 0.0 0.0 0.0 0.0 0.0 0.0 10.7 0.0 32.1 0.0 0.0 41.4 55.7 0.0 0.0 3.6 5.9 2.8-0.08 San Mateo 9 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 3.8 4.6 5.9 9.0 26.4 20.7 0.0 76.5 2.1 4.4 1.6-1.50 Tanay 2 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 126.1 0.0 0.9 2.5 1.8-2.12 * Taytay 20 0.0 0.0 0.0 0.0 0.0 0.0 0.0 2.2 2.7 13.4 8.5 27.0 20.0 50.7 26.8 60.4 3.3 6.7 1.6 0.11 Teresa 0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0-1.83 36
Table 3.5.1.2. Metro Manila and Rizal Province annual incidence rate per 100,000, stomach, female, by age group (years), 2003-2007. Female Stomach (C16) AREAS CASES 0-5- 10-15- 20-25- 30-35- 40-45- 50-55- 60-65- 70-75+ CRUDE RATE ASR WORLD S.E. MANTEL- HAENSZEL TEST All Areas 887 0.0 0.0 0.0 0.1 0.2 0.4 0.8 1.3 2.0 4.7 6.2 12.1 15.7 26.6 36.2 49.6 2.8 4.5 0.2 PCS-MCR 465 0.0 0.0 0.0 0.1 0.2 0.4 0.9 1.3 2.0 5.3 6.2 14.6 17.2 26.4 44.0 55.3 3.1 5.0 0.2 1.67 City of Manila 185 0.0 0.0 0.0 0.2 0.4 1.0 1.2 2.1 2.0 8.2 9.2 21.2 22.0 32.6 45.2 64.9 4.5 6.3 0.5 4.38 * Caloocan City 60 0.0 0.0 0.0 0.0 0.0 0.0 1.1 0.4 1.0 4.9 6.3 14.0 8.1 15.9 20.3 24.4 1.8 3.0 0.4-2.69 * Pasay City 33 0.0 0.0 0.0 0.0 0.0 0.0 0.0 1.4 1.8 8.7 10.8 11.7 15.4 29.7 88.3 50.9 3.3 6.0 1.1 1.38 Quezon City 187 0.0 0.0 0.0 0.0 0.3 0.3 0.7 1.3 2.5 3.1 3.5 10.6 18.6 26.3 47.7 61.0 2.9 4.8 0.4 0.41 DOH-RCR 422 0.0 0.0 0.0 0.1 0.2 0.3 0.8 1.3 2.0 4.1 6.2 9.9 14.3 26.8 28.9 44.2 2.5 4.1 0.2-1.62 Metro Manila 330 0.0 0.0 0.0 0.1 0.3 0.4 1.0 1.5 2.1 3.6 6.9 10.9 13.4 30.1 33.5 53.4 2.8 4.5 0.3 0.04 City of Las Piñas 40 0.0 0.0 0.0 0.0 0.0 0.7 0.9 2.1 3.8 4.6 5.5 13.7 15.2 40.2 43.8 41.7 3.0 5.1 0.8 0.73 City of Makati 42 0.0 0.0 0.0 0.0 0.6 0.0 0.0 1.0 1.1 4.0 3.4 2.5 10.3 31.5 42.1 72.6 3.0 4.3 0.7-0.39 City of Malabon 22 0.0 0.0 0.0 0.0 0.0 1.2 0.0 0.0 0.0 0.0 5.5 19.9 5.5 23.0 33.0 62.3 2.5 4.0 0.9-0.71 City of Mandaluyong 23 0.0 0.0 0.0 0.0 0.0 0.0 0.0 5.3 6.5 2.6 16.0 0.0 6.2 35.7 36.7 30.9 3.0 4.3 0.9 0.13 City of Marikina 23 0.0 0.0 0.0 0.0 0.9 0.0 0.0 1.3 1.5 3.7 2.2 9.3 17.0 17.6 24.3 26.9 2.2 3.2 0.7-1.72 City of Muntinlupa 27 0.0 0.0 0.0 0.0 0.0 2.4 1.1 0.0 1.6 3.7 11.7 3.6 5.2 15.8 84.5 40.1 2.5 4.5 0.9 0.06 City of Navotas 22 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 2.9 7.0 4.4 19.0 26.5 49.4 18.2 110.6 3.7 6.7 1.5 1.56 City of Parañaque 42 0.0 0.0 0.0 0.0 0.0 0.0 0.9 2.0 2.4 3.0 7.5 19.6 23.6 28.1 16.3 71.7 3.1 5.2 0.8 0.89 City of Pasig 42 0.0 0.0 0.0 0.7 0.6 0.0 2.3 2.7 1.1 2.7 6.7 12.4 6.8 34.4 36.3 48.1 2.8 4.5 0.7 0.18 City of San Juan 15 0.0 0.0 0.0 0.0 0.0 0.0 3.6 0.0 0.0 0.0 13.6 27.3 24.9 0.0 41.4 71.7 4.6 5.2 1.4 0.73 Pateros 3 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 10.6 0.0 15.6 0.0 27.4 0.0 0.0 0.0 2.0 2.5 1.5-0.92 Taguig City 29 0.0 0.0 0.0 0.0 0.6 0.0 2.5 1.0 1.2 6.1 6.1 6.3 14.3 48.9 0.0 38.1 2.0 4.0 0.8-0.32 Rizal Province 92 0.0 0.0 0.0 0.0 0.0 0.2 0.2 0.8 1.9 5.5 4.5 7.4 16.5 19.1 17.6 20.3 1.8 3.0 0.3-3.55 Angono 5 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 7.0 8.7 0.0 16.1 20.7 31.4 0.0 0.0 2.2 3.4 1.6-0.52 Baras 3 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 73.4 188.0 0.0 0.0 4.2 8.6 4.9 0.64 Binangonan 10 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 10.9 0.0 19.6 18.2 12.6 19.7 0.0 1.8 2.9 1.0-1.29 Cainta 12 0.0 0.0 0.0 0.0 0.0 0.0 1.7 0.0 0.0 2.7 6.7 0.0 14.4 20.9 16.4 41.8 1.7 3.0 0.9-1.60 Cardona 2 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 17.5 0.0 0.0 0.0 0.0 0.0 57.4 1.9 2.2 1.6-0.79 City of Antipolo 23 0.0 0.0 0.0 0.0 0.0 0.7 0.0 2.0 1.2 3.0 6.0 2.9 17.1 24.2 18.6 24.6 1.6 3.1 0.7-1.74 Jala-Jala 2 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 76.3 0.0 159.5 0.0 3.0 6.2 4.4 0.11 Montalban 13 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 11.5 14.5 6.2 8.9 12.3 17.3 53.2 23.6 2.9 4.8 1.4 0.54 Morong 3 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 16.4 19.1 0.0 0.0 0.0 0.0 43.5 2.5 2.8 1.6-0.57 Pililla 3 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 27.9 0.0 107.1 0.0 0.0 2.3 4.3 2.5-0.36 San Mateo 5 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 3.9 0.0 5.9 8.7 12.0 0.0 0.0 22.5 1.2 1.8 0.8-1.89 Tanay 4 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 12.6 17.7 23.7 0.0 48.6 0.0 1.8 3.3 1.7-0.76 Taytay 7 0.0 0.0 0.0 0.0 0.0 0.0 0.0 2.2 0.0 6.7 0.0 6.5 18.1 0.0 0.0 16.5 1.2 1.8 0.7-2.15 * Teresa 0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0-1.61 37
Figure 3.5.1.2. Metro Manila and Rizal Province age-standardized incidence rates, stomach cancer, females, 2003-2007. Figure 3.5.2.1. Metro Cebu age-standardized incidence rates, stomach cancer, males, 2003-2007. 38
Table 3.5.2.1. Metro Cebu annual incidence rate per 100,000, stomach, male, by age group (years), 2003-2007. Male Stomach (C16) AREAS CASES 0-5- 10-15- 20-25- 30-35- 40-45- 50-55- 60-65- 70-75+ CRUDE RATE ASR WORLD S.E. MANTEL- HAENSZEL TEST Metro Cebu 142 0.0 0.0 0.0 0.0 0.0 0.0 0.3 2.7 1.6 5.7 10.8 9.6 26.2 26.0 42.2 71.8 2.8 5.6 0.5 Cebu City 84 0.0 0.0 0.0 0.0 0.0 0.0 0.7 4.6 2.8 7.6 16.6 13.4 42.6 25.2 57.6 107.3 4.4 8.1 0.9 2.75 * Mandaue City 16 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 3.1 8.3 6.2 19.0 29.9 47.8 136.9 2.1 6.2 1.6-0.35 Lapu-Lapu City 8 0.0 0.0 0.0 0.0 0.0 0.0 0.0 4.3 2.8 3.7 0.0 0.0 10.8 30.4 23.6 0.0 1.2 2.5 1.0-1.96 * Talisay City 9 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 4.9 0.0 9.0 13.6 58.9 62.5 30.4 2.2 4.8 1.6-0.87 Naga City 5 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 7.9 9.2 24.6 0.0 0.0 0.0 0.0 39.9 1.9 3.1 1.4-1.09 Minglanilla 4 0.0 0.0 0.0 0.0 0.0 0.0 0.0 6.2 0.0 0.0 12.1 0.0 23.7 0.0 0.0 49.6 1.5 2.9 1.5-1.21 San Fernando 3 0.0 0.0 0.0 0.0 0.0 0.0 0.0 11.8 0.0 0.0 0.0 0.0 37.0 50.8 0.0 0.0 2.2 3.7 2.2-0.73 Consolacion 4 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 9.9 0.0 37.2 0.0 0.0 61.3 0.0 1.9 3.3 1.7-0.81 Lilo-an 4 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 9.8 13.4 0.0 28.8 0.0 0.0 45.9 1.9 3.3 1.7-0.97 Compostela 4 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 30.0 42.7 0.0 88.4 0.0 89.7 4.3 7.7 3.9 0.58 Cordova 1 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 133.5 0.0 0.9 2.7 2.7-1.05 Table 3.5.2.2. Metro Cebu annual incidence rate per 100,000, stomach, female, by age group (years), 2003-2007. Female Stomach (C16) AREAS CASES 0-5- 10-15- 20-25- 30-35- 40-45- 50-55- 60-65- 70-75+ CRUDE RATE ASR WORLD S.E. MANTEL- HAENSZEL TEST Metro Cebu 134 0.0 0.0 0.0 0.5 0.0 0.6 1.8 2.1 2.9 3.5 7.1 11.3 15.7 26.3 36.4 26.3 2.6 4.2 0.4 Cebu City 78 0.0 0.0 0.0 0.8 0.0 0.5 2.7 2.3 4.5 6.4 9.0 15.9 14.7 32.8 63.9 40.6 4.0 5.8 0.7 2.37 * Mandaue City 10 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 3.1 7.9 0.0 26.1 12.0 16.8 27.2 1.3 2.9 0.9-1.67 Lapu-Lapu City 11 0.0 0.0 0.0 1.3 0.0 0.0 0.0 4.5 0.0 0.0 4.8 6.7 27.2 36.8 0.0 0.0 1.6 3.1 1.0-1.11 Talisay City 21 0.0 0.0 0.0 0.0 0.0 2.7 3.2 3.5 12.4 5.0 12.5 25.8 23.8 65.1 22.6 37.4 4.9 7.4 1.7 2.60 * Naga City 4 0.0 0.0 0.0 0.0 0.0 0.0 6.3 0.0 0.0 0.0 0.0 0.0 0.0 26.3 35.2 27.3 1.8 2.4 1.2-0.98 Minglanilla 1 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 21.5 0.0 0.0 0.0 0.4 0.9 0.9-2.17 San Fernando 0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0-2.00 * Consolacion 1 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 13.0 0.0 0.0 0.0 0.0 0.0 0.5 0.7 0.7-1.91 Lilo-an 8 0.0 0.0 0.0 0.0 0.0 5.2 5.9 6.8 0.0 0.0 0.0 36.3 0.0 0.0 80.5 27.1 3.8 4.8 1.8 0.80 Compostela 0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0-1.63 Cordova 0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0-1.65 39
Figure 3.5.2.2. Metro Cebu age-standardized incidence rates, stomach cancer, females, 2003-2007. Philippines PCS-MCR Philippines DOH-RCR Philippines EAF-MCCR Singapore Chinese Singapore Indian Singapore Malay Germany Saarland USA Los Angeles Black USA Los Angeles Chinese USA Los Angeles Filipino USA Los Angeles Non-Hispanic White 6.5 5.6 4.6 5.0 5.7 8.1 9.2 9.3 9.9 12.4 15.9 0 2 4 6 8 10 12 14 16 18 ASR (W) Figure 3.5.3.1. Comparison of age-standardized incidence rates with other countries, stomach, males, 2003-2007. 40
Philippines PCS-MCR Philippines DOH-RCR Philippines EAF-MCCR Singapore Chinese Singapore Indian Singapore Malay Germany Saarland USA Los Angeles Black USA Los Angeles Chinese USA Los Angeles Filipino USA Los Angeles Non-Hispanic White 5.0 4.1 4.2 7.8 4.7 2.6 6.2 5.4 6.5 3.5 2.3 0 2 4 6 8 10 12 14 16 18 ASR (W) Figure 3.5.3.2. Comparison of age-standardized incidence rates with other countries, stomach, females, 2003-2007. 3.6. Colon 3.6.1. Metro Manila and Rizal Province Between 2003 and 2007, a total of 3,990 new cases of colon cancer were recorded by PCS-MCR and DOH-RCR. Among these, 2,031 cases were males and 1,959 were females, resulting in a sex ratio of 1.04. The CR among males was 6.6 per 100,000 while the ASR was 13.2 per 100,000. For females, it was 6.1 per 100,000 (CR) and 10.0 per 100,000 (ASR). An ASR of 17.7 per 100,000 male population was recorded for PCS-MCR, which was significantly higher than the overall. The ASRs for the entire DOH-RCR areas (9.2 per 100,000), the DOH-RCR Metro Manila areas (9.6 per 100,000) and the Rizal Province (8.1 per 100,000) were significantly lower. Among males (Table 3.6.1.1 and Figure 3.6.1.1) the areas with ASRs that were significantly higher than the overall were Manila and Quezon City. On the other hand, the areas with ASRs that were significantly lower than the overall were Makati, Malabon, Marikina, Navotas, Pasig, Pateros, Taguig, Angono, Binangonan, Pililla, San Mateo, and Taytay. Similar to that in males, the ASR of the PCS-MCR (13.6 per 100,000) for females (Table 3.6.1.2 and Figure 3.6.1.2) was significantly higher than that of the overall. The ASR for DOH-RCR (6.7 per 100,000) was significantly lower the overall. The same can be said for the DOH-RCR Metro Manila areas (6.9 per 100,000) and Rizal Province (6.2 per 100,000). Among the areas, Manila and Quezon City showed significantly higher ASRs than the overall. Contrastingly, those that presented significantly lower ASRs were Malabon, Mandaluyong, Marikina, Muntinlupa, Navotas, Pasig, Taguig, Angono, Baras, Binangonan, Cainta, Antipolo, Montalban, and Taytay. 41
3.6.2. Metro Cebu The EAF-MCCR recorded a total of 790 new cases of colon cancer were recorded for both sexes in the period 2003 to 2007 by the EAF-MCCR. Of these new cases, 441 were male and 349 were female, with a male to female ratio of 1.26. The CR and ASR among males were 8.8 per 100,000 and 16.1 per 100,000, respectively. Among females, the CR was 6.9 per 100,000 while the ASR was 11.3 per 100,000. Among males, the ASR of residents of Cebu City of 23.0 per 100,000 was significantly higher than Metro Cebu (Table 3.6.2.1 and Figure 3.6.2.1). Lapu-Lapu City, on the other hand, had a significantly lower ASR (12.5 per 100,000) compared with the overall. Among females in the EAF-MCCR areas, Cebu City had the highest ASR (15.3 per 100,000) and it was significantly different from the overall Metro Cebu (Table 3.6.2.2 and Figure 3.6.2.2). The ASRs in Lapu-Lapu City, Naga City and Minglanilla were significantly lower than the overall. 3.6.3. Comparison with other countries The colon cancer rates among male Singapore Indians and of those in the DOH-RCR area were the lowest (Figure 3.6.3.1). These rates were less than half the ASR observed among Filipino and Chinese residents in L.A. The ASRs in the PCS-MCR and EAF-MCCR areas were almost twice the ASR seen in the DOH-RCR area. The highest rates were seen among the Black and Non-Hispanic White residents in L.A., Saarland, Germany residents and among the Singaporean Chinese. The lowest colon cancer rates among females were observed in the DOH-RCR registry and among the Singaporean Indians (Figure 3.6.4). The rate among Filipino residents in L.A. was only slightly higher than those in the PCS-MCR area. The ASR in EAF-MCCR was only slightly lower that of the PCS-MCR. The highest rates were observed among the Black and Non-Hispanic White residents in L.A., the Singaporean Chinese and among Saarland, Germany residents. The differences in rates may be largely attributable to lifestyle variability. Figure 3.6.1.1. Metro Manila and Rizal Province age-standardized incidence rates, colon cancer, males, 2003-2007. 42
Table 3.6.1.1. Metro Manila and Rizal Province Annual incidence rate per 100,000, colon, male, by age group (years), 2003-2007. Male Colon (C-18) AREAS CASES 0-5- 10-15- 20-25- 30-35- 40-45- 50-55- 60-65- 70-75+ CRUDE RATE ASR WORLD S.E. MANTEL- HAENSZEL TEST All Areas 2031 0.1 0.0 0.0 0.3 0.5 0.8 1.9 4.4 5.9 11.3 16.9 33.6 46.7 77.3 104.2 158.9 6.6 13.2 0.3 PCS-MCR 1272 0.1 0.0 0.0 0.5 0.7 1.2 2.7 6.1 7.6 15.7 21.5 42.2 62.2 103.9 140.9 219.6 8.9 17.7 0.5 8.25 * City of Manila 430 0.0 0.0 0.0 1.3 0.9 2.0 3.4 8.7 7.5 21.0 24.5 42.6 67.8 129.5 139.9 241.4 10.8 19.9 1.0 8.17 * Caloocan City 196 0.3 0.0 0.0 0.3 0.0 1.0 0.8 3.3 7.5 12.1 17.4 26.3 47.2 84.3 111.9 132.5 6.0 12.8 1.0-0.47 Pasay City 73 0.0 0.0 0.0 0.0 1.0 0.0 2.3 8.4 9.1 11.1 14.1 55.2 38.0 29.4 303.5 152.1 7.7 16.4 2.1 1.72 Quezon City 573 0.1 0.0 0.0 0.2 0.8 1.0 3.2 5.7 7.5 14.8 22.8 48.4 69.9 107.2 133.2 248.7 9.4 18.8 0.8 7.32 * DOH-RCR 759 0.0 0.0 0.0 0.1 0.2 0.4 1.2 2.9 4.4 7.4 12.8 26.2 33.3 54.5 71.4 104.0 4.6 9.2 0.4-8.40 * Metro Manila 544 0.0 0.0 0.0 0.1 0.0 0.5 1.4 3.1 4.1 6.8 11.9 28.2 35.1 61.9 69.0 114.5 4.8 9.6 0.4-6.77 * City of Las Piñas 89 0.0 0.0 0.0 0.8 0.0 0.8 2.9 4.4 2.8 11.5 16.0 59.8 39.3 82.5 105.1 148.6 7.1 13.7 1.6 0.64 City of Makati 66 0.0 0.0 0.0 0.0 0.0 0.8 0.0 2.1 1.3 10.7 20.5 26.1 52.0 37.1 74.8 66.5 5.3 9.0 1.2-3.08 * City of Malabon 30 0.0 0.0 0.0 0.0 0.0 0.0 0.0 1.6 1.9 4.6 2.8 29.1 24.8 99.5 15.9 54.0 3.4 7.2 1.4-3.69 * City of Mandaluyong 46 0.0 0.0 0.0 0.0 0.0 0.0 1.6 3.7 7.0 8.5 21.2 51.7 30.0 57.4 72.4 148.6 6.5 11.7 1.8-0.53 City of Marikina 45 0.0 0.0 0.0 0.0 0.0 0.0 2.4 1.3 4.8 5.8 4.8 24.1 45.8 42.9 34.6 110.0 4.5 8.1 1.3-3.39 * City of Muntinlupa 53 0.0 0.0 0.0 0.0 0.0 1.8 2.2 4.0 4.9 21.3 7.3 22.1 22.4 55.4 62.3 152.9 5.2 10.2 1.6-1.47 City of Navotas 15 0.0 0.0 0.0 0.0 0.0 0.0 0.0 4.6 5.6 0.0 8.4 6.3 9.6 30.5 80.9 54.3 2.5 5.3 1.5-3.74 * City of Parañaque 81 0.0 0.0 0.0 0.0 0.0 0.8 1.9 4.2 6.6 6.4 12.0 24.4 56.7 77.8 87.4 224.7 6.4 13.6 1.6-0.32 City of Pasig 62 0.0 0.0 0.0 0.0 0.0 0.0 1.6 2.7 5.8 0.0 10.9 27.1 32.0 85.3 92.9 56.2 4.3 9.1 1.2-3.14 * City of San Juan 18 0.0 0.0 0.0 0.0 0.0 0.0 4.2 0.0 5.4 0.0 0.0 22.7 32.3 46.4 62.5 202.4 6.3 9.5 2.3-1.51 Pateros 4 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 16.8 0.0 32.6 46.4 75.4 0.0 2.7 5.0 2.6-2.16 * Taguig City 35 0.0 0.0 0.0 0.0 0.0 0.7 0.0 3.8 2.4 1.5 14.2 9.9 16.1 44.0 46.8 105.1 2.5 6.6 1.3-4.45 * Rizal Province 215 0.0 0.0 0.0 0.2 0.8 0.2 0.7 2.6 5.1 8.9 15.0 21.7 29.1 37.4 76.9 78.2 4.1 8.1 0.6-6.02 * Angono 5 0.0 0.0 0.0 4.5 0.0 0.0 0.0 0.0 0.0 0.0 0.0 32.9 0.0 0.0 66.0 67.6 2.2 4.4 2.1-2.58 * Baras 3 0.0 0.0 0.0 0.0 0.0 0.0 0.0 19.0 0.0 0.0 35.0 51.9 0.0 0.0 0.0 0.0 4.0 5.0 2.9-0.91 Binangonan 16 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 7.0 13.8 13.5 19.3 30.1 104.8 28.6 2.9 6.0 1.6-3.41 * Cainta 42 0.0 0.0 0.0 0.0 0.0 0.0 0.0 3.9 11.9 11.2 17.8 36.8 49.3 52.5 112.7 106.1 6.0 11.9 2.0-0.34 Cardona 6 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 14.8 35.4 0.0 0.0 0.0 72.0 244.5 0.0 5.5 10.1 4.4-0.73 City of Antipolo 70 0.0 0.0 0.0 0.0 0.8 0.0 0.9 2.9 3.6 13.1 15.6 32.5 36.3 75.3 76.6 137.8 4.8 11.4 1.5-1.27 Jala-Jala 2 0.0 0.0 0.0 0.0 0.0 0.0 0.0 21.1 0.0 0.0 38.0 0.0 0.0 0.0 0.0 0.0 2.9 3.2 2.3-1.36 Montalban 19 0.0 0.0 0.0 0.0 0.0 2.5 0.0 5.6 3.5 4.5 17.7 26.0 26.0 63.6 64.7 35.5 4.1 7.9 2.0-1.82 Morong 6 0.0 0.0 0.0 0.0 17.8 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 87.7 227.3 5.0 7.7 3.3-1.20 Pililla 2 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 19.9 0.0 0.0 0.0 0.0 81.0 1.4 2.6 1.9-2.46 * San Mateo 13 0.0 0.0 0.0 0.0 0.0 0.0 3.0 0.0 7.6 9.2 5.9 18.1 39.6 0.0 33.5 38.2 3.1 5.2 1.6-2.79 * Tanay 8 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 15.7 9.7 24.1 0.0 50.0 0.0 0.0 57.4 3.5 5.9 2.2-1.79 Taytay 18 0.0 0.0 0.0 0.0 1.9 0.0 2.0 0.0 2.7 6.7 21.2 6.8 20.0 0.0 80.3 60.4 3.0 5.8 1.5-3.08 * Teresa 5 0.0 0.0 0.0 0.0 0.0 0.0 0.0 12.4 15.7 0.0 0.0 0.0 61.1 92.9 172.1 0.0 5.0 10.4 5.2-0.53 43
Table 3.6.1.2. Metro Manila and Rizal Province annual incidence rate per 100,000, colon, female, by age group (years), 2003-2007. Female Colon (C18) AREAS CASES 0-5- 10-15- 20-25- 30-35- 40-45- 50-55- 60-65- 70-75+ CRUDE RATE ASR WORLD S.E. MANTEL- HAENSZEL TEST All Areas 1959 0.0 0.0 0.0 0.1 0.4 0.7 1.7 3.1 4.9 8.5 15.1 24.0 34.9 55.5 80.6 121.4 6.1 10.0 0.2 PCS-MCR 1271 0.0 0.0 0.0 0.1 0.5 1.1 2.3 4.3 6.7 12.3 21.2 31.4 50.4 74.4 111.9 156.4 8.6 13.6 0.4 8.59 * City of Manila 479 0.0 0.0 0.0 0.0 0.4 2.1 4.0 7.0 9.3 13.9 31.5 41.5 53.8 97.9 125.5 163.9 11.6 16.4 0.8 10.08 * Caloocan City 167 0.0 0.0 0.0 0.0 0.6 0.0 0.4 2.1 4.5 10.5 13.3 23.3 35.6 50.1 61.0 103.8 5.1 8.9 0.7-1.51 Pasay City 66 0.0 0.0 0.0 0.0 0.8 0.9 2.4 2.9 3.6 13.0 5.4 31.3 61.6 74.3 99.4 112.0 6.7 11.9 1.5 1.18 Quezon City 559 0.0 0.0 0.0 0.1 0.6 1.1 2.2 4.1 6.6 12.2 20.3 28.2 53.5 68.5 127.1 177.0 8.7 14.1 0.6 7.01 * DOH-RCR 688 0.0 0.0 0.0 0.1 0.3 0.4 1.1 2.0 3.3 5.2 9.8 17.5 21.0 38.1 51.0 87.9 4.0 6.7 0.3-9.05 * Metro Manila 506 0.0 0.0 0.0 0.1 0.5 0.4 0.9 2.3 3.6 5.4 9.5 19.3 20.7 36.9 54.7 92.5 4.3 6.9 0.3-7.30 * City of Las Piñas 70 0.0 0.0 0.0 0.0 0.0 0.7 0.9 3.2 5.1 4.6 14.7 27.5 15.2 57.4 105.2 97.2 5.3 9.1 1.1-0.93 City of Makati 83 0.0 0.0 0.0 0.0 1.2 1.3 1.7 1.9 3.4 9.4 18.4 5.1 17.1 36.0 84.2 113.5 6.0 8.0 0.9-1.58 City of Malabon 30 0.0 0.0 0.0 0.0 0.0 0.0 1.4 0.0 1.9 4.5 2.7 19.9 5.5 38.3 33.0 97.9 3.4 5.4 1.0-3.52 * City of Mandaluyong 31 0.0 0.0 0.0 0.0 1.2 0.0 0.0 3.6 8.7 7.8 9.6 28.1 6.2 8.9 36.7 72.2 4.1 5.6 1.0-2.60 * City of Marikina 41 0.0 0.0 0.0 0.0 0.9 0.0 1.2 2.6 1.5 9.2 11.1 21.8 29.7 23.5 8.1 47.0 3.9 5.4 0.9-3.71 * City of Muntinlupa 37 0.0 0.0 0.0 0.0 0.0 0.8 0.0 0.0 4.7 3.7 7.0 21.9 31.3 23.8 12.1 120.4 3.5 6.4 1.1-2.81 * City of Navotas 14 0.0 0.0 0.0 0.0 0.0 0.0 4.4 2.4 0.0 10.5 0.0 12.7 8.8 37.0 0.0 31.6 2.4 3.6 1.0-3.50 * City of Parañaque 70 0.0 0.0 0.0 0.0 0.0 0.0 0.0 1.0 4.8 1.5 7.5 30.8 31.4 45.0 73.1 156.4 5.2 9.2 1.1-1.15 City of Pasig 70 0.0 0.0 0.0 0.0 0.6 0.0 0.8 4.5 2.2 6.8 5.0 19.9 20.3 44.2 101.7 96.1 4.6 8.0 1.0-2.07 * City of San Juan 23 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 4.8 0.0 13.6 18.2 37.4 49.9 62.2 129.1 7.0 8.5 1.8-0.89 Pateros 9 0.0 0.0 0.0 0.0 0.0 0.0 8.3 9.0 21.1 0.0 15.6 20.7 27.4 74.0 0.0 0.0 5.9 7.2 2.5-0.66 Taguig City 28 0.0 0.0 0.0 0.7 0.6 0.7 0.0 2.9 1.2 1.5 8.1 6.3 23.8 27.9 21.6 28.6 2.0 4.0 0.8-4.77 * Rizal Province 182 0.0 0.0 0.0 0.0 0.0 0.4 1.7 1.3 2.6 4.7 10.5 13.3 21.6 41.1 41.7 75.8 3.5 6.2 0.5-6.43 * Angono 6 0.0 0.0 0.0 0.0 0.0 0.0 5.6 0.0 7.0 0.0 10.5 0.0 0.0 0.0 48.1 77.9 2.7 3.8 1.6-2.13 * Baras 0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0-2.15 * Binangonan 13 0.0 0.0 0.0 0.0 0.0 0.0 4.6 0.0 0.0 0.0 9.1 13.0 27.2 25.3 0.0 33.7 2.3 3.8 1.1-3.48 * Cainta 27 0.0 0.0 0.0 0.0 0.0 1.4 1.7 1.9 0.0 5.4 10.0 20.6 7.2 73.1 16.4 83.6 3.7 6.5 1.3-2.28 * Cardona 8 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 35.1 0.0 29.8 38.9 117.0 83.3 57.4 7.5 11.2 4.0 0.11 City of Antipolo 50 0.0 0.0 0.0 0.0 0.0 0.7 0.0 1.0 4.9 10.5 12.0 2.9 21.4 36.3 65.1 98.6 3.4 7.0 1.0-2.64 * Jala-Jala 3 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 41.2 0.0 76.3 0.0 0.0 115.6 4.6 7.4 4.3-0.54 Montalban 7 0.0 0.0 0.0 0.0 0.0 0.0 5.3 0.0 0.0 0.0 0.0 8.9 12.3 17.3 0.0 47.1 1.5 2.6 1.1-3.54 * Morong 6 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 36.2 92.9 65.4 87.1 5.0 7.3 3.0-1.08 Pililla 9 0.0 0.0 0.0 0.0 0.0 0.0 0.0 11.1 0.0 0.0 20.8 83.8 41.5 53.5 0.0 113.5 6.8 10.6 3.6 0.29 San Mateo 22 0.0 0.0 0.0 0.0 0.0 0.0 0.0 3.2 3.9 0.0 17.8 8.7 12.0 52.4 98.9 179.7 5.2 9.3 2.0-0.63 Tanay 9 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 10.3 12.6 17.7 47.4 64.7 48.6 38.4 4.1 7.5 2.5-1.08 Taytay 17 0.0 0.0 0.0 0.0 0.0 0.0 2.0 2.2 2.7 0.0 12.9 13.0 27.1 27.2 57.3 16.5 2.8 5.0 1.3-2.92 * Teresa 5 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 17.2 0.0 0.0 84.0 53.2 0.0 0.0 87.5 5.1 8.3 3.8-0.31 44
Figure 3.6.1.2. Metro Manila and Rizal Province age-standardized incidence rates, colon cancer, females, 2003-2007. Figure 3.6.3.1. Metro Cebu age-standardized incidence rates, colon cancer, males, 2003-2007. 45
Table 3.6.2.1. Metro Cebu annual incidence rate per 100,000, colon, male, by age group (years), 2003-2007. Male Colon (C-18) AREAS CASES 0-5- 10-15- 20-25- 30-35- 40-45- 50-55- 60-65- 70-75+ CRUDE RATE ASR WORLD S.E. MANTEL- HAENSZEL TEST Metro Cebu 441 0.0 0.0 0.0 0.2 1.0 2.4 3.4 8.6 11.2 18.8 24.4 40.7 59.7 90.2 108.0 160.9 8.8 16.1 0.8 Cebu City 254 0.0 0.0 0.0 0.0 1.9 3.8 5.5 10.8 14.8 32.5 31.8 57.6 73.8 113.2 172.8 250.4 13.3 23.0 1.5 4.57 * Mandaue City 50 0.0 0.0 0.0 0.0 0.0 1.3 1.6 13.4 4.9 3.1 24.8 37.0 47.6 104.7 143.4 182.6 6.7 15.8 2.4-0.79 Lapu-Lapu City 37 0.0 0.0 0.0 0.0 0.0 0.0 1.8 4.3 5.7 11.0 18.9 47.6 75.5 76.1 23.6 123.0 5.5 12.5 2.2-1.87 * Talisay City 30 0.0 0.0 0.0 2.3 0.0 0.0 6.4 10.4 16.2 9.8 0.0 35.8 81.6 117.8 31.3 30.4 7.2 12.2 2.4-1.18 Naga City 19 0.0 0.0 0.0 0.0 0.0 5.3 0.0 2.1 23.7 27.7 49.3 0.0 90.9 0.0 91.7 39.9 7.2 12.4 3.0-1.14 Minglanilla 16 0.0 0.0 0.0 0.0 4.7 0.0 0.0 6.2 12.8 9.3 12.1 33.6 23.7 33.2 0.0 148.8 6.0 8.9 2.6-1.64 San Fernando 8 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 14.0 0.0 20.0 28.7 0.0 0.0 209.1 122.0 5.9 9.6 3.4-1.50 Consolacion 16 0.0 0.0 0.0 0.0 0.0 10.6 6.0 0.0 0.0 19.9 52.7 0.0 0.0 118.7 61.3 175.6 7.8 13.3 3.6-0.61 Lilo-an 5 0.0 0.0 0.0 0.0 0.0 0.0 0.0 12.9 8.3 9.8 0.0 0.0 0.0 37.8 0.0 0.0 2.4 3.0 1.5-3.30 Compostela 1 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 88.4 0.0 0.0 1.1 2.7 2.7-2.65 Cordova 5 0.0 0.0 0.0 0.0 0.0 0.0 0.0 28.1 0.0 0.0 0.0 41.7 58.9 87.9 0.0 0.0 4.7 8.3 4.1-1.22 Table 3.6.2.2. Metro Cebu annual incidence rate per 100,000, colon, female, by age group (years), 2003-2007. Female Colon (C-18) AREAS CASES 0-5- 10-15- 20-25- 30-35- 40-45- 50-55- 60-65- 70-75+ CRUDE RATE ASR WORLD S.E. MANTEL- HAENSZEL TEST Metro Cebu 349 0.0 0.0 0.0 0.3 0.5 0.6 3.4 5.1 2.9 9.7 16.9 31.6 47.1 72.0 72.8 113.0 6.9 11.3 0.6 Cebu City 200 0.0 0.0 0.0 0.4 0.9 0.5 6.1 7.8 6.3 17.1 22.0 38.9 58.7 104.9 100.5 136.5 10.1 15.3 1.1 3.59 * Mandaue City 48 0.0 0.0 0.0 0.0 1.1 1.3 1.7 4.0 0.0 6.2 31.8 29.0 43.5 72.1 84.2 163.0 6.3 12.5 1.9 0.59 Lapu-Lapu City 26 0.0 0.0 0.0 0.0 0.0 0.0 1.8 0.0 0.0 3.7 9.6 26.9 45.4 36.8 53.2 109.6 3.8 8.1 1.6-2.07 * Talisay City 19 0.0 0.0 0.0 0.0 0.0 0.0 3.2 0.0 4.1 0.0 0.0 34.4 23.8 48.8 45.3 112.2 4.4 7.4 1.7-1.93 Naga City 7 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 16.1 21.2 0.0 70.4 82.0 3.1 4.5 1.7-2.47 * Minglanilla 1 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 35.6 0.0 0.4 0.7 0.7-3.94 * San Fernando 7 0.0 0.0 0.0 7.4 0.0 0.0 0.0 25.5 0.0 0.0 21.1 0.0 32.7 79.9 0.0 0.0 5.4 7.0 2.7-1.14 Consolacion 16 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 10.1 0.0 91.1 82.8 67.7 91.2 126.9 7.8 14.0 3.5 0.50 Lilo-an 18 0.0 0.0 0.0 0.0 0.0 0.0 5.9 6.8 0.0 21.2 40.3 18.1 25.6 127.6 40.3 108.2 8.5 12.6 3.1 0.50 Compostela 5 0.0 0.0 0.0 0.0 0.0 12.5 0.0 34.2 0.0 0.0 0.0 0.0 55.4 0.0 0.0 62.5 5.4 6.5 3.1-0.79 Cordova 2 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 100.0 0.0 0.0 0.0 1.9 4.0 2.8-1.89 46
Figure 3.6.3.2. Metro Cebu age-standardized incidence rates, colon cancer, females, 2003-2007. Philippines PCS-MCR Philippines DOH-RCR Philippines EAF-MCCR Singapore Chinese Singapore Indian Singapore Malay Germany Saarland USA Los Angeles Black USA Los Angeles Chinese USA Los Angeles Filipino USA Los Angeles Non-Hispanic White 7.8 9.2 17.7 16.1 14.5 19.0 18.5 25.6 28.9 32.1 23.1 0 5 10 15 20 25 30 35 ASR (W) Figure 3.6.3.1. Comparison of age-standardized incidence rates with other countries, colon, males, 2003-2007. 47
Philippines PCS-MCR Philippines DOH-RCR Philippines EAF-MCCR Singapore Chinese Singapore Indian Singapore Malay Germany Saarland USA Los Angeles Black USA Los Angeles Chinese USA Los Angeles Filipino USA Los Angeles Non-Hispanic White 6.7 6.8 13.6 11.3 20.7 12.2 19.4 16.7 15.2 18.2 26.0 0 5 10 15 20 25 30 35 ASR (W) Figure 3.6.4. Comparison of age-standardized incidence rates with other countries, colon, females, 2003-2007. 3.6. Rectum 3.7.1. Metro Manila and Rizal Province A total of 2,841 new rectal cancer cases were identified in the PCS-MCR and DOH-RCR areas for the period between 2003 and 2007. Among these, 1,536 were males and 1,305 were females resulting in a sex ratio of 1.2. The CR for males was 5.0 per 100,000 while the ASR was 9.3 per 100,000. For females, the CR was 4.1 per 100,000 while the ASR was 6.5 per 100,000. In males (Table 3.7.1.1 and Figure 3.7.1.1), the computed ASRs for PCS-MCR (10.2 per 100,000) and DOH-RCR (8.5 per 100,000) were not significantly different than the overall ASR. For the Metro Manila areas covered by the DOH-RCR (9.9 per 100,000), there was no sufficient evidence to say that the ASR was significantly lower. For Rizal Province, the ASR of 5.2 per 100,000 was significantly lower than the overall. The areas with an ASR that were significantly higher than the overall were Manila, Parañaque, Pasig, and San Juan. On the other hand, the areas with significantly lower ASRs were Caloocan, Taguig, Binangonan, Antipolo, and Montalban. The computed ASRs for females (Table 3.7.2.1 and Figure 3.7.2.1) for the PCS-MCR (6.9 per 100,000) and DOH- RCR (6.0 per 100,000) were not significantly different from the overall. The ASR for Rizal Province (4.1 per 100,000) was significantly lower than the overall but not for the Metro Manila areas covered by the DOH-RCR (6.8 per 100,000). The cities/municipalities that showed a significantly higher ASR than the overall were Manila, Las Piñas, and Parañaque. Conversely, those that presented significantly lower ASRs were Caloocan, Navotas, Angono, Binangonan and Montalban. There was no case reported for the municipality of Jala-Jala. 3.7.2. Metro Cebu The EAF-MCCR recorded a total of 282 new cases of rectal cancer for both sexes in the period 2003 to 2007. Of these new cases, 173 were male and 109 were female, with a male to female ratio of 1.59. The CR and ASR among males were 3.4 per 100,000 and 6.5 per 100,000, respectively. The ASRs were significantly higher in Cebu City and Mandaue City compared to the overall Metro Cebu (Table 3.7.2.1 and Figure 3.7.2.1). The cities and municipalities of Lapu- 48
Lapu, Talisay, Naga, Minglanilla, San Fernando, Consolacion and Lilo-an had significantly lower ASRs compared to the overall. Among females, the CR was 2.1 per 100,000 while the ASR was 3.6 per 100,000. Only Cebu City had a significantly higher ASR (5.1 per 100,000) compared to Metro Cebu. The other areas of EAF-MCCR had lower ASRs than the overall, however, they were not statistically significant. 3.7.3. Comparison with other countries The highest male rectum cancer ASRs were among Saarland, Germany residents and the Chinese residents in Singapore (Figure 3.7.3.1). The lowest rates were seen among the Philippine residents, specifically EAF-MCCR and Singaporean Indians. Slightly higher rates were observed among Filipino, Black, Chinese and Non-Hispanic White residents in L.A and Singaporean Malays. The ASRs among females were lower compared to males (Figure 3.7.3.2). The pattern of the differences was however quite similar. The differences (or similarities) between and among sexes may also be attributable to lifestyle variations. Figure 3.7.1.1. Metro Manila and Rizal Province age-standardized incidence rates, rectum cancer, males, 2003-2007. 49
Table 3.7.1.1. Metro Manila and Rizal Province annual incidence rate per 100,000, rectum, male, by age group (years), 2003-2007. Male Rectum (C19-C21) AREAS CASES 0-5- 10-15- 20-25- 30-35- 40-45- 50-55- 60-65- 70-75+ CRUDE RATE ASR WORLD S.E. MANTEL- HAENSZEL TEST All Areas 1536 0.0 0.0 0.0 0.0 0.4 1.2 2.5 3.5 5.4 8.9 14.4 27.9 37.4 59.0 66.1 75.6 5.0 9.3 0.3 PCS-MCR 775 0.0 0.0 0.0 0.0 0.4 0.9 2.4 3.4 5.7 9.9 13.9 33.1 45.8 65.5 69.0 81.2 5.4 10.2 0.4 1.80 City of Manila 277 0.0 0.0 0.0 0.0 0.2 1.7 4.0 2.8 10.9 11.0 13.5 35.4 65.2 91.9 66.8 82.7 6.9 12.3 0.8 4.25 * Caloocan City 114 0.0 0.0 0.0 0.0 0.0 0.3 1.5 2.9 3.5 9.7 9.5 22.7 20.0 49.4 48.6 55.2 3.5 6.8 0.7-3.20 * Pasay City 55 0.0 0.0 0.0 0.0 1.0 0.0 4.6 5.6 3.6 8.9 11.2 42.5 31.7 49.0 118.0 152.1 5.8 11.8 1.8 1.40 Quezon City 329 0.0 0.0 0.0 0.0 0.6 0.8 1.5 3.7 3.8 9.6 16.9 35.7 47.6 57.4 73.5 81.4 5.4 10.2 0.6 1.24 DOH-RCR 761 0.0 0.0 0.0 0.1 0.4 1.6 2.5 3.6 5.2 7.9 14.9 23.4 30.1 53.4 63.4 70.6 4.6 8.5 0.3-1.68 Metro Manila 611 0.0 0.0 0.0 0.1 0.4 1.7 2.6 3.9 6.0 10.0 16.6 26.5 39.2 55.7 76.6 86.5 5.4 9.9 0.4 1.48 City of Las Piñas 70 0.0 0.0 0.0 0.0 0.0 1.6 3.8 5.5 11.1 4.9 20.0 14.2 56.7 48.1 58.4 99.1 5.6 10.1 1.3 0.85 City of Makati 83 0.0 0.0 0.0 0.0 0.0 2.3 1.9 4.2 5.1 13.7 16.8 31.9 30.3 86.7 74.8 88.6 6.7 10.9 1.3 1.37 City of Malabon 33 0.0 0.0 0.0 0.0 1.1 1.2 5.6 1.6 3.8 2.3 14.0 24.9 31.0 39.8 15.9 36.0 3.7 6.1 1.2-1.69 City of Mandaluyong 47 0.0 0.0 0.0 0.0 0.0 1.3 3.2 3.7 7.0 8.5 10.6 31.0 74.9 80.3 54.3 130.0 6.6 12.3 1.9 1.53 City of Marikina 46 0.0 0.0 0.0 0.0 0.0 2.1 0.0 0.0 3.2 9.7 19.3 20.7 30.5 28.6 92.2 61.1 4.6 7.9 1.2-1.29 City of Muntinlupa 46 0.0 0.0 0.0 0.0 1.0 0.9 2.2 4.0 4.9 11.6 9.8 22.1 27.9 37.0 93.5 85.0 4.5 8.7 1.4-0.54 City of Navotas 23 0.0 0.0 0.0 0.0 0.0 3.5 4.1 6.9 5.6 6.7 8.4 19.0 28.9 15.3 27.0 54.3 3.8 6.1 1.4-1.11 City of Parañaque 92 0.0 0.0 0.0 0.0 0.8 0.0 0.9 7.3 9.2 12.7 16.0 33.5 52.4 77.8 131.1 165.5 7.3 14.4 1.6 3.46 * City of Pasig 90 0.0 0.0 0.0 0.8 0.7 1.3 3.2 2.7 7.0 11.6 21.8 37.9 40.0 79.2 82.6 89.9 6.3 11.7 1.3 2.25 * City of San Juan 42 0.0 0.0 0.0 0.0 0.0 3.3 12.7 18.4 5.4 31.3 79.3 22.7 97.0 69.6 187.4 25.3 14.8 19.4 3.1 5.41 * Pateros 4 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 11.0 0.0 33.7 0.0 0.0 0.0 0.0 79.7 2.7 3.9 2.1-1.51 Taguig City 35 0.0 0.0 0.0 0.0 0.0 2.8 0.8 0.9 2.4 8.9 2.0 29.6 5.4 35.2 46.8 52.6 2.5 5.6 1.1-2.93 * Rizal Province 150 0.0 0.0 0.0 0.0 0.6 1.3 2.2 2.9 3.5 3.5 11.0 16.4 10.1 48.1 32.5 31.3 2.9 5.2 0.5-6.06 * Angono 12 0.0 0.0 0.0 0.0 0.0 0.0 0.0 5.9 14.2 17.8 11.1 32.9 0.0 37.5 132.0 67.6 5.4 9.3 3.0 0.19 Baras 3 0.0 0.0 0.0 0.0 14.6 0.0 0.0 0.0 0.0 0.0 35.0 0.0 0.0 118.9 0.0 0.0 4.0 6.5 4.1-0.39 Binangonan 9 0.0 0.0 0.0 0.0 0.0 4.2 0.0 2.4 2.9 3.5 13.8 0.0 0.0 15.0 0.0 0.0 1.6 2.0 0.7-3.57 * Cainta 27 0.0 0.0 0.0 0.0 1.5 3.0 3.5 2.0 4.8 2.8 17.8 15.8 8.2 65.7 45.1 53.1 3.9 6.9 1.5-1.19 Cardona 2 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 30.9 44.3 0.0 0.0 0.0 1.8 3.0 2.2-1.64 City of Antipolo 33 0.0 0.0 0.0 0.0 0.8 0.0 3.6 1.0 2.4 2.9 5.8 17.7 4.5 45.2 63.9 27.6 2.3 5.0 1.0-3.71 * Jala-Jala 2 0.0 0.0 0.0 0.0 0.0 17.3 0.0 0.0 0.0 0.0 0.0 0.0 74.7 0.0 0.0 0.0 2.9 4.4 3.3-0.89 Montalban 12 0.0 0.0 0.0 0.0 0.0 0.0 2.6 5.6 0.0 4.5 23.6 8.7 13.0 42.4 0.0 0.0 2.6 4.1 1.3-2.10 * Morong 2 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 13.7 0.0 0.0 0.0 0.0 58.4 0.0 0.0 1.7 2.6 1.9-1.92 Pililla 0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0-2.67 San Mateo 14 0.0 0.0 0.0 0.0 0.0 0.0 0.0 3.2 0.0 4.6 17.8 9.0 13.2 103.7 33.5 38.2 3.3 6.8 1.9-1.53 Tanay 9 0.0 0.0 0.0 0.0 0.0 5.5 0.0 13.8 0.0 0.0 12.0 34.7 0.0 36.1 0.0 114.7 4.0 6.6 2.4-0.63 Taytay 23 0.0 0.0 0.0 0.0 0.0 0.0 4.1 4.4 8.1 3.3 4.2 33.8 30.0 50.7 26.8 60.4 3.8 7.2 1.7-0.96 Teresa 2 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 41.1 0.0 92.9 0.0 0.0 2.0 4.4 3.2-1.26 50
Table 3.7.1.2. Metro Manila and Rizal Province annual incidence rate per 100,000, rectum, female, by age group (years), 2003-2007. Female Rectum (C19-C21) AREAS CASES 0-5- 10-15- 20-25- 30-35- 40-45- 50-55- 60-65- 70-75+ CRUDE RATE ASR WORLD S.E. MANTEL- HAENSZEL TEST All Areas 1305 0.0 0.0 0.0 0.1 0.4 0.7 1.7 2.9 4.6 7.1 10.3 15.3 27.2 37.9 44.6 56.7 4.1 6.5 0.2 PCS-MCR 665 0.0 0.0 0.0 0.1 0.4 0.8 1.5 2.9 5.7 6.6 12.3 17.1 28.7 39.5 48.0 60.7 4.5 6.9 0.3 1.48 City of Manila 241 0.0 0.0 0.0 0.0 0.6 1.4 1.8 3.5 10.2 7.2 14.3 18.7 36.2 44.5 59.6 58.4 5.8 8.1 0.5 3.50 * Caloocan City 79 0.0 0.0 0.0 0.0 0.3 0.6 0.8 3.4 3.0 8.6 6.3 7.0 16.2 13.7 23.7 27.5 2.4 3.7 0.4-4.15 * Pasay City 47 0.0 0.0 0.0 0.0 0.0 1.7 4.7 0.0 5.4 8.7 10.8 19.5 15.4 52.0 44.2 112.0 4.8 7.9 1.2 1.37 Quezon City 298 0.0 0.0 0.0 0.1 0.4 0.3 1.1 2.8 4.3 5.0 14.1 20.6 31.6 46.8 50.8 69.6 4.6 7.5 0.4 1.81 DOH-RCR 640 0.0 0.0 0.0 0.1 0.3 0.6 1.9 2.8 3.6 7.6 8.6 13.8 25.9 36.4 41.5 52.9 3.7 6.0 0.2-1.42 Metro Manila 509 0.0 0.0 0.0 0.1 0.1 0.6 2.5 3.1 4.3 8.5 8.8 15.0 28.9 43.0 48.5 60.5 4.3 6.8 0.3 0.93 City of Las Piñas 75 0.0 0.0 0.0 0.0 0.0 0.7 4.6 1.1 5.1 7.7 12.8 22.0 26.7 51.6 70.1 138.9 5.7 9.5 1.1 3.00 * City of Makati 60 0.0 0.0 0.0 0.0 0.0 0.7 1.7 2.9 2.3 9.4 8.4 15.2 34.3 49.5 48.1 22.7 4.3 6.3 0.8-0.57 City of Malabon 39 0.0 0.0 0.0 0.0 0.0 0.0 1.4 1.6 3.8 6.8 16.4 11.9 27.4 46.0 55.0 62.3 4.4 6.9 1.1 0.24 City of Mandaluyong 43 0.0 0.0 0.0 0.0 0.0 1.2 4.6 3.6 6.5 15.6 9.6 18.8 37.3 26.8 61.2 72.2 5.7 8.1 1.3 1.75 City of Marikina 38 0.0 0.0 0.0 0.0 0.0 1.0 3.5 3.9 3.1 5.5 0.0 15.6 21.2 41.2 8.1 53.8 3.6 5.0 0.8-1.43 City of Muntinlupa 37 0.0 0.0 0.0 0.9 0.0 0.0 3.3 0.0 0.0 5.6 14.0 21.9 31.3 23.8 24.1 70.2 3.5 6.0 1.0-0.46 City of Navotas 9 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 2.9 3.5 0.0 0.0 8.8 24.7 54.6 15.8 1.5 2.9 1.0-2.94 * City of Parañaque 78 0.0 0.0 0.0 0.0 0.0 0.7 1.7 9.9 4.8 12.0 11.3 22.4 35.4 50.6 73.1 78.2 5.8 9.2 1.1 3.18 * City of Pasig 59 0.0 0.0 0.0 0.0 0.0 0.0 1.5 1.8 6.7 8.1 5.0 10.0 47.3 29.5 58.1 48.1 3.9 6.6 0.9-0.18 City of San Juan 24 0.0 0.0 0.0 0.0 0.0 0.0 7.3 8.0 4.8 16.1 0.0 9.1 0.0 99.7 82.9 71.7 7.3 8.6 1.8 1.49 Pateros 7 0.0 0.0 0.0 0.0 0.0 6.8 0.0 0.0 21.1 0.0 0.0 0.0 27.4 37.0 0.0 81.4 4.6 5.6 2.2-0.12 Taguig City 40 0.0 0.0 0.0 0.0 0.6 0.7 1.6 2.9 4.8 7.6 12.1 9.5 14.3 48.9 21.6 28.6 2.8 5.1 0.9-0.95 Rizal Province 131 0.0 0.0 0.0 0.0 1.0 0.8 0.5 2.1 1.9 5.5 8.0 11.1 18.5 20.5 24.2 33.3 2.5 4.1 0.4-4.67 * Angono 2 0.0 0.0 0.0 0.0 0.0 0.0 5.6 6.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.9 0.7 0.5-2.40 * Baras 1 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 31.3 0.0 0.0 0.0 0.0 0.0 0.0 1.4 1.9 1.9-1.15 Binangonan 6 0.0 0.0 0.0 0.0 2.0 0.0 0.0 2.5 0.0 0.0 0.0 6.5 9.1 0.0 19.7 16.9 1.1 1.7 0.7-3.43 * Cainta 26 0.0 0.0 0.0 0.0 0.0 0.0 0.0 3.8 0.0 10.7 3.3 10.3 21.6 52.2 32.8 97.5 3.6 6.5 1.3-0.43 Cardona 1 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 21.9 0.0 0.0 0.0 0.0 0.0 0.9 1.1 1.1-1.79 City of Antipolo 36 0.0 0.0 0.0 0.0 0.0 0.7 0.0 0.0 2.4 7.5 10.0 17.7 21.4 18.2 46.5 32.9 2.5 4.9 0.8-1.90 Jala-Jala 0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0-1.64 Montalban 8 0.0 0.0 0.0 0.0 4.9 2.4 0.0 3.0 0.0 4.8 6.2 0.0 12.3 0.0 0.0 23.6 1.8 2.3 0.9-2.11 * Morong 6 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 13.5 0.0 19.1 0.0 36.2 46.4 130.8 0.0 5.0 7.2 3.0 0.02 Pililla 3 0.0 0.0 0.0 0.0 0.0 0.0 0.0 11.1 0.0 0.0 0.0 0.0 0.0 107.1 0.0 0.0 2.3 3.9 2.4-1.01 San Mateo 12 0.0 0.0 0.0 0.0 2.5 0.0 3.0 3.2 0.0 0.0 5.9 17.5 24.0 0.0 0.0 89.8 2.8 4.3 1.3-1.19 Tanay 6 0.0 0.0 0.0 0.0 0.0 5.6 0.0 0.0 0.0 0.0 0.0 35.3 23.7 32.3 0.0 38.4 2.7 4.5 1.9-0.86 Taytay 19 0.0 0.0 0.0 0.0 1.7 1.8 0.0 0.0 5.4 10.0 12.9 13.0 36.1 27.2 19.1 0.0 3.1 5.0 1.2-0.83 Teresa 5 0.0 0.0 0.0 0.0 0.0 0.0 0.0 13.4 17.2 0.0 85.7 0.0 0.0 0.0 0.0 0.0 5.1 6.1 2.8 0.59 51
Figure 3.7.1.2. Metro Manila and Rizal Province age-standardized incidence rates, rectum cancer, females, 2003-2007. Figure 3.7.2.1. Metro Cebu age-standardized incidence rates, rectum cancer, males, 2003-2007. 52
Table 3.7.2.1. Metro Cebu annual incidence rate per 100,000, rectum, male, by age group (years), 2003-2007. Male Rectum (C19-C21) AREAS CASES 0-5- 10-15- 20-25- 30-35- 40-45- 50-55- 60-65- 70-75+ CRUDE RATE ASR WORLD S.E. MANTEL- HAENSZEL TEST Metro Cebu 173 0.0 0.0 0.0 0.0 0.0 0.4 1.3 2.9 3.9 8.3 9.1 18.4 26.2 50.3 34.3 52.0 3.4 6.5 0.5 Cebu City 98 0.0 0.0 0.0 0.0 0.0 0.5 2.0 6.2 7.4 11.9 8.3 21.1 39.7 50.3 57.6 89.4 5.1 9.0 1.0-6.66 * Mandaue City 29 0.0 0.0 0.0 0.0 0.0 0.0 1.6 0.0 7.3 12.3 12.4 49.3 9.5 89.8 0.0 68.5 3.9 8.3 1.7-4.32 * Lapu-Lapu City 14 0.0 0.0 0.0 0.0 0.0 1.5 1.8 2.1 2.8 3.7 14.2 6.8 0.0 60.9 0.0 24.6 2.1 4.0 1.2-4.29 * Talisay City 12 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 4.9 19.3 9.0 40.8 39.3 62.5 0.0 2.9 5.7 1.7-3.72 * Naga City 4 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 18.5 12.3 16.3 0.0 0.0 0.0 0.0 1.5 2.4 1.2-2.97 * Minglanilla 2 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 103.2 0.0 0.8 2.1 1.5-2.95 * San Fernando 2 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 28.7 0.0 50.8 0.0 0.0 1.5 2.7 1.9-2.26 * Consolacion 5 0.0 0.0 0.0 0.0 0.0 0.0 0.0 6.6 0.0 0.0 0.0 0.0 60.0 39.6 0.0 58.5 2.4 5.2 2.4-2.67 * Lilo-an 5 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 28.8 113.4 0.0 45.9 2.4 5.5 2.5-2.73 * Compostela 1 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 62.5 0.0 0.0 0.0 1.1 2.5 2.5-1.83 Cordova 1 0.0 0.0 0.0 0.0 0.0 0.0 0.0 14.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.9 0.8 0.8-1.83 Table 3.7.2.2. Metro Cebu annual incidence rate per 100,000, rectum, female, by age group (years), 2003-2007. Female Rectum (C19-C21) AREAS CASES 0-5- 10-15- 20-25- 30-35- 40-45- 50-55- 60-65- 70-75+ CRUDE RATE ASR WORLD S.E. MANTEL- HAENSZEL TEST Metro Cebu 109 0.0 0.0 0.0 0.0 0.0 0.4 0.5 0.6 2.2 3.1 7.1 7.5 19.9 18.0 26.8 32.5 2.1 3.6 0.4 Cebu City 65 0.0 0.0 0.0 0.0 0.0 0.5 0.7 1.6 3.6 5.3 7.7 7.1 24.5 22.9 41.1 59.0 3.3 5.1 0.6 2.27 * Mandaue City 12 0.0 0.0 0.0 0.0 0.0 0.0 1.7 0.0 2.5 3.1 11.9 5.8 8.7 12.0 33.7 13.6 1.6 2.9 0.9-0.44 Lapu-Lapu City 7 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 3.7 4.8 13.5 9.1 12.3 0.0 15.7 1.0 2.0 0.8-1.46 Talisay City 9 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 12.5 8.6 47.6 32.5 0.0 0.0 2.1 3.8 1.3-0.12 Naga City 3 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 21.2 52.6 0.0 0.0 1.3 2.4 1.4-1.03 Minglanilla 2 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 35.6 28.9 0.7 1.3 0.9-1.45 San Fernando 1 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 14.9 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.8 0.9 0.9-1.28 Consolacion 2 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 13.0 18.2 0.0 0.0 0.0 0.0 1.0 1.4 1.0-1.13 Lilo-an 5 0.0 0.0 0.0 0.0 0.0 5.2 0.0 0.0 0.0 0.0 0.0 0.0 25.6 0.0 40.3 54.1 2.4 3.3 1.6 0.02 Compostela 1 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 90.2 0.0 1.1 1.8 1.8-0.81 Cordova 2 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 39.4 50.0 0.0 0.0 0.0 1.9 3.6 2.5-0.13 53
Figure 3.7.2.2. Metro Cebu age-standardized incidence rates, rectum cancer, females, 2003-2007. Philippines PCS-MCR Philippines DOH-RCR Philippines EAF-MCCR Singapore Chinese Singapore Indian Singapore Malay Germany Saarland USA Los Angeles Black USA Los Angeles Chinese USA Los Angeles Filipino USA Los Angeles Non-Hispanic White 6.5 10.2 8.5 9.8 11.5 13.1 12.0 14.2 12.0 19.0 23.2 0 5 10 15 20 25 ASR (W) Figure 3.7.3.1. Comparison of age-standardized incidence rates with other countries, rectum, males, 2003-2007. 54
Philippines PCS-MCR Philippines DOH-RCR Philippines EAF-MCCR Singapore Chinese Singapore Indian Singapore Malay Germany Saarland USA Los Angeles Black USA Los Angeles Chinese USA Los Angeles Filipino USA Los Angeles Non-Hispanic White 3.6 4.1 6.9 6.0 7.3 8.4 8.0 7.3 8.6 10.8 12.4 0 5 10 15 20 25 ASR (W) Figure 3.7.3.2. Comparison of age-standardized incidence rates with other countries, rectum, females, 2003-2007. 3.8. Liver 3.8.1. Metro Manila and Rizal Province A total of 4,481 new cases of liver cancer were recorded by PCS-MCR and DOH-RCR from 2003 to 2007. Among these new cases, 3,191 were males and 1,290 were females resulting in a sex ratio of 2.5. The CR among males was 10.3 per 100,000 while the ASR was 18.6 per 100,000. On the other hand, the CR was 4.0 per 100,000 and the ASR was 6.5 per 100,000 for females. For males (Table 3.8.1.1 and Figure 3.8.1.1), an ASR of 20.5 per 100,000 population was recorded for PCS-MCR, which was significantly higher than the overall. Meanwhile, for DOH-RCR, the ASR of 16.9 per 100,000 was significantly lower than the overall. Likewise, the ASR of Rizal Province (13.6 per 100,000) was also significantly lower. There was no sufficient evidence to say that the ASR for the DOH-RCR Metro Manila areas (18.3 per 100,000) was different from the overall. Only Manila had an ASR that was significantly higher than the overall. On the other hand, the areas with ASRs that were significantly lower than the overall ASR were Navotas, Taguig, Binangonan, Cainta, San Mateo and Tanay. For females (Table 3.8.1.2 and Figure 3.8.1.2), there was not enough evidence to say that the ASRs of PCS-MCR (6.9 per 100,000) and DOH-RCR (6.2 per 100,000) were significantly different than the overall. Areas in Rizal Province exhibited a significantly lower ASR (5.2 per 100,000), but the same cannot be said of the ASR from the DOH-RCR Metro Manila areas (6.6 per 100,000). The cities that showed a significantly higher ASRs than the overall were Manila, Pasay, and Parañaque. Contrastingly, Mandaluyong presented a significantly lower ASR. 55
3.8.2. Metro Cebu The EAF-MCCR recorded a total of 2004 new cases of liver cancer for both sexes in the period 2003 to 2007. Of these new cases, 1526 were male and 478 were female, with a male to female ratio of 3.19. The CR and ASR among males were 30.4 per 100,000 and 54.4 per 100,000, respectively. Among females, the CR was 9.4 per 100,000 while the ASR was 15.6 per 100,000. Among males, Cebu City had a significantly higher ASR (74.5 per 100,000) compared to the overall Metro Cebu (Table 3.8.2.1 and Figure 3.8.2.1). On the other hand, significantly lower ASRs than the overall were observed in Mandaue City, Talisay City, Naga City, Minglanilla, Consolacion, and Lilo-an. Similarly, the ASR of females from Cebu City was also significantly higher than the overall (Table 3.8.2.2 and Figure 3.8.2.2). Talisay City was significantly lower than Metro Cebu. 3.8.3. Comparison with other countries The highest ASR among males was observed in the EAF-MCCR areas, 2.5 times higher than the residents of PCS-MCR and DOH-RCR (Figure 3.8.3.1). The rate among Filipino residents in L.A. was lower, but still higher than those observed among Saarland residents and Non-Hispanic Whites in L.A. The ASRs among females were lower compared to males (Figure 3.8.3.2) but the pattern of differences between populations was basically similar. The differences (or similarities) between and among sexes may be largely attributable to the prevalence of hepatitis B infection, particularly chronic HBV infection. Figure 3.8.1.1. Metro Manila and Rizal Province age-standardized incidence rates, liver cancer, males, 2003-2007. 56
Table 3.8.1.1. Metro Manila and Rizal Province annual incidence rate per 100,000, liver, male, by age group (years), 2003-2007. Male Liver (C-22) AREAS CASES 0-5- 10-15- 20-25- 30-35- 40-45- 50-55- 60-65- 70-75+ CRUDE RATE ASR WORLD S.E. MANTEL- HAENSZEL TEST All Areas 3191 0.7 0.2 0.1 0.5 0.6 1.5 4.2 7.1 13.9 22.3 35.6 57.3 72.7 96.2 114.0 162.2 10.3 18.6 0.4 PCS-MCR 1641 0.6 0.1 0.0 0.7 0.7 1.6 4.2 9.1 14.8 25.2 39.8 64.6 69.9 107.7 126.2 192.6 11.4 20.5 0.6 3.23 * City of Manila 599 0.2 0.2 0.0 1.5 1.6 2.0 6.4 11.8 19.3 34.9 56.3 87.1 61.2 123.2 114.5 251.4 15.0 24.6 1.1 7.24 * Caloocan City 292 0.5 0.0 0.0 0.6 0.6 1.6 5.3 12.1 13.0 22.4 32.4 46.6 63.6 95.9 48.6 93.8 8.9 15.2 1.0-1.72 Pasay City 95 0.9 0.0 0.0 0.0 0.0 2.8 0.0 4.2 9.1 15.5 30.9 76.5 107.8 78.4 185.5 185.9 10.0 20.8 2.3 0.09 Quezon City 655 0.8 0.0 0.0 0.3 0.3 1.1 3.0 6.5 13.7 21.7 33.7 56.7 73.8 107.2 163.1 193.7 10.7 20.2 0.9 0.74 DOH-RCR 1550 0.9 0.3 0.2 0.4 0.5 1.5 4.2 5.4 13.1 19.8 32.0 50.9 75.2 86.3 103.1 134.8 9.4 16.9 0.5-3.06 * Metro Manila 1147 1.0 0.3 0.1 0.4 0.4 1.5 4.2 5.6 14.0 20.3 32.9 54.7 81.3 92.9 116.8 156.6 10.2 18.3 0.6-0.85 City of Las Piñas 140 3.4 0.0 0.0 0.0 0.0 1.6 1.9 5.5 16.6 26.2 36.0 59.8 69.8 103.1 151.8 185.8 11.2 20.4 1.9 0.79 City of Makati 137 0.0 0.0 0.0 0.0 0.0 1.5 4.7 5.3 11.4 22.8 37.2 58.0 121.4 55.7 56.1 132.9 11.1 17.3 1.6-0.80 City of Malabon 99 0.9 1.0 0.0 1.2 0.0 1.2 4.2 7.8 9.5 18.2 50.4 62.3 99.3 99.5 95.4 162.1 11.2 19.9 2.2 0.70 City of Mandaluyong 75 0.0 0.0 0.0 0.0 1.4 0.0 4.8 1.8 13.9 25.6 28.2 82.7 67.4 45.9 199.1 130.0 10.5 18.3 2.2-0.27 City of Marikina 100 0.9 0.0 0.0 0.0 1.0 2.1 6.1 8.1 19.4 11.6 19.3 41.4 66.1 114.3 80.7 134.4 9.9 16.1 1.7-1.37 City of Muntinlupa 88 0.9 0.9 0.0 1.1 0.0 0.0 4.4 7.9 12.9 11.6 34.2 44.3 72.7 101.7 77.9 102.0 8.6 15.5 1.8-1.52 City of Navotas 82 2.6 0.0 0.0 0.0 0.0 3.5 12.4 9.2 22.4 33.7 50.4 101.4 106.1 45.8 134.9 81.4 13.5 21.8 2.7 2.71 * City of Parañaque 133 0.0 1.5 0.0 1.7 0.8 0.0 3.7 6.2 14.4 22.3 37.9 30.5 52.4 141.4 153.0 212.8 10.6 19.9 1.9 0.10 City of Pasig 140 0.6 0.0 0.7 0.0 0.7 2.7 2.4 4.6 10.5 21.8 16.4 51.5 88.1 103.5 123.9 247.4 9.8 19.7 1.8-0.49 City of San Juan 39 0.0 0.0 0.0 0.0 0.0 0.0 4.2 0.0 16.3 31.3 23.8 68.2 64.7 69.6 218.7 177.1 13.7 19.6 3.2 0.16 Pateros 21 0.0 0.0 0.0 0.0 0.0 0.0 8.5 0.0 11.0 26.9 84.2 22.9 97.7 139.3 226.1 159.5 14.1 23.7 5.4 0.91 Taguig City 93 1.1 0.0 0.0 0.0 0.0 2.8 2.4 3.8 13.2 11.9 26.4 49.4 80.4 79.3 62.4 87.6 6.6 14.1 1.7-2.51 * Rizal Province 403 0.6 0.2 0.5 0.4 0.8 1.5 4.4 5.0 11.1 18.6 30.0 42.6 61.5 71.2 71.0 81.3 7.7 13.6 0.7-4.94 * Angono 19 0.0 0.0 0.0 0.0 0.0 0.0 5.7 5.9 14.2 26.7 33.2 49.4 48.1 37.5 66.0 135.2 8.5 13.9 3.5-0.95 Baras 3 0.0 0.0 0.0 0.0 0.0 0.0 19.1 38.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 4.0 3.4 2.0-1.72 Binangonan 34 0.0 0.0 1.6 0.0 2.0 0.0 4.7 0.0 8.8 14.1 27.5 26.9 58.0 15.0 78.6 85.9 6.1 10.5 2.0-3.14 * Cainta 53 0.0 0.0 0.0 0.0 0.0 1.5 1.8 2.0 16.6 19.5 28.4 31.6 90.3 52.5 67.6 106.1 7.6 13.9 2.1-2.10 * Cardona 13 0.0 0.0 0.0 0.0 0.0 0.0 0.0 39.2 0.0 53.1 62.1 61.8 44.3 0.0 122.2 0.0 12.0 15.3 4.5 0.14 City of Antipolo 118 1.5 0.5 0.0 0.0 0.8 0.8 6.3 2.0 13.2 21.9 29.2 62.1 77.1 82.9 102.2 68.9 8.1 15.9 1.6-1.17 Jala-Jala 5 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 29.8 38.0 0.0 149.5 106.4 0.0 0.0 7.2 12.9 5.9-0.96 Montalban 37 0.0 0.0 0.0 0.0 0.0 4.9 2.6 0.0 7.0 18.1 41.3 86.7 26.0 127.1 64.7 35.5 7.9 14.4 2.6-1.27 Morong 9 0.0 0.0 7.5 0.0 0.0 0.0 0.0 0.0 13.7 0.0 19.7 0.0 81.1 58.4 87.7 151.5 7.4 12.3 4.3-1.49 Pililla 10 0.0 0.0 0.0 0.0 0.0 8.6 10.0 10.7 12.9 16.1 39.9 0.0 0.0 111.4 0.0 81.0 7.2 10.6 3.6-1.22 San Mateo 31 0.0 0.0 2.2 2.4 0.0 5.5 3.0 6.3 11.4 13.8 5.9 63.3 26.4 83.0 100.5 38.2 7.4 12.1 2.4-1.93 * Tanay 4 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 9.7 0.0 0.0 50.0 36.1 0.0 0.0 1.8 3.7 1.9-3.97 * Taytay 59 1.3 0.0 0.0 1.7 3.7 0.0 6.1 13.3 5.4 20.0 55.2 13.5 80.0 118.2 53.5 181.3 9.8 18.0 2.7 0.02 Teresa 8 0.0 0.0 0.0 0.0 0.0 0.0 0.0 12.4 47.2 0.0 0.0 82.2 0.0 92.9 0.0 137.2 8.1 12.4 4.9-0.61 57
Table 3.8.1.2. Metro Manila and Rizal Province annual incidence rate per 100,000, liver, female, by age group (years), 2003-2007. Female Liver (C22) AREAS CASES 0-5- 10-15- 20-25- 30-35- 40-45- 50-55- 60-65- 70-75+ CRUDE RATE ASR WORLD S.E. MANTEL- HAENSZEL TEST All Areas 1290 0.4 0.0 0.2 0.2 0.3 0.6 1.1 1.8 4.3 5.0 9.8 16.1 19.4 37.2 60.8 68.8 4.0 6.5 0.2 PCS-MCR 653 0.3 0.0 0.4 0.5 0.4 0.5 0.9 2.0 5.2 5.8 7.7 19.0 22.3 37.7 51.9 83.8 4.4 6.9 0.3 1.27 City of Manila 230 0.2 0.0 0.0 0.2 0.0 0.0 2.2 2.4 6.5 7.7 8.0 22.0 27.4 40.1 65.8 92.5 5.5 7.9 0.5 2.75 * Caloocan City 116 0.3 0.0 0.0 1.2 0.6 0.6 0.4 0.9 6.1 4.3 8.6 18.6 24.3 34.1 33.9 55.0 3.5 5.9 0.6-0.77 Pasay City 50 0.0 0.0 0.0 0.0 0.0 0.0 2.4 5.8 3.6 4.3 8.1 23.5 25.7 44.6 66.3 142.5 5.1 8.8 1.3 1.99 * Quezon City 257 0.3 0.0 0.9 0.3 0.6 0.8 0.2 1.7 4.1 5.6 7.0 16.5 17.0 36.5 47.7 81.8 4.0 6.3 0.4-0.34 DOH-RCR 637 0.6 0.1 0.1 0.1 0.3 0.6 1.3 1.6 3.6 4.3 11.6 13.6 16.7 36.8 69.2 54.5 3.7 6.2 0.3-1.22 Metro Manila 477 0.6 0.0 0.1 0.1 0.3 0.6 1.4 1.8 3.5 4.7 10.9 14.3 15.1 39.9 74.9 64.1 4.0 6.6 0.3-0.05 City of Las Piñas 65 2.2 0.0 0.0 0.0 0.7 0.0 3.7 2.1 3.8 6.2 9.2 27.5 19.1 45.9 87.7 69.4 4.9 8.1 1.1 1.82 City of Makati 49 1.6 0.0 0.0 0.0 0.0 0.0 0.8 1.9 0.0 4.0 5.0 17.7 10.3 31.5 66.2 45.4 3.5 5.1 0.8-1.91 City of Malabon 43 0.0 0.0 0.0 0.0 1.1 1.2 2.9 4.9 3.8 6.8 13.7 11.9 38.3 69.0 44.0 26.7 4.8 7.5 1.2 0.92 City of Mandaluyong 20 1.3 0.0 0.0 0.0 0.0 1.2 0.0 0.0 4.4 2.6 3.2 0.0 0.0 53.6 36.7 51.6 2.6 4.2 1.0-2.17 * City of Marikina 47 0.0 0.0 0.0 0.9 0.0 1.0 1.2 0.0 6.2 5.5 8.9 9.3 4.2 23.5 121.7 67.2 4.4 6.4 1.0-0.13 City of Muntinlupa 42 0.0 0.0 0.0 0.0 0.8 1.6 1.1 1.3 6.3 5.6 7.0 10.9 15.7 55.4 84.5 70.2 3.9 7.2 1.2 0.51 City of Navotas 26 0.0 0.0 0.0 0.0 0.0 0.0 2.2 2.4 2.9 3.5 17.5 12.7 17.6 49.4 91.0 79.0 4.4 7.6 1.5 0.63 City of Parañaque 70 0.0 0.0 0.0 0.0 0.0 0.7 0.9 4.0 3.6 10.5 13.2 14.0 23.6 22.5 97.5 130.3 5.2 8.6 1.1 2.27 * City of Pasig 57 0.6 0.0 0.0 0.0 0.0 1.2 0.8 0.9 5.5 2.7 11.7 22.4 13.5 39.3 58.1 54.1 3.8 6.2 0.9-0.29 City of San Juan 19 0.0 0.0 0.0 0.0 0.0 0.0 0.0 4.0 4.8 0.0 20.4 36.4 0.0 16.6 82.9 71.7 5.8 6.6 1.5 0.25 Pateros 6 0.0 0.0 0.0 0.0 0.0 0.0 16.6 0.0 0.0 0.0 0.0 0.0 0.0 0.0 53.6 122.1 3.9 4.5 1.9-0.49 Taguig City 33 0.0 0.0 0.7 0.0 0.6 0.0 0.0 1.0 0.0 1.5 20.2 0.0 19.0 48.9 53.9 28.6 2.3 5.2 1.0-1.77 Rizal Province 160 0.6 0.2 0.0 0.0 0.2 0.6 1.0 1.1 3.9 3.2 13.1 11.8 20.6 29.3 54.9 29.6 3.0 5.2 0.4-2.52 * Angono 11 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 10.5 48.2 41.4 0.0 48.1 155.8 4.9 8.2 2.5 0.60 Baras 0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0-1.74 Binangonan 13 3.2 0.0 0.0 0.0 0.0 0.0 2.3 0.0 0.0 3.6 4.5 6.5 27.2 0.0 59.0 16.9 2.3 3.8 1.1-1.89 Cainta 20 0.0 0.0 0.0 0.0 0.0 0.0 0.0 1.9 2.3 2.7 6.7 10.3 14.4 41.8 82.1 27.9 2.8 5.2 1.2-1.44 Cardona 1 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 15.5 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.9 0.9 0.9-1.79 City of Antipolo 41 0.5 0.6 0.0 0.0 0.7 2.2 0.9 3.0 2.4 1.5 8.0 5.9 17.1 54.5 65.1 16.4 2.8 5.4 0.9-1.08 Jala-Jala 2 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 26.0 0.0 41.2 0.0 0.0 0.0 0.0 0.0 3.0 3.6 2.6-0.42 Montalban 14 1.8 0.0 0.0 0.0 0.0 0.0 0.0 0.0 3.8 4.8 18.6 0.0 49.1 34.6 0.0 47.1 3.1 5.6 1.6-0.58 Morong 7 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 13.5 0.0 0.0 78.6 72.3 0.0 65.4 0.0 5.9 8.2 3.1 0.39 Pililla 6 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 16.6 41.6 0.0 0.0 53.5 72.5 56.8 4.5 7.3 3.0 0.26 San Mateo 9 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 3.9 4.7 11.9 0.0 12.0 17.5 49.5 22.5 2.1 3.5 1.2-1.87 Tanay 5 0.0 0.0 0.0 0.0 0.0 0.0 6.5 0.0 8.3 0.0 25.2 17.7 0.0 0.0 0.0 0.0 2.3 2.9 1.3-1.20 Taytay 27 0.0 0.0 0.0 0.0 0.0 0.0 2.0 0.0 8.0 6.7 34.3 25.9 18.1 40.9 38.2 32.9 4.5 7.1 1.4 0.92 Teresa 4 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 324.7 87.5 4.1 8.2 4.1 0.10 58
Figure 3.8.1.2. Metro Manila and Rizal Province age-standardized incidence rates, liver cancer, females, 2003-2007. Figure 3.8.2.1. Metro Cebu age-standardized incidence rates, liver cancer, males, 2003-2007. 59
Table 3.8.2.1. Metro Cebu annual incidence rate per 100,000, liver, male, by age group (years), 2003-2007. Male Liver (C-22) AREAS CASES 0-5- 10-15- 20-25- 30-35- 40-45- 50-55- 60-65- 70-75+ CRUDE RATE ASR WORLD S.E. MANTEL- HAENSZEL TEST Metro Cebu 1526 1.9 0.5 0.2 0.4 2.2 4.3 15.8 25.7 43.4 66.0 103.2 159.6 214.7 305.3 355.7 406.0 30.4 54.4 1.5 Cebu City 847 2.7 1.5 0.0 0.0 2.9 4.9 25.2 33.9 69.3 85.7 150.9 211.1 315.0 394.2 460.8 548.6 44.3 74.5 2.7 7.59 * Mandaue City 166 0.0 0.0 0.0 1.3 2.4 7.7 11.3 26.7 31.7 55.4 82.5 86.3 142.8 284.3 430.3 433.6 22.1 47.5 4.1-2.09 * Lapu-Lapu City 153 4.4 0.0 0.0 0.0 1.5 1.5 9.2 25.5 34.0 84.7 71.0 142.7 151.0 228.3 330.4 393.5 22.9 46.6 4.1-1.76 Talisay City 83 0.0 0.0 0.0 0.0 0.0 5.6 0.0 10.4 44.6 39.2 58.0 116.4 135.9 215.9 218.8 273.4 20.1 35.4 4.1-4.04 * Naga City 40 0.0 0.0 0.0 0.0 0.0 0.0 12.2 10.5 31.7 27.7 61.6 97.8 113.7 165.3 137.5 79.8 15.2 25.8 4.4-4.76 * Minglanilla 40 3.5 0.0 0.0 3.5 0.0 0.0 17.3 24.9 7.7 37.0 12.1 184.8 71.0 132.8 103.2 148.8 15.0 25.8 4.4-4.74 * San Fernando 45 5.7 0.0 6.1 0.0 8.3 0.0 0.0 35.5 55.8 68.1 99.9 229.3 369.7 101.7 139.4 244.0 33.3 51.1 7.8-0.16 Consolacion 48 0.0 0.0 0.0 0.0 0.0 10.6 11.9 33.1 23.7 39.8 65.9 93.0 90.0 237.5 367.8 409.7 23.4 40.6 6.3-2.04 * Lilo-an 42 0.0 0.0 0.0 0.0 0.0 0.0 0.0 12.9 24.8 58.9 53.5 74.5 57.5 415.8 268.9 229.7 19.8 36.2 5.8-3.10 * Compostela 24 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 39.5 0.0 180.1 128.0 312.5 265.2 110.0 358.7 25.9 46.3 9.7-1.14 Cordova 38 0.0 0.0 0.0 0.0 9.7 0.0 59.4 56.2 33.8 43.2 85.9 208.3 117.7 527.6 667.3 414.2 35.9 67.1 11.9 1.45 Table 3.8.2.1. Metro Cebu annual incidence rate per 100,000, liver, male, by age group (years), 2003-2007. Female Liver (C-22) AREAS CASES 0-5- 10-15- 20-25- 30-35- 40-45- 50-55- 60-65- 70-75+ CRUDE RATE ASR WORLD S.E. MANTEL- HAENSZEL TEST Metro Cebu 478 1.2 0.0 0.0 0.3 0.7 1.5 2.3 6.9 7.3 10.1 23.0 43.7 62.8 102.4 134.0 122.3 9.4 15.6 0.7 Cebu City 259 1.9 0.0 0.0 0.0 0.9 1.1 4.1 10.1 10.8 11.7 28.4 53.0 63.6 134.4 173.5 191.8 13.1 20.0 1.3 3.40 * Mandaue City 57 0.0 0.0 0.0 0.0 1.1 0.0 0.0 8.0 7.5 6.2 23.8 63.9 43.5 108.1 134.7 108.6 7.5 15.0 2.1-0.39 Lapu-Lapu City 45 2.4 0.0 0.0 1.3 0.0 4.2 0.0 0.0 2.9 18.7 19.1 33.6 72.6 61.3 53.2 125.2 6.6 12.6 2.0-1.23 Talisay City 20 2.0 0.0 0.0 0.0 0.0 0.0 3.2 6.9 0.0 0.0 6.2 0.0 59.4 32.5 113.1 56.1 4.6 7.9 1.8-3.21 * Naga City 16 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 20.3 12.1 0.0 85.0 131.4 70.4 54.6 7.2 11.7 2.9-1.57 Minglanilla 21 0.0 0.0 0.0 0.0 0.0 5.0 0.0 0.0 7.8 9.5 36.1 31.5 129.3 54.7 142.5 28.9 7.6 14.7 3.3-0.59 San Fernando 15 0.0 0.0 0.0 0.0 0.0 0.0 0.0 12.7 29.8 17.5 21.1 52.9 98.2 119.9 56.7 42.5 11.5 16.3 4.3 0.07 Consolacion 13 0.0 0.0 0.0 4.6 4.9 0.0 0.0 0.0 8.3 10.1 13.0 72.9 0.0 33.9 45.6 84.6 6.4 9.1 2.6-1.43 Lilo-an 16 0.0 0.0 0.0 0.0 0.0 0.0 0.0 6.8 0.0 0.0 40.3 36.3 76.7 0.0 201.3 54.1 7.6 12.0 3.1-1.19 Compostela 7 0.0 0.0 0.0 0.0 0.0 0.0 29.9 0.0 0.0 0.0 0.0 39.3 0.0 196.0 90.2 0.0 7.6 11.1 4.3-0.86 Cordova 9 0.0 0.0 0.0 0.0 0.0 10.5 0.0 29.8 0.0 0.0 0.0 39.4 0.0 198.2 176.5 0.0 8.7 13.7 4.8-0.22 60
Figure 3.8.2.2. Metro Cebu age-standardized incidence rates, liver cancer, females, 2003-2007. Philippines PCS-MCR Philippines DOH-RCR Philippines EAF-MCCR Singapore Chinese Singapore Indian Singapore Malay Germany Saarland USA Los Angeles Black USA Los Angeles Chinese USA Los Angeles Filipino USA Los Angeles Non-Hispanic White 20.5 16.9 19.0 9.0 12.6 7.5 10.2 18.4 14.8 5.7 54.4 0 5 10 15 20 25 30 35 40 45 50 55 60 ASR (W) Figure 3.8.3.1 Comparison of age-standardized incidence rates with other countries, liver, males, 2003-2007. 61
Philippines PCS-MCR Philippines DOH-RCR Philippines EAF-MCCR Singapore Chinese Singapore Indian Singapore Malay Germany Saarland USA Los Angeles Black USA Los Angeles Chinese USA Los Angeles Filipino USA Los Angeles Non-Hispanic White 6.9 6.2 4.8 3.1 3.6 2.9 3.2 6.0 3.7 2.0 15.6 0 5 10 15 20 25 30 35 40 45 50 55 60 ASR (W) Figure 3.8.3.2. Comparison of age-standardized incidence rates with other countries, liver, females, 2003-2007. 3.9. Lung 3.9.1. Metro Manila and Rizal Province There were a total number of 8,900 new lung cancer cases during the period between 2003 and 2007 in the PCS-MCR and DOH-RCR areas. There were 6,242 males and 2,658 females, resulting in a sex ratio of 2.8. The CR and ASR among males were 20.2 per 100,000 and 42.8 per 100,000, respectively. For females, the CR was 8.3 per 100,000 while the ASR was 13.7 per 100,000. For males (Table 3.9.1.1 and Figure 3.9.1.1), the ASR of 44.8 per 100,000 population for PCS-MCR was significantly higher than the overall. Meanwhile, for DOH-RCR, an ASR of 41.0 per 100,000 was significantly lower than the overall. Likewise, the ASR of Rizal Province (34.2 per 100,000) was also significantly lower than the overall, but the same could not be said for the DOH-RCR Metro Manila areas (43.9 per 100,000). The areas with ASRs that were significantly higher than the overall were Manila, Quezon City, Malabon, Pasig and San Juan. On the other hand, the areas with ASRs that were significantly lower than the overall ASR were Caloocan, Taguig, Baras, Binangonan, Antipolo, Jala-Jala, Pililla, and Teresa. For females (Table 3.91.2 and Figure 3.9.1.2), the ASR of PCS-MCR (14.7 per 100,000) was significantly higher while the ASR of DOH-RCR (12.9 per 100,000) was significantly lower from the overall. There was no sufficient evidence to conclude that the ASR from the DOH-RCR Metro Manila areas (14.0 per 100,000) was significantly different from the overall. However, the ASR for Rizal Province (10.1 per 100,000) was significantly lower than the overall. The cities/municipalities that showed a significantly higher ASR than the overall were Manila, Quezon City, Parañaque and San Juan. Contrastingly, those that presented a significantly lower ASR were Caloocan, Pateros, Binangonan, San Mateo, Tanay, and Taytay. 62
Table 3.9.1.1. Metro Manila and Rizal Province Annual incidence rate per 100,000, lung, male, by age group (years), 2003-2007. Male Lung (C33-34) AREAS CASES 0-5- 10-15- 20-25- 30-35- 40-45- 50-55- 60-65- 70-75+ CRUDE RATE ASR WORLD S.E. MANTEL- HAENSZEL TEST All Areas 6242 0.0 0.0 0.0 0.0 0.6 1.0 2.3 4.5 13.5 25.7 61.2 113.8 199.8 286.5 353.6 430.5 20.2 42.8 0.6 PCS-MCR 3066 0.0 0.0 0.0 0.0 0.7 1.0 2.8 5.3 14.3 26.5 67.0 122.6 198.8 292.3 379.4 458.3 21.4 44.8 0.9 2.35 * City of Manila 1062 0.0 0.0 0.0 0.0 0.9 1.0 2.5 5.9 18.0 26.9 78.9 158.7 232.8 367.5 407.1 492.8 26.6 52.0 1.7 6.18 * Caloocan City 375 0.0 0.0 0.0 0.0 0.6 1.0 2.3 4.2 7.5 16.4 43.5 80.1 99.9 168.6 209.1 187.6 11.4 24.3 1.4-9.67 * Pasay City 176 0.0 0.0 0.0 0.0 1.0 0.9 2.3 4.2 5.4 20.0 73.1 97.7 171.2 244.9 489.0 456.2 18.5 42.7 3.4-0.42 Quezon City 1453 0.0 0.0 0.0 0.0 0.6 1.1 3.4 5.7 16.9 32.6 70.4 123.6 231.0 309.5 425.0 543.7 23.7 50.0 1.4 5.42 * DOH-RCR 3176 0.0 0.0 0.0 0.1 0.6 0.9 1.9 3.8 12.8 25.0 56.2 106.3 200.6 281.5 330.5 405.3 19.2 41.0 0.8-2.19 * Metro Manila 2378 0.0 0.0 0.0 0.1 0.6 1.3 2.0 4.0 15.2 28.0 62.7 111.7 207.4 303.3 337.7 451.8 21.1 43.9 0.9 1.09 City of Las Piñas 249 0.0 0.0 0.0 0.8 0.0 3.2 1.0 3.3 6.9 16.4 58.0 108.2 218.1 309.2 361.9 396.3 20.0 42.4 2.8-0.50 City of Makati 271 0.0 0.0 0.0 0.0 0.0 0.0 0.9 3.2 12.7 25.9 57.7 115.9 164.7 241.4 355.1 398.8 21.9 39.0 2.4-1.48 City of Malabon 222 0.0 0.0 0.0 0.0 0.0 0.0 2.8 4.7 22.8 38.7 75.6 157.7 192.4 388.1 286.1 630.5 25.0 51.9 3.7 3.01 * City of Mandaluyong 174 0.0 0.0 0.0 0.0 1.4 4.0 3.2 5.5 25.6 48.3 63.5 160.2 179.9 252.4 271.5 501.6 24.5 45.2 3.6 1.62 City of Marikina 257 0.0 0.0 0.0 0.0 0.0 0.0 3.7 2.7 9.7 34.7 77.3 86.2 218.8 371.4 426.6 476.5 25.4 48.3 3.1 1.59 City of Muntinlupa 175 0.0 0.0 0.0 0.0 0.0 0.0 0.0 6.6 11.3 32.9 61.2 62.7 218.0 249.5 311.6 305.9 17.2 37.2 3.0-1.72 City of Navotas 111 0.0 0.0 0.0 0.0 1.7 0.0 2.1 6.9 8.4 27.0 54.6 69.7 241.1 228.8 431.6 407.1 18.2 41.6 4.2-0.59 City of Parañaque 251 0.0 0.0 0.0 0.0 1.6 0.8 0.9 3.1 22.3 20.7 63.9 124.9 192.0 261.6 306.0 378.4 20.0 40.4 2.7-0.45 City of Pasig 350 0.0 0.0 0.0 0.0 2.1 2.7 4.7 2.7 17.5 33.4 71.0 130.0 284.2 347.2 309.7 573.4 24.5 52.1 3.0 3.76 * City of San Juan 102 0.0 0.0 0.0 0.0 0.0 3.3 4.2 4.6 32.5 43.9 87.3 125.1 339.6 301.4 374.9 455.4 36.0 54.0 5.5 2.52 * Pateros 29 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 11.0 40.3 67.3 45.7 97.7 232.2 301.4 558.2 19.5 36.3 7.0-1.03 Taguig City 187 0.0 0.0 0.0 0.0 0.0 1.4 0.8 4.7 12.0 10.4 38.6 102.0 128.7 361.1 312.1 473.0 13.3 39.5 3.2-2.20 * Rizal Province 798 0.0 0.0 0.0 0.0 0.4 0.0 1.7 3.4 7.6 18.6 41.6 94.2 185.7 231.4 313.4 291.0 15.2 34.2 1.3-6.41 * Angono 42 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 7.1 26.7 55.3 131.7 168.5 300.2 528.1 135.2 18.8 39.1 6.3-0.64 Baras 6 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 51.9 149.9 237.8 182.8 0.0 8.0 18.9 7.8-2.43 * Binangonan 57 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 11.7 17.6 9.2 87.5 145.1 150.5 131.0 85.9 10.2 20.4 2.8-5.32 * Cainta 117 0.0 0.0 0.0 0.0 0.0 0.0 1.8 2.0 9.5 13.9 46.2 79.0 271.0 249.5 270.4 371.5 16.8 38.3 3.8-1.66 Cardona 18 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 62.1 154.6 221.4 72.0 244.5 208.3 16.5 29.4 7.2-1.43 City of Antipolo 205 0.0 0.0 0.0 0.0 0.8 0.0 3.6 2.0 6.0 20.4 46.8 94.6 167.9 278.7 344.8 303.1 14.1 36.1 2.7-2.75 * Jala-Jala 5 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 149.5 319.1 0.0 0.0 7.2 15.6 7.0-2.70 * Montalban 75 0.0 0.0 0.0 0.0 0.0 0.0 0.0 5.6 14.1 27.1 64.9 86.7 273.4 148.3 161.8 319.4 16.1 34.5 4.2-1.39 Morong 21 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 13.7 15.6 39.5 26.3 162.3 233.5 350.9 303.0 17.4 31.4 7.0-1.70 Pililla 17 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 39.9 81.5 82.9 222.7 367.6 162.1 12.3 25.8 6.4-2.35 * San Mateo 82 0.0 0.0 0.0 0.0 0.0 0.0 6.0 9.5 7.6 13.8 35.7 117.5 171.7 249.0 402.0 611.9 19.5 43.3 5.1-0.38 Tanay 36 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 15.7 48.4 72.3 69.4 149.9 180.4 252.2 229.5 16.0 31.3 5.4-1.52 Taytay 113 0.0 0.0 0.0 0.0 1.9 0.0 0.0 11.1 2.7 20.0 38.2 135.1 170.0 304.0 561.8 453.3 18.8 45.7 4.6 0.05 Teresa 4 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 41.1 122.2 0.0 172.1 0.0 4.0 10.0 5.1-3.47 * 63
Table 3.9.1.2. Metro Manila and Rizal Province Annual incidence rate per 100,000, lung, female, by age group (years), 2003-2007. Female Lung (C33-C34) AREAS CASES 0-5- 10-15- 20-25- 30-35- 40-45- 50-55- 60-65- 70-75+ CRUDE RATE ASR WORLD S.E. MANTEL- HAENSZEL TEST All Areas 2658 0.0 0.0 0.0 0.0 0.4 0.8 1.5 3.2 6.9 12.5 22.0 39.8 51.6 82.3 112.6 136.6 8.3 13.7 0.3 PCS-MCR 1371 0.0 0.0 0.0 0.0 0.6 0.9 1.5 3.9 8.8 13.7 24.2 43.3 52.4 82.4 119.2 150.5 9.2 14.7 0.4 2.40 * City of Manila 460 0.0 0.0 0.0 0.0 0.2 1.7 1.8 4.5 10.6 18.3 26.4 44.8 53.8 103.9 141.9 129.8 11.1 16.1 0.8 3.26 * Caloocan City 216 0.0 0.0 0.0 0.0 0.0 0.6 1.9 2.6 7.6 7.4 22.7 36.1 51.8 45.5 108.4 97.7 6.5 11.4 0.8-2.48 * Pasay City 74 0.0 0.0 0.0 0.0 0.8 0.0 1.2 1.4 1.8 13.0 18.9 46.9 51.3 81.8 110.4 142.5 7.5 13.5 1.6-0.39 Quezon City 621 0.0 0.0 0.0 0.0 1.1 0.8 1.1 4.5 9.4 14.0 24.2 45.2 51.9 84.5 108.0 188.0 9.7 15.4 0.6 3.10 * DOH-RCR 1287 0.0 0.0 0.0 0.1 0.2 0.6 1.4 2.7 5.2 11.5 20.0 36.8 50.8 82.2 106.3 123.4 7.5 12.9 0.4-2.30 * Metro Manila 990 0.0 0.0 0.0 0.1 0.2 0.7 1.5 3.1 4.9 12.7 22.1 39.0 52.3 92.7 115.5 137.4 8.4 14.0 0.5 0.11 City of Las Piñas 116 0.0 0.0 0.0 0.0 0.0 2.2 2.7 2.1 5.1 16.9 14.7 57.7 45.7 97.5 122.7 145.8 8.8 15.0 1.4 0.88 City of Makati 128 0.0 0.0 0.0 0.0 0.6 0.0 1.7 0.0 3.4 10.8 23.5 48.2 48.0 76.5 126.3 131.6 9.3 13.5 1.2-0.45 City of Malabon 68 0.0 0.0 0.0 0.0 0.0 1.2 0.0 0.0 7.6 9.1 30.0 23.9 60.3 76.7 88.0 115.6 7.6 12.3 1.5-1.01 City of Mandaluyong 59 0.0 0.0 0.0 0.0 0.0 0.0 0.0 1.8 0.0 5.2 22.4 46.9 68.4 80.4 122.4 92.8 7.8 12.9 1.7-0.97 City of Marikina 91 0.0 0.0 0.0 0.0 0.0 1.0 2.3 5.2 0.0 14.8 20.1 40.5 55.2 64.7 105.5 114.2 8.6 12.6 1.3-0.81 City of Muntinlupa 79 0.0 0.0 0.0 0.0 0.0 0.8 0.0 0.0 7.8 16.7 11.7 32.8 41.8 142.5 84.5 170.6 7.4 14.5 1.7-0.10 City of Navotas 41 0.0 0.0 0.0 1.7 0.0 0.0 4.4 7.3 2.9 10.5 30.6 31.7 61.7 24.7 109.2 63.2 6.9 11.1 1.8-0.90 City of Parañaque 146 0.0 0.0 0.0 0.0 0.7 0.0 0.9 4.0 7.2 12.0 26.4 42.0 86.4 118.1 162.5 221.6 10.9 19.2 1.6 3.43 * City of Pasig 127 0.0 0.0 0.0 0.0 0.0 0.6 1.5 4.5 5.5 18.9 25.1 27.4 44.0 113.0 116.2 132.1 8.4 14.3 1.3 0.42 City of San Juan 50 0.0 0.0 0.0 0.0 0.0 0.0 0.0 8.0 0.0 10.7 20.4 54.6 62.3 182.8 145.0 200.8 15.2 19.2 2.8 2.10 * Pateros 7 0.0 0.0 0.0 0.0 0.0 0.0 8.3 9.0 10.6 0.0 0.0 20.7 0.0 74.0 0.0 40.7 4.6 5.5 2.2-2.10 * Taguig City 78 0.0 0.0 0.0 0.0 0.0 1.3 1.6 4.8 7.2 9.1 24.3 28.4 23.8 69.8 97.1 114.4 5.5 11.1 1.4-1.42 Rizal Province 297 0.0 0.0 0.0 0.0 0.2 0.4 1.2 1.6 5.8 8.7 15.1 31.7 47.3 57.2 83.5 86.9 5.7 10.1 0.6-5.13 * Angono 18 0.0 0.0 0.0 0.0 0.0 4.8 0.0 6.0 0.0 26.0 31.4 64.3 41.4 31.4 48.1 77.9 8.0 11.6 2.8-0.23 Baras 2 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 73.4 94.0 0.0 0.0 2.8 5.8 4.1-1.68 Binangonan 22 0.0 0.0 0.0 0.0 0.0 0.0 2.3 0.0 3.0 7.3 18.2 0.0 36.3 88.4 19.7 33.7 4.0 6.8 1.5-3.44 * Cainta 56 0.0 0.0 0.0 0.0 0.0 0.0 1.7 3.8 6.8 2.7 20.0 56.5 100.7 62.6 98.5 83.6 7.7 13.7 1.9-0.15 Cardona 4 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 15.5 0.0 21.9 0.0 0.0 58.5 0.0 57.4 3.8 4.9 2.5-1.99 City of Antipolo 96 0.0 0.0 0.0 0.0 0.0 0.0 0.9 2.0 6.1 9.0 10.0 47.2 47.0 72.7 158.1 172.5 6.6 14.1 1.5-0.32 Jala-Jala 1 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 41.2 0.0 0.0 0.0 0.0 0.0 1.5 2.1 2.1-1.93 Montalban 24 0.0 0.0 0.0 0.0 0.0 0.0 2.6 0.0 15.3 4.8 0.0 26.6 24.5 51.9 186.1 70.7 5.3 10.1 2.2-1.64 Morong 7 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 16.4 38.1 0.0 36.2 0.0 130.8 43.5 5.9 7.8 3.0-1.55 Pililla 6 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 20.8 55.9 83.1 53.5 0.0 0.0 4.5 8.2 3.4-1.51 San Mateo 20 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 11.6 14.0 17.8 8.7 48.1 17.5 49.5 67.4 4.7 7.6 1.8-2.44 * Tanay 6 0.0 0.0 0.0 0.0 0.0 5.6 0.0 0.0 0.0 0.0 0.0 17.7 0.0 64.7 48.6 38.4 2.7 4.8 2.0-2.75 * Taytay 29 0.0 0.0 0.0 0.0 1.7 0.0 0.0 2.2 2.7 16.7 17.1 25.9 36.1 40.9 19.1 82.4 4.8 8.0 1.6-2.54 * Teresa 6 0.0 0.0 0.0 0.0 0.0 0.0 12.1 0.0 0.0 0.0 0.0 42.0 53.2 78.4 0.0 175.0 6.2 10.4 4.4-0.64 64
Figure 3.9.1.1. Metro Manila and Rizal Province age-standardized incidence rates, lung cancer, males, 2003-2007. Figure 3.8.1.2. Metro Manila and Rizal Province age-standardized incidence rates, lung cancer, females, 2003-2007. 65
3.9.2. Metro Cebu A total of 1596 new cases of lung cancer for both sexes in the period 2003 to 2007 were registered in the EAF-MCCR. Of these new cases, 1028 were male and 568 were female, with a male to female ratio of 1.81. The CR and ASR among males were 20.5 per 100,000 and 42.3 per 100,000, respectively. Among females, the CR was 11.2 per 100,000 while the ASR was 19.0 per 100,000. Among males, the ASR of 58.9 per 100,000 in Cebu City was significantly higher than the overall (Table 3.9.2.1 and Figure 3.9.2.1). The other cities and municipalities, such as Talisay City, Naga City, San Fernando, Consolacion, and Lilo-an had ASRs that were significantly lower than the overall. From Table 3.9.2.2 and Figure 3.9.2.2, the ASR of Cebu City among females was also significantly higher than the overall. The other cities and municipalities that had significantly lower ASRs than the overall were Lapu-Lapu City, Talisay City, Naga City, Minglanilla, San Fernando, and Cordova. 3.9.3. Comparison with other countries The highest male lung cancer ASRs were observed among Black residents in L.A. and among Saarland residents (Figure 3.9.3.1). The lowest rate was seen among the Indians in Singapore. A range of intermediate rates could be observed among the other populations. The rate observed in the PCS-MCR area was higher than that of Filipino residents in L.A. The rates among females were lower but the pattern was essentially similar (Figure 3.9.3.2). The three Philippine registries had similar ASRs. The rate observed among female Filipino residents in L.A. was slightly higher than that observed among Philippine residents. The differences (or similarities) between and among the sexes may be largely attributable to the prevalence of cigarette smoking and the level of exposure to secondhand smoke. Figure 3.9.2.1. Metro Cebu age-standardized incidence rates, lung cancer, males, 2003-2007. 66
Table 3.9.2.1. Metro Cebu annual incidence rate per 100,000, liver, male, by age group (years), 2003-2007. Male Lung (C33-C34) AREAS CASES 0-5- 10-15- 20-25- 30-35- 40-45- 50-55- 60-65- 70-75+ CRUDE RATE ASR WORLD S.E. MANTEL- HAENSZEL TEST Metro Cebu 1028 0.0 0.0 0.2 0.0 1.0 0.6 3.6 8.0 11.8 28.4 67.5 104.6 204.0 267.2 384.7 378.8 20.5 42.3 1.4 Cebu City 586 0.0 0.0 0.5 0.0 1.9 1.6 4.8 13.1 18.5 42.3 84.4 132.4 255.4 390.0 556.7 566.5 30.7 58.9 2.5 6.44 * Mandaue City 109 0.0 0.0 0.0 0.0 0.0 0.0 3.2 5.7 9.8 24.6 61.9 55.5 171.4 269.3 382.5 365.2 14.5 37.8 3.8-1.53 Lapu-Lapu City 100 0.0 0.0 0.0 0.0 0.0 0.0 1.8 10.6 11.3 14.7 66.3 129.1 172.5 197.8 236.0 344.3 15.0 35.2 3.7-1.47 Talisay City 67 0.0 0.0 0.0 0.0 2.6 0.0 0.0 7.0 16.2 24.5 32.2 98.5 231.1 196.3 125.1 243.1 16.2 31.1 4.0-2.21 * Naga City 21 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 18.5 24.6 32.6 90.9 99.2 275.0 79.8 8.0 17.4 3.8-4.64 * Minglanilla 40 0.0 0.0 0.0 0.0 0.0 0.0 5.8 12.4 0.0 37.0 60.6 67.2 283.8 166.0 257.9 99.2 15.0 32.5 5.3-1.79 San Fernando 21 0.0 0.0 0.0 0.0 0.0 0.0 32.6 0.0 0.0 0.0 59.9 57.3 147.9 50.8 348.4 183.0 15.5 25.3 5.7-2.10 * Consolacion 21 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 39.5 74.4 179.9 79.2 183.9 175.6 10.2 21.7 4.9-3.38 * Lilo-an 29 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 8.3 9.8 66.9 111.8 28.8 151.2 376.5 183.7 13.7 25.8 4.9-2.56 * Compostela 21 0.0 0.0 0.0 0.0 0.0 0.0 0.0 16.4 59.3 23.8 60.0 170.7 125.0 176.8 220.0 358.7 22.6 37.7 8.5-0.08 Cordova 13 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 21.6 114.6 41.7 58.9 263.8 133.5 276.1 12.3 27.2 7.8-1.57 Table 3.9.2.1. Metro Cebu annual incidence rate per 100,000, liver, male, by age group (years), 2003-2007. Female Lung (C33-C34) AREAS CASES 0-5- 10-15- 20-25- 30-35- 40-45- 50-55- 60-65- 70-75+ CRUDE RATE ASR WORLD S.E. MANTEL- HAENSZEL TEST Metro Cebu 568 0.3 0.0 0.0 0.0 1.5 2.1 2.3 1.8 6.9 15.4 26.8 36.9 73.3 135.7 187.6 176.5 11.2 19.0 0.8 Cebu City 337 0.5 0.0 0.0 0.0 2.2 3.2 2.0 3.9 8.1 20.3 36.2 53.0 95.5 203.2 269.4 261.9 17.1 27.0 1.5 5.09 * Mandaue City 56 1.1 0.0 0.0 0.0 1.1 3.8 0.0 0.0 7.5 9.3 27.8 17.4 43.5 120.1 168.4 135.8 7.4 15.0 2.1-1.63 Lapu-Lapu City 46 0.0 0.0 0.0 0.0 1.3 0.0 5.3 2.2 5.8 18.7 14.3 26.9 72.6 85.8 124.1 78.3 6.7 13.3 2.1-2.14 * Talisay City 28 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 8.3 5.0 24.9 43.0 59.4 16.3 113.1 93.5 6.5 10.8 2.1-2.87 * Naga City 17 0.0 0.0 0.0 0.0 0.0 0.0 6.3 0.0 0.0 20.3 24.2 16.1 21.2 131.4 35.2 109.3 7.6 11.1 2.7-2.14 * Minglanilla 17 0.0 0.0 0.0 0.0 0.0 5.0 5.9 0.0 7.8 9.5 24.0 31.5 0.0 82.1 106.8 86.7 6.2 10.6 2.6-2.19 * San Fernando 7 0.0 0.0 0.0 0.0 9.2 0.0 0.0 0.0 0.0 0.0 0.0 26.4 32.7 40.0 0.0 127.4 5.4 6.8 2.6-2.56 * Consolacion 29 0.0 0.0 0.0 0.0 4.9 0.0 0.0 0.0 16.6 20.2 13.0 18.2 165.7 101.6 364.7 211.5 14.2 25.2 4.8 1.26 Lilo-an 23 0.0 0.0 0.0 0.0 0.0 0.0 5.9 0.0 0.0 10.6 26.8 18.1 76.7 159.6 80.5 216.4 10.9 16.9 3.6-0.59 Compostela 5 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 39.3 110.8 65.3 90.2 0.0 5.4 9.8 4.4-1.95 Cordova 3 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 22.4 0.0 0.0 0.0 0.0 176.5 0.0 2.9 4.9 2.8-2.50 * 67
Figure 3.9.2.2. Metro Cebu age-standardized incidence rates, lung cancer, females, 2003-2007. Philippines PCS-MCR Philippines DOH-RCR Philippines EAF-MCCR Singapore Chinese Singapore Indian Singapore Malay Germany Saarland USA Los Angeles Black USA Los Angeles Chinese USA Los Angeles Filipino USA Los Angeles Non-Hispanic White 17.4 44.8 41.0 42.3 44.7 34.0 31.4 40.1 39.4 58.4 59.1 0 5 10 15 20 25 30 35 40 45 50 55 60 65 ASR (W) Figure 3.9.3.1. Comparison of age-standardized incidence rates with other countries, lung, males, 2003-2007. 68
Philippines PCS-MCR Philippines DOH-RCR Philippines EAF-MCCR Singapore Chinese Singapore Indian Singapore Malay Germany Saarland USA Los Angeles Black USA Los Angeles Chinese USA Los Angeles Filipino USA Los Angeles Non-Hispanic White 4.3 14.7 12.9 19.0 17.6 12.2 21.1 19.0 15.8 31.9 35.8 0 5 10 15 20 25 30 35 40 45 50 55 60 65 ASR (W) Figure 3.9.3.2. Comparison of age-standardized incidence rates with other countries, lung, females, 2003-2007. 3.10. Breast 3.10.1. Metro Manila and Rizal Province Breast cancer was the most frequent type of cancer among females in the Philippines. There were a total of 13618 new cases registered among females from 2003 to 2007 in the PCS-MCR and DOH-RCR areas. The CR was 42.6 per 100,000 while the ASR was 59.6 per 100,000. The ASR of PCS-MCR (65.2 per 100,000) was significantly higher than that of the overall (Table 3.10.1 and Figure 3.10.1). DOH-RCR on the other hand, had a significantly lower ASR (54.6 per 100,000) than that of the overall. There is no sufficient evidence to conclude that the ASRs of DOH-RCR Metro Manila areas and that of the Rizal Province were different (60.9 per 100,000 and 39.5 per 100,000, respectively). The cities/municipalities that showed a significantly higher ASRs than the overall were Manila, Quezon City, Las Piñas, Makati, Mandaluyong, Parañaque, Pasig and San Juan. Contrastingly, those that presented significantly lower ASRs were Caloocan, Marikina, Navotas, Taguig, Baras, Binangonan, Cardona, Antipolo, Jala-Jala, Montalban, Morong, Pililla, San Mateo, Tanay, Taytay and Teresa. 3.10.2. Metro Cebu In the EAF-MCCR areas, 1729 new cases of breast cancer were recorded from 2003 to 2007. The CR and ASR among females were 34.0 per 100,000 and 50.2 per 100,000, respectively. The ASR of Cebu City (71.3 per 100,000) was significantly higher than the overall Metro Cebu (Table 3.10.2 and Figure 3.10.2). Except for Talisay City, other cities/municipalities of Metro Cebu had significantly lower ASRs compared with the overall. 69
Table 3.10.1. Metro Manila and Rizal Province annual incidence rate per 100,000, breast, female, by age group (years), 2003-2007. Female Breast (C50) AREAS CASES 0-5- 10-15- 20-25- 30-35- 40-45- 50-55- 60-65- 70-75+ CRUDE RATE ASR WORLD S.E. MANTEL- HAENSZEL TEST All Areas 13618 0.0 0.0 0.1 0.1 2.4 6.4 19.3 47.5 90.8 133.6 166.2 208.5 225.5 221.9 223.2 231.4 42.6 59.6 0.5 PCS-MCR 6975 0.0 0.1 0.1 0.2 3.0 7.1 19.8 50.2 97.2 149.1 174.5 223.5 247.2 242.5 253.7 272.4 46.9 65.2 0.8 5.76 * City of Manila 2507 0.0 0.3 0.0 0.2 6.1 8.4 26.2 65.0 117.0 172.7 207.4 271.3 345.9 295.3 292.0 277.5 60.5 79.4 1.6 13.00 * Caloocan City 916 0.0 0.0 0.3 0.0 1.5 7.3 12.3 33.7 63.0 95.5 112.9 142.1 128.0 150.2 118.6 152.7 27.8 39.4 1.4-11.58 * Pasay City 376 0.0 0.0 0.0 0.0 2.5 6.9 14.2 40.5 78.6 136.6 170.4 203.3 169.4 185.9 176.7 295.2 38.1 55.4 3.0-1.35 Quezon City 3176 0.0 0.0 0.0 0.3 1.7 6.2 20.4 50.8 104.8 162.7 183.3 233.3 246.4 256.9 298.6 313.8 49.4 69.3 1.3 7.21 * DOH-RCR 6643 0.0 0.0 0.1 0.0 1.9 5.8 18.9 45.2 85.2 120.1 158.9 195.2 205.9 203.0 194.4 192.2 38.9 54.6 0.7-5.49 * Metro Manila 5183 0.0 0.0 0.1 0.0 1.8 6.8 20.9 49.6 90.6 131.5 175.1 215.9 238.0 234.0 214.2 220.7 43.8 60.9 0.9 1.25 City of Las Piñas 636 0.0 0.0 0.0 0.0 0.7 6.5 25.6 57.9 111.6 152.5 185.3 241.7 240.2 252.5 315.6 173.6 48.1 67.3 2.8 3.16 * City of Makati 730 0.0 0.0 0.0 0.0 3.0 7.2 27.6 60.3 91.6 147.0 187.8 225.6 243.3 265.4 204.5 285.9 52.8 66.3 2.6 3.02 * City of Malabon 355 0.0 0.0 0.0 0.0 4.4 5.8 17.2 37.3 85.1 141.0 128.3 239.0 153.4 268.3 153.9 177.9 39.9 54.4 3.0-1.61 City of Mandaluyong 389 0.0 0.0 0.0 0.0 1.2 9.7 19.8 44.5 113.2 135.4 192.3 243.8 317.2 276.9 281.6 216.5 51.2 70.0 3.7 2.73 * City of Marikina 433 0.0 0.0 0.0 0.0 0.9 3.9 23.3 28.6 89.4 118.2 176.1 202.5 203.7 176.5 146.1 161.3 40.9 52.4 2.6-2.45 * City of Muntinlupa 426 0.0 0.0 0.0 0.0 0.0 4.9 17.5 34.4 95.7 133.8 175.4 273.7 224.4 142.5 205.2 160.5 40.0 57.6 3.0-0.51 City of Navotas 155 0.0 0.0 0.0 0.0 1.7 7.4 19.7 36.7 63.7 91.2 87.5 145.9 97.0 160.4 109.2 79.0 26.1 36.1 3.0-5.67 * City of Parañaque 706 0.0 0.0 0.0 0.0 0.7 9.0 20.8 78.5 90.3 140.6 186.4 254.9 345.8 281.2 292.5 364.9 52.6 75.5 3.0 5.53 * City of Pasig 698 0.0 0.0 0.0 0.0 3.6 8.0 22.0 65.5 103.2 139.4 201.2 164.3 240.1 230.8 261.5 246.3 46.3 64.1 2.6 2.33 * City of San Juan 213 0.0 0.0 0.0 0.0 2.5 11.1 21.8 67.7 95.3 171.9 217.3 173.0 324.1 282.6 269.4 372.9 64.8 74.6 5.3 3.25 * Pateros 63 0.0 0.0 6.9 0.0 0.0 0.0 16.6 36.1 31.7 103.7 156.3 186.5 329.2 295.9 107.2 162.7 41.0 54.6 7.0-1.12 Taguig City 379 0.0 0.0 0.0 0.0 1.9 5.3 13.1 25.0 61.1 84.8 157.9 176.9 185.4 202.5 86.3 85.8 26.7 43.5 2.4-6.21 * Rizal Province 1460 0.0 0.0 0.0 0.0 2.0 3.1 14.3 35.3 72.9 93.5 120.1 146.1 129.6 129.1 145.0 118.3 27.8 39.5 1.1-13.85 * Angono 81 0.0 0.0 0.0 0.0 0.0 9.6 5.6 53.6 76.5 78.0 94.2 241.1 165.7 282.6 192.6 155.8 35.8 50.0 5.8-1.82 Baras 13 0.0 0.0 0.0 0.0 0.0 0.0 20.1 59.5 24.5 93.9 75.3 54.9 0.0 0.0 0.0 186.7 18.1 21.6 6.1-3.07 * Binangonan 116 0.0 0.0 0.0 0.0 2.0 4.1 4.6 43.2 47.2 61.8 104.4 110.9 45.4 75.8 157.3 33.7 21.0 27.5 2.7-7.73 * Cainta 283 0.0 0.0 0.0 0.0 1.3 4.1 17.0 36.0 89.0 142.3 163.4 205.5 172.6 156.6 213.4 236.9 39.1 54.5 3.4-1.29 Cardona 30 0.0 0.0 0.0 0.0 0.0 0.0 13.4 25.8 31.1 157.8 65.6 178.9 77.8 117.0 83.3 114.9 28.2 34.7 6.5-2.86 * City of Antipolo 397 0.0 0.0 0.0 0.0 1.4 2.2 17.8 31.8 78.3 88.5 130.0 141.6 149.6 212.0 139.5 156.1 27.3 43.7 2.4-6.08 * Jala-Jala 8 0.0 0.0 0.0 0.0 0.0 0.0 21.0 0.0 78.0 32.6 82.3 0.0 0.0 0.0 0.0 115.6 12.2 14.3 5.1-3.71 * Montalban 122 0.0 0.0 0.0 0.0 2.5 4.8 7.9 39.2 84.2 77.1 117.8 159.7 147.2 138.4 186.1 23.6 27.0 39.6 3.8-4.18 * Morong 38 0.0 0.0 0.0 0.0 0.0 0.0 34.9 63.2 107.7 32.8 133.5 104.8 180.8 46.4 130.8 43.5 31.9 37.3 6.2-2.58 * Pililla 22 0.0 0.0 0.0 0.0 0.0 8.8 10.4 11.1 68.8 49.9 83.3 55.9 83.1 0.0 72.5 113.5 16.5 22.6 5.0-4.35 * San Mateo 134 0.0 0.0 0.0 0.0 9.9 2.5 24.0 44.9 97.0 112.2 106.7 165.8 96.1 52.4 123.6 112.3 31.6 39.8 3.6-3.39 * Tanay 46 0.0 0.0 0.0 0.0 5.0 0.0 26.1 50.8 16.6 51.6 125.9 105.9 71.1 64.7 194.4 76.9 21.0 29.8 4.6-4.39 * Taytay 149 0.0 0.0 0.0 0.0 0.0 1.8 8.0 19.9 69.6 90.1 102.8 142.7 171.6 81.7 95.5 98.8 24.6 35.4 3.1-6.26 * Teresa 21 0.0 0.0 0.0 0.0 0.0 0.0 0.0 13.4 34.3 193.4 114.3 0.0 159.7 78.4 108.2 0.0 21.6 31.1 7.0-3.00 * 70
Table 3.10.2. Metro Cebu annual incidence rate per 100,000, breast, female, by age group (years), 2003-2007. Female Breast (C50) AREAS CASES 0-5- 10-15- 20-25- 30-35- 40-45- 50-55- 60-65- 70-75+ CRUDE RATE ASR WORLD Metro Cebu 1729 0.0 0.0 0.0 0.0 0.8 4.6 18.5 40.5 78.4 114.6 143.8 159.7 188.4 214.6 153.2 202.8 34.0 50.2 1.3 S.E. MANTEL- HAENSZEL TEST Cebu City 1017 0.0 0.0 0.0 0.0 0.9 5.9 25.2 51.9 107.3 163.2 215.6 249.3 252.1 285.1 237.4 287.7 51.6 71.3 2.3 8.88 * Mandaue City 167 0.0 0.0 0.0 0.0 1.1 3.8 15.2 31.9 42.3 90.1 103.3 87.1 95.6 192.2 84.2 258.0 22.0 36.2 3.0-4.03 * Lapu-Lapu City 169 0.0 0.0 0.0 0.0 0.0 5.6 15.9 40.1 72.8 78.6 133.9 107.7 163.3 171.6 70.9 187.8 24.6 40.7 3.3-2.34 * Talisay City 132 0.0 0.0 0.0 0.0 2.4 2.7 12.8 44.9 66.2 109.1 112.1 77.3 261.6 227.8 203.7 56.1 30.5 45.6 4.1-1.41 Naga City 32 0.0 0.0 0.0 0.0 0.0 0.0 19.0 20.9 50.9 40.5 12.1 80.4 85.0 26.3 70.4 82.0 14.4 18.9 3.4-5.39 * Minglanilla 60 0.0 0.0 0.0 0.0 0.0 5.0 0.0 25.5 38.9 95.1 60.1 188.8 193.9 218.9 71.2 115.6 21.8 38.6 5.1-2.49 * San Fernando 33 0.0 0.0 0.0 0.0 0.0 9.9 11.6 12.7 89.5 87.7 0.0 158.6 98.2 159.9 56.7 212.4 25.4 33.3 5.9-2.21 * Consolacion 51 0.0 0.0 0.0 0.0 4.9 5.2 17.7 33.6 91.5 111.3 65.2 54.7 82.8 169.3 45.6 84.6 24.9 32.5 4.8-2.45 * Lilo-an 36 0.0 0.0 0.0 0.0 0.0 0.0 23.7 20.3 17.5 31.8 94.0 54.4 153.4 127.6 40.3 81.2 17.0 24.9 4.4-4.44 * Compostela 12 0.0 0.0 0.0 0.0 0.0 0.0 0.0 51.4 86.7 0.0 0.0 0.0 55.4 65.3 180.4 62.5 13.0 17.3 5.2-3.64 * Cordova 20 0.0 0.0 0.0 0.0 0.0 0.0 12.2 29.8 75.0 44.8 170.1 78.8 0.0 66.1 88.3 79.7 19.3 26.7 6.1-2.45 * 71
Figure 3.10.1. Metro Manila and Rizal Province age-standardized incidence rates, breast cancer, females, 2003-2007. Figure 3.10.2. Metro Cebu age-standardized incidence rates, breast cancer, females, 2003-2007. 72
3.10.3. Comparison with other countries The breast cancer ASRs observed among women in the PCS-MCR area, Singaporean Chinese and Chinese residents in L.A. were similar (Figure 3.10.3). Interestingly, the rate among female Filipino residents in L.A. was almost double, and higher than those observed among Black residents in L.A. and in Saarland. The highest rate was seen among the Non-Hispanic White residents in L.A. The differences (or similarities) between populations could be largely attributable to variations in reproductive behavior and lifestyle. Philippines PCS-MCR Philippines DOH-RCR Philippines EAF-MCCR Singapore Chinese Singapore Indian Singapore Malay Germany Saarland USA Los Angeles Black USA Los Angeles Chinese USA Los Angeles Filipino USA Los Angeles Non-Hispanic White 65.2 54.6 50.2 59.2 49.0 53.6 58.9 81.9 86.0 100.0 103.4 0 10 20 30 40 50 60 70 80 90 100 110 120 ASR (W) Figure 3.10.3. Comparison of age-standardized incidence rates with other countries, breast, females, 2003-2007. 3.11. Cervix Uteri 3.11.1. Metro Manila and Rizal Province For cancer of the cervix uteri, a total of 4,292 new cases were diagnosed between 2003 and 2007 in the PCS-MCR and DOH-RCR areas. The CR was 13.4 per 100,000 whereas the ASR was 17.5 per 100,000. The ASR of 19.0 per 100,000 in PCS-MCR was significantly higher than that of the overall (Table 3.11.1 and Figure 3.11.1). Conversely, DOH-RCR had a significantly lower ASR (16.2 per 100,000) than that of the overall. Likewise, the Province of Rizal exhibited a significantly lower ASR (12.1 per 100,000). For the DOH-RCR Metro Manila areas, there was not enough evidence to say that the ASR (17.9 per 100,000) was significantly different than the overall. The cities/municipalities that showed a significantly higher ASR than the overall were Manila, Pasay, and Las Piñas. Contrastingly, those that presented a significantly lower ASR were Caloocan, Quezon City, Baras, Binangonan, Cainta, Cardona, Antipolo, Montalban, San Mateo and Teresa. 73
Table 3.11.1. Metro Manila and Rizal Province annual incidence rate per 100,000, cervix uteri cancer, by age group (years), 2003-2007. Cervix uteri (C53) AREAS CASES 0-5- 10-15- 20-25- 30-35- 40-45- 50-55- 60-65- 70-75+ CRUDE RATE ASR WORLD S.E. MANTEL- HAENSZEL TEST All Areas 4292 0.0 0.0 0.0 0.1 0.6 2.4 8.2 18.2 36.5 50.0 55.8 60.8 43.2 58.9 42.7 45.7 13.4 17.5 0.3 PCS-MCR 2207 0.0 0.0 0.0 0.1 0.5 2.8 9.3 20.8 39.4 54.7 67.4 64.8 36.2 66.9 42.6 48.9 14.9 19.0 0.4 3.53 * City of Manila 772 0.0 0.0 0.0 0.0 0.8 3.3 12.0 24.3 45.9 69.7 83.6 74.9 40.6 81.6 49.4 53.6 18.6 22.8 0.8 7.10 * Caloocan City 344 0.0 0.0 0.0 0.0 0.0 1.6 7.7 17.9 32.8 39.5 47.8 51.2 25.9 29.6 30.5 15.3 10.4 13.3 0.8-4.02 * Pasay City 313 0.0 0.0 0.0 0.0 2.5 5.2 16.6 49.1 91.0 110.6 165.0 156.4 66.7 171.0 88.3 91.6 31.7 42.6 2.5 15.88 * Quezon City 778 0.0 0.0 0.0 0.1 0.3 2.6 7.4 15.8 31.4 44.6 52.0 50.5 33.2 58.2 36.5 53.7 12.1 15.7 0.6-2.84 * DOH-RCR 2085 0.0 0.0 0.0 0.1 0.6 2.0 7.2 16.0 33.9 45.8 45.6 57.2 49.6 51.5 42.8 42.7 12.2 16.2 0.4-3.34 * Metro Manila 1617 0.0 0.0 0.0 0.0 0.7 2.3 7.7 18.0 37.0 49.4 50.2 64.8 56.6 55.9 49.4 45.6 13.7 17.9 0.5 0.30 City of Las Piñas 209 0.0 0.0 0.0 0.0 0.7 2.2 8.2 17.9 52.6 46.2 62.4 79.6 53.4 86.1 52.6 69.4 15.8 21.2 1.5 2.35 * City of Makati 196 0.0 0.0 0.0 0.0 0.6 2.6 6.7 16.3 36.2 43.1 38.6 65.9 75.4 58.5 72.2 27.2 14.2 17.7 1.3-0.48 City of Malabon 109 0.0 0.0 0.0 0.0 0.0 1.2 5.7 17.9 32.1 36.4 46.4 55.8 71.2 61.3 44.0 35.6 12.2 16.5 1.6-1.09 City of Mandaluyong 121 0.0 0.0 0.0 0.0 0.0 3.6 9.1 24.9 34.8 57.3 57.7 75.0 49.8 89.3 49.0 41.2 15.9 20.2 1.9 1.44 City of Marikina 131 0.0 0.0 0.0 0.0 0.9 0.0 5.8 7.8 26.2 59.1 42.4 46.7 55.2 82.4 40.6 26.9 12.4 16.0 1.4-1.66 City of Muntinlupa 134 0.0 0.0 0.0 0.0 0.0 1.6 6.6 20.4 32.9 46.5 53.8 58.4 52.2 23.8 36.2 90.3 12.6 16.9 1.6-0.50 City of Navotas 74 0.0 0.0 0.0 0.0 0.0 3.7 6.6 9.8 37.6 66.7 56.9 38.1 61.7 24.7 0.0 79.0 12.4 16.7 2.0-0.33 City of Parañaque 207 0.0 0.0 0.0 0.0 2.0 2.8 9.5 23.9 40.9 61.3 56.5 75.6 62.9 28.1 48.8 39.1 15.4 19.5 1.4 1.89 City of Pasig 197 0.0 0.0 0.0 0.0 1.8 1.8 8.3 16.2 30.0 48.7 55.3 69.7 40.6 58.9 58.1 36.0 13.1 17.3 1.3-0.33 City of San Juan 56 0.0 0.0 0.0 0.0 0.0 5.5 21.8 23.9 47.6 37.6 40.7 63.7 49.9 16.6 0.0 100.4 17.0 17.4 2.4 0.54 Pateros 26 0.0 0.0 0.0 0.0 0.0 0.0 0.0 27.1 21.1 77.8 46.9 124.3 54.9 74.0 107.2 0.0 16.9 21.4 4.3 0.77 Taguig City 157 0.0 0.0 0.0 0.0 0.0 3.3 6.6 19.2 41.9 39.4 40.5 56.9 47.5 41.9 64.7 28.6 11.1 16.0 1.4-0.99 Rizal Province 468 0.0 0.0 0.0 0.2 0.4 1.2 6.1 11.5 26.8 37.5 34.7 39.1 32.9 41.1 26.4 35.1 8.9 12.1 0.6-7.61 * Angono 24 0.0 0.0 0.0 0.0 0.0 0.0 5.6 0.0 48.7 43.3 31.4 64.3 41.4 31.4 48.1 0.0 10.6 13.6 2.9-1.30 Baras 2 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 31.3 37.7 0.0 0.0 0.0 0.0 0.0 2.8 3.8 2.7-2.38 * Binangonan 31 0.0 0.0 0.0 0.0 2.0 0.0 4.6 2.5 17.7 25.5 18.2 26.1 18.2 25.3 19.7 16.9 5.6 7.3 1.4-5.00 * Cainta 68 0.0 0.0 0.0 0.0 0.0 1.4 5.1 15.2 18.3 40.3 30.0 46.2 50.3 31.3 16.4 55.7 9.4 12.6 1.6-2.95 * Cardona 5 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 15.5 17.5 21.9 0.0 0.0 58.5 83.3 0.0 4.7 6.5 3.0-2.67 * City of Antipolo 145 0.0 0.0 0.0 0.7 0.7 1.5 9.8 20.9 30.6 42.0 32.0 56.0 25.6 48.5 18.6 41.1 10.0 13.9 1.2-2.12 * Jala-Jala 4 0.0 0.0 0.0 0.0 0.0 18.0 0.0 22.3 52.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 6.1 5.9 3.0-1.56 Montalban 40 0.0 0.0 0.0 0.0 0.0 0.0 10.5 0.0 15.3 48.2 55.8 17.7 12.3 34.6 79.8 117.8 8.9 13.4 2.2-2.20 * Morong 11 0.0 0.0 0.0 0.0 0.0 0.0 0.0 12.6 26.9 65.6 19.1 26.2 72.3 0.0 0.0 0.0 9.2 11.2 3.5-1.58 Pililla 10 0.0 0.0 0.0 0.0 0.0 0.0 0.0 22.1 13.8 49.9 20.8 27.9 41.5 53.5 0.0 0.0 7.5 10.6 3.5-1.66 San Mateo 39 0.0 0.0 0.0 0.0 0.0 2.5 3.0 9.6 23.3 37.4 41.5 43.6 72.1 34.9 0.0 0.0 9.2 12.3 2.1-2.36 * Tanay 24 0.0 0.0 0.0 0.0 0.0 0.0 13.1 7.3 33.3 51.6 62.9 35.3 23.7 64.7 48.6 38.4 10.9 15.5 3.3-0.60 Taytay 62 0.0 0.0 0.0 0.0 0.0 1.8 2.0 11.1 40.1 26.7 51.4 38.9 27.1 81.7 38.2 49.4 10.2 14.3 1.9-1.92 Teresa 3 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 34.3 0.0 0.0 0.0 53.2 0.0 0.0 0.0 3.1 4.2 2.6-2.71 * 74
Table 3.11.2. Metro Cebu annual incidence rate per 100,000, cervix uteri cancer, by age group (years), 2003-2007. Cervix uteri (C53) AREAS CASES 0-5- 10-15- 20-25- 30-35- 40-45- 50-55- 60-65- 70-75+ CRUDE RATE ASR WORLD S.E. MANTEL- HAENSZEL TEST Metro Cebu 371 0.0 0.0 0.0 0.0 0.3 1.0 3.1 12.3 21.1 32.2 30.1 28.6 33.5 27.7 32.5 27.9 7.3 10.3 0.6 Cebu City 236 0.0 0.0 0.0 0.0 0.9 2.1 6.1 21.7 35.2 46.9 45.2 40.7 39.2 39.3 50.2 47.9 12.0 15.4 1.0 5.25 * Mandaue City 38 0.0 0.0 0.0 0.0 0.0 0.0 0.0 6.0 7.5 37.3 23.8 17.4 43.5 48.0 33.7 0.0 5.0 8.8 1.5-1.68 Lapu-Lapu City 36 0.0 0.0 0.0 0.0 0.0 0.0 0.0 8.9 29.1 18.7 19.1 20.2 27.2 24.5 35.5 47.0 5.2 8.6 1.5-1.18 Talisay City 24 0.0 0.0 0.0 0.0 0.0 0.0 6.4 10.4 8.3 5.0 37.4 34.4 47.6 16.3 0.0 18.7 5.5 7.8 1.7-1.41 Naga City 1 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 16.1 0.0 0.0 0.0 0.0 0.4 0.6 0.6-3.88 * Minglanilla 8 0.0 0.0 0.0 0.0 0.0 0.0 5.9 6.4 23.3 19.0 0.0 0.0 0.0 0.0 35.6 0.0 2.9 4.0 1.4-2.29 * San Fernando 4 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 17.5 0.0 0.0 32.7 40.0 56.7 0.0 3.1 4.7 2.4-1.91 Consolacion 13 0.0 0.0 0.0 0.0 0.0 0.0 0.0 6.7 0.0 30.3 26.1 54.7 82.8 0.0 0.0 42.3 6.4 9.9 2.8-0.65 Lilo-an 5 0.0 0.0 0.0 0.0 0.0 5.2 0.0 6.8 8.8 21.2 0.0 0.0 0.0 0.0 0.0 0.0 2.4 2.6 1.2-2.71 * Compostela 2 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 47.7 0.0 0.0 0.0 0.0 0.0 0.0 2.2 2.9 2.0-1.87 Cordova 4 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 22.4 56.7 39.4 0.0 0.0 0.0 0.0 3.9 5.8 2.9-1.24 75
3.11.2. Metro Cebu In the EAF-MCCR areas, 371 new cases of cervix uteri cancer were recorded from 2003 to 2007. The CR and ASR among females were 7.3 per 100,000 and 10.3 per 100,000, respectively. Table 3.11.2 and Figure 3.11.2 show that the ASR of Cebu City was significantly higher than overall Metro Cebu. On the other hand, Naga City, Minglanilla, and Lilo-an had ASRs that were significantly lower than the overall. 3.11.3. Comparison with other countries Compared to other countries, the ASRs of cervical cancer cases among female residents in the PCS-MCR and DOH- RCR residents were the highest (Figure 3.11.3). The lowest rate was observed among Chinese residents in L.A. The ASRs of PCS-MCR and DOH-RCR residents were more than double of what was observed among Filipino residents in L.A. The ASR in the EAF-MCCR was almost half of that of PCS-MCR and DOH-RCR. The differences (or similarities) between populations can be largely attributed to the varying prevalence of chronic cervical HPV infection, and safe sex practices. To a certain extent, prevention resulting from screening may also have played a role. Figure 3.11.1. Metro Manila and Rizal Province age-standardized incidence rates, cervix uteri cancer, 2003-2007. 76
Figure 3.11.2. Metro Cebu age-standardized incidence rates, cervix uteri cancer, 2003-2007. Philippines PCS-MCR Philippines DOH-RCR Philippines EAF-MCCR Singapore Chinese Singapore Indian Singapore Malay Germany Saarland USA Los Angeles Black USA Los Angeles Chinese USA Los Angeles Filipino USA Los Angeles Non-Hispanic White 10.3 9.4 3.7 8.4 8.6 6.1 5.0 7.4 6.0 16.2 19.0 0 2 4 6 8 10 12 14 16 18 20 ASR (W) Figure 3.11.3. Comparison of age-standardized incidence rates with other countries, cervix uteri cancer, 2003-2007. 77
3.12. Prostate 3.12.1. Metro Manila and Rizal Province For cancer of the prostate among PCS-MCR and DOH-RCR residents, a total of 3,782 new cases were diagnosed between 2003 and 2007. The CR was 12.3 per 100,000 whereas the ASR was 31.8 per 100,000. Compared with the overall ASR, the ASR of 34.1 per 100,000 for PCS-MCR, was significantly higher while the ASR of DOH-RCR of 29.8 per 100,000 was significantly lower (Table 3.12.1 and Figure 3.12.1). Similarly, Rizal Province exhibited a significantly lower ASR (19.4 per 100,000). For the DOH-RCR Metro Manila areas, the ASR (34.1 per 100,000) was significantly higher from the overall. The cities/municipalities that showed a significantly higher ASR than the overall were Manila, Quezon City, Las Piñas, Mandaluyong, Parañaque, and San Juan. Contrastingly, those that presented significantly lower ASRs were Caloocan, Malabon, Navotas, Baras, Binangonan, Cardona, Antipolo, Jala-Jala, Montalban, Morong, Pililla, Tanay, Taytay and Teresa. 3.12.2. Metro Cebu In the EAF-MCCR areas, 423 new cases of prostate cancer were recorded from 2003 to 2007. The CR and ASR were 8.4 per 100,000 and 20.5 per 100,000, respectively. Consistently, Cebu City had a higher ASR (8.4 per 100,000) compared with the overall Metro Cebu (Table 3.12.2 and Figure 3.12.2). Cities/municipalities that had significantly lower ASRs than the overall were Lapu-Lapu City, Naga City, and San Fernando. Figure 3.12.1. Metro Manila and Rizal Province age-standardized incidence rates, prostate cancer, 2003-2007. 78
Table 3.12.1. Metro Manila and Rizal Province annual incidence rate per 100,000, prostate cancer, by age group (years), 2003-2007. Prostate (C61) AREAS CASES 0-5- 10-15- 20-25- 30-35- 40-45- 50-55- 60-65- 70-75+ CRUDE RATE ASR WORLD S.E. MANTEL- HAENSZEL TEST All Areas 3782 0.0 0.0 0.0 0.0 0.0 0.0 0.1 0.1 1.4 2.9 10.4 37.4 84.8 208.0 339.2 653.5 12.3 31.8 0.5 PCS-MCR 1897 0.0 0.0 0.0 0.1 0.1 0.0 0.1 0.0 1.7 2.4 11.9 38.7 90.0 221.8 368.6 702.1 13.2 34.1 0.8 2.40 * City of Manila 603 0.0 0.0 0.0 0.0 0.2 0.0 0.3 0.0 3.4 1.0 12.8 41.7 93.1 192.1 343.5 840.1 15.1 35.8 1.5 2.68 * Caloocan City 245 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 1.5 2.4 4.7 28.7 50.9 180.2 218.9 402.9 7.5 21.5 1.4-5.85 * Pasay City 94 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 1.8 0.0 14.1 17.0 95.1 176.3 421.5 439.3 9.9 27.8 2.9-1.35 Quezon City 955 0.0 0.0 0.0 0.2 0.0 0.0 0.0 0.0 0.8 3.6 14.7 45.2 107.8 271.8 450.3 763.8 15.6 39.6 1.3 6.00 * DOH-RCR 1885 0.0 0.0 0.0 0.0 0.0 0.0 0.1 0.2 1.1 3.4 9.1 36.3 80.4 196.3 312.8 609.8 11.4 29.8 0.7-2.26 * Metro Manila 1512 0.0 0.0 0.0 0.0 0.0 0.0 0.1 0.4 1.3 4.3 9.2 40.2 95.9 214.3 367.8 703.8 13.4 34.1 0.9 2.33 * City of Las Piñas 198 0.0 0.0 0.0 0.0 0.0 0.0 0.0 1.1 1.4 4.9 12.0 39.9 109.1 295.5 537.0 730.7 15.9 41.2 3.0 3.54 * City of Makati 211 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 1.3 3.0 14.9 43.5 112.7 210.4 373.8 627.8 17.1 33.6 2.3 0.78 City of Malabon 82 0.0 0.0 0.0 0.0 0.0 0.0 0.0 1.6 1.9 6.8 5.6 20.8 74.5 129.4 270.2 504.4 9.2 24.1 2.7-2.41 * City of Mandaluyong 121 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 5.7 7.1 46.5 134.9 298.3 434.4 743.1 17.0 40.4 3.7 2.58 * City of Marikina 141 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 5.8 7.2 34.5 86.5 142.9 299.7 757.6 14.0 31.0 2.6-0.45 City of Muntinlupa 110 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 3.2 3.9 4.9 44.3 61.5 166.3 311.6 730.7 10.8 30.7 3.0-0.46 City of Navotas 33 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 3.4 12.6 19.0 28.9 91.5 161.9 298.5 5.4 14.7 2.7-4.32 * City of Parañaque 223 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 1.3 3.2 8.0 45.7 122.2 325.2 437.1 1028.7 17.8 46.5 3.1 5.22 * City of Pasig 189 0.0 0.0 0.0 0.0 0.0 0.0 0.8 0.0 2.3 2.9 10.9 46.1 116.1 225.4 330.4 708.3 13.2 34.9 2.6 1.46 City of San Juan 91 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 6.3 7.9 56.9 129.4 371.0 718.5 936.0 32.1 52.4 5.5 4.57 * Pateros 14 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 16.8 45.7 97.7 46.4 150.7 398.7 9.4 19.0 5.2-1.77 Taguig City 99 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.9 1.2 4.5 6.1 42.8 59.0 149.7 265.3 578.1 7.0 26.1 2.8-1.77 Rizal Province 373 0.0 0.0 0.0 0.0 0.0 0.0 0.2 0.0 0.6 1.5 9.0 27.7 45.9 154.8 183.3 378.6 7.1 19.4 1.0-8.86 * Angono 20 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 22.1 49.4 24.1 225.1 264.0 270.5 8.9 21.5 5.0-1.46 Baras 2 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 182.8 161.3 2.7 6.9 4.9-2.53 * Binangonan 31 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 4.6 13.5 29.0 105.3 183.4 315.1 5.5 15.1 2.8-4.44 * Cainta 82 0.0 0.0 0.0 0.0 0.0 0.0 1.8 0.0 0.0 5.6 14.2 52.6 32.8 249.5 315.5 742.9 11.7 33.2 3.8 0.48 Cardona 8 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 44.3 216.1 122.2 312.5 7.4 17.0 6.0-1.97 * City of Antipolo 100 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 2.4 0.0 7.8 32.5 77.1 180.8 217.1 344.4 6.9 21.6 2.2-3.47 * Jala-Jala 2 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 324.1 2.9 6.5 4.6-2.61 * Montalban 24 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 4.5 5.9 26.0 65.1 84.8 129.4 212.9 5.1 13.6 2.9-3.92 * Morong 9 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 52.7 0.0 175.1 87.7 227.3 7.4 13.7 4.6-2.52 * Pililla 8 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 19.9 0.0 0.0 0.0 91.9 486.2 5.8 12.6 4.5-2.64 * San Mateo 37 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 4.6 11.9 9.0 39.6 269.7 201.0 420.7 8.8 23.3 3.9-1.91 Tanay 9 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 25.0 0.0 126.1 344.2 4.0 10.4 3.5-3.77 * Taytay 38 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 12.7 33.8 60.0 135.1 80.3 392.9 6.3 17.9 3.0-3.30 * Teresa 3 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 172.1 274.3 3.0 8.9 5.2-2.58 * 79
Table 3.12.2. Metro Cebu annual incidence rate per 100,000, prostate cancer, by age group (years), 2003-2007. Prostate (C61) AREAS CASES 0-5- 10-15- 20-25- 30-35- 40-45- 50-55- 60-65- 70-75+ CRUDE RATE ASR WORLD S.E. MANTEL- HAENSZEL TEST Metro Cebu 423 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.5 1.0 0.4 4.0 20.0 45.3 144.0 168.6 495.1 8.4 20.5 1.0 Cebu City 254 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.8 0.9 1.1 5.5 19.2 59.6 209.7 281.6 727.5 13.3 30.1 1.9 4.71 * Mandaue City 50 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 4.9 0.0 0.0 37.0 47.6 164.6 95.6 502.1 6.7 20.6 3.0 0.24 Lapu-Lapu City 28 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 4.7 6.8 43.1 76.1 23.6 393.5 4.2 12.9 2.4-2.50 * Talisay City 26 0.0 0.0 0.0 0.0 0.0 0.0 0.0 3.5 0.0 0.0 6.4 9.0 27.2 117.8 125.1 334.2 6.3 14.7 2.9-1.57 Naga City 9 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 48.9 22.7 66.1 0.0 119.7 3.4 7.2 2.4-3.08 * Minglanilla 16 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 12.1 16.8 71.0 66.4 154.8 297.7 6.0 15.2 3.8-1.17 San Fernando 7 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 28.7 0.0 203.3 69.7 61.0 5.2 9.9 3.7-2.16 * Consolacion 10 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 18.6 30.0 0.0 122.6 351.2 4.9 11.4 3.6-1.86 Lilo-an 12 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 18.6 28.8 75.6 53.8 321.5 5.7 11.7 3.4-1.92 Compostela 7 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 88.4 329.9 269.1 7.5 14.6 5.6-0.97 Cordova 4 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 133.5 414.2 3.8 11.0 5.5-1.40 80
Figure 3.12.2. Metro Cebu age-standardized incidence rates, prostate cancer, 2003-2007. 3.12.3. Comparison with other countries The highest rate was observed in the Black population in L.A. (Figure 3.12.3), while the lowest rates were seen among the Philippine and Singaporean populations. There was a wide range of intermediate rates observed in the other populations. Differences in the hormonal milieu that could have been brought about by lifestyle variations may be partly responsible for the differences in risk. Philippines PCS-MCR Philippines DOH-RCR Philippines EAF-MCCR Singapore Chinese Singapore Indian Singapore Malay Germany Saarland USA Los Angeles Black USA Los Angeles Chinese USA Los Angeles Filipino USA Los Angeles Non-Hispanic White 34.1 29.8 20.5 25.6 15.9 17.9 51.6 75.9 90.7 98.7 149.2 0 20 40 60 80 100 120 140 160 180 ASR (W) Figure 3.12.3. Comparison of age-standardized incidence rates with other countries, prostate cancer, 2003-2007. 81
3.13. Thyroid 3.13.1. Metro Manila and Rizal Province There were a total of 3,774 new cases of thyroid cancers recorded in the two registries from 2003 to 2007. Of these, 716 were males while 3,058 were females, resulting in a sex ratio of 1 male for every 4.3 females. The CR for males was 2.3 per 100,000 whereas the ASR was 3.4 per 100,000. For females it was 9.6 per 100,000 (CR) and 11.4 per 100,000 (ASR). For males (Table 3.13.1 and Figure 3.13.1), there was not enough evidence to say that an ASR of 3.8 per 100,000 for PCS-MCR and an ASR of 3.1 per 100,000 for DOH-RCR were significantly different from the overall. The ASR of Rizal Province (1.9 per 100,000) was significantly lower, while there was not enough evidence to say that the ASR of the DOH-RCR Metro Manila areas (3.9 per 100,000) was also significantly higher than the overall. Only Manila and Quezon City had ASRs that were significantly higher than the overall. On the other hand, only Taytay had an ASR that was significantly lower than the overall ASR. No case was reported for the municipality of Cardona. For females (Table 3.13.2 and Figure 3.13.2), the ASRs of PCS-MCR (12.5 per 100,000) and DOH-RCR (10.4 per 100,000) were significantly different from the overall. The ASR of Rizal Province (7.4 per 100,000) was significantly lower but there was not enough evidence to say the same for the ASR of the DOH-RCR Metro Manila areas (10.0 per 100,000). The cities/municipalities that showed significantly higher ASRs than the overall were Manila, Quezon City, Makati, Mandaluyong, Parañaque and San Juan. Contrastingly, those that presented a significantly lower ASR were Caloocan, Pasay, Malabon, Marikina, Muntinlupa, Antipolo, Binangonan, Montalban, Morong, Pililla, Tanay and Teresa. 3.13.2. Metro Cebu In the EAF-MCCR areas, 752 new cases of thyroid cancer were recorded from 2003 to 2007. Of these, 171 were male and 581 were female, with a male to female ratio of 0.29. The CR and ASR among males were 3.4 per 100,000 and 4.8 per 100,000, respectively. Among females, the CR and ASR were 11.4 per 100,000 and 14.8 per 100,000, respectively. Among males, Cebu City and Lapu-Lapu City had significantly higher ASRs compared with the overall Metro Cebu (Table 3.13.1 and Figure 3.13.1). Other Metro Cebu areas had significantly lower ASRs compared with the overall except Compostela and Cordova. Among females, a significantly higher ASR (21.7 per 100,000) compared with the overall was observed in Cebu City (Table 3.13.2.2 and Figure 3.13.2.2). Lapu-Lapu City, Talisay City, Naga City, and Lilo-an had significantly lower ASRs compared with the overall. 3.13.3. Comparison with other countries Figure 3.13.3.1 shows that the ASRs of male thyroid cancer were low, the highest being those among Filipino and Non-Hispanic White residents in L.A. The rates among Philippine residents were also higher than those seen in the other populations. Figure 3.14.3.2 shows that the ASRs in females were practically triple those in males. The highest rate was observed among female Filipino residents in L.A., whose rates were among the highest in the world. While dietary and genetic factors had been implicated, the higher rates observed among women and in some populations still has to be adequately investigated. 82
Table 3.13.1. Metro Manila and Rizal Province annual incidence rate per 100,000, thyroid, male, by age group (years), 2003-2007. Male Thyroid (C73) AREAS CASES 0-5- 10-15- 20-25- 30-35- 40-45- 50-55- 60-65- 70-75+ CRUDE RATE ASR WORLD S.E. MANTEL- HAENSZEL TEST All Areas 716 0.0 0.0 0.1 0.4 1.1 1.2 2.7 2.8 4.1 4.8 6.2 10.7 11.3 14.2 17.7 19.5 2.3 3.4 0.1 PCS-MCR 377 0.0 0.0 0.2 0.5 1.3 1.0 2.9 3.4 5.0 6.3 6.6 11.7 12.0 17.0 19.7 17.0 2.6 3.8 0.2 1.90 City of Manila 129 0.0 0.0 0.3 1.3 1.4 1.5 3.7 4.2 5.0 7.0 7.3 11.8 20.0 16.7 25.4 16.5 3.2 4.5 0.4 3.08 * Caloocan City 59 0.0 0.0 0.0 0.6 0.3 0.7 3.0 0.8 4.5 5.5 4.0 7.2 1.8 17.4 24.3 16.6 1.8 2.9 0.4-1.63 Pasay City 18 0.0 0.0 0.0 0.0 1.9 0.0 0.0 4.2 0.0 2.2 8.4 8.5 12.7 9.8 50.6 16.9 1.9 3.5 0.9-0.79 Quezon City 171 0.0 0.0 0.3 0.0 1.6 1.0 2.9 4.1 5.9 6.9 7.2 14.6 11.6 18.1 9.2 17.6 2.8 3.9 0.3 2.14 * DOH-RCR 339 0.1 0.0 0.0 0.3 0.9 1.4 2.5 2.2 3.4 3.4 5.9 9.7 10.7 11.9 15.9 21.7 2.1 3.1 0.2-1.80 Metro Manila 276 0.1 0.0 0.0 0.3 0.9 1.5 3.1 2.5 4.4 3.9 6.3 12.1 12.6 12.4 22.6 24.2 2.5 3.7 0.2 0.59 City of Las Piñas 33 0.0 0.0 0.0 0.0 0.8 0.0 5.8 3.3 5.5 6.5 8.0 8.5 4.4 13.7 23.3 37.2 2.6 3.9 0.8 0.69 City of Makati 43 0.0 0.0 0.0 0.9 0.0 3.1 6.6 5.3 3.8 1.5 3.7 17.4 17.3 12.4 28.0 36.9 3.5 4.6 0.8 1.92 City of Malabon 13 0.0 0.0 0.0 1.2 1.1 1.2 2.8 0.0 3.8 2.3 5.6 0.0 0.0 29.9 0.0 0.0 1.5 2.0 0.6-1.66 City of Mandaluyong 18 0.0 0.0 0.0 0.0 1.4 0.0 6.3 0.0 4.6 5.7 7.1 15.5 15.0 0.0 18.1 18.6 2.5 3.4 0.9 0.18 City of Marikina 25 0.0 0.0 0.0 0.0 1.0 1.0 2.4 1.3 6.5 1.9 12.1 10.3 20.4 0.0 23.1 12.2 2.5 3.4 0.7 0.01 City of Muntinlupa 25 0.0 0.0 0.0 0.0 1.9 2.7 1.1 2.6 0.0 3.9 4.9 18.5 16.8 27.7 15.6 17.0 2.5 4.0 0.9 0.26 City of Navotas 12 0.0 0.0 0.0 0.0 0.0 1.8 2.1 6.9 2.8 0.0 4.2 12.7 0.0 30.5 27.0 0.0 2.0 3.0 1.0-0.44 City of Parañaque 35 0.0 0.0 0.0 0.9 1.6 0.8 0.9 1.0 3.9 9.6 8.0 9.1 17.5 7.1 43.7 47.3 2.8 4.7 0.9 0.96 City of Pasig 36 0.0 0.0 0.0 0.0 1.4 2.7 2.4 0.9 4.7 2.9 5.5 13.5 20.0 6.1 31.0 33.7 2.5 4.1 0.8 0.48 City of San Juan 11 3.7 0.0 0.0 0.0 0.0 0.0 8.5 0.0 5.4 6.3 0.0 45.5 0.0 0.0 31.2 25.3 3.9 4.6 1.4 1.08 Pateros 1 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 16.8 0.0 0.0 0.0 0.0 0.0 0.7 0.8 0.8-1.40 Taguig City 24 0.0 0.0 0.0 0.0 0.0 1.4 0.8 4.7 7.2 3.0 4.1 6.6 10.7 17.6 0.0 0.0 1.7 2.5 0.6-0.93 Rizal Province 63 0.0 0.0 0.0 0.2 0.8 1.1 1.0 1.6 1.3 2.3 5.0 4.5 6.7 10.7 0.0 15.6 1.2 1.9 0.3-4.79 * Angono 5 0.0 0.0 0.0 4.5 0.0 0.0 0.0 5.9 0.0 8.9 0.0 16.5 0.0 37.5 0.0 0.0 2.2 3.1 1.5-0.10 Baras 1 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 161.3 1.3 3.2 3.2-0.53 Binangonan 7 0.0 0.0 0.0 0.0 4.0 2.1 0.0 0.0 0.0 3.5 4.6 0.0 9.7 0.0 0.0 28.6 1.3 1.9 0.8-1.62 Cainta 9 0.0 0.0 0.0 0.0 0.0 3.0 1.8 2.0 0.0 0.0 3.6 0.0 16.4 26.3 0.0 0.0 1.3 2.1 0.8-1.74 Cardona 0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0-1.64 City of Antipolo 20 0.0 0.0 0.0 0.0 0.0 0.8 2.7 2.9 1.2 2.9 11.7 5.9 4.5 0.0 0.0 13.8 1.4 1.9 0.5-1.83 Jala-Jala 1 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 25.1 0.0 0.0 0.0 0.0 0.0 0.0 0.0 1.4 1.5 1.5-0.50 Montalban 6 0.0 0.0 0.0 0.0 2.6 0.0 0.0 0.0 3.5 4.5 5.9 0.0 0.0 0.0 0.0 71.0 1.3 2.4 1.1-1.33 Morong 1 0.0 0.0 0.0 0.0 0.0 9.8 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.8 0.8 0.8-1.19 Pililla 1 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 55.7 0.0 0.0 0.7 1.7 1.7-1.21 San Mateo 4 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 3.8 4.6 0.0 18.1 0.0 0.0 0.0 0.0 1.0 1.2 0.6-1.84 Tanay 1 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 25.0 0.0 0.0 0.0 0.4 1.0 1.0-1.78 Taytay 6 0.0 0.0 0.0 0.0 1.9 0.0 0.0 2.2 0.0 0.0 0.0 6.8 10.0 33.8 0.0 0.0 1.0 2.0 0.9-2.01 * Teresa 1 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 29.6 0.0 0.0 0.0 0.0 0.0 1.0 1.5 1.5-0.82 83
Table 3.13.1.2. Metro Manila and Rizal Province annual incidence rate per 100,000, thyroid, female, by age group (years), 2003-2007. Female Thyroid (C73) AREAS CASES 0-5- 10-15- 20-25- 30-35- 40-45- 50-55- 60-65- 70-75+ CRUDE RATE ASR WORLD S.E. MANTEL- HAENSZEL TEST All Areas 3058 0.0 0.0 0.3 1.4 5.0 9.0 13.4 16.1 17.6 19.8 27.3 27.5 32.2 35.0 29.8 34.9 9.6 11.4 0.2 PCS-MCR 1573 0.0 0.1 0.5 1.3 5.7 8.6 15.0 19.2 18.3 22.8 29.9 29.4 33.8 41.0 31.3 39.2 10.6 12.5 0.3 2.98 * City of Manila 525 0.0 0.0 0.8 0.9 5.9 11.0 21.9 26.4 16.2 25.5 34.4 39.1 37.3 41.5 28.8 32.5 12.7 14.2 0.6 5.08 * Caloocan City 232 0.0 0.3 0.6 1.5 4.1 4.2 9.2 11.5 18.7 15.4 24.3 9.3 21.1 34.1 30.5 24.4 7.0 8.7 0.6-4.02 * Pasay City 69 0.0 0.0 1.2 1.0 4.1 2.6 9.5 14.5 17.9 6.5 18.9 27.4 41.1 22.3 22.1 10.2 7.0 8.6 1.1-2.53 * Quezon City 747 0.0 0.0 0.2 1.5 6.6 10.3 14.6 19.2 19.4 27.1 31.3 32.9 36.5 46.8 34.9 53.7 11.6 13.8 0.5 4.49 * DOH-RCR 1485 0.0 0.0 0.2 1.5 4.4 9.3 11.9 13.5 17.1 17.2 24.9 25.9 30.7 29.4 28.3 30.8 8.7 10.4 0.3-2.83 * Metro Manila 1183 0.0 0.0 0.3 1.8 5.3 11.0 12.8 15.2 19.0 19.3 29.0 28.4 30.2 33.2 33.5 36.3 10.0 11.7 0.4 0.91 City of Las Piñas 139 0.0 0.0 0.0 1.5 4.1 10.8 9.1 11.6 28.2 20.0 29.4 43.9 41.9 28.7 43.8 48.6 10.5 13.1 1.2 1.09 City of Makati 172 0.0 0.0 0.9 2.9 7.3 15.6 23.4 12.4 15.8 17.5 33.5 38.0 27.4 40.5 12.0 40.8 12.4 12.9 1.0 2.24 * City of Malabon 63 0.0 0.0 0.0 0.0 5.4 7.0 5.7 9.7 13.2 20.5 19.1 19.9 16.4 38.3 33.0 26.7 7.1 8.7 1.2-2.37 * City of Mandaluyong 96 0.0 0.0 0.0 2.7 5.8 13.3 12.2 24.9 26.1 18.2 38.5 32.8 31.1 26.8 49.0 61.9 12.6 14.2 1.5 2.27 * City of Marikina 84 0.0 0.0 0.0 1.9 5.4 14.7 8.2 11.7 17.0 9.2 17.8 24.9 4.2 17.6 24.3 40.3 7.9 8.4 1.0-2.12 * City of Muntinlupa 78 0.0 0.0 1.1 1.9 1.6 4.9 14.2 7.7 11.0 16.7 37.4 18.2 26.1 31.7 12.1 10.0 7.3 8.8 1.1-2.32 * City of Navotas 42 0.0 0.0 0.0 0.0 6.8 13.0 4.4 9.8 8.7 31.6 8.8 19.0 26.5 24.7 18.2 31.6 7.1 8.8 1.5-1.65 City of Parañaque 164 0.0 0.0 0.0 2.9 5.3 9.7 11.3 20.9 25.3 17.9 41.4 36.4 51.1 61.9 40.6 45.6 12.2 15.1 1.3 2.89 * City of Pasig 168 0.0 0.0 0.0 0.7 7.8 9.9 18.2 22.4 22.2 23.0 25.1 17.4 44.0 34.4 29.1 36.0 11.1 12.7 1.1 1.82 City of San Juan 53 0.0 0.0 0.0 0.0 10.0 16.6 18.2 12.0 19.1 32.2 61.1 45.5 49.9 49.9 41.4 28.7 16.1 16.8 2.4 2.70 * Pateros 8 0.0 0.0 0.0 0.0 6.6 6.8 0.0 18.1 0.0 0.0 31.3 20.7 27.4 0.0 0.0 0.0 5.2 5.6 2.1-1.91 Taguig City 116 0.0 0.0 0.7 2.8 2.6 10.6 11.5 17.3 18.0 21.2 18.2 19.0 14.3 14.0 86.3 19.1 8.2 10.2 1.1-0.79 Rizal Province 302 0.0 0.0 0.0 0.9 2.0 5.0 9.7 9.3 12.6 12.2 15.1 19.9 31.9 20.5 15.4 16.6 5.8 7.4 0.5-7.66 * Angono 14 0.0 0.0 0.0 0.0 0.0 4.8 16.8 0.0 7.0 8.7 0.0 32.1 62.2 62.8 48.1 0.0 6.2 8.9 2.6-1.66 Baras 3 0.0 0.0 0.0 0.0 15.4 0.0 20.1 0.0 24.5 0.0 0.0 0.0 0.0 0.0 0.0 0.0 4.2 3.9 2.3-1.36 Binangonan 29 0.0 0.0 0.0 1.8 2.0 4.1 16.2 5.1 17.7 3.6 4.5 13.0 36.3 12.6 19.7 0.0 5.2 6.2 1.2-3.12 * Cainta 54 0.0 0.0 0.0 0.0 1.3 2.8 13.6 15.2 16.0 18.8 20.0 20.6 43.2 31.3 32.8 0.0 7.5 9.3 1.4-1.76 Cardona 6 0.0 0.0 0.0 9.3 0.0 0.0 13.4 25.8 0.0 0.0 0.0 29.8 0.0 0.0 83.3 0.0 5.6 6.0 2.6-1.39 City of Antipolo 76 0.0 0.0 0.0 2.0 1.4 5.2 5.3 10.9 7.3 15.0 16.0 32.4 25.6 12.1 9.3 24.6 5.2 7.2 0.9-4.28 * Jala-Jala 4 0.0 0.0 0.0 0.0 17.2 0.0 0.0 0.0 0.0 32.6 41.2 0.0 0.0 101.6 0.0 0.0 6.1 8.4 4.4-0.81 Montalban 27 0.0 0.0 0.0 0.0 2.5 7.3 7.9 15.1 19.1 19.3 0.0 17.7 36.8 17.3 0.0 0.0 6.0 7.2 1.5-2.10 * Morong 3 0.0 0.0 0.0 0.0 9.0 10.0 11.6 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 2.5 2.2 1.3-2.59 * Pililla 2 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 16.6 0.0 0.0 0.0 0.0 0.0 56.8 1.5 2.1 1.5-2.85 * San Mateo 39 0.0 0.0 0.0 0.0 5.0 7.4 12.0 12.8 19.4 9.3 59.3 17.5 60.1 17.5 0.0 22.5 9.2 11.2 1.9-0.13 Tanay 2 0.0 0.0 0.0 0.0 0.0 5.6 0.0 0.0 0.0 0.0 12.6 0.0 0.0 0.0 0.0 0.0 0.9 1.1 0.8-3.90 * Taytay 42 0.0 0.0 0.0 0.0 0.0 7.0 12.0 6.6 21.4 13.3 12.9 13.0 36.1 40.9 19.1 65.9 6.9 9.3 1.6-1.86 Teresa 1 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 42.0 0.0 0.0 0.0 0.0 1.0 1.7 1.7-2.66 * 84
Figure 3.13.1.1 Metro Manila and Rizal Province age-standardized incidence rates, thyroid, males, 2003-2007. Figure 3.13.1.2. Metro Manila and Rizal Province age-standardized incidence rates, thyroid, females, 2003-2007. 85
Figure 3.13.2.1. Metro Cebu age-standardized incidence rates, thyroid, males, 2003-2007. Figure 3.13.2.2. Metro Cebu age-standardized incidence rates, thyroid, females, 2003-2007. 86
Table 3.13.2.1. Metro Cebu annual incidence rate per 100,000, thyroid cancer, male, by age group (years), 2003-2007. Male Thyroid (C73) AREAS CASES 0-5- 10-15- 20-25- 30-35- 40-45- 50-55- 60-65- 70-75+ CRUDE RATE ASR WORLD S.E. MANTEL- HAENSZEL TEST Metro Cebu 171 0.0 0.0 0.8 0.4 1.4 2.6 3.9 5.3 6.3 7.9 12.5 10.4 16.7 5.2 21.1 34.7 3.4 4.8 0.4 Cebu City 100 0.0 0.0 1.0 0.0 1.9 4.4 6.8 8.5 10.2 11.9 16.6 15.4 19.9 8.4 32.0 53.7 5.2 7.0 0.8-6.50 * Mandaue City 20 0.0 0.0 0.0 0.0 1.2 1.3 4.8 3.8 9.8 9.2 8.3 6.2 0.0 0.0 0.0 68.5 2.7 3.9 1.0-4.56 * Lapu-Lapu City 19 0.0 0.0 0.0 0.0 1.5 0.0 0.0 6.4 5.7 3.7 18.9 0.0 43.1 15.2 47.2 24.6 2.8 5.6 1.4-4.30 * Talisay City 12 0.0 0.0 2.3 2.3 0.0 2.8 3.2 3.5 4.1 0.0 6.4 26.9 27.2 0.0 0.0 0.0 2.9 3.8 1.2-3.65 * Naga City 2 0.0 0.0 0.0 0.0 0.0 0.0 0.0 2.1 0.0 0.0 12.3 0.0 0.0 0.0 0.0 0.0 0.8 0.7 0.6-2.93 * Minglanilla 3 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 12.1 0.0 0.0 0.0 51.6 49.6 1.1 2.6 1.6-2.91 * San Fernando 1 0.0 0.0 6.1 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.7 0.5 0.5-2.14 * Consolacion 5 0.0 0.0 0.0 4.8 0.0 0.0 6.0 0.0 7.9 9.9 13.2 0.0 0.0 0.0 0.0 0.0 2.4 2.5 1.2-2.64 * Lilo-an 5 0.0 0.0 0.0 0.0 5.1 5.4 0.0 6.5 0.0 9.8 0.0 18.6 0.0 0.0 0.0 0.0 2.4 2.6 1.2-2.67 * Compostela 2 0.0 0.0 0.0 0.0 0.0 12.3 0.0 16.4 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 2.2 2.0 1.4-1.77 Cordova 2 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 21.6 0.0 0.0 58.9 0.0 0.0 0.0 1.9 3.7 2.7-1.83 Table 3.13.2.2. Metro Cebu annual incidence rate per 100,000, thyroid cancer, female, by age group (years), 2003-2007. Female Thyroid (C73) AREAS CASES 0-5- 10-15- 20-25- 30-35- 40-45- 50-55- 60-65- 70-75+ CRUDE RATE ASR WORLD S.E. MANTEL- HAENSZEL TEST Metro Cebu 581 0.7 0.0 0.8 2.6 6.7 9.2 14.8 18.6 20.8 22.9 29.5 39.9 49.2 67.8 28.7 43.3 11.4 14.8 0.7 Cebu City 351 1.0 0.0 1.1 3.7 10.1 15.5 21.8 30.2 26.1 37.3 47.8 56.6 68.5 78.6 50.2 70.1 17.8 21.7 1.2 5.90 * Mandaue City 73 0.0 0.0 0.0 1.1 5.5 7.5 16.8 8.0 24.9 24.9 23.8 34.9 60.9 108.1 16.8 0.0 9.6 14.2 1.9-0.85 Lapu-Lapu City 53 0.0 0.0 0.0 1.3 5.1 5.6 7.0 24.5 5.8 11.2 14.3 40.4 18.1 110.3 17.7 47.0 7.7 11.5 1.7-2.18 * Talisay City 27 0.0 0.0 2.1 1.9 2.4 2.7 12.8 3.5 8.3 14.9 18.7 25.8 23.8 32.5 22.6 37.4 6.2 8.2 1.7-3.09 * Naga City 8 3.5 0.0 0.0 0.0 15.1 0.0 6.3 0.0 8.5 0.0 0.0 0.0 21.2 0.0 0.0 27.3 3.6 3.9 1.4-3.49 * Minglanilla 19 0.0 0.0 0.0 3.9 0.0 5.0 5.9 25.5 23.3 0.0 12.0 47.2 21.5 82.1 0.0 28.9 6.9 10.4 2.5-1.95 San Fernando 11 6.2 0.0 0.0 0.0 18.3 0.0 0.0 12.7 29.8 0.0 0.0 52.9 32.7 40.0 56.7 0.0 8.5 10.5 3.2-1.09 Consolacion 17 0.0 0.0 0.0 0.0 4.9 0.0 11.8 13.5 33.3 20.2 0.0 18.2 82.8 33.9 0.0 42.3 8.3 11.0 2.9-1.41 Lilo-an 11 0.0 0.0 4.7 9.2 0.0 10.4 5.9 0.0 17.5 0.0 26.8 0.0 25.6 0.0 0.0 0.0 5.2 5.9 1.9-2.71 * Compostela 5 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 43.3 23.8 29.6 0.0 55.4 0.0 0.0 0.0 5.4 7.7 3.5-1.72 Cordova 6 0.0 0.0 0.0 0.0 10.1 10.5 24.4 0.0 0.0 0.0 28.4 0.0 0.0 0.0 0.0 79.7 5.8 6.1 2.6-1.62 87
Philippines PCS-MCR Philippines DOH-RCR Philippines EAF-MCCR Singapore Chinese Singapore Indian Singapore Malay Germany Saarland USA Los Angeles Black USA Los Angeles Chinese USA Los Angeles Filipino USA Los Angeles Non-Hispanic White 3.8 3.1 4.8 2.1 1.8 2.3 1.9 2.2 2.5 6.0 5.0 0 5 10 15 20 25 ASR (W) Figure 3.13.3.1. Comparison of age-standardized incidence rates with other countries, thyroid, males, 2003-2007. Philippines PCS-MCR Philippines DOH-RCR Philippines EAF-MCCR Singapore Chinese Singapore Indian Singapore Malay Germany Saarland USA Los Angeles Black USA Los Angeles Chinese USA Los Angeles Filipino USA Los Angeles Non-Hispanic White 12.5 10.4 14.8 5.7 4.8 7.5 4.5 7.1 9.1 13.5 21.4 0 5 10 15 20 25 ASR (W) Figure 3.13.3.1. Comparison of age-standardized incidence rates with other countries, thyroid, females, 2003-2007. 88
APPENDIX I 2007 Population Census by Area, Age Group and Sex POPULATIONS BY AREA, AGE GROUP AND SEX, PCS-MCR and DOH-RCR (2007 Census) Age Group PCS-MCR DOH-RCR PCS-MCR and DOH-RCR Male Female Male Female Male Female 0-4 340224 317395 405846 379926 746070 697321 5-9 325105 304472 395605 371668 720710 676140 10-14 293709 282344 358033 346138 651742 628482 15-19 295439 327077 337684 364414 633123 691491 20-24 309055 341763 335764 376950 644819 718713 25-29 302206 319473 345253 371791 647459 691264 30-34 245546 247634 284954 294353 530500 541987 35-39 221679 222056 261308 264867 482987 486923 40-44 178652 186510 206746 216430 385398 402940 45-49 150676 158164 174127 182393 324803 340557 50-54 119968 129210 139134 149480 259102 278690 55-59 83887 91318 98380 105443 182267 196761 60-64 51730 61578 61548 70932 113278 132510 65-69 33193 45296 40191 51034 73384 96330 70-74 21319 32581 24447 35367 45766 67948 75+ 21109 40094 24043 42738 45152 82832 Total 2993497 3106965 3493063 3623924 6486560 6730889 89
POPULATIONS BY AREA, AGE GROUP AND SEX, PCS-MCR (2007 Census) Age Group City of Manila Caloocan City Male Female Male Female 0-4 89390 82983 80262 75069 5-9 84028 78895 80348 74995 10-14 76490 73667 73163 70360 15-19 81625 89954 68946 72721 20-24 87272 95113 66627 69865 25-29 84023 86338 64779 66397 30-34 65077 64593 53908 53337 35-39 59070 58552 50104 48817 40-44 47958 49801 41267 41509 45-49 41037 42780 35307 35248 50-54 33562 36205 27348 27859 55-59 24003 26822 18730 19510 60-64 15072 18094 11545 12992 65-69 9618 13592 7301 9565 70-74 6309 10072 4460 6602 75+ 6031 12686 3910 7091 Total 810565 840147 688005 691937 POPULATIONS BY AREA, AGE GROUP AND SEX, PCS-MCR (2007 Census) Age Group Pasig City Quezon City Male Female Male Female 0-4 22467 21210 148105 138133 5-9 20411 18917 140318 131665 10-14 17751 17163 126305 121154 15-19 18388 20841 126480 143561 20-24 21625 25007 133531 151778 25-29 23017 24986 130387 141752 30-34 17831 17318 108730 112386 35-39 14961 14528 97544 100159 40-44 11320 11553 78107 83647 45-49 9221 9748 65111 70388 50-54 7255 7757 51803 57389 55-59 5154 5575 36000 39411 60-64 3124 4018 21989 26474 65-69 2092 2833 14182 19306 70-74 1205 1945 9345 13962 75+ 1230 1985 9938 18332 Total 197052 205384 1297875 1369497 90
POPULATIONS BY AREA, AGE GROUP AND SEX, DOH-RCR, METRO MANILA (2007 Census) Age Group City of Las Piñas City of Makati City of Malabon Male Female Male Female Male Female 0-4 28899 27497 26490 24835 21524 19975 5-9 28538 27405 25618 24509 20439 19348 10-14 25901 24954 22810 22673 18961 18131 15-19 25168 27576 23633 28858 18058 18419 20-24 25244 29531 27139 34511 17728 18205 25-29 26385 29474 27260 32612 17427 17403 30-34 21578 22487 21690 24741 14250 13883 35-39 19250 19968 19526 21871 13071 12493 40-44 14719 16071 16122 18477 10571 10650 45-49 12523 13615 13861 16090 8940 9082 50-54 10405 11744 11287 13141 7272 7671 55-59 7856 8297 7736 9066 5244 5509 60-64 4915 5653 4878 6221 3295 3805 65-69 3141 3885 3351 4730 2094 2739 70-74 1871 2455 2057 3708 1286 1938 75+ 1741 3087 3004 4989 1131 2379 Total 258134 273699 256462 291032 181291 181630 POPULATIONS BY AREA, AGE GROUP AND SEX, DOH-RCR, METRO MANILA (2007 Census) Age Group City of Mandaluyong City of Marikina City of Muntinlupa Male Female Male Female Male Female 0-4 15601 14830 21941 20574 22938 21444 5-9 15066 14353 22533 21193 22323 20912 10-14 13571 13375 21417 20928 20263 19100 15-19 13722 15335 20114 22100 19840 21664 20-24 14706 17516 19785 22298 21688 25771 25-29 15535 17072 19764 21177 24168 26808 30-34 12645 13253 16403 17267 18735 19212 35-39 11240 11549 15488 16023 16166 16744 40-44 8808 9392 12621 13362 12092 13157 45-49 7275 8077 10735 11156 10413 11489 50-54 5944 6545 8726 9541 8349 9364 55-59 4265 4719 6535 7249 5921 6328 60-64 2729 3346 3998 4916 3773 4136 65-69 1838 2381 2970 3658 2326 2827 70-74 1180 1813 1875 2684 1385 1775 75+ 1143 2064 1784 3205 1237 2131 Total 145268 155620 206689 217331 211617 222862 91
POPULATIONS BY AREA, AGE GROUP AND SEX, DOH-RCR, METRO MANILA (2007 Census) Age Group City of Navotas City of Parañaque City of Pasig Male Female Male Female Male Female 0-4 15536 14386 30052 28079 34874 32474 5-9 14893 13538 28809 27184 33629 31996 10-14 12980 12786 25832 25104 29808 28910 15-19 12559 12371 25234 28853 28204 31507 20-24 11691 11625 26559 31720 29703 34775 25-29 11377 10961 27850 31239 32124 34794 30-34 9670 9088 22498 24343 26649 27801 35-39 8916 8314 20734 21639 23601 24084 40-44 7215 7029 15808 17569 18083 19186 45-49 6117 5912 13258 14459 14746 15759 50-54 4943 4817 10702 11653 11716 13185 55-59 3473 3469 7408 8150 8535 9363 60-64 2117 2356 4814 5406 5313 6371 65-69 1387 1708 3001 3869 3550 4598 70-74 751 1187 1994 2748 2156 3111 75+ 787 1349 1839 3329 1974 3681 Total 124412 120896 266392 285344 304665 321595 POPULATIONS BY AREA, AGE GROUP AND SEX, DOH-RCR, METRO MANILA (2007 Census) Age Group City of San Juan Taguig City Pateros Male Female Male Female Male Female 0-4 5376 5004 38561 35748 3366 3155 5-9 5294 4981 34796 32850 3403 3050 10-14 5198 4901 29914 29074 3081 2973 15-19 5490 6896 28685 30978 2974 3223 20-24 6026 8126 30278 32746 2806 3009 25-29 6063 7285 31258 32951 2884 3040 30-34 4630 5551 26187 25987 2298 2398 35-39 4446 5114 23029 22569 2264 2306 40-44 3685 4292 17700 18001 1898 1948 45-49 3333 3948 14818 15004 1504 1610 50-54 2611 3146 11271 11561 1224 1361 55-59 1905 2430 7297 7710 980 1073 60-64 1267 1650 4107 4670 619 766 65-69 876 1228 2587 3289 452 590 70-74 649 1006 1384 2180 295 404 75+ 835 1469 1268 2337 270 537 Total 57684 67027 303140 307655 30318 31443 92
POPULATIONS BY AREA, AGE GROUP AND SEX, DOH-RCR, RIZAL PROVINCE (2007 Census) Age Group Angono Baras Binangonan Male Female Male Female Male Female 0-4 5319 5129 2012 1946 13846 13057 5-9 5842 5277 1973 1850 14312 13483 10-14 5338 5113 1846 1702 13783 13053 15-19 4819 4855 1620 1557 12191 11969 20-24 4253 4454 1454 1368 10720 10606 25-29 4323 4613 1334 1355 10206 10595 30-34 3635 3692 1093 1027 8814 9058 35-39 3653 3611 1152 1117 8741 8463 40-44 3053 3119 887 889 7273 7373 45-49 2443 2522 780 680 6224 6087 50-54 2013 2227 641 606 4900 5020 55-59 1393 1431 452 422 3473 3556 60-64 934 1097 295 302 2251 2440 65-69 593 712 197 244 1473 1791 70-74 347 468 117 160 841 1144 75+ 351 571 139 235 734 1284 Total 48309 48891 15992 15460 119782 118979 POPULATIONS BY AREA, AGE GROUP AND SEX, DOH-RCR, RIZAL PROVINCE (2007 Census) Age Group Cainta Cardona City of Antipolo Male Female Male Female Male Female 0-4 17318 16344 2371 2282 41578 39070 5-9 16571 15283 2564 2399 40500 37827 10-14 15186 14733 2547 2450 36140 35254 15-19 14556 16060 2397 2249 31524 33179 20-24 14564 16232 2037 1922 28300 30133 25-29 14741 15954 1966 1822 28740 29562 30-34 11891 12268 1648 1500 23816 23942 35-39 10865 11268 1606 1620 22215 21971 40-44 8602 9116 1400 1320 17667 17656 45-49 7588 8141 1209 1243 14926 14718 50-54 6189 6851 1084 1013 11367 11459 55-59 4430 4642 759 761 7886 8056 60-64 2669 3097 490 580 4826 5187 65-69 1722 2243 316 363 2954 3760 70-74 1008 1377 177 249 1738 2473 75+ 796 1634 194 358 1627 2844 Total 17318 16344 22765 22131 315804 317091 93
POPULATIONS BY AREA, AGE GROUP AND SEX, DOH-RCR, RIZAL PROVINCE (2007 Census) Age Group Jala-Jala Montalban Morong Male Female Male Female Male Female 0-4 1669 1618 14595 13390 2838 2705 5-9 1739 1666 14550 13433 2810 2682 10-14 1776 1619 12699 11641 2867 2590 15-19 1567 1404 10521 10501 2579 2525 20-24 1308 1199 9167 9550 2368 2308 25-29 1259 1222 9928 10302 2245 2186 30-34 1068 984 9229 9432 1749 1690 35-39 1006 973 8865 8312 1802 1653 40-44 863 811 6901 6452 1538 1546 45-49 727 694 5353 5039 1332 1279 50-54 605 546 4090 4072 1093 1156 55-59 390 393 2894 2959 822 837 60-64 290 283 1821 1909 548 587 65-69 203 228 1111 1418 362 479 70-74 142 137 751 941 237 322 75+ 135 192 677 1040 268 486 Total 14747 13969 113152 110391 25458 25031 POPULATIONS BY AREA, AGE GROUP AND SEX, DOH-RCR, RIZAL PROVINCE (2007 Census) Age Group Pililla San Mateo Tanay Male Female Male Female Male Female 0-4 3655 5319 10729 10037 6087 5713 5-9 3727 5842 10838 10167 6042 5672 10-14 3637 5338 9758 9555 5882 5715 15-19 3135 4819 9281 9470 5182 4950 20-24 2492 4253 8313 8656 4102 4119 25-29 2518 4323 8193 8688 3836 3819 30-34 2104 3635 7262 7085 3214 3193 35-39 2077 3653 6981 6847 3037 2938 40-44 1662 3053 5628 5608 2650 2578 45-49 1371 2443 4814 4725 2176 2064 50-54 1157 2013 3764 3825 1810 1782 55-59 836 1393 2585 2753 1293 1265 60-64 531 934 1671 1849 848 914 65-69 409 593 1089 1302 582 679 70-74 230 347 675 930 344 437 75+ 263 351 561 970 365 568 Total 29804 48309 92142 92467 47450 46406 94
POPULATIONS BY AREA, AGE GROUP AND SEX, DOH-RCR, RIZAL PROVINCE (2007 Census) Age Group Taytay Teresa Male Female Male Female 0-4 15891 14660 2780 2470 5-9 15936 14493 2860 2663 10-14 14297 13877 2541 2490 15-19 12535 12939 2096 2038 20-24 11517 12323 1816 1794 25-29 11983 12468 1886 1943 30-34 10480 10647 1718 1758 35-39 9822 9781 1755 1692 40-44 7852 7916 1448 1344 45-49 6493 6578 1168 1096 50-54 5194 5295 777 802 55-59 3443 3640 569 543 60-64 2190 2452 359 419 65-69 1356 1612 251 294 70-74 832 1187 125 228 75+ 751 1361 169 257 Total 130572 131229 22318 21831 95
POPULATIONS BY AGE GROUP AND SEX, EAF-MCCR (2007 Census) Age Group EAF-MCCR Male Female 0-4 127728 119802 5-9 118006 110016 10-14 107752 103648 15-19 114318 125437 20-24 107538 114528 25-29 99325 101883 30-34 80535 79919 35-39 72143 70445 40-44 58623 57723 45-49 49008 48455 50-54 38254 39552 55-59 27334 29032 60-64 17430 19727 65-69 12092 15250 70-74 7977 11105 75+ 8303 13403 Total 1046366 1059925 96
POPULATIONS BY AREA, AGE GROUP AND SEX, EAF-MCCR (2007 Census) Age Group Cebu City Lapu-Lapu City Mandaue City Male Female Male Female Male Female 0-4 44142 41248 18995 17730 20529 19413 5-9 41116 38178 17610 16498 17752 16468 10-14 39042 37086 14746 14504 15457 14964 15-19 44987 50632 14987 16547 16825 18809 20-24 43334 46932 14751 16730 17871 18709 25-29 38247 39002 14537 15682 16456 16934 30-34 29904 29624 11839 12363 12927 12280 35-39 26701 26525 10368 9881 11129 10609 40-44 22220 22750 7729 7530 8579 8453 45-49 19330 19580 5959 5923 7000 6870 50-54 15343 16498 4738 4617 5286 5507 55-59 11230 12275 3263 3286 3553 3812 60-64 7215 8317 1962 2320 2195 2400 65-69 4959 6372 1397 1747 1408 1794 70-74 3253 4634 878 1202 890 1281 75+ 3437 5649 852 1359 922 1495 Total 394460 405302 144611 147919 158779 159798 POPULATIONS BY AREA, AGE GROUP AND SEX, EAF-MCCR (2007 Census) Age Group City of Naga City of Talisay Compostela Male Female Male Female Male Female 0-4 6360 5835 10813 10313 2592 2445 5-9 5945 5593 10161 9684 2316 2329 10-14 5467 5255 9306 10453 2239 2079 15-19 5145 5060 9304 11957 2097 2037 20-24 4212 4072 8152 8453 1696 1768 25-29 3954 3797 7622 7758 1739 1725 30-34 3401 3289 6460 6451 1417 1454 35-39 3145 3063 6089 6176 1308 1243 40-44 2690 2475 5255 5140 1076 976 45-49 2336 2117 4452 4361 904 909 50-54 1798 1802 3350 3471 735 742 55-59 1345 1365 2462 2550 536 569 60-64 928 954 1551 1775 326 372 65-69 628 812 1101 1334 234 325 70-74 472 600 684 945 187 232 75+ 508 740 682 1094 231 329 Total 48334 46829 87444 91915 19633 19534 97
POPULATIONS BY AREA, AGE GROUP AND SEX, EAF-MCCR (2007 Census) Age Group Consolacion Cordova Lilo-an Male Female Male Female Male Female 0-4 5659 5301 2945 2789 6142 5810 5-9 5090 4664 2884 2641 5538 5010 10-14 4320 4112 2418 2301 4798 4567 15-19 4468 4745 2333 2393 4596 4817 20-24 4007 4410 2226 2119 4238 4401 25-29 4093 4141 2023 2097 4085 4272 30-34 3601 3608 1810 1772 3591 3713 35-39 3213 3153 1562 1468 3393 3272 40-44 2664 2511 1295 1148 2669 2512 45-49 2108 2086 1014 1003 2276 2080 50-54 1603 1627 798 783 1675 1681 55-59 1127 1152 535 541 1226 1270 60-64 673 750 364 419 742 825 65-69 497 570 246 331 568 667 70-74 318 455 163 248 405 544 75+ 322 496 142 255 444 779 Total 43763 43781 22758 22308 46386 46220 POPULATIONS BY AREA, AGE GROUP AND SEX, EAF-MCCR (2007 Census) Age Group Minglanilla San Fernando Male Female Male Female 0-4 6005 5689 3546 3229 5-9 6108 5553 3486 3398 10-14 6540 5132 3419 3195 15-19 6535 5612 3041 2828 20-24 4546 4689 2505 2245 25-29 4327 4345 2242 2130 30-34 3722 3607 1863 1758 35-39 3458 3419 1777 1636 40-44 2923 2806 1523 1422 45-49 2377 2308 1252 1218 50-54 1838 1831 1090 993 55-59 1317 1393 740 819 60-64 911 991 563 604 65-69 646 775 408 523 70-74 420 601 307 363 75+ 430 731 333 476 Total 52103 49482 28095 26837 98
APPENDIX II A PHILIPPINES, MANILA (2003-2007) Annual Incidence per 100,000 by Age Group Male Cancer Incidence in the Five Continents Vol. X, IARC - 2013 99
APPENDIX II B PHILIPPINES, MANILA (2003-2007) Annual Incidence per 100,000 by Age Group Female Cancer Incidence in the Five Continents Vol. X, IARC - 2013 100
APPENDIX II C PHILIPPINES, RIZAL (2003-2007) Annual Incidence per 100,000 by Age Group Male Cancer Incidence in the Five Continents Vol. X, IARC - 2013 101
APPENDIX II D PHILIPPINES, RIZAL (2003-2007) Annual Incidence per 100,000 by Age Group Female Cancer Incidence in the Five Continents Vol. X, IARC - 2013 102
APPENDIX II E PHILIPPINES, METRO CEBU (2003-2007) Annual Incidence per 100,000 by Age Group Male SITE ALL AGE CRUDE CUM CUM ASR 0-5- 10-15- 20-25- 30-35- 40-45- 50-55- 60-65- 70-75+ (%) AGES UNK RATE 0-64 0-74 (W) ICD (10th) Lip 1 0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 2.6 0.0 0.0 0.0 0.00 0.01 0.1 C00 Tongue 63 2 0.0 0.0 0.0 0.2 0.0 0.0 0.5 1.9 1.0 4.4 2.8 5.6 13.1 8.7 13.2 17.3 1.3 0.8 0.15 0.26 2.2 C01-02 Mouth 25 0 0.0 0.0 0.0 0.0 0.0 0.2 0.0 0.0 0.0 1.7 1.7 1.6 1.2 6.9 0.0 24.8 0.5 1.2 0.03 0.07 1.0 C03-06 Salivary glands 22 0 0.3 0.0 0.0 0.0 0.0 0.4 0.0 0.3 0.3 0.4 1.7 0.8 1.2 5.2 15.8 2.5 0.4 0.1 0.03 0.13 0.8 C07-08 Tonsil 4 2 0.0 0.0 0.0 0.0 0.0 0.0 0.5 0.3 0.0 0.0 0.6 0.0 0.0 0.0 0.0 0.0 0.1 0.0 0.01 0.01 0.1 C09 Other oropharynx 5 0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.3 0.0 0.0 0.0 0.8 1.2 1.7 2.6 0.0 0.1 0.0 0.01 0.03 0.2 C10 Nasopharynx 100 2 0.0 0.0 0.6 0.4 0.8 0.0 0.5 0.8 3.3 3.9 11.9 10.4 4.8 13.9 29.0 24.8 2.0 1.2 0.19 0.40 3.4 C11 Hypopharynx 7 0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.3 0.4 0.0 2.4 0.0 1.7 0.0 2.5 0.1 0.1 0.02 0.02 0.2 C12-13 Pharynx unspecified 34 0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.3 0.0 0.9 2.8 1.6 7.2 8.7 7.9 24.8 0.7 1.2 0.06 0.15 1.5 C14 Oesophagus 82 1 0.0 0.0 0.0 0.0 0.0 0.0 0.3 0.8 1.0 1.7 6.2 4.0 19.1 29.5 29.0 27.2 1.6 1.3 0.17 0.46 3.5 C15 Stomach 142 2 0.0 0.0 0.0 0.0 0.0 0.0 0.3 2.7 1.6 5.7 10.8 9.6 26.2 26.0 42.2 71.8 2.8 3.4 0.28 0.63 5.6 C16 Small intestine 21 1 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.5 0.7 0.4 2.3 3.2 4.8 3.5 2.6 2.5 0.4 0.1 0.06 0.09 0.7 C17 Colon 441 13 0.0 0.0 0.0 0.2 1.0 2.4 3.4 8.6 11.2 18.8 24.4 40.7 59.7 90.2 108.0 160.9 8.8 7.7 0.85 1.84 16.1 C18 Rectum 173 6 0.0 0.0 0.0 0.0 0.0 0.4 1.3 2.9 3.9 8.3 9.1 18.4 26.2 50.3 34.3 52.0 3.4 2.5 0.35 0.78 6.5 C19-20 Anus 5 0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 3.6 3.5 0.0 0.0 0.1 0.0 0.02 0.04 0.2 C21 Liver 1526 62 1.9 0.5 0.2 0.4 2.2 4.3 15.8 25.7 43.4 66.0 103.2 159.6 214.7 305.3 355.7 406.0 30.4 19.4 3.19 6.50 54.4 C22 Gallbladder etc. 14 1 0.0 0.0 0.0 0.0 0.0 0.0 0.3 0.0 0.3 0.0 1.1 0.0 6.0 6.9 2.6 0.0 0.3 0.0 0.04 0.09 0.6 C23-24 Pancreas 73 0 0.0 0.0 0.0 0.0 0.8 0.0 0.0 0.8 1.0 3.1 4.5 8.8 19.1 10.4 29.0 9.9 1.5 0.5 0.19 0.39 2.8 C25 Nose, sinuses etc. 21 2 0.0 0.0 0.0 0.0 0.0 0.0 0.5 0.5 1.0 1.3 1.7 0.0 1.2 5.2 7.9 2.5 0.4 0.1 0.03 0.10 0.7 C30-31 Larynx 70 0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.7 1.7 1.7 11.2 16.7 26.0 21.1 24.8 1.4 1.2 0.16 0.40 3.0 C32 Trachea, bronchus and lung 1028 14 0.0 0.0 0.2 0.0 1.0 0.6 3.6 8.0 11.8 28.4 67.5 104.6 204.0 267.2 384.7 378.8 20.5 18.1 2.15 5.41 42.3 C33-34 Other thoracic organs 10 0 0.0 0.0 0.2 0.2 0.4 0.4 0.0 0.0 0.0 0.4 0.0 0.0 1.2 1.7 0.0 2.5 0.2 0.1 0.01 0.02 0.3 C37-38 Bone 143 8 0.3 1.6 1.4 3.7 1.6 1.5 2.1 1.1 3.6 3.9 5.7 8.8 13.1 27.8 13.2 12.4 2.8 0.6 0.24 0.45 4.0 C40-41 Melanoma of skin 16 1 0.0 0.0 0.0 0.0 0.0 0.2 0.3 0.3 0.0 0.4 0.6 2.4 1.2 3.5 2.6 9.9 0.3 0.5 0.03 0.06 0.6 C43 Other skin 47 0 0.0 0.0 0.2 0.7 0.0 0.4 0.0 0.5 0.7 2.6 2.3 2.4 9.5 10.4 10.5 12.4 0.9 0.6 0.10 0.20 1.7 C44 Mesothelioma 0 0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.00 0.00 0.0 C45 Kaposi sarcoma 0 0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.00 0.00 0.0 C46 Connective and soft tissue 37 2 0.5 0.4 0.0 1.1 0.2 0.4 0.5 0.8 0.3 0.9 0.6 0.8 3.6 5.2 5.3 12.4 0.7 0.6 0.05 0.10 1.1 C47,C49 Breast 23 0 0.0 0.0 0.0 0.0 0.4 0.0 0.0 0.0 0.0 2.2 0.0 3.2 3.6 5.2 10.5 5.0 0.5 0.2 0.05 0.13 0.9 C50 Penis 2 0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.6 0.8 0.0 0.0 0.0 0.0 0.0 0.0 0.01 0.01 0.1 C60 Prostate 423 1 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.5 1.0 0.4 4.0 20.0 45.3 144.0 168.6 495.1 8.4 23.7 0.36 1.92 20.5 C61 Testis 22 2 0.2 0.0 0.2 0.0 0.2 1.1 0.5 0.3 0.7 0.0 1.1 0.0 4.8 1.7 5.3 0.0 0.4 0.0 0.04 0.08 0.6 C62 Other male genital 1 1 0.0 0.0 0.0 0.0 0.0 0.0 0.3 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.00 0.00 0.0 C63 Kidney 96 3 0.8 0.2 0.2 0.0 0.0 0.0 0.8 0.5 2.0 6.1 5.1 10.4 10.7 24.3 18.4 29.7 1.9 1.4 0.18 0.40 3.5 C64 Renal pelvis 0 0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.00 0.00 0.0 C65 Ureter 0 0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.00 0.00 0.0 C66 Bladder 84 5 0.2 0.0 0.0 0.0 0.0 0.2 1.3 1.3 0.7 1.3 3.4 10.4 13.1 19.1 15.8 49.5 1.7 2.4 0.16 0.33 3.3 C67 Other urinary organs 0 0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.00 0.00 0.0 C68 Eye 17 0 2.1 0.4 0.0 0.2 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 2.6 0.0 0.3 0.0 0.01 0.03 0.4 C69 Brain, nervous system 124 5 1.6 0.7 1.0 0.4 1.0 1.7 1.3 5.1 2.3 3.1 6.8 12.0 9.5 12.1 15.8 9.9 2.5 0.5 0.23 0.37 3.4 C70-72 Thyroid 171 15 0.0 0.0 0.8 0.4 1.4 2.6 3.9 5.3 6.3 7.9 12.5 10.4 16.7 5.2 21.1 34.7 3.4 1.7 0.34 0.47 4.8 C73 Adrenal gland 5 0 0.0 0.0 0.0 0.0 0.0 0.4 0.0 0.3 0.0 0.0 0.0 0.0 0.0 3.5 0.0 0.0 0.1 0.0 0.00 0.02 0.2 C74 Other endocrine 2 0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.6 0.8 0.0 0.0 0.0 0.0 0.0 0.0 0.01 0.01 0.1 C75 Hodgkin disease 26 2 0.0 0.4 0.0 0.6 1.4 0.2 0.5 0.8 0.3 0.0 1.1 0.8 2.4 3.5 0.0 0.0 0.5 0.0 0.04 0.06 0.6 C81 Non-Hodgkin lymphoma 216 9 0.6 1.2 0.8 3.2 2.2 2.1 2.3 4.3 3.6 6.6 7.4 20.8 25.1 33.0 42.2 42.1 4.3 2.0 0.40 0.78 6.8 C82-85,C96 Immunoproliferative diseases 1 0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 1.2 0.0 0.0 0.0 0.0 0.0 0.01 0.01 0.0 C88 Multiple myeloma 26 0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.3 0.3 0.0 1.1 2.4 4.8 13.9 10.5 7.4 0.5 0.4 0.04 0.17 1.2 C90 Lymphoid leukaemia 137 5 6.6 4.8 3.7 1.1 1.6 1.1 1.3 0.8 0.3 0.9 2.3 1.6 4.8 5.2 5.3 12.4 2.7 0.6 0.15 0.21 3.0 C91 Myeloid leukaemia 154 14 1.0 0.7 0.6 2.4 2.0 3.9 3.6 3.2 4.3 3.1 4.0 4.8 14.3 19.1 18.4 27.2 3.1 1.3 0.24 0.43 4.2 C92-94 Leukaemia unspecified 87 3 2.1 1.9 1.7 0.9 1.8 0.4 0.8 0.3 1.6 0.0 2.3 1.6 3.6 6.9 18.4 22.3 1.7 1.1 0.10 0.22 2.4 C95 Other and unspecified 274 11 0.6 0.2 0.2 0.2 1.0 1.5 2.3 2.7 7.6 9.6 17.0 22.4 25.1 83.3 79.1 84.2 5.5 4.0 0.45 1.26 10.2 Other All sites 6001 195 19.0 12.9 11.8 16.3 20.7 26.6 48.7 82.6 117.1 196.6 332.3 519.7 843.5 1299.4 1552.1 2101.7 119.5 11.24 25.50 219.8 ALL All sites but C44 5954 195 19.0 12.9 11.6 15.5 20.7 26.2 48.7 82.1 116.5 194.0 330.0 517.3 833.9 1289.0 1541.5 2089.4 118.5 100.0 11.14 25.29 218.1 ALLbC44 103
APPENDIX II F PHILIPPINES, METRO CEBU (2003-2007) Annual Incidence per 100,000 by Age Group Female SITE ALL AGE CRUDE CUM CUM ASR 0-5- 10-15- 20-25- 30-35- 40-45- 50-55- 60-65- 70-75+ (%) AGES UNK RATE 0-64 0-74 (W) ICD (10th) Lip 0 0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.00 0.00 0.0 C00 Tongue 43 2 0.2 0.0 0.0 0.0 0.0 0.0 0.5 0.3 2.6 0.0 3.3 0.8 5.2 2.8 11.5 18.6 0.8 1.6 0.06 0.14 1.3 C01-02 Mouth 17 0 0.0 0.2 0.0 0.0 0.0 0.2 0.0 0.6 0.0 0.4 0.0 2.3 3.1 0.0 3.8 6.2 0.3 0.5 0.03 0.05 0.5 C03-06 Salivary glands 32 0 0.0 0.2 0.0 0.5 0.3 0.4 0.0 0.0 0.7 1.8 2.2 2.3 4.2 2.8 3.8 4.6 0.6 0.4 0.06 0.10 0.9 C07-08 Tonsil 1 0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.4 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.00 0.00 0.0 C09 Other oropharynx 7 0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 1.6 0.8 0.0 4.2 0.0 0.0 0.1 0.0 0.01 0.03 0.2 C10 Nasopharynx 39 2 0.0 0.0 0.0 0.0 0.0 0.2 0.5 0.0 1.8 2.2 2.2 2.3 3.1 9.7 7.7 7.7 0.8 0.7 0.06 0.15 1.2 C11 Hypopharynx 1 0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 1.5 0.0 0.1 0.00 0.00 0.0 C12-13 Pharynx unspecified 26 0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.6 0.0 0.9 0.0 0.8 5.2 1.4 11.5 13.9 0.5 1.2 0.04 0.10 0.9 C14 Oesophagus 25 1 0.0 0.0 0.0 0.0 0.0 0.0 0.3 0.6 0.4 0.4 3.3 0.8 2.1 1.4 5.7 10.8 0.5 0.9 0.04 0.07 0.8 C15 Stomach 134 7 0.0 0.0 0.0 0.5 0.0 0.6 1.8 2.1 2.9 3.5 7.1 11.3 15.7 26.3 36.4 26.3 2.6 2.2 0.23 0.54 4.2 C16 Small intestine 5 0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 1.1 0.0 0.0 2.8 0.0 1.5 0.1 0.1 0.01 0.02 0.2 C17 Colon 349 13 0.0 0.0 0.0 0.3 0.5 0.6 3.4 5.1 2.9 9.7 16.9 31.6 47.1 72.0 72.8 113.0 6.9 9.5 0.59 1.32 11.3 C18 Rectum 109 3 0.0 0.0 0.0 0.0 0.0 0.4 0.5 0.6 2.2 3.1 7.1 7.5 19.9 18.0 26.8 32.5 2.1 2.7 0.21 0.43 3.6 C19-20 Anus 2 0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.4 0.4 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.00 0.00 0.0 C21 Liver 478 9 1.2 0.0 0.0 0.3 0.7 1.5 2.3 6.9 7.3 10.1 23.0 43.7 62.8 102.4 134.0 122.3 9.4 10.3 0.80 1.98 15.6 C22 Gallbladder etc. 31 0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.7 0.4 1.1 3.0 4.2 6.9 13.4 9.3 0.6 0.8 0.05 0.15 1.1 C23-24 Pancreas 104 3 0.0 0.0 0.0 0.0 0.0 0.4 0.8 0.0 2.9 2.6 3.3 12.8 16.7 19.4 23.0 31.0 2.0 2.6 0.20 0.41 3.4 C25 Nose, sinuses etc. 8 0 0.0 0.0 0.0 0.0 0.2 0.0 0.0 0.0 0.4 0.4 1.6 0.0 0.0 1.4 0.0 1.5 0.2 0.1 0.01 0.02 0.2 C30-31 Larynx 19 0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.4 0.0 3.8 3.1 6.9 1.9 6.2 0.4 0.5 0.04 0.08 0.7 C32 Trachea, bronchus and lung 568 9 0.3 0.0 0.0 0.0 1.5 2.1 2.3 1.8 6.9 15.4 26.8 36.9 73.3 135.7 187.6 176.5 11.2 14.8 0.84 2.45 19.0 C33-34 Other thoracic organs 10 0 0.0 0.0 0.0 0.2 0.3 0.2 0.0 0.0 0.0 0.0 0.0 3.0 0.0 0.0 1.9 1.5 0.2 0.1 0.02 0.03 0.2 C37-38 Bone 122 5 0.5 1.1 1.6 0.3 0.7 2.5 1.3 1.2 2.2 4.0 4.9 5.3 12.6 23.5 17.2 13.9 2.4 1.2 0.19 0.39 3.4 C40-41 Melanoma of skin 12 1 0.0 0.0 0.0 0.0 0.3 0.2 0.0 0.0 0.0 0.4 0.0 1.5 1.0 2.8 0.0 4.6 0.2 0.4 0.02 0.03 0.3 C43 Other skin 47 2 0.0 0.0 0.0 0.2 0.2 0.4 0.5 1.2 0.0 1.3 3.3 3.0 7.3 4.2 13.4 10.8 0.9 0.9 0.09 0.17 1.4 C44 Mesothelioma 0 0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.00 0.00 0.0 C45 Kaposi sarcoma 0 0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.00 0.00 0.0 C46 Connective and soft tissue 65 3 0.7 0.0 0.4 1.0 0.3 0.8 0.8 1.2 3.3 1.3 3.8 5.3 7.3 2.8 7.7 1.5 1.3 0.1 0.13 0.18 1.7 C47,C49 Breast 1729 73 0.0 0.0 0.0 0.0 0.8 4.6 18.5 40.5 78.4 114.6 143.8 159.7 188.4 214.6 153.2 202.8 34.0 17.0 3.75 5.59 50.2 C50 Vulva 8 0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.3 0.0 0.0 0.0 3.8 1.0 0.0 0.0 1.5 0.2 0.1 0.03 0.03 0.2 C51 Vagina 4 0 0.0 0.0 0.2 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.5 0.0 0.0 1.4 1.9 0.0 0.1 0.0 0.00 0.02 0.1 C52 Cervix uteri 371 13 0.0 0.0 0.0 0.0 0.3 1.0 3.1 12.3 21.1 32.2 30.1 28.6 33.5 27.7 32.5 27.9 7.3 2.3 0.81 1.11 10.3 C53 Corpus uteri 309 11 0.0 0.0 0.0 0.0 0.2 1.5 2.9 9.6 15.3 18.1 30.1 36.9 39.8 13.8 23.0 17.0 6.1 1.4 0.77 0.96 8.7 C54 Uterus unspecified 237 9 0.0 0.0 0.0 0.0 0.3 0.6 2.3 6.0 9.8 14.1 16.4 27.9 28.3 20.8 23.0 35.6 4.7 3.0 0.53 0.75 6.9 C55 Ovary 393 15 0.0 0.4 0.8 0.2 1.7 2.5 3.9 6.6 19.7 19.0 27.9 40.7 44.0 48.4 51.7 32.5 7.7 2.7 0.84 1.34 11.3 C56 Other female genital organs 3 0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.7 0.0 0.0 0.0 0.0 0.0 0.0 1.5 0.1 0.1 0.00 0.00 0.1 C57 Placenta 34 6 0.0 0.0 0.0 0.0 1.2 3.1 1.6 0.6 1.1 0.4 0.0 0.0 0.0 0.0 0.0 0.0 0.7 0.0 0.04 0.04 0.6 C58 Kidney 56 3 1.6 0.8 0.2 0.0 0.5 0.0 0.5 0.3 0.4 1.3 4.4 2.3 4.2 5.5 15.3 7.7 1.1 0.7 0.08 0.19 1.6 C64 Renal pelvis 0 0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.00 0.00 0.0 C65 Ureter 0 0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.00 0.00 0.0 C66 Bladder 35 0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.7 0.9 1.6 6.0 3.1 4.2 19.1 6.2 0.7 0.5 0.06 0.18 1.2 C67 Other urinary organs 3 0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 1.4 0.0 3.1 0.1 0.3 0.00 0.01 0.1 C68 Eye 12 0 1.2 0.0 0.2 0.0 0.0 0.0 0.0 0.0 0.4 0.0 0.0 0.0 1.0 0.0 0.0 3.1 0.2 0.3 0.01 0.01 0.3 C69 Brain, nervous system 121 7 1.6 1.3 1.0 0.3 0.0 1.9 1.8 5.1 1.5 5.7 7.1 9.8 6.3 9.7 7.7 7.7 2.4 0.7 0.22 0.30 3.0 C70-72 Thyroid 581 57 0.7 0.0 0.8 2.6 6.7 9.2 14.8 18.6 20.8 22.9 29.5 39.9 49.2 67.8 28.7 43.3 11.4 3.6 1.08 1.56 14.8 C73 Adrenal gland 1 0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.5 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.00 0.00 0.0 C74 Other endocrine 1 0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 1.5 0.0 0.1 0.00 0.00 0.0 C75 Hodgkin disease 29 5 0.0 0.6 0.2 0.2 0.5 1.5 1.3 0.0 0.7 1.3 0.5 0.0 0.0 2.8 1.9 0.0 0.6 0.0 0.03 0.06 0.6 C81 Non-Hodgkin lymphoma 188 7 0.9 0.9 0.4 1.7 1.3 0.8 1.6 2.4 8.8 7.1 2.7 10.5 12.6 34.6 23.0 49.5 3.7 4.2 0.26 0.55 5.3 C82-85,C96 Immunoproliferative diseases 0 0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.00 0.00 0.0 C88 Multiple myeloma 28 0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.4 0.4 1.1 4.5 5.2 5.5 11.5 4.6 0.6 0.4 0.06 0.14 1.0 C90 Lymphoid leukaemia 99 3 6.4 1.9 2.8 1.4 0.7 0.6 0.8 0.0 1.8 0.0 1.1 0.0 1.0 5.5 9.6 4.6 1.9 0.4 0.09 0.17 2.1 C91 Myeloid leukaemia 142 9 1.7 0.4 1.0 1.7 1.7 1.3 2.3 3.6 2.2 4.0 2.2 9.0 12.6 12.5 11.5 31.0 2.8 2.6 0.22 0.34 3.6 C92-94 Leukaemia unspecified 99 11 1.2 2.3 2.6 1.9 0.8 1.3 2.9 2.7 0.4 1.8 1.6 2.3 1.0 4.2 9.6 7.7 1.9 0.7 0.11 0.18 2.1 C95 Other and unspecified 295 7 0.3 0.4 0.0 0.2 0.8 1.3 1.8 3.3 6.9 8.4 19.7 27.9 29.3 49.8 44.0 97.5 5.8 8.2 0.50 0.97 9.1 Other All sites 7032 296 18.5 10.3 12.2 13.5 22.7 41.7 75.2 134.2 228.6 311.6 433.5 588.5 754.7 977.3 1047.3 1202.7 138.2 13.23 23.35 205.4 ALL All sites but C44 6985 294 18.5 10.3 12.2 13.3 22.6 41.3 74.7 133.0 228.6 310.3 430.2 585.5 747.4 973.1 1033.9 1191.9 137.3 100.0 13.14 23.17 204.0 ALLbC44 104
APPENDIX III Comparison of the Most Common Cancer Sites for 1983-1987, 1988-1992, 1993-1997, 1998-2002, 2003-2007 Appendix IIIA. Comparison of the Most Common Cancer Sites for Both Sexes for Five Time Periods, PCS-MCR and DOH-RCR 1983-1987 1988-1992 1993-1997 1998-2002 2003-2007 Site Number % Site Number % Site Number % Site Number % Site Number % Lung 5093 14.7 Lung 6432 15.2 Breast 7929 15.0 Breast 10221 11.3 Breast 13210 17.1 Breast 4707 13.6 Breast 5814 13.7 Lung 7244 13.7 Lung 8182 9.0 Lung 9044 11.7 Liver 2632 7.6 Liver 3043 7.2 Liver 3549 6.7 Liver 4090 4.5 Colon 4818 6.2 Cervix 2448 7.1 Cervix 2768 6.5 Cervix 3378 6.4 Cervix uteri 3842 4.2 Liver 4638 6.0 Leukemias 1621 4.6 Colon 1770 4.2 Leukemia 2391 4.5 Colon 3440 3.8 Cervix uteri 3999 5.2 Stomach 1556 4.5 Thyroid 1568 3.7 Colon 2501 4.7 Leukemias 2667 2.9 Thyroid 3769 4.9 Colon 1332 3.9 Stomach 1518 3.6 Thyroid 2024 3.8 Thyroid 2334 2.6 Prostate 3708 4.8 Thyroid 1280 3.7 Leukemias 1404 3.3 Ovary 1934 3.7 Rectum 2238 2.5 Leukemias 3407 4.4 Rectum 1123 3.2 Nasopharynx 1275 3.0 Stomach 1718 3.3 Ovary 2234 2.5 Rectum 2841 3.7 Prostate 952 2.7 Ovary 1229 2.9 Rectum 1712 3.2 Prostate 2219 2.4 Ovary 2776 3.6 105
Appendix IIIB. Comparison of the Most Common Cancer Sites for Males for Five Time Periods, PCS-MCR and DOH-RCR 1983-1987 1988-1992 1993-1997 1998-2002 2003-2007 Site Number % Site Number % Site Number % Site Number % Site Number % Lung 3791 24.7 Lung 4808 24.9 Lung 5431 23.2 Lung 6012 15.5 Lung 6357 19.6 Liver 1903 12.4 Liver 2222 11.5 Liver 2624 11.2 Liver 2964 7.7 Prostate 3708 11.4 Prostate 950 6.2 Prostate 1188 6.2 Prostate 1590 6.8 Prostate 2219 5.7 Liver 3269 10.1 Stomach 896 5.8 Colon 903 4.7 Leukemia 1276 5.5 Colon 1783 4.6 Colon 2429 7.5 Leukemia 839 5.4 Stomach 875 4.5 Colon 1257 5.4 Leukemias 1419 3.7 Leukemias 1763 5.4 Nasopharynx 703 4.6 Nasopharynx 843 4.4 Stomach 993 4.3 Rectum 1231 3.2 Rectum 1538 4.7 Colon 665 4.3 Leukemia 728 3.8 Nasopharynx 930 4.0 Nasopharynx 998 2.6 Non-Hodgkin lymphoma 1125 3.5 Rectum 614 4.0 Rectum 645 3.3 Rectum 910 3.9 Stomach 977 2.5 Nasopharynx 1072 3.3 Oral Cavity 379 2.5 Oral Cavity 578 3.0 Non-Hodgkin Lymphoma 852 3.6 Thyroid 745 1.9 Stomach 1052 3.2 Non-Hodgkin Lymphoma 402 2.6 Non-Hodgkin Lymphoma 567 2.9 Oral Cavity 663 2.8 Non-Hodgkin Lymphoma 673 1.7 Kidney 730 2.3 106
Appendix IIIC. Comparison of the Most Common Cancer Sites for Females for Five Time Periods, PCS-MCR and DOH-RCR 1983-1987 1988-1992 1993-1997 1998-2002 2003-2007 Site Number % Site Number % Site Number % Site Number % Site Number % Breast 4645 24.3 Breast 5814 25.2 Breast 7929 27.0 Breast 10083 19.4 Breast 13051 29.1 Cervix 2446 12.8 Cervix 2768 12.0 Cervix 3378 11.5 Cervix uteri 3842 7.4 Cervix uteri 3999 8.9 Lung 1273 6.7 Lung 1624 7.0 Ovary 1934 6.6 Ovary 2234 4.3 Thyroid 3056 6.8 Thyroid 1013 5.3 Thyroid 1268 5.5 Lung 1813 6.2 Lung 2170 4.2 Ovary 2776 6.2 Ovary 1009 5.3 Ovary 1229 5.3 Thyroid 1639 5.6 Colon 1657 3.2 Lung 2687 6.0 Leukemias 772 4.1 Liver 821 3.6 Colon 1244 4.2 Thyroid 1589 3.1 Colon 2389 5.3 Liver 718 3.8 Colon 867 3.8 Leukemia 1115 3.8 Corpus uteri 1507 2.9 Corpus uteri 2178 4.9 Colon 664 3.5 Leukemias 676 2.9 Liver 925 3.2 Brain, Nervous System 1263 2.4 Leukemias 1644 3.7 Stomach 654 3.5 Stomach 643 2.8 Corpus uteri 867 3.0 Leukemias 1248 2.4 Liver 1369 3.1 Corpus uteri 549 2.9 Corpus uteri 642 2.8 Rectum 802 2.7 Liver 1126 2.2 Rectum 1303 2.9 107
Appendix IIID. Most Common Cancer Sites for Both Sexes and by Age, EAF-MCCR, 2003-2007 Both Sexes Male Female Site Number % Site Number % Site Number % Liver 2004 15.5 Liver 1526 25.6 Breast 1729 24.8 Breast 1752 13.5 Lung 1028 17.3 Thyroid 581 8.3 Lung 1596 12.3 Colon 441 7.4 Lung 568 8.1 Colon 790 6.1 Prostate 423 7.1 Liver 478 6.8 Thyroid 752 5.8 Non-Hodgkin lymphoma 216 3.6 Ovary 393 5.6 Prostate 423 3.3 Rectum 173 2.9 Cervix uteri 371 5.3 Non-Hodgkin lymphoma 404 3.1 Thyroid 171 2.9 Colon 349 5.0 Ovary 393 3.0 Myeloid leukaemia 154 2.6 Corpus uteri 309 4.4 Cervix uteri 371 2.9 Bone 143 2.4 Uterus unspecified 237 3.4 Corpus uteri 309 2.4 Stomach 142 2.4 Non-Hodgkin lymphoma 188 2.7 108
Contributors Cynthia A. Mapua holds a Master of Science in Epidemiology from the College of Public Health, University of the Philippines Manila. Her association with the Philippine Cancer Society Manila Cancer Registry began with her Masteral thesis which was on population- based survival of breast cancer. Cyndi had undergone training on cancer registration methods and cancer epidemiology at the International Agency for Research on Cancer in Lyon, France. Cyndi is currently a Scientist/Epidemiologist at the Center for Biostatistics and Molecular Epidemiology and Center for Human Research Protection, Research and Biotechnology Group, St. Luke s Medical Center. Adriano V. Laudico is a surgical oncologist and Professor Emeritus of Surgery at the University of the Philippines Manila. He was the former head of the Department of Health- Rizal Cancer Registry, and currently heads the Philippine Cancer Society- Manila Cancer Registry. He was a Past President of the Philippine College of Surgeons, and the Founding President of the Surgical Oncology Society of the Philippines. Yago was also a Short Term Consultant on Cancer of the World Health Organization Western Pacific Region to several counties in Southeast Asia and the Pacific. Maria Rica Mirasol-Lumague is a general surgeon, and is the current head of the Department of Health Rizal Cancer Society. Rica is the Chief of Medical Professional Staff II of Rizal Medical Center, where she coordinates breast cancer treatment for the pilot study of DOH. She underwent training on Cancer Registration Methods and Cancer Epidemiology at the International Agency for Research on Cancer in Lyon, France Maria Theresa M. Redaniel holds a Doctor of Science in the Humanities at the Ruprecht-Karis-Universitat Heidelberg and a Master of Science in Epidemiology (Public Health) from the University of the Philippines Manila. Her association with the Philippine Cancer Society-Manila Cancer Registry started with her Masteral thesis which was on population-based survival of cervical cancer, and has subsequently coauthored several publications with the registry. Her doctoral dissertation was on the recent trends, up-to-date estimates and the determinants of cancer survival in a Philippine urban population, using the period analysis methodology. Toni Patama holds a degree of Master of Science (Environmental Sciences) from the University of Kuopio and specializes on geographical information systems and spatial epidemiology. Toni is currently an Assistant Researcher at the Finnish Cancer Registry. Eero Pukkala obtained his M.A. from the University of Helsinki, and his Ph.D. from the University of Tampere. He is currently Director of Statistics and an epidemiologist at the Finnish Cancer Registry, Institute for Statistical and Epidemiological Cancer Research, Helsinki. Eero is also Professor of Public Health and Epidemiology at Tampere School of Public Health, University of Tampere, chairman of the national Epidemiological Society and leader of several national and international research programs. 109
Philippine Cancer Society Board of Trustees Chairman Vice Chairman President Vice President Treasurer Assistant. Treasurer Executive Director and Corporate Secretary Philippine Cancer Society Manila Cancer Registry Ellen Nora S. Mesina Siony P. Alcos Erlinda G. Abris Marisol L. Mirasol Dency B. Orengo Lydia T. Navarro Josephine R. Isla Officers Roberto M. Paterno, PhD Antonio Ma. J. Guerrero Corazon A. Ngelangel, MD Atty. Enrique D. Perez Jose S. Sandejas, MD Virgilio L. Peña Rachel Marie B. Rosario, MD Trustees Emily Altomonte-Abrera Angela U. Crisostomo, MD Gloria Cristal-Luna, MD Francisco C. Eizmendi, Jr. Don M. Ferry, MD Jaime Z. Galvez-Tan, MD Cecilia Ladines-Llave, MD Conrado Ll. Lorenzo, MD Alberto B. Roxas, MD Department of Health Rizal Cancer Registry Wilma M. Grafilo Elena DC. Marquez The publication of this monograph was generously supported by the Degenerative Disease Office-National Center for Disease Prevention and Control of the Department of Health, under Dr. Yolanda E. Oliveros. The preparation of the manuscript was assisted by Francisco G. Valenzuela of Surgery Research Unit of the University of the Philippines Manila. 110