CANCER INCIDENCE IN THAILAND, 1988-1991

Results from three cancer registries (Chiang Mai, Khon Kaen, and Songk hla) in different regions of Thailand and from a cancer survey in the population of Bangkok during the years 1988-1991 are presented, togeth er with an estimate of the incidence of cancer for the country as a wh ole, Overall, liver cancer is the most frequent malignancy, but there are large regional differences in incidence and in histological type, with very high rates of cholangiocarcinoma in the northeast (associate d with endemic opisthorchiasis) but a more even distribution of hepato cellular carcinoma, Lung cancer is second in frequency, with the highe st rates in northern Thailand, where the incidence in women (Age Stand ardized Rate, 37.4 per 100,000) is among the highest in the world. A l ink with tobacco smoking is suggested by similarly raised rates, espec ially in women, for cancers of the larynx and pancreas, Cervical cance r is the most common malignancy in women, with relatively little regio nal variation in risk, while the incidence of breast cancer is low, Ot her cancer sites showing moderately increased rates include the lip an d oral cavity, particularly in females from the north and northeast, w here the chewing of betel nut remains common among older generations, nasopharyngeal cancer, carcinoma of the esophagus in the southern regi on, and penile cancer, especially in the north and northeast, Previous studies which have investigated the etiological factors underlying th ese patterns are reviewed, and the implications for future research an d for national cancer control policies are discussed.