Cancer Registration in an LMIC: Insights from a Comprehensive Cancer Center in Luxor

Abstract Introduction Cancer registries are vital for informing cancer control, especially in low- and middle-income countries (LMICs) where data is limited. This study describes the Shefa Al Orman Hospital (SOH) Cancer Registry in Luxor, Egypt, which follows ICD-O3, SEER staging, and Toronto pediatric staging. Methods A prospective cohort registry was established at SOH from May 2016 to May 2024. Data were collected via house made electronic health records and included demographics, tumor site, morphology, stage, diagnosis method, survival, and geolocation. Descriptive statistics and crude rate calculations were used to analyze distributions and regional patterns. Results A total of 44,134 patients were registered: 42,807 adults and 1,327 children. Patients came from Luxor (44.7%), Qena (34.2%), and other governorates (21%). There were 22,479 (50.9%) cancer cases, 9,203 (20.8%) non-cancer (reflecting weak referral systems and limited primary care), 1,106 (2.5%) deaths before diagnosis (delayed presentation/referral), 6,737 (15.2%) lost to follow-up (suggesting fear or low awareness), and 2,491 (5.6%) referred. In females, top cancers were breast (42.8%), digestive (15.9%), and female genital (9.4%). In males: digestive (30.5%), respiratory (13.7%), and urinary (13.4%). Annual crude cancer rates per 100,000 (8 years): Luxor: Qesm Luxor(246.5), Armant(191.6), Tiba(184.4), Qurna(178.2), Luxor Markaz(162.7), Esna(136.0). Qena: Southern Qena: Qus (110.3), Naqada (97.0), Qeft (76.4). Northern Qena: Qena Markaz (43.4), Farshout (39.7), Deshna (38.1), Nag Hammadi (48.2) The lower rates in northern Qena likely reflect that southern Qena residents primarily attend SOH, while those in the north often seek care in Sohag Conclusions The SOH registry shows that high-quality cancer registration is feasible in LMICs. It highlights the need for better early detection, awareness, referral efficiency, and care coordination, offering a model for cancer control in resource-limited settings. Key messages • Cancer registries in LMICs can reveal critical gaps in referral, diagnosis, and follow-up that impact timely cancer care. • SOH registry data supports early detection and improved care coordination in underserved regions.