Subtype Specific Nasopharyngeal Carcinoma Incidence and Survival Trends: Differences between Endemic and Non-Endemic Populations.
Asian Pac J Cancer Prev
; 21(11): 3291-3299, 2020 Nov 01.
Article
de En
| MEDLINE
| ID: mdl-33247687
ABSTRACT
BACKGROUND:
While nasopharyngeal carcinoma (NPC) is rare in non-endemic regions such as the North America, endemic countries, such as Thailand, continue to struggle with high incidence and mortality rates. NPC has a complex etiology that varies by histological subtype.METHODS:
NPC cases (1990-2014) were identified using the International Classification of Diseases for Oncology (ICD-O) code C11 from the Chiang Mai, Khon Kaen, Lampang, and Songkhla cancer registries and compared to Asian/Pacific Islanders (A/PI) from the US SEER program. Age-standardized incidence rates and changes in annual percent change (APC) for overall and subtype specific NPC were assessed using R and Joinpoint. Kaplan Meier curves were generated in SAS to evaluate differences in survival by sex, year of diagnosis and histological subtype. Five-year relative survival estimates were calculated between 2000-2014.RESULTS:
Non-keratinizing NPC predominated across all registries except Songkhla, where the keretinizing subtype made up ~60% of all reported cases. Incidence of keratinizing NPC significantly decreased among Chiang Mai males between 1996 and 2014 (APC-13.0 [95%CI-16.2, -9.6]), Songkhla females (APC-4.0 [95%CI -7.4, -0.5]) and males between 2006 and 2014 (APC-15.5 [95%CI-25.0, -4.7]), as well as A/PI females (APC-5.1 [95%CI-6,7, -3.4]) and males (APC -4.8 [95%CI-5.9, -3.7]). Non-keratinizing NPC increased among Songkhla males (APC4.3 [95%CI1.8, 6.9]). The keratinizing subtype exhibited the worst survival, while the non-keratinizing undifferentiated subtype had the best survival. Although US A/PI had the highest 5-year relative survival estimates, among the Thai registries Chiang Mai had the best and Lampang the worst survival.CONCLUSION:
Although US A/PIs exhibited similar rates of NPC as seen in the endemic Thai population, improved tobacco control has led to a decrease in keratinizing NPC incidence irrespective of geography. Additionally, while challenges associate with access to care may still exist among rural Thais, chemoradiation was shown to confer a survival benefit in non-keratinizing NPC treatment.Mots clés
Texte intégral:
1
Collection:
01-internacional
Base de données:
MEDLINE
Sujet principal:
Enregistrements
/
Tumeurs du rhinopharynx
/
Mortalité
/
Maladies endémiques
/
Cancer du nasopharynx
Type d'étude:
Incidence_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limites:
Female
/
Humans
/
Male
/
Middle aged
Pays/Région comme sujet:
Asia
Langue:
En
Journal:
Asian Pac J Cancer Prev
Sujet du journal:
NEOPLASIAS
Année:
2020
Type de document:
Article
Pays d'affiliation:
Thaïlande