Abstract
BackgroundIn China, most patients with nasopharyngeal carcinoma (NPC) are diagnosed at a late stage and consequently have a poor prognosis. This study aimed to investigate potential factors associated with the clinical stage of NPC at diagnosis.MethodsData were obtained from 118 patients with early-stage NPC and 274 with late-stage NPC who were treated at Sun Yat-sen University Cancer Center between August 2014 and July 2015. Patients were individually matched by age, sex, and residence, and a conditional logistic regression model was applied to assess the associations of clinical stage at diagnosis with socioeconomic status indicators, knowledge of NPC, physical examinations, patient interval, and risk factors for NPC.ResultsAlthough knowledge of early NPC symptoms, smoking cessation, and patient interval were important factors, the number of cigarettes smoked per day, motorbike ownership, and physical examination exhibited the strongest associations with the clinical stage of NPC at diagnosis. Compared with smoking fewer than ten cigarettes a day, smoking 10–30 cigarettes [odds ratio (OR) 4.03; 95% confidence interval (CI) 1.11–14.68] or more than 30 cigarettes (OR 11.46; 95% CI 1.26–103.91) was associated with an increased risk of late diagnosis. Compared with not owning a motorbike, owning a motorbike (OR 0.38; 95% CI 0.23–0.64) was associated with early diagnosis. Subjects who underwent physical examinations were less likely to receive a late diagnosis than those who did not undergo examinations (OR 0.50; 95% CI 0.28–0.89). However, indicators of wealth were not significant factors.ConclusionsInitiatives to improve NPC patient prognosis should aim to promote knowledge about early symptoms and detection, health awareness, and accessibility to health facilities among all patients, regardless of socioeconomic status.
Highlights
In China, most patients with nasopharyngeal carcinoma (NPC) are diagnosed at a late stage and con‐ sequently have a poor prognosis
Of the 118 earlystage patients, 80 were each matched with two patients with late-stage disease, and 38 were each matched with three patients with late-stage disease; a total of 274 late-stage patients were recruited
Owning a car or vacuum cleaner was associated with the highest level of wealth in the multiple correspondence analysis (MCA), they were not related to an early diagnosis of NPC
Summary
In China, most patients with nasopharyngeal carcinoma (NPC) are diagnosed at a late stage and con‐ sequently have a poor prognosis. This study aimed to investigate potential factors associated with the clinical stage of NPC at diagnosis. South China [1], with incidences as high as 20–30 per 100,000 individuals [2] Most patients in this region are initially diagnosed with late-stage disease [3, 4]. Among patients with NPC, survival is largely dependent on the clinical stage at diagnosis [5]: the 5-year overall survival rates exceed 90% for early-stage (stage I and II) patients [6, 7], but are less than 50% for late-stage (stage III and IV) patients [8]. Only three studies have investigated the association between the patient interval, defined in accordance with the Aarhus Statement as the time interval between
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