Abstract
BackgroundNasopharyngeal carcinoma (NPC) is a rare malignancy in most parts of the world but is common in southern China. A recent report from the Hong Kong Cancer Registry, a high-risk area for NPC in southern China, showed that incidence rate decreased by 29% for males and by 30% for females from 1980–1999, while mortality rate decreased by 43% for males and 50% for females. Changing environmental risk factors and improvements in diagnosis and treatment were speculated to be the major factors contributing to the downward trend of the incidence and mortality rates of NPC. To investigate the secular trends in different Cantonese populations with different socio-economic backgrounds and lifestyles, we report the incidences and mortality rates from two population-based cancer registries in Sihui and Cangwu counties from 1978–2002.MethodsIncidence and mortality rates were aggregated by 5-year age groups and 5 calendar years. To adjust for the effect of difference in age composition for different periods, the total and age-specific rates of NPC incidence and mortality rate were adjusted by direct standardization according to the World Standard Population (1960). The Estimated Annual Percentage Change (EAPC) was used as an estimate of the trend.ResultsThe incidence rate of NPC has remained stable during the recent two decades in Sihui and in females in Cangwu, with a slight increase observed in males in Cangwu from 17.81 to 19.76 per 100,000. The incidence rate in Sihui is 1.4–2.0 times higher during the corresponding years than in Cangwu, even though the residents of both areas are of Cantonese ethnicity. A progressive decline in mortality rate was observed in females only in Sihui, with an average reduction of 6.3% (p = 0.016) per five-year period.ConclusionTo summarize, there is great potential to work in the area of NPC prevention and treatment in southern China to decrease NPC risk and improve survival risk rates in order to reduce M:I ratios. Future efforts on effective prevention, early detection and treatment strategies were also discussed in this paper. Furthermore, the data quality and completeness also need to be improved.
Highlights
Nasopharyngeal carcinoma (NPC) is a rare malignancy in most parts of the world but is common in southern China
To investigate the secular trends in NPC in different Cantonese populations with different socio-economic backgrounds and lifestyles, we examined the incidence of and mortality from NPC from 1978 to 2002 in Sihui and Cangwu counties to search for possible etiological clues and provide guidelines for primary and secondary prevention in a southern Chinese population
A very informative epidemiological study from the Hong Kong Cancer Registry reported that the agestandardized incidence rate of NPC in Hong Kong steadily decreased between 1980 and 1999; the total decrease amounted to 29% for males and 30% for females over the 20-year period [3]
Summary
Nasopharyngeal carcinoma (NPC) is a rare malignancy in most parts of the world but is common in southern China. A recent report from the Hong Kong Cancer Registry, a high-risk area for NPC in southern China, showed that incidence rate decreased by 29% for males and by 30% for females from 1980–1999, while mortality rate decreased by 43% for males and 50% for females. To investigate the secular trends in different Cantonese populations with different socio-economic backgrounds and lifestyles, we report the incidences and mortality rates from two population-based cancer registries in Sihui and Cangwu counties from 1978–2002. Sihui city, located along the Xijiang River in the middle east of Guangdong province, has the highest incidence of NPC in China. In the 1970s, a cancer registry was established in Sihui to report the incidence and mortality of the major cancers, including NPC. Given the high incidence of NPC in Cangwu, a cancer registry system was established there in the 1980s
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