TY - JOUR ID - 89350 TI - Subtype Specific Nasopharyngeal Carcinoma Incidence and Survival Trends: Differences between Endemic and Non-Endemic Populations JO - Asian Pacific Journal of Cancer Prevention JA - APJCP LA - en SN - 1513-7368 AU - Argirion, Ilona AU - Zarins, Katie R AU - Suwanrungruang, Krittika AU - Pongnikorn, Donsuk AU - Chitapanarux, Imjai AU - Sriplung, Hutcha AU - Vatanasapt, Patravoot AU - Rozek, Laura S. AD - Department of Environmental Health Sciences, University of Michigan School of Public Health, Ann Arbor, MI, Thailand. AD - Cancer Unit, Srinagarind Hospital, Khon Kaen University, Khon Kaen, Thailand. AD - Lampang Cancer Hospital, Lampang, Thailand. AD - Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand. AD - Songkhla Cancer Registry, Prince of Songkla University, Songkhla, Thailand. AD - Department of Otorhinolaryngology, Faculty of Medicine, Khon Kaen University, Thailand. Y1 - 2020 PY - 2020 VL - 21 IS - 11 SP - 3291 EP - 3299 KW - Nasopharyngeal carcinoma KW - incidence rates KW - survival KW - global epidemiology DO - 10.31557/APJCP.2020.21.11.3291 N2 - 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 (APC:4.3 [95%CI:1.8, 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. UR - https://journal.waocp.org/article_89350.html L1 - https://journal.waocp.org/article_89350_9d1e5de4cc68329d04347321876dacb5.pdf ER -