Elsevier

Seminars in Cancer Biology

Volume 12, Issue 6, December 2002, Pages 421-429
Seminars in Cancer Biology

Epidemiology of nasopharyngeal carcinoma

https://doi.org/10.1016/S1044579X02000858Get rights and content

Abstract

Nasopharyngeal carcinoma (NPC) is a rare malignancy in most parts of the world, with an incidence well under 1 per 100 000 person-years. Exceptions are the Chinese, especially the Cantonese living in the central region of Guangdong Province in Southern China. Other populations with elevated rates include the natives of Southeast Asia, the natives of the Artic region, and the Arabs of North Africa and parts of the Middle East. Intake of preserved foods at an early age has been linked to NPC risk in all population groups with increased NPC rates. Other recognized risk factors for NPC are cigarette smoking, and occupational exposure to formaldehyde and wood dust.

Introduction

Cancer of the nasopharynx is a disease with a remarkable geographic and racial distribution worldwide. Except for a handful of populations, this is a rare human malignancy with an incidence well under 1 per 100 000 population per year. Regardless of race and geography, the commonest form of nasopharyngeal cancers are those arising from the epithelial cells lining the nasopharynx. These carcinomas (commonly referred to as NPC) constitute 75–95% of nasopharyngeal cancers in low-risk populations and virtually all nasopharyngeal cancers in high-risk populations.[1]

Hereditary and viral risk factors for NPC are discussed separately in this issue of the journal. Therefore, this paper will focus primarily on the demographic patterns of NPC and its nonviral environmental risk or protective factors.

Section snippets

International variation

Most cancer registries only present incidence data for cancer of the nasopharynx as a whole. Therefore, rates for nasopharyngeal cancer, which, for most populations, are indistinguishable from their respective NPC rates, are used to compare worldwide incidence of NPC. In most parts of the world, annual incidence of NPC is below 1 per 100 000 for both men and women. For example, in the United States, the age-standardized (world population) incidence rates in white (including Hispanic white) men

Cantonese-style salted fish and other preserved foods

An astute radiation oncologist named John Ho in Hong Kong first proposed in 1971 that Cantonese-style salted fish, a common item in the local diet and a popular weaning food, may be an etiological factor for NPC.[24] A large number of case-control studies conducted in diverse (Cantonese, other Southern Chinese, Northern Chinese, and Thais) populations residing in different parts of Asia and North America have confirmed Ho’s hypothesis.[14], [23], [25], [26], [27], [28], [29], [30] Age at first

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