Epidemiology of nasopharyngeal carcinoma
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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