Nasopharyngeal carcinoma: nationwide trends in subtype-specific incidence and survival over 3 decades in a non-endemic area

Jort S van Velsen; Bert van der Vegt; Boudewijn E C Plaat; Johannes A Langendijk; Chantal C H J Epskamp-Kuijpers; Boukje A C van Dijk; Sjoukje F Oosting

doi:10.1007/s00432-023-05547-8

Nasopharyngeal carcinoma: nationwide trends in subtype-specific incidence and survival over 3 decades in a non-endemic area

J Cancer Res Clin Oncol. 2024 Jan 29;150(2):49. doi: 10.1007/s00432-023-05547-8.

Authors

Jort S van Velsen¹, Bert van der Vegt², Boudewijn E C Plaat³, Johannes A Langendijk⁴, Chantal C H J Epskamp-Kuijpers⁵, Boukje A C van Dijk^{6

7}, Sjoukje F Oosting⁸

Affiliations

¹ Department of Medical Oncology, University Medical Center Groningen, University of Groningen, Hanzeplein 1, PO Box 30.001, 9700 RB, Groningen, The Netherlands.
² Department of Pathology and Medical Biology, University Medical Center Groningen, University of Groningen, PO Box 30.001, 9700 RB, Groningen, The Netherlands.
³ Department of Otorhinolaryngology-Head and Neck Surgery, University Medical Center, University of Groningen, PO Box 30.001, 9700 RB, Groningen, The Netherlands.
⁴ Department of Radiation Oncology, University Medical Center Groningen, University of Groningen, PO Box 30.001, 9700 RB, Groningen, The Netherlands.
⁵ PALGA Foundation, De Bouw 123, 3991 SZ, Houten, the Netherlands.
⁶ Department of Epidemiology, University Medical Center Groningen, University of Groningen, PO Box 30.001, 9700 RB, Groningen, The Netherlands.
⁷ Department of Research and Development, Netherlands Comprehensive Cancer Organisation (IKNL), PO Box 19079, 3501 DB, Utrecht, The Netherlands.
⁸ Department of Medical Oncology, University Medical Center Groningen, University of Groningen, Hanzeplein 1, PO Box 30.001, 9700 RB, Groningen, The Netherlands. s.oosting@umcg.nl.

Abstract

Purpose: To identify trends in incidence and survival of NPC, subdivided by EBV status and histopathological subtype, over a 30-year period in the Netherlands.

Methods: Anonymized data from the Netherlands Cancer Registry and the Dutch Nationwide Pathology Databank (PALGA) for the period 1989-2018 were linked to identify and classify NPC cases.

Results: Incidence of NPC remained stable, with an annual percentage change (APC) of - 0.2. (95% CI - 0.9; 0.5). EBV testing became routine only in the last decade, the incidence of EBV-positive tumors remained stable over this period (APC 1.2, 95% CI - 1.3; 3.8). An increase in EBV-negative tumors (APC: 7.1, 95% CI 2.5; 11.9) and a decrease in untested tumors were found (APC: - 10.7, 95% CI - 15.7; - 5.7). The incidence of non-keratinizing, differentiated tumors increased (APC: 3.8, (95% CI 2.2; 5.5) while the incidence of other histological subtypes remained stable. Overall survival was better in patients diagnosed after 1998 (hazard ratio 0.8, 95% CI 0.6; 0.9). EBV status, histology, stage, and age were independently associated with relative excess risk of dying, but period of diagnosis was not.

Conclusion: Testing for EBV increased over time, and a stable incidence of EBV-positive NPC over the last 10 years. The rising incidence of non-keratinizing, differentiated NPC mirrors data from the US and suggests a shift in non-endemic regions.

Keywords: Epstein–Barr virus; Incidence; Nasopharyngeal carcinoma; Non-endemic; Survival.

MeSH terms

Databases, Factual
Ethnicity*
Humans
Incidence
Nasopharyngeal Carcinoma
Nasopharyngeal Neoplasms* / epidemiology