Epidemiology of nasopharyngeal carcinoma (NPC) in Pahang, Malaysia

Abstract

Nasopharyngeal carcinoma (NPC) is among the most frequently reported cancer in Malaysia. The Malaysian National Cancer Registry Report 2007-2011 stated that NPC was the fifth most common cancer among Malaysian and the third most common cancer among Malaysian men. While there have been several studies on NPC previously carried out in a few states in Malaysia, a comprehensive study in Pahang had never been reported. This study was designed to feature the number of cases and distribution of newly diagnosed NPC in Pahang, as well as to investigate the risk factors of the disease. This study involved two main referral hospitals in Pahang, namely Hospital Tengku Ampuan Afzan (HTAA) in Kuantan and Hospital Sultan Haji Ahmad Shah (HOSHAS) in Temerloh. NPC cases diagnosed within the year 2012-2017 in those hospitals were included in this study. The crude rate (CR) and age-standardized rate (ASR) were computed to investigate the NPC incidence. Furthermore, the patients that met the inclusion and exclusion criteria were invited to participate in a case-control study. A face-to-face interview was conducted using adapted questionnaires which included demographic data, family history of cancers and lifestyles (smoking status, alcohol drinking status and dietary intake of preserved foods). Then, the NPC cases were matched with similar gender, ethnic and age (within five years) of control group consisting cancer free individual. Logistic Regression analysis was performed to identify the factor associated with NPC. A total of 143 new cases of NPC were reported from both hospitals. The age at diagnosis of the patients ranged from 14 to 82 years old with mean age of 52.0 ±13.7 years old. Majority of cases were male gender (74.1%) with the ratio of male to female was 2.9:1. Ethnically, Chinese males were found to have the highest incidence with the mean ASR of 4.7 per 100,000 populations. Overall, the mean ASR for Pahang were 2.4 per 100,000 population in males and 0.9 per 100,000 population in females. The incidence of NPC in Pahang within the studied time frame were intermediate in males and low in female. In the case-control study, family history of NPC (p=0.002) and smoking status (p=0.006) were significantly associated with the risk for NPC. An individual who had family history of NPC had a risk more than seven times to develop the disease (AOR= 7.90, 95% CI= 2.12, 29.38) compared with those who did not have the history of the disease. Furthermore, the current smoker was found to have three folds increase odds in the risk for NPC (AOR=3.01, 95% CI=1.38, 6.59) compared to never smoker. The finding in the case-control study suggested that the family history of NPC and smoking status has been linked to NPC risk in Pahang population.