Nasopharyngeal Cancer Incidence is Declining, Not Increasing
No, the incidence of nasopharyngeal carcinoma (NPC) is not increasing—it has been declining worldwide over recent decades. 1
Global Incidence Trends
The most authoritative data from the ESMO-EURACAN guidelines clearly demonstrates that in recent decades (1970-2007), the incidence of NPC has declined worldwide, with substantial reductions in South and East Asia, North America and the Nordic countries. 1 This represents a consistent downward trend across multiple geographic regions over nearly four decades.
More recent epidemiological analysis confirms this pattern, noting that incidence has declined gradually but progressively in the past decade, and mortality has been reduced substantially. 2 These improvements likely reflect lifestyle and environmental changes, enhanced understanding of pathogenesis and risk factors, and population screening initiatives. 2
Current Geographic Distribution
Despite the declining trend, NPC maintains distinct geographic patterns: 1
- Highest rates: East and Southeast Asia with age-standardized incidence rates (ASIRs) of 7 per 100,000 in Singapore, the Maldives, and Indonesia; 6 per 100,000 in Malaysia and Vietnam; 3 per 100,000 in China 1
- Europe: ASIR of 0.4 per 100,000, with approximately 5,000 new cases annually 1
- Global: Approximately 129,000 new cases reported in 2018 1
The male-to-female incidence ratio remains 2.75:1. 1
Clinical Implications
The declining incidence should not diminish vigilance, particularly in high-risk populations including individuals of Southern Chinese, Southeast Asian, Arctic, or Middle Eastern/North African descent. 3 Key risk factors remain: elevated Epstein-Barr virus antibody titers, consumption of salt-preserved fish, family history of NPC, and certain HLA class I genotypes. 3