Trends and Projections of Incidence and Mortality of Nasopharyngeal Carcinoma in China from 1990 to 2019

Abstract

Background In 2020, there were 62 000 new cases of nasopharyngeal carcinoma (NPC) in China, accounting for about 80% of the NPC cases worldwide. Analysis of the trend and projection of the incidence and mortality of NPC can provide a scientific basis for the prevention and treatment of NPC. Objective To evaluate the trend of incidence and mortality of NPC in Chinese residents, and explore the effects of age, period and cohort on the risk of incidence and death of NPC. Methods From December 2022 to January 2023, data on the ASIR (age standardized incidence rate) and ASMR (age standardized mortality rate) of NPC in China were extracted from the Global Burden of Disease 2019 database. The Joinpoint regression model was used to analyze the trends in ASIR and ASMR of NPC in China from 1990 to 2019. The age-period-cohort model was used to analyze the age effect, period effect and cohort effect affecting the risk of incidence and death of NPC in China. The ASIR and ASMR of NPC in China in the next 20 years were predicted using the R BAPC package. Results There was an overall increasing trend in ASIR of NPC (AAPC=1.82, P<0.01) and decreasing trend in ASMR of NPC (AAPC=-2.45, P<0.01) among Chinese residents from 1990 to 2019. The overall risk of incidence and death of NPC generally increased with age (RR values ranged from 0.09 to 2.24 and 0.10 to 4.43 for males, 0.13 to 1.84 and 0.12 to 4.44 for females, respectively), but the incidence risk of NPC decreased after 55 years old (RR values ranged from 2.24 to 2.99 for males and 1.84 to 2.33 for females). The incidence risk of NPC increased (RR value ranged from 0.61 to 1.81 in males and 1.33 to 0.84 in females) over the years, and the risk of death from NPC decreased in females (RR value ranged from 1.42 to 0.79) and increased in males after 2005 (RR value ranged from 0.95 to 0.99). The later the birth was correlated with lower the risk of incidence and death of NPC (RR values ranged from 0.57 to 3.47 and 0.12 to 3.49 for males, 0.31 to 2.64 and 0.19 to 2.46 for females). It is predicted that the ASIR of NPC in China will continue to rise in the next 20 years, with 21.32/105 in males and 4.95/105 in females in 2039, the ASMR of NPC will decrease, with 1.88/105 in males and 0.53/105 in females in 2039. Conclusion The incidence of NPC in Chinese residents showed an increasing trend and mortality showed a decreasing trend from 1990 to 2019. Age effect and period effect dominate in terms of incidence risk of NPC, and age effect dominates in terms of the risk of death of NPC. It is predicted that the incidence of NPC will still increase and the mortality will decrease in the future.

Keywords

• nasopharyngeal carcinoma|burden of illness|incidence|mortality|age-period-cohort model