Department of Population Health, Hofstra University, Hempstead, New York, USA.
Public Health Program, Fairfield University, Fairfield, Connecticut, USA.
Community Dent Oral Epidemiol. 2023 Oct;51(5):1037-1044. doi: 10.1111/cdoe.12829. Epub 2022 Dec 9.
The incidence of nasopharyngeal cancer (NPC) has been declining in the United States (US) in recent years. However, little is known about the latest trends in NPC mortality in the US population. This study aimed to examine the trends in NPC mortality rate by age, sex, race and ethnicity and US Census Region from 1999 to 2020.
Mortality data were extracted from the Centers for Disease Control and Prevention's Wide-ranging Online Data for Epidemiologic Research (WONDER) database. Decedents whose cause of death was NPC were identified using the International Classification of Diseases Codes, 10th Revision: C11.0-C11.9. Trends in age adjusted mortality rates (AAMR) from NPC were assessed using a joinpoint regression model. Annual Percentage Changes (APC) and Average Annual Percentage Changes were examined overall and by age, sex, race and ethnicity and census region.
From 1999 through 2020, a total of 14 534 NPC deaths were recorded in the US (AAMR = 0.2 per 100 000; 95% CI: 0.2, 0.2). Overall trends remained stationary throughout the study period. Since 2006, recent trends declined by 6.1% per year (95% CI: -8.4, -3.7) among Non-Hispanic Whites, and by 2.7% per year among Non-Hispanic Blacks, Asians/Pacific Islanders and Hispanics. Trends either stabilized or declined by sex, age and US Census Region. Similar results were obtained when the analysis was restricted to decedents aged 65 years and above.
Stationary or declining trends in NPC mortality could be due to the falling incidence of the disease and/or advances in medical diagnosis and treatment. Considering the enigmatic nature of NPC, future studies should explore the genetic and sociodemographic factors associated with the trends reported in this study.
近年来，美国（US）的鼻咽癌（NPC）发病率一直在下降。然而，对于美国人群中 NPC 死亡率的最新趋势知之甚少。本研究旨在检查 1999 年至 2020 年期间，按年龄、性别、种族和族裔以及美国人口普查区域划分的 NPC 死亡率趋势。
死亡率数据从疾病控制和预防中心的广域在线流行病学研究（WONDER）数据库中提取。使用国际疾病分类第 10 版（ICD-10）：C11.0-C11.9 代码确定死亡原因是 NPC 的死者。使用 Joinpoint 回归模型评估 NPC 的年龄调整死亡率（AAMR）趋势。总体和按年龄、性别、种族和族裔以及人口普查区域检查年度百分比变化（APC）和平均年度百分比变化。
1999 年至 2020 年，美国共记录 NPC 死亡 14534 例（AAMR=0.2/100000；95%CI：0.2，0.2）。整个研究期间总体趋势保持稳定。自 2006 年以来，非西班牙裔白人的趋势每年下降 6.1%（95%CI：-8.4，-3.7），非西班牙裔黑人、亚洲/太平洋岛民和西班牙裔的趋势每年下降 2.7%。按性别、年龄和美国人口普查区域，趋势要么稳定，要么下降。当分析仅限于 65 岁及以上的死者时，得到了类似的结果。
NPC 死亡率的稳定或下降趋势可能是由于疾病发病率下降和/或医疗诊断和治疗的进步。考虑到 NPC 的神秘性质，未来的研究应该探索与本研究报告的趋势相关的遗传和社会人口因素。
