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Q ing Liu, Jinou Chen, Qihong Huang, Yanhua Li Cancer Center, Sun Yat-sen University

Trends in the survival of patients with nasopharyngeal carcinoma 1976-2005 in Sihui city, Guangdong province, P.R. of China: a population-based study. Q ing Liu, Jinou Chen, Qihong Huang, Yanhua Li Cancer Center, Sun Yat-sen University Sihui Cancer Institute.

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Q ing Liu, Jinou Chen, Qihong Huang, Yanhua Li Cancer Center, Sun Yat-sen University

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  1. Trends in the survival of patients with nasopharyngeal carcinoma 1976-2005 in Sihui city, Guangdong province, P.R. of China: a population-based study Qing Liu, Jinou Chen, Qihong Huang, Yanhua Li Cancer Center, Sun Yat-sen University Sihui Cancer Institute

  2. NPC Epidemiological Charateristics in Sihui Incidence rate of NPC: 30.9 in male and 13.0 in female Mortality rate of NPC: 22.0 in male and 7.7 in female Incidence rates and mortality rates of NPC kept stable Comparing to the reduction in HK, TW, LA in USA

  3. Trend of NPC incidence 1988-2002 in HK

  4. Trend of NPC incidence 1978-2002 in Sihui

  5. Materials and methods Cancer registry system since 1973 in Sihui Follow up system for NPC cases since 1978 1761 incidence cases of NPC were chose during 1976-2005 Follow up to the end of 2006 , Max follow up year=30.4 1239 (70.3%) cases with pathological evidence

  6. Materials and methods Kaplan–Meier estimate for survival rates Cox proportional hazards regression for risk factor screening Risk factors: gender,age,period of diagnosis,clinical stage, pathological status,diagnosis medical unit were analyzed

  7. Materials and methods Relative survival probabilities for NPC were assessed by matched sex, age group, period of diagnosis with general population Age-specific death rates and life table of Sihui general population was available based on death registry system SURV3 was used for relative survival rate estimation SAS 9.2 for other statistical analyses

  8. Results

  9. Characteristics of patients with NPC 1976-2005 • Gender N % • Male 1189 67.5 • Female 572 32.5 • Age at diagnosis • <40 498 28.2 • 40- 545 30.9 • 50- 414 23.5 • 60+ 304 17.3

  10. Characteristics of patients with NPC 1976-2005 • Clinical stage N % • I 107 6.1 • II 546 31.0 • III 467 26.5 • IV 119 6.8 • Unknown 522 29.6 • Pathological diagnosis • WHO I 159 9.0 • WHO II/III 1080 61.3 • Unknown 522 29.6

  11. Characteristics of patients with NPC 1976-2005 • Period diagnosed N % • 1976- 409 23.2 • 1986- 472 26.8 • 1993- 534 30.3 • 2000- 346 19.6 • Diagnostic hospital • CC 1076 61.1 • Other 685 38.9

  12. Five year survival of NPC patients in Sihui • MTS OS(95%CI) RS(95%CI) • All cases 5.1 50.5(48.1-52.9) 60.3(57.5-63.1) • Gender • Male 4.5 48.4(45.5-51.3) 59.3(55.8-62.8) • Female 6.2 54.5(50.4-58.7) 62.2(57.6-66.8) • Age at diagnosis • <40 8.7 56.4(51.9-60.9) 59.4(54.7-64.1) • 40- 5.9 53.9(49.6-58.1) 60.1(55.4-64.8) • 50- 4.8 48.7(43.8-53.6) 62.5(56.3-68.6) • 60+ 2.8 36.4(30.8-41.9) 59.1(50.5-67.6)

  13. Five year survival of NPC patients in Sihui • MTS OS(95%CI) RS(95%CI) • Clinical Stages • I 14.4 73.7(65.3-82.1) 85.2(75.8-94.5) • II 6.3 57.4(53.1-61.7) 69.4(64.5-74.3) • III 2.8 38.3(33.8-42.8) 44.7(39.5-50.0) • IV 2.3 31.5(22.8-40.2) 37.9(27.6-48.2) • Unknown 6.1 52.8(48.4-57.2) 64.4(59.2-69.6) • Path • WHO I 5.1 49.8(41.1-58.6) 56.9(52.3-61.5) • WHO II/III 5.5 52.1(49.1-55.1) 62.3(58.8-65.8) • Unknown 4.2 46.4(42.0-50.9) 58.8(53.5-64.1)

  14. Five year survival of NPC patients in Sihui • MTS OS(95%CI) RS(95%CI) • Period diagnosed • 1976-1985 3.8 42.5(37.8-47.3) 51.8(46.2-57.4) • 1986-1992 4.0 43.4(39.0-47.9) 51.1(45.9-56.3) • 1993-1999 5.5 52.1(47.8-56.3) 62.5(57.5-67.6) • 2000-2005 - 69.8(64.1-75.4) 84.8(79.1-90.6) • Diagnostic Hospital • CC 5.5 52.3(49.3-55.3) 62.3(58.8-65.8) • Others 4.3 47.4(43.5-51.2) 56.9(52.3-61.5)

  15. Risk factors related to death from NPC by Multivariate Cox Regression • HR 95%CI • Gender Male 1.00 • Female 0.76 0.65-0.90 • Age <40 1.00 • 40- 1.21 0.99-1.49 • 50- 1.51 1.22-1.88 • 60+ 2.22 1.73-2.84 • Stage I 1.00 • II 1.61 1.17-2.22 • III 2.61 1.89-3.60 • IV 3.41 2.34-4.99 • Histo WHOII/III 1.00 • WHO I 1.28 1.00-1.64 • Period 1976-1985 1.00 • 1986-1992 0.76 0.63-0.91 • 1993-1999 0.55 0.45-0.68 • 2000-2005 0.28 0.20-0.40

  16. Observed and relative survival (95%CI) of NPC in Sihui 1976-2005

  17. Relative survival of NPC, stage I and II

  18. Relative survival of NPC, stage III and IV

  19. Conclusion • Significant improvement of NPC survival • No change of proportion of stage of NPC cases • Improved radiotherapy might contribute to survival of NPC • Screening for NPC will definitely increase survival of NPC • May predict a reduction of mortality rates of NPC in Sihui

  20. Thanks! screening

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