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
中山大学肿瘤防治中心
SUN YAT-SEN UNIVERSITY CANCER CENTER

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
中山大学肿瘤防治中心
SUN YAT-SEN UNIVERSITY CANCER CENTER

Trend of NPC incidence 1988-2002 in HK
中山大学肿瘤防治中心
SUN YAT-SEN UNIVERSITY CANCER CENTER

Trend of NPC incidence 1978-2002 in Sihui
40
35
30 men women
15
10
5
0
25
20
19
79
19
81
19
83
19
85
19
87
19
89
19
91
19
93
19
95
19
97
19
99
20
01
年份
中山大学肿瘤防治中心
SUN YAT-SEN UNIVERSITY CANCER CENTER

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
中山大学肿瘤防治中心
SUN YAT-SEN UNIVERSITY CANCER CENTER

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
中山大学肿瘤防治中心
SUN YAT-SEN UNIVERSITY CANCER CENTER

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
中山大学肿瘤防治中心
SUN YAT-SEN UNIVERSITY CANCER CENTER

中山大学肿瘤防治中心
SUN YAT-SEN UNIVERSITY CANCER CENTER

Characteristics of patients with NPC 1976-2005
Gender
Male
N
1189
Female 572
Age at diagnosis
<40
40-
498
545
50-
60+
414
304
%
67.5
32.5
28.2
30.9
23.5
17.3
中山大学肿瘤防治中心
SUN YAT-SEN UNIVERSITY CANCER CENTER

Characteristics of patients with NPC 1976-2005
Clinical stage
I
II
III
N
107
546
467
IV
Unknown
119
522
Pathological diagnosis
WHO I
WHO II/III
Unknown
159
1080
522
%
6.1
31.0
26.5
6.8
29.6
9.0
61.3
29.6
中山大学肿瘤防治中心
SUN YAT-SEN UNIVERSITY CANCER CENTER

Characteristics of patients with NPC 1976-2005
Period diagnosed
1976-
1986-
1993-
2000-
Diagnostic hospital
CC
Other
N
409
472
534
346
1076
685
%
23.2
26.8
30.3
19.6
61.1
38.9
中山大学肿瘤防治中心
SUN YAT-SEN UNIVERSITY CANCER CENTER

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

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

Five year survival of NPC patients in Sihui
RS(95%CI) MTS OS(95%CI)
Period diagnosed
1976-1985 3.8
42.5(37.8-47.3)
1986-1992 4.0
43.4(39.0-47.9)
1993-1999 5.5
52.1(47.8-56.3)
2000-2005 69.8(64.1-75.4)
Diagnostic Hospital
CC
Others
5.5
4.3
52.3(49.3-55.3)
47.4(43.5-51.2)
51.8(46.2-57.4)
51.1(45.9-56.3)
62.5(57.5-67.6)
84.8(79.1-90.6)
62.3(58.8-65.8)
56.9(52.3-61.5)
中山大学肿瘤防治中心
SUN YAT-SEN UNIVERSITY CANCER CENTER

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

Observed and relative survival (95%CI) of NPC in Sihui 1976-2005
OSR
RSR
1.0
0.9
0.8
0.7
0.6
0.5
0.4
0.3
0.2
0.1
0.0
0 2 4 6 year after diagnosis
8 10
中山大学肿瘤防治中心
SUN YAT-SEN UNIVERSITY CANCER CENTER

Relative survival of NPC, stage I and II
中山大学肿瘤防治中心
SUN YAT-SEN UNIVERSITY CANCER CENTER

Relative survival of NPC, stage III and IV
中山大学肿瘤防治中心
SUN YAT-SEN UNIVERSITY CANCER CENTER

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
中山大学肿瘤防治中心
SUN YAT-SEN UNIVERSITY CANCER CENTER

screening
中山大学肿瘤防治中心
SUN YAT-SEN UNIVERSITY CANCER CENTER