Post on 29-Jan-2016
description
中山大学肿瘤防治中心 SUN YAT-SEN UNIVERSITY CANCER CENTER
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
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
0
5
10
15
20
25
30
35
40
年份
(/10
)发
病率
万
men
women
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, path
ological 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 match
ed sex, age group, period of diagnosis with general population
Age-specific death rates and life table of Sihui general populati
on 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
Results
中山大学肿瘤防治中心 SUN YAT-SEN UNIVERSITY CANCER CENTER
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
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 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
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 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
中山大学肿瘤防治中心 SUN YAT-SEN UNIVERSITY CANCER CENTER
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)
中山大学肿瘤防治中心 SUN YAT-SEN UNIVERSITY CANCER CENTER
Five year survival of NPC patients in Sihui
MTS OS(95%CI) RS(95%CI)Clinical StagesI 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)PathWHO 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)
中山大学肿瘤防治中心 SUN YAT-SEN UNIVERSITY CANCER CENTER
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)
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 HR 95%CI
Gender Male 1.00Female 0.76 0.65-0.90
Age <40 1.0040- 1.21 0.99-1.4950- 1.51 1.22-1.8860+ 2.22 1.73-2.84
Stage I 1.00II 1.61 1.17-2.22III 2.61 1.89-3.60IV 3.41 2.34-4.99
Histo WHOII/III 1.00WHO I 1.28 1.00-1.64
Period 1976-1985 1.001986-1992 0.76 0.63-0.911993-1999 0.55 0.45-0.682000-2005 0.28 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
0 2 4 6 8 100.0
0.1
0.2
0.3
0.4
0.5
0.6
0.7
0.8
0.9
1.0
year after diagnosis
OSR RSR
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
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
中山大学肿瘤防治中心 SUN YAT-SEN UNIVERSITY CANCER CENTER
screening