Early onset of nasopharyngeal cancer in Asian/Pacific Islander Americans revealed by age-specific analysis

Lee, Alice W.; Sou, Angela; Patel, Maitri; Guzman, Sofia; Liu, Lihua

doi:10.1016/j.annepidem.2023.02.006

Cited by 3 publications

(2 citation statements)

References 23 publications

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“…Nasopharyngeal carcinoma is more prevalent in Asia than in Western regions and is more likely to undergo higher-dose radiotherapy. However, evidence of whether radiation-induced sarcomas in the head and neck regions are more common in Asia than in Western countries is lacking [1,35].…”

Section: Factors Related To Radiation Exposurementioning

confidence: 99%

“…The global incidence of malignancies varies substantially by region and ethnicity. For example, the incidence of nasopharyngeal carcinoma is considerably higher in Asians and Pacific Islanders than in other ethnic groups [1]. Additionally, patients with breast cancer in Asia tend to be younger and more likely to have hormone-receptor-positive breast cancer compared with women in Western countries [2]; similarly, patients with lung cancer in Asia are more likely to exhibit EGFR alterations than do those elsewhere [3,4].…”

Section: Introductionmentioning

confidence: 99%

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Sarcoma incidence worldwide: regional differences in histology and molecular subtypes

Lee,

Chen

2024

Current Opinion in Oncology

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Purpose of review There are numerous sarcoma subtypes and vary widely in terms of epidemiology, clinical characteristics, genetic profiles, and pathophysiology. They also differ widely between ethnic groups. This review focuses on the different incidence rates of sarcomas in different regions and the potential explanations for these disparities. Recent findings In an intercontinental study using national cancer registry databases from France and Taiwan, the French population had a higher risk of liposarcomas, leiomyosarcomas, and synovial sarcomas, whereas the Taiwanese population had a higher incidence of angiosarcomas and malignant peripheral nerve sheath tumors. The anatomical distribution of these sarcomas also varied between these two regions. In France, most angiosarcoma cases occurred in the extremities and trunk, whereas in Taiwan, angiosarcoma cases in the abdomen and pelvis were more common. Another international study showed that in addition to the common known TP53 and NF1 germline mutations, genes involved in centromere and telomere maintenance were also involved in sarcomagenesis. We reviewed factors related to genetics, environmental effects, chemical exposure, and radiation exposure that could explain the differences in sarcoma incidence among different geographical or ethnic regions. Summary Our understanding of the potential cause of sarcomas with different subtypes is limited. Establishing a comprehensive global database for patients with sarcomas from all ethnic groups is essential to deepen our understanding of the potential risk factors and the pathophysiology of all sarcoma subtypes.

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Section: Factors Related To Radiation Exposurementioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Sarcoma incidence worldwide: regional differences in histology and molecular subtypes

Lee,

Chen

2024

Current Opinion in Oncology

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Nasopharynx Cancer in the United States: Racial and Ethnic Disparities in Stage at Presentation

Dee,

Wang,

et al. 2024

The Laryngoscope

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IntroductionAlthough nasopharynx cancer (NPC) is rare in the United States, global epidemiology varies greatly. Therefore, understanding NPC disparities in the diverse US setting is critical.Methods and MaterialsData from the National Cancer Database (NCDB, 2004‐2021) identified patients with NPC; NCDB allows disaggregation by Asian American (AA) subgroups. Multivariable ordinal logistic regression adjusting for demographic and socioeconomic factors defined adjusted odds ratios (aORs).ResultsOf 15,862 patients, 11,173 (70.4%) were male (median age 59). Commonest groups included 10,034 (63.3%) White, 2,272 (14.3%) Black, 1,103 (7.0%) Chinese, 442 (2.8%) Filipino, and 338 (2.1%) Vietnamese patients. Prior to disaggregation, the proportion of stage IV disease at presentation was 43.2% among White (ref), 50.0% among Black (aOR 1.12, p = 0.012), 52.0% among Native American (aOR 1.18, p > 0.05), 41.9% among AA (aOR 0.97, p > 0.05), and 55.1% among Native Hawaiian and Other Pacific Islander patients (aOR 1.47, p = 0.021).Upon disaggregation, the proportion of stage IV disease was the greatest (>50%) among Black (50.0%, aOR 1.12, p = 0.012), Laotian (61.5%, aOR 2.21, p = 0.001), Hmong (73.2%, aOR 2.92, p < 0.001), and Other Pacific Islander patients (60.9%, aOR 1.83, p = 0.004); 44.2% of Filipino patients also presented with stage IV disease (aOR 1.21, p = 0.033). Odds of presenting with advanced stage disease were lower among Chinese patients (35.7% stage IV, aOR 0.72, p < 0.001).ConclusionsAlthough most NPC patients were Chinese, White, or Black, stage IV disease at presentation was most common among Hmong, Laotian, non‐Hawaiian Pacific Islander, and Black patients. Efforts are needed to improve awareness of NPC among less canonically affected groups.Level of EvidenceLevel 4 Laryngoscope, 2024

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Identification of High-Incidence Populations in the United States for Anti–Epstein-Barr Virus Serologic Screening for Nasopharyngeal Carcinoma

Clark,

Taparra,

Miller

2024

Cancer Epidemiology, Biomarkers &Amp; Prevention

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Background: In the United States (US), Epstein-Barr Virus (EBV)-associated nasopharyngeal carcinoma (NPC) disproportionately impacts Asian Americans (AA) and Native Hawaiians and other Pacific Islanders (NHPI) who have no access to screening. EBV-based screening trials in Asia have detected most cases at early stages. We sought to identify a US target population for NPC screening and hypothesized that once-lifetime screening could be cost-effective. Methods: We obtained NPC incidence data from the SEER Asian and Pacific Islander datasets. We estimated the number needed to screen, mortality reduction, and resource utilization using a validated model and performance data from trials. Six evaluated strategies incorporated serology, nasopharyngeal swab PCR, and endoscopy or MRI. Results: Intermediate-incidence and high-incidence populations accounted for 10.7% of US person-years yet 42.7% of cases. Anti-BNLF2b screening with selective endoscopy was the preferred strategy. In high-incidence populations, the median NNS to detect one case was 1,992, with a median of 7.12 NPC deaths averted per 100,000 screened. Screening met the willingness-to-pay threshold in all five high-incidence populations (median ICER/GDP 0.82) and among men in intermediate-incidence populations. Conclusions: Nearly half of NPC in the US arises among the 10% with AA or NHPI ethnicity. A suitable target population for US screening trials would be men and women age 35-65 of Chinese, Sāmoan, or Southeast Asian ethnicity, or men age 35-60 of Guamanian/Chamorro, Filipino, or Native Hawaiian ethnicity. Once-lifetime anti-BNLF2b screening could be cost-effective. Impact: These data may aid the design of US screening trials. Targeted NPC screening might mitigate health disparities.

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Early onset of nasopharyngeal cancer in Asian/Pacific Islander Americans revealed by age-specific analysis

Cited by 3 publications

References 23 publications

Sarcoma incidence worldwide: regional differences in histology and molecular subtypes

Sarcoma incidence worldwide: regional differences in histology and molecular subtypes

Nasopharynx Cancer in the United States: Racial and Ethnic Disparities in Stage at Presentation

Identification of High-Incidence Populations in the United States for Anti–Epstein-Barr Virus Serologic Screening for Nasopharyngeal Carcinoma

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