| Back ground Nasopharyngeal carcinoma(NPC)is rare in most parts of the world but common in Guangdong,Guangxi and HongKong.Owing to NPC initiated in the fossa of rosenmuller,no early obvious symptoms,easily metastasis,and high malignancy(undifferentiated carcinoma),lots of NPC patients are in intermediate and late stage when they come to see the doctor.Radiotherapy and chemotherapy are the mainly treatments,and the cost of which is a huge burden for the family and our country.Early diagnosis and treatment could improve the survival and quality of life for NPC patient effectively,the survival rate was up to 90%when the patient were in T1 or T2 stage,and which was 60%in patients with advanced stage,but the survival rate was 15-20%when the ones were in advanced stage with distant metastasis.And now the current treatment of nasopharyngeal carcinoma has been closed to the bottleneck,it is significant to carry out tertiary preventions of NPC in order to improve the awareness of high-risk groups and the survival rate,and reduce the mortality.In order to search for and cure the patients in early stage,it is good to relieve of the burden,and for the treatment and prevention of NPC by investigating epidemiology of nasopharyngeal carcinoma,finding out the etiology,screening for high-risk groups.It is very important to establish the NPC high-risk filed to study the distribution and high-risk factors of NPC,and to take the preventive measures.So far,two cancer registries have been established in NPC high-risk area Cangwu in Guangxi and Sihui in Guangdong,and Epstein-Barr virus(EBV)serological screening is carried out in the high-risk groups,working at searching for and curing the NPC patients in early stage.And now,several scientific research groups try to carry out a population-based case-control study for NPC together in south China(Zhaoqing,Wuzhou,Guiping and Pingnan included)by the funding of National Institutes of Health(NIH)in 5 years from March2010.The cases are 2000,and the controls are 2000 too.The population-based case-control investigation for Guiping and Pingnan is part of the project,as a good foundation for the etiology of NPC.Abstract objective We try to establish a population-based case-control investigation field for nasopharyngeal carcinoma(NPC)in Guiping and Pingnan in Guangxi province.In order to get the knowledge about the epidemiology of NPC in Guiping and Pingnan,we also analyzed the NPC cases retrospectively in 2009-2011.At last,we would like to establish a biological specimen bank.Methods We investigated the new Guiping and Pingnan NPC cases aged 20-75,from March 2010,in Peoples' hospital of Guiping,Peoples'hospital of Pingnan,the second hospital of Pingnan,Wuzhou red cross hospital and the first affiliated hospital of Guangxi Medical University(GMU).And the population-based controls were investigated from February 2011 to March 2012 by the principle of case-control match.We collected the biological sample such as blood,hair,nail,saliva and pathological slide(only for the cases)both cases and control.The questionnaire about family history,past history,residential history,occupational history,and diet information was finished by surveyor.The surveyor also charged the data entry on the computer.The samples should be transported to Medical Science Experiment Center,Guangxi Medical University in order to set up the biological specimen bank.We investigated the lost cases in 2011 retrospectively for more cases included.In order to understand the studied population epidemiological characteristics of nasopharyngeal carcinoma,we surveyed the new NPC cases retrospectively in Peoples' hospital of Guiping,Peoples' hospital of Pingnan,the second hospital of Pingnan,Wuzhou red cross hospital,Yulin red cross hospital,the first hospital of Yulin,the tumor hospital of GMU and the first affiliated hospital of GMU between 2009 to 2011.We calculated the gender ratio,the gender incidence,age-specific incidence,the incidence of Guping,the incidence of Pingnan,the incidence of Guiping and Pingnan,the China standardized incidence rate,the world standardized incidence rate by SPSS 13.0.The data of population came from the fifth census data published on the website of the National Bureau of Statistics of China in 2000.The world standard population data in use is also in 2000.Results We totally finished 229 cases questionnaire(18cases included retrospectively)from March 2010 to December 2011.There were 92 cases in 2010,and 119cases in 2011.And there were 138 cases in Guiping and 91 cases in Pingnan.The Peoples' hospital of Gulping with the cases is the most,the first affiliated hospital of(GMU)is the second,and the Peoples' hospital of Pingnan is the third.The NPC cases we collected in Guiping and Pingnan were stable monthly,in line with the Characteristics of NPC.We found that 46 lost cases distributed in the First People's Hospital of Yulin,Yulin Red Cross Hospital,Tumor Hospital of GMU in 2011 and 18 cases were investigated retrospectively.The response rate 70.83%increased to 81.55%when the 18 cases were investigated retrospectively.We investigated 57 controls from February 2011 to March 2012,34 in Guiping and 23 in Pingnan.By comparative analysis of 23 controls in Pingnan,the response rate of Pingnan County was 7.7%,while the response rate of the towns was 81.5%,and the overall response rate was 57.5%.When analyzing the first sampling controls of Pingnan further,we found that only 23 of 41 controls agreed to the survey,up to 11 controls were unable to find,three controls refused to be investigated,another three controls were outside for the long-term work and one had died.In addition to collect 211 cases(excluding 18 patients to complete the questionnaire retrospectively)in 2010-2011,we retrospectively investigated 310 new cases from 2009 to 2011,and the total number was 521 cases of Guiping and Pingnan.In all the cases,male were 361 and female were 160,the male to female ratio was 2.26:1.The NPC incidences of male in Guiping and Pingnan were 9.63 per 105,9.24 per 105,9.16 per 105,with an average incidence rate of 9.34 per 105;and the NPC incidences for female were 4.88 per105,4.88 per105,4.44 per105,with an average incidence rate of 4.73 per105.The incidence of NPC for male to female ratio was 1.97:1.After statistics analyze of age-specific distribution,the peak age of NPC patients was in the 40-49 years.In 2009-2011 the crude NPC incidences of Guiping were 7.21 per105,7.13 per105,7.65 per105,the average NPC incidence Guiping was 7.34 per105.And the crude NPC incidences of Pingnan were 7.71 per105,7.33/10 per105,6.10 per105.And the average NPC incidence of Pingnan was 7.05 per105.The average NPC incidence rate of Guiping and Pingnan was 7.21 per105,with the average China standardized incidence rate 8.48 per105,and the average world standardized rate was 8.31per105.Conclusion We have initially established a population-based case-control study field for NPC in Guiping and Pingnan,and have got the studied population,the database and biological specimen bank.We also have got the technological standards about biological samples collection,processing,preservation,and transportation.There is a high NPC incidence in Guiping and Pingnan,Guangxi,the crude NPC incidence rate was 7.21 per105,with the China standardized incidence rate 8.48,and the world standardized rate was 8.31 per105.It likely happens to men,and 40-49 is the NPC peak incidence.The prevention and treatment should be strengthened in the region.Guiping and Pingnan NPC incidences were 7.43 per105,7.22 per105,6.97 per105,in 2009-2011,suggesting a relatively stable in the region. |
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