Dewi Renaningtyas

Retno Asih Y.S

Journal Identity
Title

Author

Nasopharyngeal carcinoma (NPC) is an aggressive

tumour of the head and neck, with a variable
incidence rate around the world.

USA & UK 1/100.000

Cina Selatan, Asia Tenggara, Mediterania and Alaska
10-30/100.000
These epidemiological differences have been
attributed to three aetiological factors:

genetic susceptibility
expo- sure to dietary or environmental carcinogens
latent Epstein-Barr Virus (EBV) infection

In New Zealand, the main ethnic groups are Europeans (67.6%),

Maori (14.6%), Pacic Islanders (6.9%) and Asians (9.2%).
4 The New Zealand Europeans have the same incidence of NPC
as do their counterparts in Europe and North America.
However, Maori and Pacic Islanders (MPIs) have a much
higher incidence of NPC, estimated at 10/100 000.5,6
There is evidence that Pacic Islanders inhabiting the South
Pacic region are descended from the Asian population that
once inhabited Southern China.
6 Thus, the higher incidence of NPC in MPIs may be attributed
to a shared ancestral genetic susceptibility.
The Asian population of New Zealand is mostly made up of
immigrants from China (Including Hong Kong and Taiwan).7

The study was based on retrospective analysis of medical

records of all the patients with a diagnosis of NPC who were
seen in Auckland Regional Head and Neck Unit, between the
years 1995 and 2007 inclusive.
Those patients who had a diagnosis of NPC made before the
year 1995 or had the initial diagnosis made at another centre
were excluded.
Therefore, only those patients presenting with a previously
undiagnosed NPC, and who had their initial investiga- tions and
work up performed in Auckland, were included.
A total of 161 patients were seen with the diagnosis of NPC in
the time frame of the study.
33 pasien excluded because dont inclusive.
Sampel 128 pasien; laki-laki 81 pasien (63%), perempuan 47
pasien (37%)

 of all

the patients with a diagnosis of NPC

who were seen in Auckland Regional Head
and Neck Unit, between the years 1995 and
2007 inclusive.

Those patients who had a diagnosis of NPC

made before the year 1995 or had the initial
diagnosis made at another centre

The patients radiological and biopsy results were

reviewed, and each patient was staged according to
the TNM stage at presentation as per the revised
2002 American Joint Committee on Cancer staging
criteria.
The Fishers exact test was used to compare the
differences between ethnicities in the T and N
stages of the disease at presentation; the Cochran
Armitage Trend test was used to look for statistically
signicant trends.

There was a statistically signicant difference in

T stage at presentation between MPIs and Asians
(P < 0.0001), with a positive, statistically
signicant (P < 0.0001) trend indicating that MPIs
present with greater T stage.
A statistically signi- cant difference in the N
stage at diagnosis between MPIs and Asians,
independent of the T stage, was found at stages
T2 (P = 0.046) and T4 (P = 0.0083), with a
statistically signicant trend (T2 P = 0.009; T4
P = 0.026).

To our knowledge, the current study is the rst to investigate

the differences in the presentation of NPC between different
ethnic groups in the New Zealand setting.
The ndings suggest that, although MPIs and Asians share a
common genetic susceptibility to NPC, the nature of the
disease at presentation between the two ethnic groups differs
signicantly.
The studys MPI patients with NPC present with a greater T
stage at the time of diagnosis, com- pared with the Asian NPC
patient population.
When considering the genetic susceptibility that the two
ethnicities share, this indicates that there may be
environmental factors affecting the volume of the primary
tumour at diagnosis.

Ethnicity is found to be an independent

inuence on the primary NPC tumour volume
at presentation, with MPI patients presenting
with more advanced T stage of the disease
compared with the Asian patients.
This indicates that an improvement in the
awareness of an increased incidence of NPC
and in the MPI population, as well as the
diseases early symptoms, is needed among the
primary healthcare providers and the MPI
population of New Zealand.
MPI patients present with more advanced nodal
disease compared with the Asian population, at
similar T stage of the cancer. This nding is
statistically signicant at T2 and T4 stages and
requires further investigation.