Nasopharyngeal Carcinoma More Common in Black Children With Late Disease

Children in the United States who present with nasopharyngeal carcinoma (NPC) are more often black and have advanced disease compared with adults, say report investigators in a study recently published in JAMA Otolaryngology Head and Neck Surgery.

Although NPC is endemic in some areas of Asia, it is uncommon in the United States and little is known about how it presents in children.

To fill this gap, investigators used data from the National Cancer Data Base from January 1998 to 2011 to identify patients with NPC and to analyze data (demographic, tumor, and treatment characteristics) to understand the difference between pediatric (<21 years) and adult NPC.

The study included 17,317 patients (699 pediatric and 16,618 adult) diagnosed with NCP. The researchers found that pediatric patients with NCP were most commonly black (43.6%), and adult patients were most often non-Hispanic white (60.0%). The study also found that pediatric patients were significantly more likely to present with stage IV disease (47.8% vs 58.4%, P<0.001).

Lead author of the study, Morgan Richards, MD, research fellow in the department of pediatric general and thoracic surgery at Seattle Children’s Hospital, said that given the retrospective nature of the study, she and her colleagues were not able to determine the cause for the racial differences, but thinks the finding warrants further investigation.

Looking at whether race conferred a survival difference among the pediatric patients, the study did not find that race, including Asian race, was associated with increased mortality in pediatric patients with NPC.

The study also found that pediatric patients were significantly less likely to be Asian than adults (5.7% vs 19.7%, P<0.001) and had a significantly lower risk of mortality compared to adults (hazard ratio, 0.37; 95% CI, 0.25-0.56).

“This study may help clinicians consider this rare diagnosis when it presents in children who do not fit the traditional adult racial demographics of this disease,” said Dr. Morgan.