Difference in the Incidence Trend of Nasopharyngeal and Oropharyngeal Carcinomas in Taiwan: Implication from Age-Period-Cohort Analysis

Lifestyle factors are considered important for the pathogenesis of both nasopharyngeal and oropharyngeal carcinomas. In Taiwan, the incidence of nasopharyngeal carcinoma gradually decreased over the past 20 years, whereas that of oropharyngeal carcinoma increased rapidly. To compare the incidence trends of nasopharyngeal and oropharyngeal carcinomas in Taiwan, the age-period-cohort model was used to analyze epidemiologic data from 1981 to 2000 obtained from the Taiwan Cancer Registry. The calendar time period of 1986 to 1990 and the 1931 to 1940 birth cohort were used as reference groups for estimates of relative risk. For nasopharyngeal carcinoma, the incidence seemed to decrease in most age groups and was more prominent in women (30%) than in men (23%). For oropharyngeal carcinoma, the incidence increased in all age groups and was more prominent in men (391.4%) than in women (59.2%). Cohort effect was found for both nasopharyngeal and oropharyngeal carcinomas. The relative risk of nasopharyngeal carcinoma for the 1971 to 1980 birth cohort was 0.38 for women and 0.68 for men. The relative risk of oropharyngeal carcinoma for the 1971 to 1980 cohort was 45.67 for men and 2.69 for women. Change in lifestyle seemed to be an important factor for the difference in the incidence trend between nasopharyngeal and oropharyngeal carcinomas and between men and women. (Cancer Epidemiol Biomarkers Prev 2006;15(5):856–61)

[1]  J. Mahanta,et al.  Risk factors for cancer nasopharynx: a case-control study from Nagaland, India. , 2000, The National medical journal of India.

[2]  D Clayton,et al.  Models for temporal variation in cancer rates. II: Age-period-cohort models. , 1987, Statistics in medicine.

[3]  M. Blaser,et al.  Population attributable risks of esophageal and gastric cancers. , 2003, Journal of the National Cancer Institute.

[4]  M. McCredie,et al.  Cancer incidence in Asian migrants to New South Wales, Australia. , 1995, British Journal of Cancer.

[5]  P. Levine,et al.  Etiology of nasopharyngeal carcinoma: a review. , 1993, Epidemiologic reviews.

[6]  J. Ferlay,et al.  Cancer Incidence in Five Continents , 1970, Union Internationale Contre Le Cancer / International Union against Cancer.

[7]  T. Dietrich,et al.  Decline of oropharyngeal cancer in Chiangmai province, Thailand, between 1988 and 1999. , 2003, Oral oncology.

[8]  C. J. Chen,et al.  Genetic polymorphisms of CYP2E1, GSTM1, and GSTT1; environmental factors and risk of oral cancer. , 1997, Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology.

[9]  Y. Ko,et al.  Betel quid chewing, cigarette smoking and alcohol consumption related to oral cancer in Taiwan. , 1995, Journal of oral pathology & medicine : official publication of the International Association of Oral Pathologists and the American Academy of Oral Pathology.

[10]  D Clayton,et al.  Models for temporal variation in cancer rates. I: Age-period and age-cohort models. , 1987, Statistics in medicine.

[11]  Tien-Yu Shieh,et al.  The incidence of oropharyngeal cancer in Taiwan: an endemic betel quid chewing area. , 2002, Journal of oral pathology & medicine : official publication of the International Association of Oral Pathologists and the American Academy of Oral Pathology.

[12]  Alfred A Cecchetti,et al.  Bioequivalence revisited: Influence of age and sex on CYP enzymes , 2004, Clinical pharmacology and therapeutics.

[13]  J. R. Scotti,et al.  Available From , 1973 .

[14]  B. Cox,et al.  Trends in oral cancer by subsite in New Zealand. , 1995, European journal of cancer. Part B, Oral oncology.

[15]  C. J. Chen,et al.  Occupational exposure to wood, formaldehyde, and solvents and risk of nasopharyngeal carcinoma. , 2001, Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology.

[16]  Chien-Jen Chen,et al.  Dietary exposure to nitrite and nitrosamines and risk of nasopharyngeal carcinoma in Taiwan , 2000, International journal of cancer.

[17]  R. Tarone,et al.  Implications of birth cohort patterns in interpreting trends in breast cancer rates. , 1992, Journal of the National Cancer Institute.

[18]  C. Compton,et al.  AJCC Cancer Staging Manual , 2002, Springer New York.

[19]  Chiun Hsu,et al.  Significant Difference in the Trends of Female Breast Cancer Incidence Between Taiwanese and Caucasian Americans: Implications from Age-Period-Cohort Analysis , 2005, Cancer Epidemiology Biomarkers & Prevention.

[20]  T. Day,et al.  Oral Cancer and Precancerous Lesions , 2002, CA: a cancer journal for clinicians.

[21]  Y. Ko,et al.  Prevalence of betel quid chewing habit in Taiwan and related sociodemographic factors. , 1992, Journal of oral pathology & medicine : official publication of the International Association of Oral Pathologists and the American Academy of Oral Pathology.

[22]  C. Gotay.  Behavior and cancer prevention. , 2005, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[23]  M. Lai,et al.  Universal hepatitis B vaccination in Taiwan and the incidence of hepatocellular carcinoma in children. Taiwan Childhood Hepatoma Study Group. , 1997, The New England journal of medicine.

[24]  Zhaoqian Liu,et al.  Phenotype distribution and gender-related differences of CYP2E1 activity in a Chinese population , 2002, Xenobiotica; the fate of foreign compounds in biological systems.

[25]  Chien-Jen Chen,et al.  Evaluation of Risk Factors for Nasopharyngeal Carcinoma in High-Risk Nasopharyngeal Carcinoma Families in Taiwan , 2005, Cancer Epidemiology Biomarkers & Prevention.

[26]  N. Day,et al.  A case‐control investigation of cancer of the oral tongue and the floor of the mouth in Southern India , 1989, International journal of cancer.

[27]  Y. Ko,et al.  The precancer risk of betel quid chewing, tobacco use and alcohol consumption in oral leukoplakia and oral submucous fibrosis in southern Taiwan , 2003, British Journal of Cancer.

[28]  M. Pike,et al.  Declining cancer rates in the 1990s. , 2000, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[29]  A. Hedley,et al.  Trends in breast cancer incidence in Hong Kong between 1973 and 1999: an age-period-cohort analysis , 2002, British Journal of Cancer.

[30]  Rajanna,et al.  A population-based case-control investigation on cancers of the oral cavity in Bangalore, India. , 1990, British Journal of Cancer.

[31]  W. Sze,et al.  Changing epidemiology of nasopharyngeal carcinoma in Hong Kong over a 20‐year period (1980–99): An encouraging reduction in both incidence and mortality , 2003, International journal of cancer.

[32]  A. Miller,et al.  Dietary factors and the incidence of cancer of the stomach. , 1985, American journal of epidemiology.

[33]  Jian-Min Yuan,et al.  Epidemiology of nasopharyngeal carcinoma. , 2002, Seminars in cancer biology.

[34]  H. Hsu,et al.  Risk of betel chewing for oesophageal cancer in Taiwan , 2001, British Journal of Cancer.

[35]  C. J. Chen,et al.  CYP2E1 genetic polymorphisms and risk of nasopharyngeal carcinoma in Taiwan. , 1997, Journal of the National Cancer Institute.

[36]  R. Doll,et al.  The causes of cancer: quantitative estimates of avoidable risks of cancer in the United States today. , 1981, Journal of the National Cancer Institute.

[37]  T. Holford,et al.  Trends in female breast cancer in Connecticut and the United States. , 1991, Journal of clinical epidemiology.

[38]  C. Wen,et al.  The current status of smoking behavior in Taiwan: Data analysis from National Health Interview Survey in 2001 , 2003 .

[39]  Chien-Jen Chen,et al.  Cigarette smoking, alcohol consumption and risk of nasopharyngeal carcinoma in Taiwan , 2004, Cancer Causes & Control.

[40]  Chien-Jen Chen,et al.  Cancer epidemiology and control in Taiwan: a brief review. , 2002, Japanese journal of clinical oncology.

[41]  Agathe Guilloux,et al.  Incidence and mortality from stomach cancer in Japan, Slovenia and the USA , 2002, International journal of cancer.

[42]  H. Adami,et al.  The decline in the incidence of stomach cancer in sweden 1960‐1984: A birth cohort phenomenon , 1991, International journal of cancer.

[43]  Chien-Jen Chen,et al.  Interaction of collagen-related genes and susceptibility to betel quid-induced oral submucous fibrosis. , 2002, Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology.

[44]  G. Bond.  Ethical issues relating to the conduct and interpretation of epidemiologic research in private industry. , 1991, Journal of clinical epidemiology.