title: Declining Incidence of Nasopharyngeal Carcinoma in Brunei Darussalam: a Three Decade Study (1986-2014).
abstract: BACKGROUND
  Nasopharyngeal carcinoma (NPC) is linked to Epstein Barr virus infection and is particularly common in the Far East, particularly among some Chinese groups. Certain ethnicities have been reported to have low incidence of NPC. This study looked at NPC in Brunei Darussalam over a three decade period.
  
  
  METHODS
  The cancer registry from 1986 to 2014 maintained by the State Laboratory was retrospectively reviewed. The age standardized rates (ASR) and the age specific incidence rates (ASIR) were calculated. Non NPC tumors were excluded from the study.
  
  
  RESULTS
  Altogether, there were a total of 450 NPC cases diagnosed accounting for 4.4% of all total cancer cases over the study period, declining from 10.3% in 1986-1990 to 2.3% in 2011-2014. The most common tumor type was the undifferentiated carcinoma (96.4%). The case characteristics were mean age 50.4 ± 14.4 years old, male 69%, and predominately Malays 74.4%, followed by Chinese 16.7%. The mean age of diagnosis increased over the study period from 45.6 ± 17.1 years (1986-1989) to 54.1 ± 12.5 years (ANOVA, p<0.01 for trend). There were no differences in the mean age of diagnosis between the ethnic groups or genders. The ASR showed a declining trend from 11.1 per 100,000 in 1986-1990 to 5.95 per 100,000 in 2011-2014, similar trends been observedfor both genders. Among the age groups, declining trends were seen in all the other age groups apart from the >70 years group. The overall ASRs for the Malays and Chinese were 7.92/100,000 and 8.83/100,000 respectively, both showing declining trends.
  
  
  CONCLUSIONS
  The incidence of NPC in Brunei Darussalam is comparable to rates reported from Singapore and Malaysia, but higher than rates reported from the other Southeast Asian nations. Unlike higher rates reported for Chinese compared to the Malays in other countries, the rates between the Malays and Chinese in our study was comparable. Importantly, the ASR is declining overall and for both genders and ethnic groups.
authors.affiliation: Department of Medicine, RIPAS Hospital, Bandar Seri Begawan BA, Brunei Darussalam E-mail : chongvuih@yahoo.co.uk.
authors.forename: Vui Heng
authors.initials: VH
authors.lastname: Chong
authors.forename: Pemsari Upali
authors.initials: PU
authors.lastname: Telisinghe
authors.forename: Edwin
authors.initials: E
authors.lastname: Lim
authors.forename: Muhammad Syafiq
authors.initials: MS
authors.lastname: Abdullah
authors.forename: Fidah
authors.initials: F
authors.lastname: Idris
authors.forename: Chee Fui
authors.initials: CF
authors.lastname: Chong
mesh_terms: D000328:Adult; D017668:Age of Onset; D000368:Aged; D002010:Brunei / Q000453:epidemiology; D002277:Carcinoma / Q000453:epidemiology / Q000208:ethnology* / Q000473:pathology; D002681:China / Q000208:ethnology; D005260:Female; D006801:Humans; D015994:Incidence; D008296:Malaysia / Q000208:ethnology; D008297:Male; D008875:Middle Aged; D009303:Nasopharyngeal Neoplasms / Q000453:epidemiology / Q000208:ethnology* / Q000473:pathology; D012189:Retrospective Studies; D012737:Sex Factors; D062211:Spatio-Temporal Analysis; D055815:Young Adult