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Abstract：
OBJECTIVE: To identify trends in incidence and survival of NPC, subdivided by EBV status and histopathological subtype, over a 30-year period in the Netherlands.
METHODS: Anonymized data from the Netherlands Cancer Registry and the Dutch Nationwide Pathology Databank (PALGA) for the period 1989-2018 were linked to identify and classify NPC cases.
RESULTS: Incidence of NPC remained stable, with an annual percentage change (APC) of - 0.2. (95% CI - 0.9; 0.5). EBV testing became routine only in the last decade, the incidence of EBV-positive tumors remained stable over this period (APC 1.2, 95% CI - 1.3; 3.8). An increase in EBV-negative tumors (APC: 7.1, 95% CI 2.5; 11.9) and a decrease in untested tumors were found (APC: - 10.7, 95% CI - 15.7; - 5.7). The incidence of non-keratinizing, differentiated tumors increased (APC: 3.8, (95% CI 2.2; 5.5) while the incidence of other histological subtypes remained stable. Overall survival was better in patients diagnosed after 1998 (hazard ratio 0.8, 95% CI 0.6; 0.9). EBV status, histology, stage, and age were independently associated with relative excess risk of dying, but period of diagnosis was not.
CONCLUSIONS: Testing for EBV increased over time, and a stable incidence of EBV-positive NPC over the last 10 years. The rising incidence of non-keratinizing, differentiated NPC mirrors data from the US and suggests a shift in non-endemic regions.
METHODS: Anonymized data from the Netherlands Cancer Registry and the Dutch Nationwide Pathology Databank (PALGA) for the period 1989-2018 were linked to identify and classify NPC cases.
RESULTS: Incidence of NPC remained stable, with an annual percentage change (APC) of - 0.2. (95% CI - 0.9; 0.5). EBV testing became routine only in the last decade, the incidence of EBV-positive tumors remained stable over this period (APC 1.2, 95% CI - 1.3; 3.8). An increase in EBV-negative tumors (APC: 7.1, 95% CI 2.5; 11.9) and a decrease in untested tumors were found (APC: - 10.7, 95% CI - 15.7; - 5.7). The incidence of non-keratinizing, differentiated tumors increased (APC: 3.8, (95% CI 2.2; 5.5) while the incidence of other histological subtypes remained stable. Overall survival was better in patients diagnosed after 1998 (hazard ratio 0.8, 95% CI 0.6; 0.9). EBV status, histology, stage, and age were independently associated with relative excess risk of dying, but period of diagnosis was not.
CONCLUSIONS: Testing for EBV increased over time, and a stable incidence of EBV-positive NPC over the last 10 years. The rising incidence of non-keratinizing, differentiated NPC mirrors data from the US and suggests a shift in non-endemic regions.
摘要：
目的：为了确定NPC的发病率和生存率的趋势，按EBV状态和组织病理学亚型细分，在荷兰的30年。
方法：来自荷兰癌症登记处和荷兰全国病理学数据库（PALGA）的1989-2018年期间的匿名数据被链接以识别和分类NPC病例。
结果：NPC的发病率保持稳定，年百分比变化(APC)为-0.2。（95%CI-0.9；0.5）。EBV测试仅在过去十年中成为常规，在此期间,EBV阳性肿瘤的发病率保持稳定(APC1.2,95%CI-1.3;3.8).发现EBV阴性肿瘤增加(APC:7.1,95%CI2.5;11.9)和未测试肿瘤减少(APC:-10.7,95%CI-15.7;-5.7)。非角质化的发生率，分化肿瘤增加(APC:3.8,(95%CI2.2;5.5),而其他组织学亚型的发生率保持稳定.1998年以后诊断的患者的总生存率较好（风险比0.8，95％CI0.6；0.9）。EBV状态,组织学,舞台,和年龄与相对超额死亡风险独立相关，但诊断期没有。
结论：EBV测试随着时间的推移而增加，在过去的10年中，EBV阳性NPC的发病率稳定。非角化的发病率上升，分化的NPC反映了来自美国的数据，并暗示了非流行地区的转变。
方法：来自荷兰癌症登记处和荷兰全国病理学数据库（PALGA）的1989-2018年期间的匿名数据被链接以识别和分类NPC病例。
结果：NPC的发病率保持稳定，年百分比变化(APC)为-0.2。（95%CI-0.9；0.5）。EBV测试仅在过去十年中成为常规，在此期间,EBV阳性肿瘤的发病率保持稳定(APC1.2,95%CI-1.3;3.8).发现EBV阴性肿瘤增加(APC:7.1,95%CI2.5;11.9)和未测试肿瘤减少(APC:-10.7,95%CI-15.7;-5.7)。非角质化的发生率，分化肿瘤增加(APC:3.8,(95%CI2.2;5.5),而其他组织学亚型的发生率保持稳定.1998年以后诊断的患者的总生存率较好（风险比0.8，95％CI0.6；0.9）。EBV状态,组织学,舞台,和年龄与相对超额死亡风险独立相关，但诊断期没有。
结论：EBV测试随着时间的推移而增加，在过去的10年中，EBV阳性NPC的发病率稳定。非角化的发病率上升，分化的NPC反映了来自美国的数据，并暗示了非流行地区的转变。
