Nasopharyngeal carcinoma in Saudi Arabian female population and wearing of facial mask

K Malaker MD PhD^a, MD Kundapur^a, AW Andejani FRCPC^b,c

^aSection of Radiation Oncology, Princess Norah Oncology Centre, Jeddah, Saudi Arabia, ^bSection of Medical Oncology, ^cSection of Tumour Registry; Princess Norah Oncology Centre, Jeddah, Saudi Arabia

AIM The aim of this presentation is to carry out a comparative study of the incidence of nasopharyngeal cancer (NPC) in the Saudi Arabian female and male populations, in some representative countries of the rest of the world; and some countries where it has a high endemic incidence. METHODS The incidence for NPC from various sources including: the WHO; the UICC; the IARC; the USA; Canada; the UK; France, China; Taiwan; Singapore; Kuwait; Brazil; and some other countries, has been compared with data in the Saudi Arabian Cancer Registry for both sexes. Apart from the actual age specific incidence (ASI), the distribution of nasopharyngeal cancers by age and sex was also studied. RESULTS For nasopharyngeal cancer: • The ASI for both males and females in Saudi Arabia has a steep identical rise from the age of 5 or 6 years until 12-13 years. • From 12-13 years the ASI of males continues to rise to adulthood with a noticeable peak at 55 – 60 years, but in the case of females, the ASI actually plateaus, or shows some slight diminution, without a noticeable peak. • Its pattern of early childhood incidence in Saudi Arabia is different from that of Western Europe and North America and other countries where it is endemic. • The pattern of incidence in adolescence and adults in both sexes in other countries and Saudi Arabian males show a peak at 55-60 years, but Saudi females do not demonstrate such a peak. CONCLUSION • The females in every country considered have a lower ASI NPC compared with their male counterparts. However, the male and female age distribution patterns are similar and peak between 55 – 60 years. Interestingly, Saudi Arabian females do not have any significant peak. • The comparatively early onset of childhood NPC in Saudi Arabia indicates the possibility of a major genetic contribution to the etiology. • There is a significantly lower ASI of NPC in Saudi females and this lack of a peak after adolescence suggests that the social practice of their wearing a Bourga (facial mask) from the onset of puberty may be a protective barrier against Epstein Barr virus infection, which has been associated with induction of NPC. • This finding indicates NPC is, to some extent, a preventable condition. Details of analysis of this conclusion will be presented.

Paper presented at the International Symposium on Predictive Oncology and Intervention Strategies; Nice, France; February 7 - 10, 2004; in oral session 891 (Risk factors).