Abstract / Summary
To characterize contemporary trends in the incidence, clinicopathologic characteristics, treatment patterns, and survival of nasopharyngeal carcinoma (NPC) in the United States from 2000 to 2023. Patients diagnosed with NPC between 2000 and 2023 were identified from the Surveillance, Epidemiology, and End Results (SEER) 17-registry database. Age-adjusted incidence rates (AAIRs) and annual percent change (APC) were estimated using Joinpoint regression. Patients were grouped by diagnosis period (2000–2011 vs 2012–2023). Five-year overall survival (OS) and disease-specific survival (DSS) were estimated by the Kaplan–Meier method and compared with the log-rank test, and Cox proportional-hazards models were used to identify independent prognostic factors. A total of 9499 patients were identified. The overall AAIR was 0.450 per 100,000 person-years (95% CI, 0.441–0.460) and declined modestly over time (APC, − 0.41%). Incidence was highest among male and Asian/Pacific Islander patients. Keratinizing squamous cell carcinoma (APC, − 0.90%) and undifferentiated non-keratinizing carcinoma (APC, − 5.67%) declined, whereas differentiated non-keratinizing carcinoma increased (APC, + 4.27%). From 2000–2011 to 2012–2023, the proportion of differentiated non-keratinizing carcinoma rose from 23.4 to 40.5%, and stage III–IV disease increased from 23.5 to 45.2%. Five-year OS improved from 54.6 to 58.3%, and 5-year DSS from 60.4 to 66.2%. In multivariable Cox models, diagnosis during 2012–2023 was independently associated with lower overall (HR, 0.80) and disease-specific (HR, 0.73) mortality. NPC incidence in the United States declined modestly from 2000 to 2023, accompanied by a histologic shift toward differentiated non-keratinizing carcinoma and improved survival in the modern treatment era.