Incidence and Demographics of Nasopharyngeal Carcinoma in Cheung Chau Island of Hong Kong – A Distinct Geographical area with Minimal Residential Mobility and Restricted Public Healthcare Referral Network

Abstract Background: Nasopharyngeal carcinoma (NPC) is endemic in Hong Kong with a skewed geographical and ethnic distribution. We performed an epidemiological study of NPC in Cheung Chau Island, a fishing village with very minimal residential mobility, and compared its demographics and survival with the rest of Hong Kong.Methods: NPC data in Cheung Chau and non-Cheung Chau residents between 2006 and 2017 treated in our tertiary center were collected. The incidence, stage distribution and mortality of Cheung Chau NPC residents were compared with those of their counterparts in the whole Hong Kong obtained from the Hong Kong Cancer Registry. Propensity score matching (PSM) was performed between Cheung Chau and non-Cheung Chau cases in a 1:4 ratio. Overall Survival (OS), progression-free survival (PFS), and cancer-specific survival (CSS) were compared between these two cohorts by product limit estimation and log-rank tests.Results: Sixty-one patients residing in Cheung Chau were identified between 2006 and 2017. There was a significantly higher NPC incidence (P<0.001) but insignificant difference in mortality rate in Cheung Chau compared to the whole Hong Kong data. After PSM with 237 non-Cheung Chau patients, Cheung Chau cohort revealed a stronger NPC family history (P<0.001). However, there were no significant differences in OS (P=0.170), PFS (P=0.053), and CSS (P=0.160) between these two cohorts.Conclusion: Our results revealed that Cheung Chau had a higher NPC incidence but similar survival outcomes compared to the whole Hong Kong. Cheung Chau can provide an excellent model for further studies on NPC oncogenesis and screening.