Clinical features of nasopharyngeal carcinoma in Jamaica

Nasopharyngeal carcinoma is endemic in China, Hong Kong, and the Philippines. However, this disease is rare in North America and the Caribbean. This paper discusses the clinical features, prognosis, treatment outcomes, and survival rates of nasopharyngeal carcinoma in Jamaica. The incidence in Jamaica is 1.4 per 100,000. The National Cancer Registry in Jamaica keeps a record of all cancers. A retrospective cohort study of patients with nasopharyngeal carcinoma between 1988-2000 was reviewed. The presenting features, staging, histological diagnosis, treatment, and patient outcome were assessed. All patients received radiation therapy, and 89% of the patients completed the course of therapy. Seventeen percent received chemotherapy, consisting of cisplatin and 5-fluorouracil. Surgery played a minor role in the definitive management of nasopharyngeal carcinoma in this study. Three-year survival rates were 21%. The study demonstrates findings unique to the Caribbean nation of Jamaica. There is a bimodal pattern to the age distribution typical in non-endemic areas, such as shown in this study. Nasopharyngeal carcinoma evades early diagnosis because of its anatomic location and varied symptomatology. Prognostic indicators include intracranial extension, cervical node, and distant metastasis.