Cancer of the naso-pharynx in Kuwait

A clinico-pathological study of 143 cases of malignancy of the naso-pharynx diagnosed and treated at the E.N.T. and Radiotherapy Departments of Al-Sabah Hospital, Kuwait, between the years 1963 to 1974 inclusive is presented. The entire population of Kuwait is served and also a variable but small number of Nomads. During the years of the survey the population has been steadily increasing from about 500,000 in 1963 to about a million in 1974. It is composed of 45 per cent Kuwaitis of pure Arab stock and 55 per cent of immigrant workers, largely of Arabic origin. Cancer of naso-pharynx is the commonest of all head and neck cancers (18.3 per cent) and comprises 4.2 per cent of all malignancies. This is comparable with the 5.1 per cent in the Arab population of North Africa. The sex incidence is 2.2 Kuwaiti males and 0.8 females per 100,000; Non-Kuwaitis 2.0 male and 1.2 female per 100,000, giving an approximate ratio of 2.9 to 1 in both groups. The age distribution shows two peaks in male patients, Kuwaitis and Non-Kuwaitis in the 2nd decade (11.1 per cent) and fifth decade (28.8 per cent). In females, the graph shows a plateau pattern from the 3rd decade onwards. Cervical lymphadenopathy (83 per cent) was the commonest presenting symptom. The commonest histological finding was undifferentiated carcinoma and squamous cell carcinoma (28 per cent each). The hypotheses of the aetiology are reviewed.