Gender disparities in the global burden of nasopharyngeal carcinoma: persistence and evolution of male predominance.
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OBJECTIVES: Nasopharyngeal carcinoma (NPC) is a malignant tumor that poses a considerable challenge to global health. This study aimed to evaluate the trends in incidence, mortality, prevalence, and disability-adjusted life years (DALYs) associated with NPC from 1990 to 2021, utilizing data from the Global Burden of Disease (GBD) study, while also examining the relationships between these trends and socioeconomic development as well as gender disparities. MATERIALS AND METHODS: The data were obtained from the GBD 2021 study, and trends were analyzed using Joinpoint regression to determine the average annual percentage change (AAPC). Future trends were forecasted using the ARIMA model. RESULTS: The findings revealed that the global number of new NPC cases increased from 76,255.8 in 1990 to 118,877.9 in 2021. East Asia bore the highest burden in 2021, with 68,038.9 new cases (57.2% of the global total) and 352,017.7 prevalent cases (62.1% of the global total). Notably, East Asia also achieved the most substantial reductions in mortality rates, with an AAPC of -3.7 (95% CI, -4.17 to -3.24) and DALYs rates with an AAPC of -3.75 (95% CI, -4.21 to -3.29). Although the global age-standardized incidence (ASIR), mortality (ASMR), and DALY rates (ASDR) declined from 1990 to 2021, the disease burden remained substantial and was substantially higher in males than in females, with a significant increase in the age-standardized prevalence rate (ASPR) among males. Prediction models indicated that the incidence and prevalence among males were expected to continue rising from 2022 to 2036, suggesting that the future burden of NPC will primarily impact males. A significant portion of the NPC burden is associated with risk factors such as alcohol consumption, smoking, and occupational exposure to formaldehyde, with variations observed by gender and age. Unlike females, for whom alcohol use was the supreme risk factor, the most important risk factor for males changed from alcohol use to smoking after age 60. Between 1990 and 2020, age-standardized rates attributable to smoking and alcohol declined significantly for both genders, although the decline was more pronounced in females, with improvements in males slowing after 2010. CONCLUSIONS: These findings provide a scientific foundation for public health policy-making regarding NPC, highlighting the necessity for targeted public health interventions that consider gender disparities to further mitigate the impact of NPC.