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. 2024 May 31;19(5):e0304371.
doi: 10.1371/journal.pone.0304371. eCollection 2024.

Ethno-geographic distribution and histopathological classification of nasopharyngeal carcinoma in a single center in Nepal

Subhas Pandit  1 , Simit Sapkota  1 , Abish Adhikari  2 , Prakriti Karki  3 , Deepak Yadav  4 , Roshani Shrestha  1 , Rijendra Yogal  4 , Sanat Chalise  5 , Rakesh Pathak  5 , Anjani Kumar Jha  2
Affiliations

Ethno-geographic distribution and histopathological classification of nasopharyngeal carcinoma in a single center in Nepal

Subhas Pandit et al. PLoS One. .

Abstract

Introduction: Nasopharyngeal carcinoma (NPC) shows geographic and ethnic variation with specific etiopathogenesis. This study characterized the distribution of NPC patients stratified by ethnicity, geography, and histology in a tertiary-level cancer center in Nepal.

Methods: A descriptive retrospective study was designed to analyze NPC cases from different regions among patients visiting the hospital from 2016 to 2021. Demographic and clinical information was obtained from medical records. Ethical approval was granted by the Nepal Health Research Council (NHRC). Data analyses and visualization were carried out with R software.

Results: During the six-year period, a total of 65 individuals were diagnosed with NPC, comprising 42 males and 23 females. Patient median age was 43 years (range 11-85 years). A bimodal age distribution of cases was observed with peaks in patients aged 30-39 years and 50-59 years. Of the NPC patients studied, 29 were from Koshi Province, with 7 cases from Ilam district and 6 cases from Morang district. There were 18 patients in Bagmati Province, and Kathmandu district had the highest number of cases within this region, with 8 patients. The highest proportion of cases were observed among patients of Janajati ethnicity (60%), including Rai, Limbu, and Sherpa people. Histologically, undifferentiated non-keratinizing NPC was the most commonly observed subtype, accounting for 43.1% of cases, followed by 20% differentiated non-keratinizing NPC and 4.6% keratinizing NPC across the entire sample population. The majority of patients (75.3%) were diagnosed at an advanced stage (stage III or IV) with none diagnosed at stage I.

Conclusions: In our study, most cases of NPC occurred in patients from provinces in eastern Nepal (Koshi province), and of the Janajati ethnic community. The most common histological subtype was undifferentiated non-keratinizing carcinoma. Further epidemiological studies could address differences in prevalence and the challenge of late presentation of NPC patients in Nepal.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Gender distribution of NPC patients across the provinces of Nepal.
Fig 2
Fig 2. Age distribution of NPC patients.
Fig 3
Fig 3. Geographical distribution of NPC in different districts of Nepal.
Darker color shades indicate a higher number, lighter shades signify a lower number, and transparent white represents an absence of cases.
Fig 4
Fig 4. Proportion of NPC cases among different ethnic groups of Nepal.
Fig 5
Fig 5. Proportion of different ethnic groups (Rai, Limbu & Sherpa) among the general population, head and neck cancer (excluding NPC), and NPC.
See this image and copyright information in PMC

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