Racial Disparities in Nasopharyngeal Carcinoma Characteristics and Survival

<b>Objective:</b> To investigate and compare the distribution of histological subtypes, stage at presentation, and survival outcomes among Chinese American, Non-Hispanic White, and African American patients with nasopharyngeal carcinoma (NPC). <b>Materials and methods:</b> We identified Chinese American, Non-Hispanic White, and African American patients with NPC who were diagnosed between 2010 and 2017. Statistical analyses were conducted using the chi-square test, propensity score matching, Kaplan-Meier analysis, and multivariate Cox proportional hazards models. <b>Results:</b> A total of 1646 eligible patients with NPC were included. Non-Hispanic White accounted for 1049 (63.7%), African Americans for 265 (16.1%), and Chinese Americans for 332 (20.2%), and their median age at diagnosis was 59, 55, and 53 years, respectively (<i>P</i> < .001). Chinese Americans most frequently harbored undifferentiated non-keratinizing squamous cell carcinoma subtype (n = 134, 40.4%) than Non-Hispanic White (n = 164, 15.6%) or African American patients (n = 44, 16.7%) (<i>P</i> < .001). Histological subtype distribution was similar between Non-Hispanic White and African American patients (<i>P</i> = .338). African American patients had the highest rate of stage III to IV disease (n = 206, 77.7%) compared to Non-Hispanic White (n = 704, 67.1%) and Chinese American patients (n = 210, 63.2%) (<i>P</i> = .009). No significant difference in stage distribution was observed between Chinese American and Non-Hispanic White patients (<i>P</i> = .494). Non-Hispanic White patients [hazard ratio (HR) 1.344, 95% confidence interval (CI) 1.007-1.479, <i>P</i> = .045] and African American patients (HR 2.314, 95% CI 1.405-3.813, <i>P</i> < .001) had significantly worse overall survival compared to Chinese American patients. However, race was not associated with NPC-specific survival in the multivariate analysis. Similar results were found after propensity score matching. <b>Conclusions:</b> Race influences the distribution of histological subtypes, stage at presentation, and survival outcomes in NPC.