Nasopharyngeal carcinoma burden in the United States and worldwide, 1990 to 2023

Nasopharyngeal carcinoma (NPC) is a rare but geographically concentrated malignancy. Long-term comparative analyses of NPC trends between the United States and global populations, particularly by sex, are limited. Using Global Burden of Disease 2023 data, we analyzed temporal trends in NPC incidence, prevalence, and mortality from 1990 to 2023 in the United States and worldwide. Age-standardized rates per 100,000 population were calculated. Joinpoint regression estimated annual percent changes (APCs) and average annual percent change (AAPC) with 95% confidence intervals. Pairwise comparisons assessed differences between United States and global trends. Mortality forecasts through 2050 were generated using the established Global Burden of Disease forecasting framework. From 1990 to 2023, US age-standardized mortality declined by 44%, from 0.34 to 0.19 per 100,000 (AAPC: -1.70), while global mortality decreased from 1.46 to 0.83 (AAPC: -1.70). Global mortality increased between 2020 and 2023 (APC: 2.06), unlike the US decline. The incidence rate declined in the United States over the study period (AAPC: -1.03), while remaining largely stable globally. However, global incidence increased between 2020 and 2023 (APC: 3.86). Similarly, prevalence decreased in the United States (AAPC: -0.81) while showing a rising trend worldwide (AAPC: 0.74). Males consistently exhibited higher rates across all measures. Pairwise comparisons showed significant differences between United States and global trends. From 2023 to 2050, global NPC age-standardized mortality rate is projected to increase by 12.05% (0.93, 95% uncertainty interval [UI]: 0.75-1.16), driven by a 21.8% rise in males (1.45, 95% UI: 1.18-1.78), while declining by 11.76% in females (0.45, 95% UI: 0.33-0.63). In the United States, age-standardized mortality rate is projected to increase by 10.5% (0.21, 95% UI: 0.18-0.23), with a 17.9% rise in males (0.33, 95% UI: 0.29-0.37) and an 11.82% decline in females (0.097, 95% UI: 0.08-0.12). US NPC burden has declined steadily, while global patterns show rising prevalence and recent mortality increases. The observed differences in burden and temporal trends underscore the importance of further research into strategies for surveillance, early detection, and prevention in high-risk populations.