Nasopharyngeal Cancer in Sudan: Epidemiology, Clinical and Histological Characteristics

OBJECTIVES: To study the epidemiology, clinical features, staging, etiology and pathology of nasopharyngeal cancer in Sudan. STUDY DESIGN: This is a retrospective study. SETTING: Ear, Nose and Throat Department Khartoum Teaching Hospital, Khartoum City, Sudan. SUBJECTS AND METHODS: Patients suspected to have nasopharyngeal cancer were assessed during the period March 2004 to May 2010. Data from confirmed cases was obtained; it included clinical and epidemiological information. RESULTS: Three hundred and eighty five cases were studied. Bimodal age distribution of the disease was noted with two peaks, one at 15–19 years and one at 50–54 years. The male to female ratio was 2.6:1 and a distinct geographical distribution of the disease was noted, with clustering of cases in the towns of Dilling, Kadogli and the surrounding rural area of the Nuba Mountains. These areas in the Western States were reported to be of high background radiation due to naturally produced radioactive uranium. The Nuba tribe headed the list among other tribes, demonstrating a clear ethnic predilection. Sixty-eight cases presented at stage IV. There was a predominance of Type II (15.58%) and Type III (65.97%). Patients were treated by neoadjuvant chemoradiotherapy. CONCLUSIONS: NPC is an important form of cancer in Sudan. Some tribes are significantly more affected than others. Patients present with advanced disease. Environmental and genetic factors need further studies. Screening at risk populations that aim at early diagnosis and management of patients is recommended.