Abstract
BACKGROUND: Nasopharyngeal carcinoma (NPC) exhibits pronounced geographical variation, with a high burden in specific regions. We assessed global, regional, and national trends in NPC burden from 1990 to 2021 and projected estimates to 2050. METHODS: We analyzed data from the Global Burden of Disease (GBD) 2021 study for 204 countries and territories across 21 regions. Age-standardized incidence rate (ASIR), age-standardized death rate (ASDR), and age-standardized disability-adjusted life-years (DALYs) rate were estimated, and temporal trends were assessed using estimated annual percentage change (EAPC) by socio-demographic index (SDI), sex, and age group. Future burden from 2022 to 2050 was projected using a Bayesian age-period-cohort model. RESULTS: In 2021, there were 118,878 incident cases, 75,359 deaths, and 2,490,191 DALYs due to NPC globally. The global ASIR was 1.38 per 100,000 population (EAPC -1.06), the ASDR was 0.87 (EAPC -2.17), and the age-standardized DALYs rate was 28.91 (EAPC -2.29). Incidence rate peaked at ages 65-69 years (4.23 per 100,000 population), with consistently higher rates in males than in females. East Asia had the highest regional ASIR, and Japan bore the highest age-specific disease burden. Projections indicate continued declines in apparent ASDR and DALYs rates globally to 2050, but rising ASIR in males, particularly in East Asia and high-middle SDI regions. CONCLUSIONS: Over the past three decades, global mortality and disability burden from NPC have decreased, whereas incidence has increased in selected populations. The projected rise in ASIR among males in high-risk regions highlights the need for targeted interventions, equitable resource allocation, and sustained surveillance to mitigate future burden.