The global incidence of nasopharyngeal carcinoma (NPC) is 84,400 new cases annually with 51,600 deaths.¹ It is an endemic disease in Southern China, with incidence rates of 15 to 50 per 100,000 persons, making it the third most common cancer in men.^2,3,4,5 However in the West, where it is associated with risk factors that are common to other cancers of the head and neck, NPC is a rare disease.^5,6 There is an intermediate incidence in populations in Alaskan Eskimos and in the Mediterranean basin.⁴ The incidence rate rises after age 20 years and decreases after age 60 years, with a male-female ratio of 3:1. The median age of presentation is 40 to 50 years, which is significantly younger than that of other head and neck cancers.^2,4 Young adults and children comprise up to 1% of all patients. However, in non-Asian areas (e.g., Northern/Central Africa), younger patients between 10 and 20 years comprise up to 15% of cases. In the United States, there is four- to sevenfold increased risk of NPC among southern Black children compared with the Caucasian population.^7,8,9,10