Materiały źródłowe

• #1 JMIR Public Health and Surveillance – Nasopharyngeal Cancer Incidence and Mortality in 185 Countries in 2020 and the Projected Burden in 2040: Population-Based Global Epidemiological Profiling

  https://publichealth.jmir.org/2023/1/e49968

  Nasopharyngeal cancer (NPC) is one of the most common head and neck cancers. This study describes the global epidemiological profiles of NPC incidence and mortality in 185 countries in 2020 and the projected burden in 2040. Globally, approximately 133,354 cases and 80,008 deaths from NPC were estimated in 2020 corresponding to ASIRs and ASMRs of 1.5 and 0.9 per 100,000 person-years, respectively. The largest numbers of both global cases and deaths from NPC occurred in Eastern Asia (65,866/133,354, 49.39% and 36,453/80,008, 45.56%, respectively), in which China contributed most to this burden (62,444/133,354, 46.82% and 34,810/80,008, 43.50%, respectively). The ASIRs and ASMRs in men were approximately 3-fold higher than those in women. Incidence rates varied across world regions, with the highest ASIRs for both men and women detected in South-Eastern Asia (7.7 and 2.5 per 100,000 person-years, respectively) and Eastern Asia (3.9 and 1.5 per 100,000 person-years, respectively). The highest ASMRs for both men and women were found in South-Eastern Asia (5.4 and 1.5 per 100,000 person-years, respectively). By 2040, the annual number of cases and deaths will increase to 179,476 (46,122/133,354, a 34.58% increase from the year 2020) and 113,851 (33,843/80,008, a 42.29% increase), respectively. Disparities in NPC incidence and mortality persist worldwide. Our study highlights the urgent need to develop and accelerate NPC control initiatives to tackle the NPC burden in certain regions and countries (eg, South-Eastern Asia, China).

• #2 Nasopharyngeal cancer in the world: epidemiology, incidence, mortality and risk factors – WCRJ

  https://www.wcrj.net/article/1046

  Nasopharyngeal cancer is one of the most common cancers in the head and neck areas. Men are two to three times more likely to develop it than women. The peak age of incidence is between 50 and 60 years. Informing about the occurrence, death and risk factors in prevention programs is very important. The aim of this study was to investigate the incidence, mortality, and risk factors for nasopharyngeal cancer in the world. […] Nasopharyngeal cancer is generally more common in Southeast Asia. The five countries with the highest incidence of nasopharyngeal cancer in the world were China, Indonesia, Vietnam, India and Malaysia, respectively. The standard incidence of nasopharyngeal cancer in the world was 1.2 per 100,000 (in men 1.7 per 100,000; in women, 0.7 per 100,000). The five countries with the highest number of deaths were China, Indonesia, Vietnam, India and Malaysia, respectively. The standardized mortality rate for nasopharyngeal cancer in the world was 0.7 per 100,000 (in men 1.0 per 100,000; in women 0.4 per 100,000). The most important risk factors for nasopharyngeal cancer were Epstein-Barr virus (EBV), heredity, human leukocyte antigen (HLA) genes, salt-preserved fish consumption, and history of respiratory diseases. […] The incidence of nasopharyngeal cancer is related to the geographic region. Training programs, early screening, good life promotion policies, timely treatment and diagnosis are good for reducing the burden of this cancer.

• #3 JMIR Public Health and Surveillance – Nasopharyngeal Cancer Incidence and Mortality in 185 Countries in 2020 and the Projected Burden in 2040: Population-Based Global Epidemiological Profiling

  https://publichealth.jmir.org/2023/1/e49968

  The largest numbers of cases and deaths from NPC in both sexes combined were estimated in Eastern Asia (65,866/133,354, 49.39% of total NPC cases and 36,453/80,008, 45.56% of total NPC deaths), followed by South-Eastern Asia (36,747/133,354, 27.55% and 24,219/80,008, 30.15%, respectively) and South-Central Asia (8366/133,354, 6.27% and 6117/80,008, 7.64%, respectively). The incidence rates of NPC showed approximately 29-fold variation in men and 63-fold variation in women across world regions. In men, the ASIR per 100,000 person-years was the highest in South-Eastern Asia (7.7), followed by Eastern Asia (3.9) and Micronesia/Polynesia (3.9), but the lowest ASIR was in Central America (0.3). In women, the highest ASIR per 100,000 person-years was detected in South-Eastern Asia (2.5), followed by Eastern Asia (1.5), and Northern Africa (1.0), and the lowest was found in Melanesia (less than 0.1). The mortality rates of NPC varied approximately by 36-fold in men and 75-fold in women among world regions.

• #4 Nasopharyngeal Cancer – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK459256/

  Nasopharyngeal carcinoma is a distinct subtype of head and neck cancer. […] This activity aims to broaden the understanding of nasopharyngeal carcinoma, shedding light on its association with the Epstein-Barr virus and distinguishing it from oropharyngeal cancers linked to other viruses. […] There are distinct geographic and ethnic risk factors for nasopharyngeal carcinoma. In Asia, mainly China, there is a high incidence of disease. […] A high incidence of nasopharyngeal cancer has also been noted in those of Native Alaskan ancestry. […] In nonendemic areas, such as the Americas and Europe, nasopharyngeal cancer is rare, with less than 1 case per 100,000 people. […] The incidence is much higher, reaching up to 21 cases per 100,000 people in certain parts of China, where nasopharyngeal carcinoma accounts for 18% of all cancers.

• #5 Nasopharyngeal carcinoma – Wikipedia

  https://en.wikipedia.org/wiki/Nasopharyngeal_carcinoma

  Nasopharyngeal carcinoma, or nasopharynx cancer, is the most common cancer originating in the nasopharynx, most commonly in the postero-lateral nasopharynx or pharyngeal recess (fossa of Rosenmüller), accounting for 50% of cases. […] NPC is uncommon in the United States and most other nations, representing less than 1 case per 100,000 in most populations, but is extremely common in southern regions of China, particularly in Guangdong, accounting for 18% of all cancers in China. […] While NPC is seen primarily in middle-aged persons in Asia, a high proportion of African cases appear in children. The cause of increased risk for NPC in these endemic regions is not clear. […] As of 2010, NPC resulted in 65,000 deaths globally up from 45,000 in 1990.

• #6 Nasopharyngeal Cancer Incidence Varies Widely Among Different Ethnic Subgroups of Asian Americans | AACR | News Releases

  https://www.aacr.org/about-the-aacr/newsroom/news-releases/nasopharyngeal-cancer-incidence-varies-widely-among-different-ethnic-subgroups-of-asian-americans/

  Chinese Americans and Laotian Americans were over 10 and 14 times more likely to be diagnosed with nasopharyngeal cancer, respectively, than non-Hispanic white Americans, with incidence rates surpassing other Asian American subgroups, according to results presented at the virtual 14th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved, held October 6-8, 2021. […] Previous research based on data from the Surveillance, Epidemiology, and End Results (SEER) database estimates that the incidence of nasopharyngeal cancer is over seven times higher among Asian Americans than non-Hispanic white Americans. […] By disaggregating this population into ethnic subgroups, researchers can better identify the genetic, environmental, and behavioral factors that increase risk for nasopharyngeal cancer, Lee said.

• #7 Nasopharyngeal Carcinoma: Epidemiology, Etiology, Screening, and Staging | Ento Key

  https://entokey.com/nasopharyngeal-carcinoma-epidemiology-etiology-screening-and-staging/

  The incidence of NPC remains high among Chinese who have migrated to North America, but is lower among Chinese born in North America than in those born in southern China. A similar higher incidence was seen among Chinese who have immigrated to Australia and the southern part of England. Migrant studies also showed that the incidence of NPC is higher in the off-spring of north Africans who have migrated to Israel than among native Israelis. These findings suggest that geographic, ethnic, and environmental influences together with other factors contribute to the etiology of nasopharyngeal carcinoma. […] […] In nearly all reports the incidence of nasopharyngeal carcinoma is 2 to 3 times higher in males than in females. As for the distribution of the disease within age groups, in low-risk regions, NPC incidence increases with increasing age. In high-risk regions, the peak incidence is around ages 50 to 59 years and declines thereafter; there is also a minor peak among young adults, consistent with exposure to carcinogenic agents in early life. […]

• #8 Descriptive epidemiology of nasopharyngeal carcinoma at Tikur Anbessa Hospital, Ethiopia | BMC Cancer | Full Text

  https://bmccancer.biomedcentral.com/articles/10.1186/s12885-021-08311-8

  Nasopharyngeal cancer is distinguished from other cancers of the head and neck in its epidemiology, histopathology, clinical characteristics, and therapeutic outcome. […] The incidence of NPC in men is shown to be higher than in women, with a ratio of 23 to 1 in both endemic and non-endemic areas of the world. […] The distinct geographic and ethnic variations of NPC worldwide suggest that both environmental factors and genetic traits contribute to its development. […] The study found 86.2% of patients presented with locoregional disease and late advanced clinical stage that is, stages III and IV disease. […] The histological findings of our study resemble that of endemic areas worldwide, with a predominance of NK NPC, especially that of undifferentiated type which accounts for 85.9%. […] Overall, the age distribution and the pathologic findings of, nonkeratinizing carcinoma being the predominant histopathologic variant resembles that seen in endemic areas of the world.

• #9 Nasopharyngeal Cancer – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK459256/

  In Asia, nasopharyngeal carcinoma is a disease of middle age, with patients presenting in the 4th through 6th decades of life. […] In Africa, another area with endemic EBV infection, the majority of cases are observed in children. […] Gender discrepancies exist in the risk of developing nasopharyngeal carcinoma and in nasopharyngeal carcinoma-specific mortality. […] It remains unclear whether this additional risk and mortality are related to differing tobacco use patterns among men and women, and much of the data originates from China. […] Over the past decade, mortality related to nasopharyngeal cancers has seen improvement attributed to early detection and advances in treatment. […] In some endemic areas worldwide, circulating EBV DNA is utilized for screening and disease surveillance.

• #10 Nasopharyngeal Cancer – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK459256/

  High circulating levels of EBV DNA are associated with poorer treatment response and higher rates of distant metastasis and mortality. […] The prognostic value of circulating EBV titers has not been extensively studied, but persistently elevated EBV titers after treatment have been described as a powerful poor prognostic factor for overall survival. […] After initial treatment, patients should maintain regular follow-ups with their oncologist for cancer surveillance. […] This may be extended to every 4 to 6 months during years 3 to 5 post-treatment and annually after that. […] Most centers conduct a posttreatment PET-CT scan 3 months after completing radiotherapy, followed by a 1-year posttreatment PET-CT if the initial scan is normal.

• #11 Nasopharyngeal Carcinoma: Epidemiology, Etiology, Screening, and Staging | Ento Key

  https://entokey.com/nasopharyngeal-carcinoma-epidemiology-etiology-screening-and-staging/

  In regions where NPC is endemic, EBV serology has been used for population screening aimed at detection of the disease in its early stage. In a prospective study performed in the early 1980s, 1,136 individuals were detected to have elevated IgA antibodies against the viral capsid antigen of EBV. They were examined regularly for 4 years. During this period, 35 NPC patients were detected, most of them (91.5%) were diagnosed in the early stages. Comparable results were reported from a similar study conducted in Guangdong province, China. The predictive value of EBV serology was also reported in a study from Taiwan that included 9,699 patients. Their EBV serological status was cross-checked with the cancer and death registry for a 15-year period. The results showed that the longer the follow-up period, the greater was the difference in cumulative incidence of nasopharyngeal carcinoma between those with elevated serology and those with negative serology. In a prospective study of 42,048 patients, this raised level of antibody titer could be detected for up to 10 years before diagnosis of the tumor. The mean duration of this preclinical serological elevation window was 37 28 months. […]

• #12

  https://link.springer.com/article/10.1007/s10555-024-10176-9

  Nasopharyngeal carcinoma (NPC) is characterised by its remarkable geographical and ethnic distribution. The current review discusses the global and regional distribution of NPC incidences, the risk factors associated with NPC, and the public health implications of these insights. Prevention strategies, including primary prevention and secondary prevention through early detection, are vital in reducing mortality and morbidity of NPC. Future investigations should consider international, large-scale prospective studies to elucidate the mechanisms underlying NPC pathogenesis and develop individualized interventions for NPC. […] Exposure to tobacco smoking, dietary factors, and inhalants has been associated with the risk of NPC. […] Other factors including medical history and oral hygiene have been implicated in NPC.

• #13 Environmental and dietary risk factors for nasopharyngeal carcinoma: a case-control study in Zangwu County, Guangxi, China | British Journal of Cancer

  https://www.nature.com/articles/bjc199492

  A case-control study was conducted on 88 incident cases of histologically confirmed undifferentiated nasopharyngeal carcinoma (NPC) in Zangwu County, China, and 176 age- sex- and neighbourhood-matched controls. […] After adjustment for a living conditions score to eliminate a confounding effect, an increased risk associated with consumption of salted fish during weaning and childhood was confirmed, especially for salted fish in rice porridge. […] The consumption of leafy vegetables was associated with a reduced risk for NPC, and consumption of melon seeds between 2 and 10 years of age with an increased risk. […] After multivariate analysis and adjustment according to the living conditions score, the consumption of salted fish in rice porridge before age 2 (OR = 3.8, P = 0.005), exposure to domestic woodfire (OR = 5.4, P = 0.01) and consumption of herbal tea (OR = 4.2, P = 0.02) were found to be independently related to the risk of NPC.

• #14 Nasopharyngeal cancer | World Cancer Research Fund

  https://www.wcrf.org/preventing-cancer/cancer-types/nasopharyngeal-cancer/

  Nasopharyngeal cancer is very rare in the UK but it is more common in some racial and ethnic groups, for example people of Chinese origin. […] Nasopharyngeal cancer is the 22nd most common cancer in the UK (2021 data), and the 23rd most common in the world (2022 data). […] Evidence for what can cause nasopharyngeal cancer comes from large population studies (called epidemiology) and biological studies (where scientists look at cells in a laboratory). […] Eating Cantonese-style salted fish is a cause of nasopharyngeal cancer. […] This means that people who eat a south-east Asian diet are at a higher risk of nasopharyngeal cancer. […] Smoking tobacco is a cause of nasopharyngeal cancer. About 23% of cases are caused by smoking. […] Epstein-Barr virus (EBV) infection is a cause of nasopharyngeal cancer.

• #15 Increased risk of incident nasopharyngeal carcinoma with exposure to air pollution | PLOS One

  https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0204568

  Increased risk of incident nasopharyngeal carcinoma with exposure to air pollution […] Nasopharyngeal carcinoma (NPC) is a race-specific malignancy. The nasal cavity is the main entry point for air pollutants or poisonous gases into the human body. However, the risk of NPC in populations exposed to air pollution remains unknown. […] We combined data from the Taiwan Air Quality Monitoring Database (TAQMD) and the Longitudinal Health Insurance Database (LHID) to assess the risk of NPC in a population exposed to air pollution. […] Multivariate analysis revealed positive trends for the association between the risk of NPC and exposure to air pollution. After adjusting for potential covariates, the risk of developing NPC increased with the increase in nitrogen dioxide (NO2) and fine particulate matter (PM2.5) exposure concentrations from 1.39 to 2.28 and 2.01 to 1.97, respectively, compared to the risks at the lowest concentration levels.

• #16 Increased risk of incident nasopharyngeal carcinoma with exposure to air pollution | PLOS One

  https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0204568

  We included a total of 162,797 participants (men: 71,397, 43.9%) with a mean age of 40.50 14.63 years and a follow-up period of 11.70 0.93 years. During the study period, 115 participants were diagnosed with NPC. The incidence of NPC increased with increased exposure to SO2, NO2, and PM2.5 concentrations from 6.14 to 6.25, 4.66 to 8.71, and 3.83 to 7.94 per 100,000 person-years, respectively. […] After adjusting for the potential covariates, a significantly higher risk of developing NPC was observed with increased air pollution exposure. Regarding the NO2 concentrations, the adjusted HRs after exposure to the 2nd, 3rd, and highest levels were 1.39 (95% CI = 0.802.42), 1.47 (95% CI = 0.842.58), and 2.28 (95% CI = 1.294.01), respectively. Regarding the PM2.5 concentrations, the adjusted HRs after exposure to the 2nd, 3rd, and highest levels were 2.01 (95% CI = 1.163.49), 1.38 (95% CI = 0.782.45), and 1.97 (95% CI = 1.133.43), respectively. A positive trend was observed for NO2 in the multivariate analysis.

• #17 Nasopharyngeal cancer | World Cancer Research Fund

  https://www.wcrf.org/preventing-cancer/cancer-types/nasopharyngeal-cancer/

  Occupational exposure to wood dust and formaldehyde is a cause of nasopharyngeal cancer. […] Men are more likely to develop nasopharyngeal cancer than women. […] Older people are more at risk of developing nasopharyngeal cancer. […] Following our Cancer Prevention Recommendations reduces your risk of nasopharyngeal cancer. […] You can reduce your risk of nasopharyngeal cancer by not smoking.

• #18 Environmental and dietary risk factors for nasopharyngeal carcinoma: a case-control study in Zangwu County, Guangxi, China | British Journal of Cancer

  https://www.nature.com/articles/bjc199492

  As well as confirming the importance of the consumption of salted fish in childhood, this study has been the first to provide unequivocal evidence for two other factors implicated in increasing the risk of NPC in China, the adult consumption of traditional medicines (herbal tea) and exposure to domestic wood fumes.

• #19

  https://link.springer.com/article/10.1007/s10555-024-10176-9

  Genetic association studies have revealed NPC-associated susceptibility loci, including genes involved in immune responses, xenobiotic metabolism, genome maintenance, and cell cycle regulation. […] EBV exposure timing and strain variation might play a role in its carcinogenicity, although further investigations are required.

• #20 Epidemiology and Outcomes of Nasopharyngeal Carcinoma | IntechOpen

  https://www.intechopen.com/chapters/75804

  The nasopharyngeal carcinoma incidence in most low-risk groups is consistent with increasing age. […] Risk factors for NPC, most commonly in men, include a family history of NPC, EBV infection, low intake of fresh vegetables and fruits, high consumption of salt-canned fish, smoking and Cantonese races. […] The relationship of NPC to EBV-associated is known and proven, and EBV infection is one of the common infectious agents in the population. […] It is known that families with a history of cancer, particularly nasopharyngeal carcinoma, are 4 to 10 times more likely to develop nasopharyngeal carcinoma. […] Several studies have reported that eating fish with salt is considered a risk factor for cancer. […] The direct relationship between nasopharyngeal carcinoma and smoking was confirmed by reports that people who had smoked cigarettes for ten years or more were more likely to develop NPC.

• #21 JMIR Public Health and Surveillance – Nasopharyngeal Cancer Incidence and Mortality in 185 Countries in 2020 and the Projected Burden in 2040: Population-Based Global Epidemiological Profiling

  https://publichealth.jmir.org/2023/1/e49968

  By HDI group, the vast majority of NPC cases and deaths occurred among 37.32% (2,909,468,000/7,794,799,000) of the world population living in high HDI countries, representing 69.85% (93,153/133,354) of new cases and 68.55% (54,850/80,008) of deaths globally. Both ASIRs and ASMRs were the highest in high HDI countries, with the rates being 2.5 and 1.4 per 100,000 person-years, respectively. Notably, both the lowest ASIRs and ASMRs were observed in very high HDI countries. […] Our findings show that the projected number of cases and deaths from NPC are expected to increase to 179,476 and 113,851 by 2040 worldwide, respectively, as a result of population growth and aging alone. A 2% annual decrease in global incidence and mortality rates would be needed to halt the increasing NPC burden by 2040. Notably, our findings show that even larger decreases in incidence and mortality rates would be required to reduce the future NPC burden in low and medium HDI countries. Given the remarkable geographic disparity of NPC burden across world regions and countries, this study highlights the urgent need to formulate more effective primary NPC prevention strategies and prioritize allocation of NPC prevention and treatment resources for high-risk populations to tackle the NPC burden in certain regions and countries.

• #22 Nasopharyngeal cancer risk assessment by country or region worldwide from 1990 to 2019 | BMC Public Health | Full Text

  https://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-024-19228-9

  However, so far, no one is currently paying attention to changes at the national level of the NPC. Since the nation is the power center of implementing health care, analyses of the changing trend of NPC morbidity and mortality at the national level can have positive significance for each country or region, and can aid to better formulate the various prevention strategies according to the different national conditions. […] This study makes full use of 30 years of NPC morbidity and mortality data, summarizes and groups the world, and clearly divides the world into 5 risk hierarchy: Group 1: The incidence rate showed an increasing trend whereas the mortality rate depicted a decreasing trend. Group 2: Morbidity as well as mortality showed a slight increase; Group 3: Morbidity as well as mortality increased significantly; Group 4: Morbidity and mortality decreased significantly; Group 5: Both morbidity as well as mortality decreased slightly. This risk stratification could aid to evaluate the effectiveness of health care policies and various strategies for NPC prevention as well as treatment in different countries or regions around the world.

• #23 Nasopharyngeal cancer risk assessment by country or region worldwide from 1990 to 2019 | BMC Public Health | Full Text

  https://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-024-19228-9

  We found that ASIR, ASDR and ASYR were increasing in Group 3 countries or regions, and NPC control in Group 3 was relatively poor in comparison with other countries or regions in the world, thereby showing a dangerous signal. In the context of the global decline in morbidity and mortality, the rapid rise of ASIR, ASDR and ASYR in group 3 is particularly striking. […] This is the first study to use EAPC and cluster methods to explore the potential NPC risk in 200 different countries or regions, and we observed that countries or regions in Group 3 were at the most at risk, with significant increases in ASIR, ASDR and ASYR.

• #24 Posttreatment surveillance of squamous cell carcinoma of the head and neck – UpToDate

  https://www.uptodate.com/contents/posttreatment-surveillance-of-squamous-cell-carcinoma-of-the-head-and-neck

  Regular posttreatment follow-up is an essential part of the care of patients who are treated for squamous cell carcinoma of the head and neck. […] The goals of posttreatment surveillance are the early detection of locoregional recurrences, distant metastases, or second primary malignancies, and evaluation for and management of treatment-related complications. […] The rationale for surveillance is that early detection of either a recurrence or a second primary tumor allows for appropriate treatment and better functional and survival outcomes. […] However, controlled prospective data demonstrating a survival benefit for any follow-up strategy do not exist. […] Therefore, retrospective data and observational studies are used to guide surveillance recommendations. […] Whether early detection of recurrent disease alters outcomes is uncertain.

• #25 Nasopharyngeal Cancer: What patients should know about – OncoDaily

  https://oncodaily.com/oncolibrary/cancer-types/nasopharyngeal-cancer-63512

  Nasopharyngeal cancer is rare in the United States, affecting only about 1 out of 100,000 people each year. However, it is more common in certain regions, particularly in Southeast Asia, North Africa, and the Middle East. In endemic areas like southern China, the incidence can be as high as 20-50 cases per 100,000 people per year. NPC is nearly twice as common among men as it is among women and is diagnosed more often among people over age 50 than it is among younger people. In the U.S., it typically affects people ages 15 to 24 and ages 65 to 79. […] Regular health check-ups and screenings are crucial for early detection, especially in high-risk populations. […] Regular follow-ups with physical exams, nasal endoscopy, and EBV DNA testing are crucial for cancer surveillance. Frequent screening is recommended in the first 2 years post-treatment, every 3-6 months, and annually thereafter. Posttreatment PET-CT scans are often performed to assess response and detect recurrence.

• #26 Prognostic value of Epstein-Barr virus biomarkers for nasopharyngeal carcinoma staging and post-treatment surveillance – Miller – Annals of Nasopharynx Cancer

  https://anpc.amegroups.org/article/view/6389/html

  The relationship between Epstein-Barr virus (EBV) infection and endemic nasopharyngeal carcinoma (NPC) has facilitated more than 40 years of biomarker-inspired translational research. […] Plasma EBV DNA remains the cornerstone of biomarker prognostication and surveillance for NPC, and there is increasing high-quality evidence that it merits inclusion in future staging systems. […] In this review, we discuss the clinical role and prognostic performance of EBV-based biomarkers for pre-treatment staging and post-treatment surveillance. […] Thereafter, we review a breadth of evidence which supports that undetectable post-treatment EBV biomarkers are highly specific for long-term cure. […] Although these novel biomarkers have yet to supersede plasma EBV DNA in clinical performance, they may complement EBV DNA and identify the subset of patients at highest risk for clinical relapse.

• #27 Prognostic value of Epstein-Barr virus biomarkers for nasopharyngeal carcinoma staging and post-treatment surveillance – Miller – Annals of Nasopharynx Cancer

  https://anpc.amegroups.org/article/view/6389/html

  The aforementioned EBV-based biomarkers are increasingly recognized for their potential to guide risk-adapted treatment intensification or de-intensification. […] The critical importance of assay harmonization for biomarker-informed management has been highlighted in multi-institutional studies that demonstrate significant inter-laboratory quantitative variability. […] Although many institutions practice routine EBV DNA surveillance, it is important to contextualize this biomarker alongside standard imaging-based response assessment. […] Multiple studies have identified post-treatment EBV DNA clearance (0 cp/mL) as most prognostic for PFS. […] The ongoing NRG-HN001 trial randomizes a similar population of patients with persistently-detectable EBV DNA to non-cross-resident paclitaxel/gemcitabine at an earlier time point, which will add further clarity to the predictive vs. prognostic significance of post-treatment EBV DNA. […] Plasma EBV BamHI-W DNA remains the most widely utilized biomarker for EBV-associated NPC before, during, and after definitive therapy. […] Ongoing and future clinical trials will determine whether biomarker-adapted management will be the standard of care.

• #28 Posttreatment surveillance of squamous cell carcinoma of the head and neck – UpToDate

  https://www.uptodate.com/contents/posttreatment-surveillance-of-squamous-cell-carcinoma-of-the-head-and-neck

  Routine surveillance has been associated with a survival benefit in some observational studies when patients diagnosed at routine follow-up were compared with those who presented with symptoms. […] However, other studies have not observed a survival benefit from detecting asymptomatic recurrences. […] One explanation for the lack of a survival benefit may be the high proportion of recurrences that are symptomatic. […] Other studies suggest that survival in patients with recurrent disease is determined primarily by the extent of prior disease, its therapy and time to recurrence, and the location of the recurrence. […] A randomized controlled trial of no meaningful follow-up versus surveillance after head and neck cancer treatment is impossible due to ethical considerations.

• #29 Nasopharyngeal Cancer Survivors | American Cancer Society

  https://www.cancer.org/cancer/types/nasopharyngeal-cancer/after-treatment/follow-up.html

  People with cancer of the nasopharynx are at risk for the cancer coming back (a recurrence) and developing new cancers in other parts of the body, so they must be watched closely after treatment. […] If you have (or have had) NPC, you probably want to know if there are things you can do that might lower your risk of the cancer growing or coming back, such as exercising, eating a certain type of diet, or taking nutritional supplements. […] Survivors of NPC should follow the American Cancer Society guidelines for the early detection of cancer, stay away from tobacco products, and avoid alcohol. […] After completing treatment for NPC, you should still see your doctor regularly. Your doctor may order tests to look for signs that the cancer has come back or spread. These tests are also useful in finding some second cancers.

• #30 Nasopharyngeal Cancer Survivors | American Cancer Society

  https://www.cancer.org/cancer/types/nasopharyngeal-cancer/after-treatment/follow-up.html

  People whove had NPC can still get other cancers. In fact, NPC survivors are at higher risk for getting some other types of cancer. […] Cancer survivors can be affected by a number of health problems, but often a major concern is facing cancer again. Cancer that comes back after treatment is called a recurrence. But some cancer survivors may develop a new, unrelated cancer later. This is called a second cancer. […] To help maintain good health, survivors should also: Get to and stay at a healthy weight, Keep physically active and limit the time you spend sitting or lying down, Follow a healthy eating pattern that includes plenty of fruits, vegetables, and whole grains, and limits or avoids red and processed meats, sugary drinks, and highly processed foods, Not drink alcohol. If you do drink, have no more than 1 drink per day for women or 2 per day for men.

• #31 Nasopharyngeal cancer

  https://www.nhs.uk/conditions/nasopharyngeal-cancer/

  Nasopharyngeal cancer is a rare type of cancer that affects the part of the throat connecting the back of the nose to the back of the mouth (the pharynx). […] In the UK, about 260 people are diagnosed with nasopharyngeal cancer each year. […] About 3 times as many men as women are affected by nasopharyngeal cancer, and the average age at diagnosis is about 50. […] Once these tests are complete, your doctors will be able to confirm whether you have nasopharyngeal cancer. […] The outlook for nasopharyngeal cancer depends on your age, general health and how advanced the condition is when you’re diagnosed. […] There aren’t any UK survival statistics for nasopharyngeal cancer. In England, almost 75 out of every 100 people diagnosed with nasopharyngeal cancer will live for at least 1 year after diagnosis. […] About 50 people out of 100 will live for 5 years or more after being diagnosed.

• #32 Survival for nasopharyngeal cancer | Cancer Research UK

  https://www.cancerresearchuk.org/about-cancer/nasopharyngeal-cancer/survival

  There are no UK wide statistics available for nasopharyngeal cancer survival by stage. […] The statistics below come from America. They come from the National Cancer Institute’s SEER programme. They are for people diagnosed with nasopharyngeal cancer between 2012 and 2018. […] Please be aware that these figures might not be a true picture of survival in the UK. This is due to differences in the American health care systems, data collection and the population. […] The American statistics are split into 3 stage groups localised, regional and distant cancers. […] More than 80 out of 100 people (more than 80%) survive their cancer for 5 years or more after diagnosis. […] More than 70 out of 100 people (more than 70%) survive their cancer for 5 years or more after diagnosis. […] Around 50 out of 100 people (around 50%) survive their cancer for 5 years or more after diagnosis.

• #33

  https://medicaljournalssweden.se/actaoncologica/article/view/40499

  Nasopharyngeal carcinoma (NPC) is a rare disease and most studies have therefore been conducted in endemic areas. The aim of this study was to describe epidemiology and treatment outcomes of NPC in a population-based, non-endemic setting. […] NPC was identified in 394 patients corresponding to age-standardized incidence rates of 0.5 and 0.2 per 100,000 in men and women, respectively. The 5-year overall (OS) and disease-specific survival (DSS) were 56 and 66%. […] NPC is a rare malignancy in Denmark, and three in four patients have EBV-associated tumors. Tumor histology, smoking status, and stage, but not EBV-status, had independent prognostic impact on survival.

• #34 The significant survival advantage of female sex in nasopharyngeal carcinoma: a propensity-matched analysis | British Journal of Cancer

  https://www.nature.com/articles/bjc201570

  In conclusion, sex significantly affected the survival of nasopharyngeal carcinoma, with a definite female advantage across all end points, independent of other prognostic factors. This female survival advantage persisted in all stages of this cancer, but disappeared among postmenopausal women. It was strongly associated with the underlying biologic traits of sex, rather than the behavioural sex disparities. Sex is of great necessity to be stratified for analysis in the upcoming randomised controlled trials.

• #35 The Effect of Marital Status on Nasopharyngeal Carcinoma Survival: A Surveillance, Epidemiology and End Results Study

  https://www.jcancer.org/v09p1870.htm

  Purpose: This study examined the role of marital status on survival outcome of nasopharyngeal carcinoma (NPC) patients using a population-based cancer registry. […] Methods: Patients with primary NPC diagnosed between 2004 and 2013 were included using the Surveillance, Epidemiology and End Results program. Patient demographic, clinicopathologic features, management, and survival outcomes were compared according to marital status. Cause-specific survival (CSS, NPC-related death) for marital status was analyzed. […] Results: The data of 3018 patients were included, with 61.4%, 11.1%, 21.8, and 5.6% of patients married, divorced (or separated), single, and widowed, respectively. […] The 5-year CSS was 76.1%, 70.8%, 73.4%, and 59.8% in the married, divorced, single, and widowed groups, respectively (p= 0.001). Marital status was the independent prognostic factor for CSS. Widowed patients had a significantly increased risk of NPC-related death compared with married (hazard ratio [HR] 2.014, 95% confidence interval [CI] 1.477-2.747,p0.001), divorced (HR 1.580, 95% CI 1.087-2.295,p= 0.017), and single (HR 2.000, 95% CI 1.402-2.854,p 0.001) patients.

• #36 The Effect of Marital Status on Nasopharyngeal Carcinoma Survival: A Surveillance, Epidemiology and End Results Study

  https://www.jcancer.org/v09p1870.htm

  Conclusions: Being widowed was associated with an increased the risk of cancer mortality in NPC compared with being married, divorced, or single. […] In this study, we investigated the impact of marital status on survival outcome in NPC patients diagnosed between 2004 and 2013 based on a population-based cohort. Our results showed that widowed patients had a poor CSS compared with those who were married, divorced, or single. […] The results of our study are consistent with those from previous studies of various cancer sites showing that widowed patients were at increased risk of cancer mortality. […] In conclusion, our results suggest that being widowed increases the risk of NPC mortality, when compared with NPC patients who are married, divorced, or single.

• #37 Nasopharyngeal carcinoma | Radiology Reference Article | Radiopaedia.org

  https://radiopaedia.org/articles/nasopharyngeal-carcinoma?lang=us

  Nasopharyngeal carcinoma accounts for ~70% of all primary malignancies of the nasopharynx, and although rare in western populations, it is one of the most common malignancies encountered in Asia, especially China. It is commonly diagnosed between 40 and 60 years. Males are more commonly affected, with a male to female ratio of 3:1. […] Non-keratinizing squamous cell carcinoma and basaloid squamous cell carcinoma are strongly associated with the Epstein-Barr virus (EBV) and are seen particularly in Asia. […] HPV infection also shows an etiologic role in the development of non-endemic EBV-negative nasopharyngeal cancers. HPV-positive and EBV/HPV-negative tumors exhibit worse outcomes than EBV-positive tumors. […] Imaging is crucial in delineating the extent of local tumor extension, as well as detecting nodal metastases which are present in the vast majority of patients at the time of diagnosis (75-90%). […] MRI is the modality of choice for tumor staging in nasopharyngeal carcinoma due to its exquisite soft tissue resolution, sensitivity to perineural spread and intracranial extension. […] F-18 FDG-PET is highly sensitive for nodal metastases and is the modality of choice to detect recurrence.

• #38 One-time Screening for Nasopharyngeal Cancer Among High-risk Populations in the U.S. May Reduce Cancer Mortality

  https://consultqd.clevelandclinic.org/one-time-screening-for-nasopharyngeal-cancer-among-high-risk-populations-in-the-us-may-reduce-cancer-mortality

  Modeled one-time screening for Epstein-Barr Virus (EBV)-associated nasopharyngeal carcinoma (NPC) among high- and intermediate-incidence populations in the United States may reduce NPC mortality and be considered cost-effective. […] Fewer than 2,000 individuals in high-incidence populations would need to be screened to detect one case of NPC. […] Approximately 45% of NPC cases in the U.S. occur in only 10% of the population, namely Asian Americans and Pacific Islanders. […] Intermediate- and high-incidence populations in the U.S. accounted for only 11% of U.S. person-years but almost 43% of NPC cases, confirming the elevated risk of NPC in these populations. […] A one-time screening strategy employing EBV anti-BNLF2b serology followed by selective endoscopy was the preferred screening strategy among the six strategies examined, due to highest sensitivity and lowest cost. […] One-time screening was likely to remain cost-effective under a variety of assumptions, such as age at first screening and different costing methods.

• #39 Immune surveillance of nasopharyngeal carcinoma (NpC)

  https://escholarship.org/uc/item/36z104n0

  In the U.S., nasopharyngeal carcinoma (NpC) kills 7,600 each year. Deaths are predominantly among adult men, and in most cases, early detection and treatment can save lives. […] Epidemiological data indicate high prevalence of EBV infection and increased risk for NpC among Central and South American and Asian immigrants in the U.S., and also predict a sharp increase in NpC incidence in the next decade. […] To face this emerging threat, it is important to develop and validate novel modes of detection and intervention for NpC.

• #40 Nasopharyngeal Carcinoma: Epidemiology, Etiology, Screening, and Staging | Ento Key

  https://entokey.com/nasopharyngeal-carcinoma-epidemiology-etiology-screening-and-staging/

  Although this elevation of antibody titer of EBV has also been reported in low-risk regions, its value in general population screening aiming to detect early stage disease for more effective treatment is not likely to be cost-effective, even in high-incidence regions. It might be applicable in the screening of family members such as first-degree relatives in a high-risk region. In a prospective study of 1,199 asymptomatic family members of NPC patients, screening identified 16 patients. The sensitivity and specificity of EBV serology were 88.9% and 87.0%, respectively, and these patients have a 10 to 12% higher survival rate than those patients diagnosed without screening. […]

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