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Nasopharyngeal Cancer

Primary prevention

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Some preventive measures can help reduce the risk of NPC:

  1. Do not smoke

  2. Do not eat preserved and fermented food

  3. Observe occupational safety and health rules and take precautionary measures to minimise exposure to causative agents for NPC at workplace

  4. Avoid burning incense sticks

 

Early detection

 

Common signs and symptoms of NPC include swollen neck lymph nodes, decreased hearing, tinnitus, recurrent ear infection, unexplained headache, double vision, stuffiness, nose bleeding, facial paralysis, hoarseness of voice and dysphagia. Individuals with these signs and symptoms should be investigated for NPC. 

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Screening Tests

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  1. As preclinical phase of NPC is commonly associated with EBV reactivation, the assessment of EBV serological status constitutes an important tool in predicting subsequent symptomatic development. High IgA viral capsid antigen (VCA), IgA diffuse early antigen (D-EA), and EBV DNAse with increasing titers correlate with subsequent diagnosis of NPC. However, a false-positive rate of 2% to 18% has been noted with these serologic testing alone. Regarding the risk associated with individual EBV marker to identify NPC susceptibles within high risk NPC families, it has been reported that EBV nuclear antigen-1 (EBNA1) IgA seropositivity was the marker most strongly associated with NPC risk.

  2. EBV DNA is shed consistently from NPC tumor cells and can be routinely detected in the plasma of patients with NPC with more than 95% sensitivity, though with limited specificity as shown in a local study.An expanded phase II project by the same group is currently undertaken.

  3. Other important advances in the early detection of NPC include serum protein profiling, measurement of plasma tumor-specific methylation, detection of multiple gene methylation and EBV copy number from brushing samples collected directly from the nasopharynx. However, the performance of all these methods as a screening test on asymptomatic individuals has not been adequately evaluated.

  4. To date, there is lack of evidence on the effectiveness of screening by EBV DNA or IgA against EBV viral antigens in reducing NPC mortality among the general population.

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