Epstein-Barr virus-based nasopharyngeal carcinoma population screening

Nasopharyngeal carcinoma (NPC) is characterized by its distinct geographical distribution and has a high incidence in southern China and Southeast Asia. Early diagnosis and treatment are the best strategies for individuals identified to have a high risk of NPC. The identification of high-risk populations and the use of appropriate screening methods are key factors when screening for NPC. Despite the discovery of the close association of Epstein-Barr virus (EBV) with NPC, the exact role of the virus in the development of NPC has not been completely elucidated. EBV serological antibody testing is of great significance while screening for NPC, and plasma EBV-DNA has been used for population screening. The screening also includes clinical examination (lymphatic palpation and indirect examination of the nasopharynx using a mirror) and obtaining the family history of patients with NPC. The main secondary screening methods include nasopharyngeal fiberscopy. Another approach to diagnose NPC includes cytological examination of the nasopharyngeal brush exfoliates. Evidence suggests that serological screening for NPC can increase the rate of early diagnosis and significantly improve the 5-year survival rate of the affected population. However, the NPC serological screening protocol has some shortcomings. For example, the positive predictive value needs to be improved. Further research into NPC should be focused on methods that will accurately identify high-risk individuals and optimize screening. Here, we have reviewed the latest progress in EBV-based NPC population screening.