A comprehensive risk score for effective risk stratification and screening of nasopharyngeal carcinoma

Xiang Zhou, Su-Mei Cao, Yong-Lin Cai, Xiao Zhang, Shanshan Zhang, Guo-Fei Feng, Yufeng Chen, Qi-Sheng Feng, Yijun Chen, Ellen T. Chang, Zhonghua Liu, Hans-Olov Adami, Jianjun Liu, Weimin Ye, Zhe Zhang (), Yi-Xin Zeng () and Miao Xu ()
Additional contact information
Xiang Zhou: Sun Yat-sen University Cancer Center
Su-Mei Cao: Sun Yat-sen University Cancer Center
Yong-Lin Cai: Wuzhou Red Cross Hospital
Xiao Zhang: Sun Yat-sen University Cancer Center
Shanshan Zhang: Sun Yat-sen University Cancer Center
Guo-Fei Feng: First Affiliated Hospital of Guangxi Medical University
Yufeng Chen: Karolinska Institutet
Qi-Sheng Feng: Sun Yat-sen University Cancer Center
Yijun Chen: Sun Yat-sen University Cancer Center
Ellen T. Chang: Center for Health Sciences, Exponent
Zhonghua Liu: The University of Hong Kong
Hans-Olov Adami: Karolinska Institutet
Jianjun Liu: Agency for Science, Technology and Research (A*STAR)
Weimin Ye: Karolinska Institutet
Zhe Zhang: First Affiliated Hospital of Guangxi Medical University
Yi-Xin Zeng: Sun Yat-sen University Cancer Center
Miao Xu: Sun Yat-sen University Cancer Center

Nature Communications, 2021, vol. 12, issue 1, 1-8

Abstract: Abstract Using Epstein-Barr virus (EBV)-based markers to screen populations at high risk for nasopharyngeal carcinoma (NPC) is an attractive preventive approach. Here, we develop a comprehensive risk score (CRS) that combines risk effects of EBV and human genetics for NPC risk stratification and validate this CRS within an independent, population-based dataset. Comparing the top decile with the bottom quintile of CRSs, the odds ratio of developing NPC is 21 (95% confidence interval: 12–37) in the validation dataset. When combining the top quintile of CRS with EBV serology tests currently used for NPC screening in southern China, the positive prediction value of screening increases from 4.70% (serology test alone) to 43.24% (CRS plus serology test). By identifying individuals at a monogenic level of NPC risk, this CRS approach provides opportunities for personalized risk prediction and population screening in endemic areas for the early diagnosis and secondary prevention of NPC.

Date: 2021
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DOI: 10.1038/s41467-021-25402-z

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