Epstein Barr virus antibody and cancer risk in two prospective cohorts in Southern China

Ming-Fang Ji, Yong-Qiao He (), Min-Zhong Tang, Wen-Qiong Xue, Xia Yu, Hua Diao, Da-Wei Yang, Zhi-Ming Mai, Io Hong Cheong, Zhi-Yang Zhao, Biao-Hua Wu, Fu-Gui Li, Ji-Yun Zhan, Chang-Ling Huang, Hao-Lin Ma, Jun Li, Yan-Cheng Li, Tong-Min Wang, Ying Liao, Xue-Yin Chen, Zhi-Heng Liang, Shi-Feng Lian, Yun Du, Xue-Jun Liang, Zisis Kozlakidis, Jun Ma and Wei-Hua Jia ()
Additional contact information
Ming-Fang Ji: Zhongshan City People’s Hospital
Yong-Qiao He: Sun Yat-sen University Cancer Center
Min-Zhong Tang: Wuzhou Red Cross Hospital
Wen-Qiong Xue: Sun Yat-sen University Cancer Center
Xia Yu: Zhongshan City People’s Hospital
Hua Diao: Sun Yat-Sen University
Da-Wei Yang: Sun Yat-Sen University
Zhi-Ming Mai: National Institutes of Health
Io Hong Cheong: Shanghai Jiao Tong University School of Medicine
Zhi-Yang Zhao: Sun Yat-Sen University
Biao-Hua Wu: Zhongshan City People’s Hospital
Fu-Gui Li: Zhongshan City People’s Hospital
Ji-Yun Zhan: Public Health Service Center of Xiaolan Town
Chang-Ling Huang: Sun Yat-Sen University
Hao-Lin Ma: Guilin Medical University
Jun Li: Wuzhou Red Cross Hospital
Yan-Cheng Li: Wuzhou Red Cross Hospital
Tong-Min Wang: Sun Yat-sen University Cancer Center
Ying Liao: Sun Yat-sen University Cancer Center
Xue-Yin Chen: Sun Yat-sen University Cancer Center
Zhi-Heng Liang: Zhongshan City People’s Hospital
Shi-Feng Lian: Zhongshan City People’s Hospital
Yun Du: Southwest Hospital
Xue-Jun Liang: Public Health Service Center of Xiaolan Town
Zisis Kozlakidis: World Health Organization
Jun Ma: Sun Yat-sen University Cancer Center
Wei-Hua Jia: Sun Yat-sen University Cancer Center

Nature Communications, 2025, vol. 16, issue 1, 1-12

Abstract: Abstract Epstein-Barr virus (EBV) has been implicated in several human cancers, but its broader cancer risk remains unclear. We investigated the association between EBV VCA-IgA antibody levels and cancer risk in two large prospective cohorts from Southern China, comprising 73,939 adults. During around 8-10 years follow-up, 964 and 1026 incident cancer cases were identified in the Zhongshan and Wuzhou cohorts. VCA-IgA seropositivity was associated with higher age-standardized incidence rates for total cancer significantly. In pooled analyses, VCA-IgA seropositive individuals had higher risks of total cancer (HR 4.88, 95% CI: 2.84-8.37), lung cancer (1.76, 1.23-2.54), liver cancer (1.70, 1.10-2.63), nasopharyngeal carcinoma (26.05, 11.77-57.65), and lymphoma (3.20, 1.46-6.99) compared to seronegative individuals. The associations showed an increased dose-response pattern, and keep persistent even up to ten years prior to diagnosis. The population-attributable risk percentage for total cancer due to VCA-IgA seropositivity is estimated at 7.8%. These findings provide prospective evidence that EBV seropositivity is associated with increased risks of multiple cancers. This association results in a heightened attributed cancer burden in Southern China.

Date: 2025
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DOI: 10.1038/s41467-025-60999-5

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