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Plasma Epstein-Barr Virus DNA and Risk of Future Nasopharyngeal Cancer.
- Source :
- NEJM Evidence; Jul2023, Vol. 2 Issue 7, p8-8, 1p
- Publication Year :
- 2023
-
Abstract
- We previously conducted a prospective study to show that nasopharyngeal cancer (NPC) screening with circulating Epstein-Barr virus (EBV) DNA analysis can improve survival. However, the long-term significance of positive results in individuals without cancer was unclear. We conducted a second-round screening at a median of 43 months after the initial screening. Participants with detectable plasma EBV DNA were retested in 4 weeks, and those with persistently positive results were investigated with nasal endoscopy and magnetic resonance imaging. Of the 20,174 volunteers who participated in the first-round screening, 17,838 (88.6%) were rescreened. Among them, 423 (2.37%) had persistently detectable plasma EBV DNA. Twenty-four patients were identified as having NPC. A significantly higher proportion of patients had stage I/II cancer than in a historical cohort (67% vs. 20%; chi-square test, P<0.001), and they had superior 3-year progression-free survival (100% vs. 78.8%). Compared with participants with undetectable plasma EBV DNA in the first round of screening, participants with transiently and persistently positive results in the first round were more likely to have a cancer identified in the second round, with relative risks of 4.4 (95% confidence interval, 1.3 to 15.0) and 16.8 (95% confidence interval, 5.7 to 49.6), respectively. Individuals with detectable plasma EBV DNA but without an immediately identifiable NPC were more likely to have the cancer identified in another round of screening performed 3 to 5 years later. (Funded by Kadoorie Charitable Foundation and others; ClinicalTrials.gov number, NCT02063399.) [ABSTRACT FROM AUTHOR]
- Subjects :
- DNA
CONFIDENCE intervals
BLOOD plasma
ENDOSCOPIC surgery
EARLY detection of cancer
MAGNETIC resonance imaging
RISK assessment
NOSE
COMPARATIVE studies
DESCRIPTIVE statistics
CHI-squared test
PROGRESSION-free survival
EPSTEIN-Barr virus diseases
NASOPHARYNX tumors
LONGITUDINAL method
ENDOSCOPY
DISEASE risk factors
DISEASE complications
Subjects
Details
- Language :
- English
- ISSN :
- 27665526
- Volume :
- 2
- Issue :
- 7
- Database :
- Supplemental Index
- Journal :
- NEJM Evidence
- Publication Type :
- Academic Journal
- Accession number :
- 164692970
- Full Text :
- https://doi.org/10.1056/EVIDoa2200309