{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T16:09:56Z","timestamp":1790784596409,"version":"4.1.0"},"reference-count":36,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2020,1,10]],"date-time":"2020-01-10T00:00:00Z","timestamp":1578614400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer Medicine"],"published-print":{"date-parts":[[2020,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>The study aims are to evaluate the associations between nasopharyngeal carcinoma (NPC) risk and cigarette smoking and to explore the effects of cigarette smoking on Epstein\u2010Barr virus (EBV) infection for NPC risk.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>1235 male NPC cases and 1262 hospital\u2010based male controls matched to cases were recruited across six collaborative hospitals between 2010 and 2014. Using a standardized questionnaire, information on cigarette smoking and other potential risk factors for NPC was obtained. Blood was collected and used for anti\u2010EBV VCA IgA and anti\u2010EBV EA\u2010EBNA1 IgA testing using standard methods. Unconditional logistic regression analysis was used to estimate odds ratio (OR) with 95% confidence interval (CI) for each risk factor after adjusting for confounders.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>63.6% of cases and 44.0% of controls reported ever smoking cigarettes. After full adjustment, current smokers had a significant 1.60\u2010fold (95% CI\u00a0=\u00a01.30\u20101.97) and former smokers a borderline significant 1.27\u2010fold (95% CI\u00a0=\u00a01.00\u20101.60) increased NPC risk compared to never smokers. NPC risk increased with increasing duration, intensity, and pack\u2010years of cigarette smoking but not with age at smoking initiation. Among controls, anti\u2010EBV VCA IgA seropositivity rate was higher in current smokers than never smokers (14.0% vs 8.4%; OR\u00a0=\u00a01.82; 95% CI\u00a0=\u00a01.19\u20102.79). Mediation analyses showed that more than 90% of the cigarette smoking effect on NPC risk is mediated through anti\u2010EBV VCA IgA.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>This study confirms the association between long\u2010term cigarette smoking and NPC and demonstrates that current smoking is associated with seropositivity of anti\u2010EBV VCA IgA antibodies.<\/jats:p><\/jats:sec>","DOI":"10.1002\/cam4.2832","type":"journal-article","created":{"date-parts":[[2020,1,11]],"date-time":"2020-01-11T03:39:31Z","timestamp":1578713971000},"page":"1867-1876","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":32,"title":["Cigarette smoking increases the risk of nasopharyngeal carcinoma through the elevated level of IgA antibody against Epstein\u2010Barr virus capsid antigen: A mediation 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