{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,27]],"date-time":"2026-03-27T15:29:53Z","timestamp":1774625393472,"version":"3.50.1"},"reference-count":14,"publisher":"Wiley","issue":"22","license":[{"start":{"date-parts":[[2021,7,29]],"date-time":"2021-07-29T00:00:00Z","timestamp":1627516800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["acsjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer"],"published-print":{"date-parts":[[2021,11,15]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Genetic and environmental factors are important determinants of nasopharyngeal carcinoma (NPC). NPC is associated with Epstein\u2010Barr virus (EBV) infection. Studies have reported familial aggregation of NPC, but evidence has been mixed for elevated rates of cancers other than NPC.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The authors reassessed their previous evaluation of familial aggregation of cancer in 348 high\u2010risk Taiwanese multiplex families with 2 or more NPC cases enrolled between 1980 and 2003. Participants were linked to the Taiwan National Cancer Registry and National Death Registry to identify cancers.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In all, 2590 individuals contributed 37,959 person\u2010years over an average of 15 years of follow\u2010up; 314 incident cancers were identified. The authors computed multiple primary standardized incidence ratios (MP\u2010SIRs) to evaluate the overall risk and the risk of infection\u2010associated, EBV\u2010associated, and individual cancers. The overall MP\u2010SIR was 1.24 (95% confidence interval [CI], 1.10\u20101.38). The exclusion of excess NPC risk led to an overall MP\u2010SIR of 1.11 (95% CI, 0.98\u20101.25). Similarly, the risk of cancers associated with infectious agents was driven by the excess in NPC, and its exclusion led to an MP\u2010SIR of 1.22 (95% CI, 0.99\u20101.48) for infection\u2010associated cancers and to an MP\u2010SIR of 1.18 (95% CI, 0.72\u20101.82) for EBV\u2010associated cancers. The authors observed a significant excess of second cancers among NPC cases (oral cancer, mouth cancer, tongue cancer, gum cancer, nasal cavity cancer, bone cancer, and non\u2010Hodgkin lymphoma).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>This reassessment of the largest NPC multiplex family study confirms the presence of NPC coaggregation within families in Taiwan but does not provide evidence for a broader familial syndrome involving NPC and other tumors. Among NPC cases, elevated rates of secondary cancers, mostly at the, head and neck and hematopoietic cancers suggest radiation treatment effects on subsequent cancer risk.<\/jats:p><\/jats:sec>","DOI":"10.1002\/cncr.33799","type":"journal-article","created":{"date-parts":[[2021,7,29]],"date-time":"2021-07-29T14:12:29Z","timestamp":1627567949000},"page":"4171-4176","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Cancer patterns in nasopharyngeal carcinoma multiplex families over 15 years"],"prefix":"10.1002","volume":"127","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3832-6586","authenticated-orcid":false,"given":"Kelly J.","family":"Yu","sequence":"first","affiliation":[{"name":"Division of Cancer Epidemiology and Genetics National Cancer Institute Rockville Maryland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7271-6070","authenticated-orcid":false,"given":"Wan\u2010Lun","family":"Hsu","sequence":"additional","affiliation":[{"name":"Genomics Research Center Academia Sinica Taipei Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chun\u2010Ju","family":"Chiang","sequence":"additional","affiliation":[{"name":"Institute of Epidemiology and Preventive Medicine College of Public Health National Taiwan University and Taiwan Cancer Registry Taipei Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tseng\u2010Cheng","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology National Taiwan University Hospital and National Taiwan University College of Medicine Taipei Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0136-651X","authenticated-orcid":false,"given":"Zhiwei","family":"Liu","sequence":"additional","affiliation":[{"name":"Division of Cancer Epidemiology and Genetics National Cancer Institute Rockville Maryland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pei\u2010Jen","family":"Lou","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology National Taiwan University Hospital and National Taiwan University College of Medicine Taipei Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Scott","family":"Diehl","sequence":"additional","affiliation":[{"name":"Center for Pharmacogenomics and Complex Disease Research University of Medicine and Dentistry of New Jersey Newark New Jersey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7538-3582","authenticated-orcid":false,"given":"Alisa 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