{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,23]],"date-time":"2026-07-23T17:32:08Z","timestamp":1784827928826,"version":"3.55.0"},"reference-count":31,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2020,1,8]],"date-time":"2020-01-08T00:00:00Z","timestamp":1578441600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Intl Journal of Cancer"],"published-print":{"date-parts":[[2020,5,15]]},"abstract":"<jats:p>We aimed to evaluate the effectiveness of nasopharyngeal cancer (NPC) screening by comprehensive clinical follow\u2010up and adjunctive Epstein\u2013Barr virus (EBV) testing. In a prospective cohort study, 524 individuals with a first\u2010degree family history of NPC were recruited at a university clinical center in Singapore. The cohort was evaluated at baseline and at 6 monthly intervals, with a complete head and neck examination including nasopharyngeal endoscopy. Blood was taken at baseline and at yearly intervals for EBV Viral Capsid Antigen (VCA) IgA, EBV Early Antigen (EA) IgA serology and serum cell\u2010free EBV DNA. Nasopharyngeal biopsy was performed when any irregularity in the nasopharynx was observed, or when EBV markers were elevated. The mean duration of follow\u2010up was 57.7 months, with an average of 8.6 clinical visits per participant. Five participants (0.96%) were identified to have NPC, giving a prevalence of 199 per 100,000 person\u2010years of screening. Four of the five NPC cases identified had asymptomatic T1 disease, at an earlier stage compared to NPC patients diagnosed in the clinic during the same time period (<jats:italic>p<\/jats:italic> = 0.0297). All NPC cases identified had elevated EBV\u2010EA IgA titers \u22651:10, with a specificity of 94.6% and a positive predictive value of 15.2%, outperforming EBV\u2010VCA IgA and serum EBV DNA. Two NPC cases were biopsied only because of elevated EBV serology titers, with increasing EBV\u2010EA IgA titers preceding the diagnosis of NPC. In conclusion, screening for NPC is effective in identifying early\u2010stage disease. Adjunctive EBV\u2010EA IgA testing improved the effectiveness of screening.<\/jats:p>","DOI":"10.1002\/ijc.32774","type":"journal-article","created":{"date-parts":[[2019,11,9]],"date-time":"2019-11-09T08:53:51Z","timestamp":1573289631000},"page":"2923-2931","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":30,"title":["A comparison of EBV serology and serum cell\u2010free DNA as screening tools for nasopharyngeal cancer: Results of the Singapore NPC screening cohort"],"prefix":"10.1002","volume":"146","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5653-4659","authenticated-orcid":false,"given":"Joshua K.","family":"Tay","sequence":"first","affiliation":[{"name":"Department of Otolaryngology \u2013 Head and Neck Surgery National University Health System  Singapore Singapore"},{"name":"Cancer Biology Program Stanford University School of Medicine  Stanford MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chor H.","family":"Siow","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology \u2013 Head and Neck Surgery National University Health System  Singapore Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Han L.","family":"Goh","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology \u2013 Head and Neck Surgery National University Health System  Singapore Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chwee M.","family":"Lim","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology \u2013 Head and Neck Surgery National University Health System  Singapore Singapore"},{"name":"Department of Otolaryngology \u2013 Head and Neck Surgery Singapore General Hospital  Singapore Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pon P.","family":"Hsu","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology \u2013 Head and Neck Surgery Changi General Hospital  Singapore Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Soh H.","family":"Chan","sequence":"additional","affiliation":[{"name":"World Health Organization Collaborating Centre for Research and Training in Immunology  Singapore Singapore"},{"name":"Pathnova Laboratories  Singapore Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kwok S.","family":"Loh","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology \u2013 Head and Neck Surgery National University Health System  Singapore 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