Center for Health Sciences, Exponent, Inc., Menlo Park, California.
Department of Cancer Prevention Center, Sun Yat-sen University Cancer Center, Guangzhou, P.R. China.
Cancer Epidemiol Biomarkers Prev. 2021 Jun;30(6):1035-1047. doi: 10.1158/1055-9965.EPI-20-1702. Epub 2021 Apr 13.
The epidemiology of nasopharyngeal carcinoma (NPC) has long been a source of fascination due to the malignancy's striking geographic distribution, the involvement of the oncogenic Epstein-Barr virus (EBV), the unique association with intake of Chinese-style salt-preserved fish, and etiologic heterogeneity by histologic subtype.
This review summarizes the current epidemiologic literature on NPC, highlighting recent results from our population-based case-control study in southern China.
Findings from our case-control study provide new insight into the epidemiology of NPC, including a diminished role of Chinese-style salt-preserved fish, a profound impact of EBV genetic sequence variation, modest positive associations with passive smoking and household air pollution, and possible effects of oral health and the oral microbiome. Recent findings from other studies include a protective association with infectious mononucleosis, suggesting a causal role of early EBV infection; familial risk conferred by shared genetic variation in the host antibody-mediated immune response to EBV infection; and an unclear association with occupational exposure to formaldehyde.
To shed further light on the interplay of environmental, genetic, and viral causes of NPC, large pooled studies must accumulate sufficient cases with detailed exposure data.
New epidemiologic findings have reshaped the causal model for NPC.
鼻咽癌（NPC）的流行病学一直令人着迷，其恶性肿瘤的分布具有明显的地理特征，与致癌性的 Epstein-Barr 病毒（EBV）有关，与中式咸鱼的摄入有关，组织学亚型的病因异质性。
本文综述了 NPC 的当前流行病学文献，重点介绍了我们在中国南方进行的基于人群的病例对照研究的最新结果。
我们的病例对照研究结果为 NPC 的流行病学提供了新的见解，包括中式咸鱼的作用减弱，EBV 遗传序列变异的深远影响，与被动吸烟和家庭空气污染的适度正相关，以及口腔健康和口腔微生物组的可能影响。其他研究的最新发现包括与传染性单核细胞增多症的保护关联，提示 EBV 感染早期的因果关系；宿主针对 EBV 感染的抗体介导免疫反应的遗传变异所导致的家族风险；以及与职业性接触甲醛的关系不明确。
为了进一步阐明 NPC 的环境、遗传和病毒病因的相互作用，必须积累具有详细暴露数据的大量 NPC 病例进行汇总研究。
新的流行病学发现重塑了 NPC 的因果模型。
