The dynamic Epstein-Barr virus-related serological monitor on a large-scale population-based screening cohort: a ten-year prospective follow-up study

Abstract Background: Previous large-scale screening studies have shown that Epstein-Barr virus antibodies (EBV) can facilitate early detection of nasopharyngeal carcinoma (NPC). However, the screening interval in population-based NPC screening remains unclear. Methods: We analyzed two previously selected EBV antibodies in plasma specimens to screen participants who participated in the NPC screening assessment in Xiaolan Town, Zhongshan City from August 2009 to September 2010. At the initial screening results, participants were divided into three groups according to the prediction formula calculated by their antibody levels (serological high-, medium- and low-groups). Participants at medium- and high-risk in initial screening were scheduled to be followed up with serological testing annually in the following 3 years, afterwards, participants can decide to continue screening or not. Participants were followed up annually through the Cancer Registry of Zhongshan City. NPC cases were confirmed by histology. Results: Among 16712 total subjects, 56 NPC cases were identified. In high-risk group, 83.8% of NPC were detected at initial screening and in first year of follow-up. All patients in high-risk group with persistent high-risk before diagnosis. 90% of subjects with NPC in medium-risk group rise to the Serological high risk before diagnosis. Among 16658 non-NPC subjects, the percentage of high, medium, and low risk subjects in each group fluctuated around (54.8%, 26.4%, 18.8%), (28.2%, 38.4%, 33.4%), and (8.6%, 17.9%, 73.5%), respectively, during the 10-year follow-up. Conclusion: NPC cases are mainly diagnosed at the first screening serologic in high risk, the persistent high-risk and medium to high serologic risk objective. Six years of follow-up is appropriate for individuals with persistent high serologic risk and for individuals with medium to high serologic risk.