NPC

The NPC study is about gene-environment-EBV interactions in the etiology of nasopharyngeal carcinoma. We are conducting a large, population-based case-control study of 2,000 NPC cases and 2,000 controls from Guangdong Province and Guangxi Autonomous Region in southern China to investigate the main and interactive effects of environmental and behavioral factors, EBV genetic variation, and host genetic variation on NPC risk.

Project leaders

Hans-Olov Adami

Professor Emeritus/Emerita

Weimin Ye

Professor

Project description

Nasopharyngeal carcinoma (NPC) is an endemic cancer in southern China, where early epidemiological studies have indicated that genetic susceptibility, Epstein-Barr virus (EBV) infection, and other environmental factors are all important in the development of NPC. However, no previous study has allowed the simultaneous quantification of the etiologic roles of these factors, along with detailed analyses of the interplay among them. Therefore, to investigate the main and interactive effects of environmental and behavioral factors, EBV genetic variation, and host genetic variation on NPC risk, we are conducting a large, population-based case-control study of 2,000 NPC cases and 2,000 controls from Guangdong Province and Guangxi Autonomous Region in southern China.

Incident NPC cases are identified through a rapid case ascertainment system involving a network of contact physicians at regional hospitals where NPC is diagnosed and treated. Controls are randomly selected from local total population registers and are frequency matched to the expected number of cases by age and sex. Cases and controls are interviewed in person using a structured, computerized questionnaire designed to obtain detailed information on potential risk factors for NPC such as diet, smoking, and personal and family medical history. Blood, hair, nail, and saliva samples are also collected for EBV serology, host and virus genotyping, and biomarker analyses.

The study has its main financing from the National Cancer Institute, National Institutes of Health, USA and is being conducted in partnership with scientists from China (Sun Yat-Sen University Cancer Center, China Center for Disease Control and Prevention, Peking Union Medical College, Guangxi Medical University, Sihui Cancer Institute, Wuzhou Red Cross Hospital, Cangwu Cancer Institute, and Zhaoqing First People’s Hospital), Sweden (Karolinska Institutet), and the United States (Harvard School of Public Health, Fred Hutchinson Cancer Research Center, and Exponent, Inc.). At present, the study is in the final year of fieldwork, with laboratory and statistical analyses set to begin shortly.

The field work has now been successfully finished and we did indeed exceed the charged number by enrolling around 2,500 cases and a similar number of controls. Even more importantly, the participation rate among eligible individuals - both cases and controls - is approximately 83%. During 2015, the database became cleaned. Since then, we are working on the first set of manuscripts, one dealing with description of the study design (and what this can learn us about prerequisites and opportunities for high quality population-based research in China), one paper on oral health as a risk factor for NPC and others on cigarette smoking and the heritability of NPC. These papers will be submitted for publication in early 2016 and followed by second wave of analyses based on questionnaire data alone, particularly early life experiences and diet.

An all collaborator meeting is scheduled in April 2016. During that meeting one main goal is to outline use of the biobank for genetic studies, EBV analyses etc. and also discuss how we can allocate adequate resources to undertake this work.

Partners

Sweden: Hans-Olov Adami, Weimin Ye, Ingemar Ernberg and Zhiwei Liu

China: Yonglin Cai, Sumei Cao, Guomin Chen, Guangwu Huang, Qihong Huang, Wenlin Huang, Weihua Jia, Jian Liao, Qing Liu, Haiqiang Mai, Jianyong Shao, Shanghang Xie, Miao Xu, Zhe Zhang and Yuming Zheng

USA: Ellen Chang

External Advisory Board

Curtis Harris, Allan Hildesheim, Xihong Lin, Youlin Qiao, and Weicheng You

Publications

A novel causal model for nasopharyngeal carcinoma.
Chang ET, Ye W, Ernberg I, Zeng YX, Adami HO
Cancer Causes Control 2022 Apr;():

A polygenic risk score for nasopharyngeal carcinoma shows potential for risk stratification and personalized screening.
He YQ, Wang TM, Ji M, Mai ZM, Tang M, Wang R, Zhou Y, Zheng Y, Xiao R, Yang D, Wu Z, Deng C, Zhang J, Xue W, Dong S, Zhan J, Cai Y, Li F, Wu B, Liao Y, Zhou T, Zheng M, Jia Y, Li D, Cao L, Yuan L, Zhang W, Luo L, Tong X, Wu Y, Li X, Zhang P, Zheng X, Zhang S, Hu Y, Qin W, Deng B, Liang X, Fan P, Feng Y, Song J, Xie SH, Chang ET, Zhang Z, Huang G, Xu M, Feng L, Jin G, Bei J, Cao S, Liu Q, Kozlakidis Z, Mai H, Sun Y, Ma J, Hu Z, Liu J, Lung ML, Adami HO, Shen H, Ye W, Lam TH, Zeng YX, Jia WH
Nat Commun 2022 Apr;13(1):1966

Influence of Pre-treatment Saliva Microbial Diversity and Composition on Nasopharyngeal Carcinoma Prognosis.
Du Y, Feng R, Chang ET, Debelius JW, Yin L, Xu M, Huang T, Zhou X, Xiao X, Li Y, Liao J, Zheng Y, Huang G, Adami HO, Zhang Z, Cai Y, Ye W
Front Cell Infect Microbiol 2022 ;12():831409

Environmental Factors for Epstein-Barr Virus Reactivation in a High-Risk Area of Nasopharyngeal Carcinoma: A Population-Based Study.
Chen Y, Chang ET, Liu Q, Cai Y, Zhang Z, Chen G, Huang QH, Xie SH, Cao SM, Jia WH, Zheng Y, Li Y, Lin L, Ernberg I, Huang G, Zeng YX, Adami HO, Ye W
Open Forum Infect Dis 2022 May;9(5):ofac128

The Evolving Epidemiology of Nasopharyngeal Carcinoma.
Chang ET, Ye W, Zeng YX, Adami HO
Cancer Epidemiol Biomarkers Prev 2021 06;30(6):1035-1047

A comprehensive risk score for effective risk stratification and screening of nasopharyngeal carcinoma.
Zhou X, Cao SM, Cai YL, Zhang X, Zhang S, Feng GF, Chen Y, Feng QS, Chen Y, Chang ET, Liu Z, Adami HO, Liu J, Ye W, Zhang Z, Zeng YX, Xu M
Nat Commun 2021 08;12(1):5189

Dietary patterns and risk of nasopharyngeal carcinoma: a population-based case-control study in southern China.
Huang T, Ploner A, Chang ET, Liu Q, Cai Y, Zhang Z, Chen G, Huang Q, Xie S, Cao S, Jia W, Zheng Y, Liao J, Chen Y, Lin L, Ernberg I, Huang G, Zeng Y, Zeng Y, Adami HO, Ye W
Am J Clin Nutr 2021 08;114(2):462-471

Intake of Alcohol and Tea and Risk of Nasopharyngeal Carcinoma: A Population-Based Case-Control Study in Southern China.
Feng R, Chang ET, Liu Q, Cai Y, Zhang Z, Chen G, Huang QH, Xie SH, Cao SM, Zhang Y, Yun JP, Jia WH, Zheng Y, Liao J, Chen Y, Huang T, Lin L, Ernberg I, Huang G, Zeng YX, Adami HO, Ye W
Cancer Epidemiol Biomarkers Prev 2021 03;30(3):545-553

Residence characteristics and risk of nasopharyngeal carcinoma in southern China: A population-based case-control study.
Chen Y, Chang ET, Liu Z, Liu Q, Cai Y, Zhang Z, Chen G, Huang QH, Xie SH, Cao SM, Jia WH, Zheng Y, Li Y, Lin L, Ernberg I, Zhao H, Feng R, Huang G, Zeng Y, Zeng YX, Adami HO, Ye W
Environ Int 2021 06;151():106455

Occupational exposures and risk of nasopharyngeal carcinoma in a high-risk area: A population-based case-control study.
Chen Y, Chang ET, Liu Q, Cai Y, Zhang Z, Chen G, Huang QH, Xie SH, Cao SM, Jia WH, Zheng Y, Li Y, Lin L, Ernberg I, Wang D, Chen W, Feng R, Huang G, Zeng YX, Adami HO, Ye W
Cancer 2021 08;127(15):2724-2735

Subspecies Niche Specialization in the Oral Microbiome Is Associated with Nasopharyngeal Carcinoma Risk.
Debelius JW, Huang T, Cai Y, Ploner A, Barrett D, Zhou X, Xiao X, Li Y, Liao J, Zheng Y, Huang G, Adami HO, Zeng Y, Zhang Z, Ye W
mSystems 2020 Jul;5(4):

Genome sequencing analysis identifies Epstein-Barr virus subtypes associated with high risk of nasopharyngeal carcinoma.
Xu M, Yao Y, Chen H, Zhang S, Cao SM, Zhang Z, Luo B, Liu Z, Li Z, Xiang T, He G, Feng QS, Chen LZ, Guo X, Jia WH, Chen MY, Zhang X, Xie SH, Peng R, Chang ET, Pedergnana V, Feng L, Bei JX, Xu RH, Zeng MS, Ye W, Adami HO, Lin X, Zhai W, Zeng YX, Liu J
Nat Genet 2019 07;51(7):1131-1136

Chinese nonmedicinal herbal diet and risk of nasopharyngeal carcinoma: A population-based case-control study.
Lin C, Cao SM, Chang ET, Liu Z, Cai Y, Zhang Z, Chen G, Huang QH, Xie SH, Zhang Y, Yun J, Jia WH, Zheng Y, Liao J, Chen Y, Lin L, Liu Q, Ernberg I, Huang G, Zeng Y, Zeng YX, Adami HO, Ye W
Cancer 2019 12;125(24):4462-4470

Reproductive history and risk of nasopharyngeal carcinoma: A population-based case-control study in southern China.
Feng RM, Chang ET, Liu Z, Liu Q, Cai Y, Zhang Z, Chen G, Huang QH, Xie SH, Cao SM, Zhang Y, Yun J, Jia WH, Zheng Y, Liao J, Chen Y, Lin L, Ernberg I, Huang G, Zeng Y, Zeng YX, Adami HO, Ye W
Oral Oncol 2019 01;88():102-108

Body mass index, body shape, and risk of nasopharyngeal carcinoma: A population-based case-control study in Southern China.
Feng R, Chang ET, Liu Z, Liu Q, Cai Y, Zhang Z, Chen G, Huang QH, Xie SH, Cao SM, Zhang Y, Yun J, Jia WH, Zheng Y, Liao J, Chen Y, Lin L, Ernberg I, Huang G, Zeng Y, Zeng YX, Adami HO, Ye W
Cancer Med 2019 04;8(4):1835-1844

Past and Recent Salted Fish and Preserved Food Intakes Are Weakly Associated with Nasopharyngeal Carcinoma Risk in Adults in Southern China.
Barrett D, Ploner A, Chang ET, Liu Z, Zhang CX, Liu Q, Cai Y, Zhang Z, Chen G, Huang QH, Xie SH, Cao SM, Shao JY, Jia WH, Zheng Y, Liao J, Chen Y, Lin L, Ernberg I, Adami HO, Huang G, Zeng Y, Zeng YX, Ye W
J Nutr 2019 09;149(9):1596-1605

Medical History, Medication Use, and Risk of Nasopharyngeal Carcinoma.
Xiao X, Zhang Z, Chang ET, Liu Z, Liu Q, Cai Y, Chen G, Huang QH, Xie SH, Cao SM, Shao JY, Jia WH, Zheng Y, Liao J, Chen Y, Lin L, Ernberg I, Huang G, Zeng Y, Zeng YX, Adami HO, Ye W
Am J Epidemiol 2018 10;187(10):2117-2125

Quantification of familial risk of nasopharyngeal carcinoma in a high-incidence area.
Liu Z, Chang ET, Liu Q, Cai Y, Zhang Z, Chen G, Huang QH, Xie SH, Cao SM, Shao JY, Jia WH, Zheng Y, Liao J, Chen Y, Lin L, Liang L, Ernberg I, Vaughan TL, Adami HO, Huang G, Zeng Y, Zeng YX, Ye W
Cancer 2017 Jul;123(14):2716-2725

Nasopharyngeal carcinoma risk prediction via salivary detection of host and Epstein-Barr virus genetic variants.
Cui Q, Feng FT, Xu M, Liu WS, Yao YY, Xie SH, Li XZ, Ye ZL, Feng QS, Chen LZ, Bei JX, Feng L, Huang QH, Jia WH, Cao SM, Chang ET, Ye W, Adami HO, Zeng YX
Oncotarget 2017 Nov;8(56):95066-95074

Active and Passive Smoking and Risk of Nasopharyngeal Carcinoma: A Population-Based Case-Control Study in Southern China.
Chang ET, Liu Z, Hildesheim A, Liu Q, Cai Y, Zhang Z, Chen G, Xie SH, Cao SM, Shao JY, Jia WH, Zheng Y, Liao J, Chen Y, Lin L, Ernberg I, Vaughan TL, Adami HO, Huang G, Zeng Y, Zeng YX, Ye W
Am J Epidemiol 2017 06;185(12):1272-1280

Oral Hygiene and Risk of Nasopharyngeal Carcinoma-A Population-Based Case-Control Study in China.
Liu Z, Chang ET, Liu Q, Cai Y, Zhang Z, Chen G, Xie SH, Cao SM, Shao JY, Jia WH, Zheng Y, Liao J, Chen Y, Ernberg I, Vaughan TL, Adami HO, Huang G, Zeng Y, Zeng YX, Ye W
Cancer Epidemiol Biomarkers Prev 2016 08;25(8):1201-7

Development of a population-based cancer case-control study in southern china.
Ye W, Chang ET, Liu Z, Liu Q, Cai Y, Zhang Z, Chen G, Huang QH, Xie SH, Cao SM, Shao JY, Jia WH, Zheng Y, Liao J, Chen Y, Lin L, Liang L, Ernberg I, Vaughan TL, Huang G, Zeng Y, Zeng YX, Adami HO
Oncotarget 2017 Oct;8(50):87073-87085

Eight-signature classifier for prediction of nasopharyngeal [corrected] carcinoma survival.
Wang HY, Sun BY, Zhu ZH, Chang ET, To KF, Hwang JS, et al
J. Clin. Oncol. 2011 Dec;29(34):4516-25