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Cancer. 2017 Jul 15;123(14):2716-2725. doi: 10.1002/cncr.30643. Epub 2017 Feb 27.

Quantification of familial risk of nasopharyngeal carcinoma in a high-incidence area.

Liu Z1, Chang ET2,3, Liu Q4,5, Cai Y6,7, Zhang Z8,9, Chen G10, Huang QH11, Xie SH4,5, Cao SM4,5, Shao JY5, Jia WH5, Zheng Y6,7, Liao J12, Chen Y9, Lin L9, Liang L13,14, Ernberg I15, Vaughan TL16,17, Adami HO1,13, Huang G8,9, Zeng Y10, Zeng YX5,18, Ye W1.

Author information

Department of Medical Epidemiology and Biostatistics, Karolinska Institute, Stockholm, Sweden.
Exponent Inc, Health Sciences Practice, Menlo Park, California.
Division of Epidemiology, Department of Health Research and Policy, Stanford University School of Medicine, Stanford, California.
Department of Cancer Prevention Center, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong, China.
State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong, China.
Department of Clinical Laboratory, Wuzhou Red Cross Hospital, Wuzhou, Guangxi, China.
Wuzhou Health System Key Laboratory for Nasopharyngeal Carcinoma Etiology and Molecular Mechanism, Wuzhou, Guangxi, China.
Department of Otolaryngology-Head and Neck Surgery, First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China.
Key Laboratory of High-Incidence Tumor Prevention and Treatment, Guangxi Medical University, Ministry of Education, Nanning, Guangxi, China.
State Key Laboratory for Infectious Diseases Prevention and Control, Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China.
Sihui Cancer Institute Sihui, Guangdong, China.
Cangwu Institute for Nasopharyngeal Carcinoma Control and Prevention, Wuzhou, Guangxi, China.
Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts.
Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, Massachusetts.
Department of Microbiology, Tumor and Cell Biology Karolinska Institute, Stockholm, Sweden.
Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, Washington.
Department of Epidemiology, University of Washington, Seattle, Washington.
Beijing Hospital, Beijing, China.



To the authors' knowledge, no studies to date have explored familial risks of nasopharyngeal carcinoma (NPC) in detail and quantified its lifetime risk in high-incidence populations.


The authors conducted a population-based case-control study of 2499 NPC cases and 2576 controls randomly selected in southern China from 2010 through 2014. Unconditional logistic regression was used to estimate multivariable-adjusted odds ratios (ORs) with 95% confidence intervals (95% CIs) associated with a family history of NPC. In addition, the authors compiled a reconstructed cohort comprising 40,781 first-degree relatives of cases and controls to calculate the lifetime cumulative risk of NPC.


Individuals with a first-degree family history of NPC were found to be at a >4-fold risk of NPC (OR, 4.6; 95% CI, 3.5-6.1) compared with those without such a history, but had no excess risk of other malignancies. The excess risk was higher for a maternal than a paternal history and was slightly stronger for a sibling compared with a parental history, and for a sororal than a fraternal history. Among relatives of cases, the cumulative risk of NPC up to age 74 years was 3.7% (95% CI, 3.3%-4.2%), whereas that among relatives of controls was 0.9% (95% CI, 0.7%-1.2%). Cumulative risk was higher in siblings than in parents among relatives of cases, whereas no such difference was noted among relatives of controls.


Individuals with a family history of NPC have a substantially higher risk of NPC. These relative and cumulative risk estimates can guide the development of strategies for early detection and clinical consultation in populations with a high incidence of NPC. Cancer 2017;123:2716-25. © 2017 American Cancer Society.


case-control study; family history; nasopharyngeal carcinoma (NPC); relative and cumulative risk; southern China

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