Abstract 2891: Control of nasopharyngeal carcinoma through serologic screening and clinical examination of at-risk subjects

Abstract

Abstract Background. Nasopharyngeal Carcinoma (NPC) could be successfully treated by radiotherapy when the tumor is localized to the nasopharynx, while further progression to the adjacent tissues is attended by poor treatment outcome. However, 93% of the patients presented to outpatients department are diagnosed with the advanced cancer, while 86% of the localized tumors are asymptomatic, detected by clinical examination of apparently healthy subjects (Ji et al., submitted). Epstein Barr Virus (EBV) antibody levels of NPC patients are raised and maintained at high levels for up to 10 years before clinical onset (Ji et al., 2007). This suggests that repeated serologic screening could serve to monitor the tumor as it enters and transits such preclinical window and clinical examination of that risk subjects could detect the tumor as it is clinically manifested. Objective: An early NPC detection program was instituted in Zhongshan City in Southern China since December 2007. The objective is to detect NPC while the tumor is confined to the nasopharynx. Method. Subjects enrolled in this program are screened annually for levels of 3 EBV antibodies, namely IgA EBNA1, IgG EBNA1 and IgG zta, simultaneously. Clinical examination and endoscopy are performed for at-risk subjects who had elevated levels of 3 antibodies or IgA EBNA1 rod≥ 3. Results: As of July 2009, 1373 adults were enrolled, 11 were assessed as high risk for NPC and 31 with elevated levels of one of 3 antibody. Five NPC cases were detected during clinical examination and all were from among those who had high levels of all the 3 EBV antibodies. Three of these cases showed no or a minimum of symptoms and were diagnosed with localized NPC (T1N0M0). The other 2 were overt cases and diagnosed with advanced loco-regional diseases (T2N1M0 and T3N1M0) Conclusions: It is possible to control NPC by serologic screening and clinical follow-up of the at-risk subjects. Note: This abstract was not presented at the AACR 101st Annual Meeting 2010 because the presenter was unable to attend. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 101st Annual Meeting of the American Association for Cancer Research; 2010 Apr 17-21; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2010;70(8 Suppl):Abstract nr 2891.