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Article: Incidence and mortality of nasopharyngeal carcinoma: interim analysis of a cluster randomized controlled screening trial (PRO-NPC-001) in southern China

TitleIncidence and mortality of nasopharyngeal carcinoma: interim analysis of a cluster randomized controlled screening trial (PRO-NPC-001) in southern China
Authors
Keywordsnasopharyngeal carcinoma
EBV
screening
incidence
mortality
Issue Date2019
PublisherOxford University Press. The Journal's web site is located at http://annonc.oxfordjournals.org/
Citation
Annals of Oncology, 2019, v. 30 n. 10, p. 1630-1637 How to Cite?
AbstractBackground: Previous mass screening studies have shown that IgA antibodies against Epstein–Barr Virus (EBV) can facilitate early detection of nasopharyngeal carcinoma (NPC), but the impact of EBV-antibody screening for NPC-specific mortality remains unknown. Patients and methods: A prospective, cluster randomized, controlled trial for NPC screening (PRO-NPC-001) was conducted in 3 selected towns of Zhongshan City and 13 selected towns of Sihui City in southern China beginning in 2008. Serum samples of the screening group were tested for two previously selected anti-EBV antibodies. Subjects with serological medium risk were subsequently retested annually for 3 years, and those with serological high risk were referred to otorhinolaryngologists for diagnostic check-up. An interim analysis was carried out to evaluate the primary end points of the NPC-specific mortality and the early diagnostic rate, and the secondary end point of the NPC incidence, through linkage with the database of Zhongshan City. Results: Among 70 296 total subjects, 29 413 screened participants (41.8% of the total subjects) in the screening group and 50 636 in the control group, 153 (43.3 per 100 000 person-year), 62 (55.3 per 100 000 person-year) and 99 (33.1 per 100 000 person-year) NPC cases were identified. The early diagnostic rates of NPC were significantly higher in the participants (79.0%, P < 0.0001) and the screening group (45.9%, P < 0.0001) compared with the control group (20.6%). Although no differences were found between NPC-specific mortality of the screening group and the control group [relative risk (RR)= 0.82, 95% confidence interval (CI) 0.37–1.79], lower NPC-specific mortality was noticed among participants from the screening group versus the control group (RR = 0.22, 95% CI 0.09–0.49). Conclusion: IgA antibodies against EBV can identify high-risk population and was effective in screening for early asymptomatic NPC. Although the mortality reduction was not significant in the primary end point, we noted encouraging evidence of a mortality reduction in screening participants in this interim analysis. Clinical trial number: NCT00941538.
Persistent Identifierhttp://hdl.handle.net/10722/274422
ISSN
2019 Impact Factor: 18.274
2015 SCImago Journal Rankings: 4.362

 

DC FieldValueLanguage
dc.contributor.authorJi, MF-
dc.contributor.authorSheng, W-
dc.contributor.authorCheng, WM-
dc.contributor.authorNg, MH-
dc.contributor.authorWU, BH-
dc.contributor.authorYu, X-
dc.contributor.authorWei, KR-
dc.contributor.authorLi, FG-
dc.contributor.authorLian, SF-
dc.contributor.authorWang, PP-
dc.contributor.authorQuan, W-
dc.contributor.authorDend, L-
dc.contributor.authorLi, XH-
dc.contributor.authorLi, XD-
dc.contributor.authorXie, YL-
dc.contributor.authorHuang, SJ-
dc.contributor.authorGe, SX-
dc.contributor.authorHuang, SL-
dc.contributor.authorLiang, XJ-
dc.contributor.authorHe, SM-
dc.contributor.authorHuang, HW-
dc.contributor.authorXia, SL-
dc.contributor.authorNg, PS-
dc.contributor.authorChen, HL-
dc.contributor.authorXie, SH-
dc.contributor.authorLiu, Q-
dc.contributor.authorHong, MH-
dc.contributor.authorMa, J-
dc.contributor.authorYuan, Y-
dc.contributor.authorXia, NS-
dc.contributor.authorZhang, J-
dc.contributor.authorCao, SM-
dc.date.accessioned2019-08-18T15:01:25Z-
dc.date.available2019-08-18T15:01:25Z-
dc.date.issued2019-
dc.identifier.citationAnnals of Oncology, 2019, v. 30 n. 10, p. 1630-1637-
dc.identifier.issn0923-7534-
dc.identifier.urihttp://hdl.handle.net/10722/274422-
dc.description.abstractBackground: Previous mass screening studies have shown that IgA antibodies against Epstein–Barr Virus (EBV) can facilitate early detection of nasopharyngeal carcinoma (NPC), but the impact of EBV-antibody screening for NPC-specific mortality remains unknown. Patients and methods: A prospective, cluster randomized, controlled trial for NPC screening (PRO-NPC-001) was conducted in 3 selected towns of Zhongshan City and 13 selected towns of Sihui City in southern China beginning in 2008. Serum samples of the screening group were tested for two previously selected anti-EBV antibodies. Subjects with serological medium risk were subsequently retested annually for 3 years, and those with serological high risk were referred to otorhinolaryngologists for diagnostic check-up. An interim analysis was carried out to evaluate the primary end points of the NPC-specific mortality and the early diagnostic rate, and the secondary end point of the NPC incidence, through linkage with the database of Zhongshan City. Results: Among 70 296 total subjects, 29 413 screened participants (41.8% of the total subjects) in the screening group and 50 636 in the control group, 153 (43.3 per 100 000 person-year), 62 (55.3 per 100 000 person-year) and 99 (33.1 per 100 000 person-year) NPC cases were identified. The early diagnostic rates of NPC were significantly higher in the participants (79.0%, P < 0.0001) and the screening group (45.9%, P < 0.0001) compared with the control group (20.6%). Although no differences were found between NPC-specific mortality of the screening group and the control group [relative risk (RR)= 0.82, 95% confidence interval (CI) 0.37–1.79], lower NPC-specific mortality was noticed among participants from the screening group versus the control group (RR = 0.22, 95% CI 0.09–0.49). Conclusion: IgA antibodies against EBV can identify high-risk population and was effective in screening for early asymptomatic NPC. Although the mortality reduction was not significant in the primary end point, we noted encouraging evidence of a mortality reduction in screening participants in this interim analysis. Clinical trial number: NCT00941538.-
dc.languageeng-
dc.publisherOxford University Press. The Journal's web site is located at http://annonc.oxfordjournals.org/-
dc.relation.ispartofAnnals of Oncology-
dc.subjectnasopharyngeal carcinoma-
dc.subjectEBV-
dc.subjectscreening-
dc.subjectincidence-
dc.subjectmortality-
dc.titleIncidence and mortality of nasopharyngeal carcinoma: interim analysis of a cluster randomized controlled screening trial (PRO-NPC-001) in southern China-
dc.typeArticle-
dc.identifier.emailChen, HL: hlchen@hku.hk-
dc.identifier.authorityChen, HL=rp00383-
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.doi10.1093/annonc/mdz231-
dc.identifier.hkuros301935-
dc.publisher.placeUnited Kingdom-

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