Work

Nasopharyngeal carcinoma screening using Epstein–Barr virus Cp methylation triage in two population-based screening cohorts

Year: 2026

Type: article

Abstract: Nasopharyngeal carcinoma screening in southern China relies on Epstein–Barr virus serology, but its limited positive predictive value leads to excessive referrals. Here we evaluate a triage approach based on nasopharyngeal swab Epstein–Barr virus C promoter methylation quantification (E-CpMQ) among serology high-risk individuals in two population-based screening cohorts (N = 55,682). In the initial screening round (≤18 months) of a single-center cohort (N = 313), E-CpMQ identifies 91.7% of nasopharyngeal carcinoma cases (22/24) with 91.7% specificity (265/289), reducing referrals by 85.3%. Findings are replicated in an independent six-center cohort (N = 345), where E-CpMQ achieves 100% sensitivity (15/15) and 96.1% specificity (317/330), reducing referrals by 91.9%. Compared with nasopharyngeal swab Epstein–Barr virus DNA load triage, E-CpMQ shows equivalent sensitivity but higher specificity, lowering referrals needed to detect one case from 10–14 to approximately 2. Modeling further indicates improved specificity and positive predictive value when integrated into serology-based screening. Nasopharyngeal carcinoma (NPC) screening in southern China uses EBV serology, but its positive predictive value is low. Here, the authors introduce a swab-based E-CpMQ method in high-risk individuals, achieving better specificity.

Source: Nature Communications

DOI: 10.1038/s41467-026-72285-z