Analysis of plasma Epstein-Barr virus DNA to screen for nasopharyngeal cancer: prospective screening study
Needs reviewPhase observationalN = 20,174NCT02063399
- Population
- Participants without symptoms of nasopharyngeal carcinoma who underwent plasma EBV DNA screening (20,174)
- Design
- Prospective screening study in people without symptoms of nasopharyngeal carcinoma. Plasma EBV DNA was measured; a positive result was retested about 4 weeks later, and persistent positives had nasal endoscopy and MRI. Outcomes of screen-detected cancers were compared with a historical cohort, not a concurrent control. Registry enrolment (20,302; ethnic Chinese men aged 40 to 62, Hong Kong) differs from the 20,174 screened in the paper's abstract.
- Arms
- Historical cohort (control): Nasopharyngeal carcinoma presenting clinically (comparison cohort; size not stated in the abstract)
- Screen-detected nasopharyngeal carcinoma (experimental, n = 34): Plasma EBV DNA screening with retest, nasal endoscopy and MRI
- All participants screened (test-performance population) (experimental, n = 20,174): Plasma EBV DNA screening with retest at about 4 weeks, then nasal endoscopy and MRI if persistently positive
- People
- Chan KCA, senior author Lo YMD
Δ Stage I or II at diagnosis+51 pointsPFSHR 0.10 (95% CI 0.05–0.18)Δ 36-month PFS+27 points
Show the numbers
| Endpoint | Analysis | Screen-detected nasopharyngeal carcinoma / All participants screened (test-performance population) | Historical cohort | Effect |
|---|---|---|---|---|
| Stage I or II at diagnosisNasopharyngeal carcinoma identified by screening vs historical cohort | exploratoryChan 2017 | 71% | 20% | P<0.001Chi-square test as reported; historical cohort, not a randomised or concurrent control. |
| PFSNasopharyngeal carcinoma identified by screening vs historical cohort | exploratoryChan 2017 | 97% at 3 y | 70% at 3 y | HR 0.10 (95% CI 0.05–0.18)Historical comparison; differences may reflect earlier detection as well as treatment. |
| SensitivityPlasma EBV DNA as a screening test for nasopharyngeal carcinoma | exploratoryChan 2017 | 97.1% | — | — |
| SpecificityPlasma EBV DNA as a screening test for nasopharyngeal carcinoma | exploratoryChan 2017 | 98.6% | — | — |
| Endpoint | Analysis | Screen-detected nasopharyngeal carcinoma / All participants screened (test-performance population) | Historical cohort | Effect |
|---|---|---|---|---|
| Stage I or II at diagnosisNasopharyngeal carcinoma identified by screening vs historical cohort | exploratoryChan 2017 | 71% | 20% | P<0.001Chi-square test as reported; historical cohort, not a randomised or concurrent control. |
| PFSNasopharyngeal carcinoma identified by screening vs historical cohort | exploratoryChan 2017 | 97% at 3 y | 70% at 3 y | HR 0.10 (95% CI 0.05–0.18)Historical comparison; differences may reflect earlier detection as well as treatment. |
| SensitivityPlasma EBV DNA as a screening test for nasopharyngeal carcinoma | exploratoryChan 2017 | 97.1% | — | — |
| SpecificityPlasma EBV DNA as a screening test for nasopharyngeal carcinoma | exploratoryChan 2017 | 98.6% | — | — |
Data table
| Endpoint | HR | 95% CI |
|---|---|---|
| PFS | 0.1 | 0.05–0.18 |