Invited Commentary: Epstein-Barr Virus-Based Screening for the Early Detection of Nasopharyngeal Carcinoma--A New Frontier

Approximately 2 million new cases of cancer are caused by infections each year. For many of these cancers, we have been successful at developing methods for prevention or effective treatment/control. Epstein-Barr virus (EBV), a ubiquitous infection that establishes lifelong latency, was the first infection to be linked to the development of cancers, including nasopharyngeal carcinoma, lymphomas, and gastric cancer. EBV infection is linked to the development of approximately 200,000 new cancers each year, yet there have been no successful efforts to implement EBV-based strategies for the reduction in the burden of EBV-associated cancers. In this issue of the Journal, Liu et al. (Am J Epidemiol. 2013;177(3):242-250) report results from the enrollment phase of a large effort to demonstrate the efficacy of an EBV-based screening strategy to detect nasopharyngeal carcinoma at early stages and hopefully reduce the mortality associated with this disease. In this invited commentary, the design and initial findings from this demonstration project are reviewed, possible ways to enrich the effort are discussed, and populations that might benefit from EBV-based screening in the future are identified.