am i at risk | NP Screen™

Am I at risk for developing NPC (Nasopharyngeal Carcinoma)?

There are many causes of NPC, including: viral infection, genetic susceptibility, and environmental factors. Genetic background plays a key role in predisposing or making someone more likely to experience increased susceptibility to this cancer. The following survey will help you estimate your risk level so that, if appropriate, early intervention such as screening can be done.

The survey won’t tell you whether you’ll get NPC or not. But it can help you to understand the important risk factors, including taking actions or making changes that can lower your risk, improve your prognosis or outcome and encourage a better quality of life.

This survey will take less than 5 minutes.

You should know

This survey is intended to provide you with a general assessment of NPC risks for your own educational purposes. The information provided has been referenced from scientific journals and publications as cited.
This survey looks at relative risks only. Please consult further with your physician and discuss which NPC monitoring program is best for you.
Your risk can change over time. We recommend taking the survey every six months to see if your risk changes.

I agree

You must agree to the above disclaimer in order to start the survey, please check off “I agree”.

Age & Gender

Why is it important?

The risk for Nasopharyngeal Cancer (NPC) changes depending on age and gender. The risk factor rises sharply after a certain age, which is usually 30 and peaks at around 55. The incident rate between males and females also differs.

What is Your Gender?

Male	Female

Age & Gender

Why is it important?

How old are you?

Under the age of 25 Between 25 to 35	Between 35 to 55 Between 55 to 65	Over 65

Family History

Has any first degree relative (e.g., parents and siblings) ever been diagnosed with Nasopharyngeal Cancer (NPC)?

Yes	No

Family History

Has any second degree relative (e.g., cousins, nieces or nephews) ever been diagnosed with Nasopharyngeal Cancer (NPC)?

Yes	No

Ethnic Background

Why is it important?

A person’s genetic background is a key factor in determining the risk of developing Nasopharyngeal Cancer (NPC). Even though NPC is rare in many populations, certain ethnic groups have a much higher likelihood of developing the disease.

Where were your parents born?

North America Central America Caribbean South America	Western Europe Africa Middle East Eastern Europe	East Asia South Asia Southeast Asia Australia & New Zeland	Pacific Islanders Arctic Region

Ethnic Background

Are you from Brazil?

Yes	No

Ethnic Background

Are you from:

Mediterranean Coast Spain	Portugal Greenland	None of the above

Ethnic Background

Are you from:

North Africa Nigeria	Kenya South Africa

Ethnic Background

Which part of China are you from?

North China Northeast China East China	Southern Central China Southwest China Northwest China

Ethnic Background

Are you from Northern India?

Yes	No

Environmental Factors

Do you have exposure to either wood dust or formaldehyde insulation in your home or work place?

Yes	No

Environmental Factors

How would you rate the air quality in your living environment? ^*

Good	Moderate	Bad

Environmental Factors

Do you regularly (two or more times per week) consume salted fish or other preserved foods in your diet?

Yes	No

Environmental Factors

Do you use Traditional Chinese Medicine (TCM) on occasion?

Yes	No

Environmental Factors

Do you regularly (two or more times per week) drink alcohol? ^*

Yes	No

Environmental Factors

Do you smoke?

Yes	No

Results from a number of prospective epidemiological studies of the occurrence and risks in certain groups revealed that chronic smoking was a risk factor for NPC. Most studies performed in China and the United States showed that drinking alcohol did not have a significant role in the development of NPC.

Results from published studies have shown that dietary intake of nitrite and nitrosamine, used especially in Cantonese salted fish and preserved foods; occupational exposure to wood dust and formaldehyde, environmental cofactors, familial tendency, and genetic background are associated with a significantly increased risk of Nasopharyngeal Cancer (NPC) according to the American Cancer Society.

Viral Infection

Why is it important?

Epstein-Barr Virus (EBV) was classified by the International Agency for Cancer Research (IARC) as a Class I carcinogen for Nasopharyngeal Cancer (NPC) in 1997; however, EBV alone is not sufficient to cause NPC. NPC has a multifactorial etiology which means it has many causes involving viral, genetic and environmental factors that can contribute to the development of NPC.

Have you ever had an infection caused by the Epstein-Barr virus (EBV) for example: mononucleosis, or to the best of your knowledge have you ever been exposed to the virus, which can be transmitted through saliva/mucus and lives in the nose and throat.

Yes	No	I don’t know

Please choose a selection

	YOUR RISK: HIGH RISK You are considered to be in the high risk patient group for Nasopharyngeal Cancer (NPC), and should speak to your doctor about annual screening for this type of cancer. YOUR RISK: MODERATE RISK You are considered moderate patient group, consult your doctor about annual screening for this type of cancer. YOUR RISK: LOW RISK You are considered to be among the low risk patient group. This will not exclude your chances of developing Nasopharyngeal Cancer (NPC), but you are in the generally low risk population of 1 out of 100,000.
	Remember: These results do not mean you will always be at a much higher than average risk or will or will not develop cancer at some point in your life. But this report can help you understand what may be putting you at risk for developing nasopharyngeal cancer and what you can do to help lower your risk. If you make changes, come back in the future to see how your risk may have changed. Your results were calculated based on your age, sex and the answer you provided. These results are based on best available current information but cancer is a complex disease and not all factors that may affect a person’s risk are known or can be measured. If you are under 30 or have had cancer, these results may be less accurate. For more information about this and other cancers, and/or how to improve your health, talk to your doctor or nurse practitioner.
	What are the main factors raising your risk? You smoke cigars and cigarettes.¹ You have a family history of nasopharyngeal cancer.² You are from the high risk NPC endemic areas.³ You are from the moderate risk area. Please consult with your physician if regular monitoring is right for you.³ You consume salted fish or other preserved foods regularly in your diet.^4,⁵ You use Traditional Chinese Medicine on occasion.⁶ Your age group is in the moderate to high range, as the risk of Nasopharyngeal Cancer (NPC) sharply increases after age 30. The age range of NPC has been shown to be as young as 4 to over 90. However, NPC incidence seems to begin at 25 to 30 years of age.⁷ You are in the peak range for Nasopharyngeal Cancer (NPC). The risk factor is considered very high in this age group. NPC incidence rises sharply from the age of 30 and peaks around 55 years of age. Statistics show that over 60-80% of cases occur in the 30-70 age group.⁷ Your age group’s risk is considered very high as Nasopharyngeal Cancer (NPC) incidence peak around 55-60 range. The age range of Nasopharyngeal Cancer (NPC) has been shown to be as young as 4 to over 90. NPC incidence starts to decrease from peak around 60 years.⁷ A male’s risk is 3 times higher than that of a female’s.⁸ You have occupational exposure to wood dust and formaldehyde.^9,¹⁰
	What are the main factors keeping your risk down? Your age group is considered low. The age range of Nasopharyngeal Cancer (NPC) diagnosis has been shown to be as young as 4 and as old as over 90. However, majority of NPC cases seems to begin after 25-30 years of age. If your children are young (less than 25), their chances of developing NPC are likely very low, but they can still be at risk.⁷ Your age group is considered low. The age range of Nasopharyngeal Cancer (NPC) has been shown to be as young as 4 to as old as over 90. After the peak ages of 35 to 55, NPC incidence begins to decrease around 60 years of age.⁷ The male to female ratio is approximately 3 to 1. So compared to men, a woman’s risk is considered moderate.⁸ Environmental Factors is not a risk factor to you. However, keep in mind that some of the known environmental trigger for Nasopharyngeal Cancer (NPC) are consumption of salted fish and preserved foods, occupational exposures to wood dust and chronic smoking. You are from the low risk region of the world. Normally the risk of having Nasopharyngeal Cancer (NPC) is less than 1 person per 100,000.³ Protect yourself Screening saves lives. Regular screening is the most important thing you can do to stay protected from nasopharyngeal cancer (NPC). In fact, if nasopharyngeal cancer (NPC) is caught early, there is a 90% chance it can be cured. Regardless of your overall risk level, because you have reported a first degree family member with a history of nasopharyngeal cancer, you are in a special category of individuals who should talk to their family doctor about nasopharyngeal cancer screening. Studies have shown that the risk of developing nasopharyngeal cancer (NPC) is 2-15 times greater compared to the general population in endemic regions or very common for a person with a first-, second-, or third-degree relative diagnosed with NPC. Make changes to help lower your risk Limit or avoid consumption of salted fish or other preserved foods. One of the most potent and confirmed risk factors for Nasopharyngeal Cancer (NPC) is salty fish consumption. Certain foods (particularly fish and food preserved in salt) contain a known carcinogen (cancer causing) N-nitrosamine, and other related substances. Commit to quit smoking. Smoking is the main risk factor for squamous cell carcinoma, a form of nasopharyngeal cancer (NPC). Results from a number of prospective epidemiological studies of the occurrence and risks in certain groups revealed that chronic smoking was a risk factor to NPC. Most studies performed in China and the United States showed that drinking alcohol did not have a significant role in the development of NPC. Limit or avoid the use of Traditional Chinese Medicine. The use of Traditional Chinese Medicine (TCM) has been associated with a 2-4 times increase in the incidence of Nasopharyngeal Cancer (NPC). Some of the elements in the traditional medicines can activate latent or hidden Epstein-Barr Virus (EBV) in the cells. Factors that may be affecting your risk You have a family history of nasopharyngeal cancer (NPC). Having a first degree relative with nasopharyngeal cancer (NPC) increases the risk of being diagnosed for NPC approximately 2 to 15 times, compared to the general population in endemic or very common regions. In fact, 30% of affected family members are usually parents, while 70% are siblings. The period between the affected parent and child being diagnosed is about 25 years. The period between affected siblings being diagnosed is about 5 years. Keep in mind that regular screening for nasopharyngeal cancer may help to reduce your risk by catching pre-cancerous and cancerous changes early. You have Epstein-Barr virus (EBV) infection. The Epstein-Barr Virus (EBV) associated with nasopharyngeal cancer (NPC) is transmitted through saliva or mucus and lives in the nose and throat. EBV infection is very common throughout the world, often occurring in childhood. 50% of kids are infected before the age of 5. You may not be aware, but you could be likely to have EBV in your system just like 95% of the adult population around the world. EBV was classified by the International Agency for Cancer Research (IARC) as a Class I carcinogen for NPC in 1997; however, EBV alone is not sufficient to cause NPC. NPC has a multifactorial etiology, which means it has many causes involving viral, genetic and environmental factors that can contribute to the development of NPC. While there’s nothing you can do about having EBV, you can help reduce your risk of NPC by making lifestyle changes, as much as possible.

Risk Factor

Gender:

Age Group:

Family History:

Ethnic Origin:

Environmental
Factors:

Viral Infection:

Keep a record of your result

^1.Hsu WL, et al (2009) Independent effect of EBV and cigarette smoking on nasopharyngeal carcinoma: a 20-year followup study on 9,622 males without family history in Taiwan. Cancer Epidemiol Biomarkers Prev 18(4):1218–1226.

^2.Jia WH, et al (2005) Complex segregation analysis of nasopharyngeal carcinoma in Guangdong, China: evidence for a multifactorial mode of inheritance (complex segregation analysis of NPC in China). Eur J Hum Genet 13(2):248–252.

^3.Muir C, Waterhouse J, Mack T, et al (eds) (1987) Cancer incidence in five continents, vol. V. IARC scientific publications, Lyon, IARC.

^4.Lee HP, et al (1994) Preserved foods and nasopharyngeal carcinoma: a case-control study among Singapore Chinese. Int J Cancer 59(5):585–590.

^5.Yu MC, Huang TB, Henderson BE (1989) Diet and nasopharyngeal carcinoma: a case-control study in Guangzhou, China. Int J Cancer 43(6):1077–1082.

^6.Zheng YM, et al (1994) Environmental and dietary risk factors for nasopharyngeal carcinoma: a case-control study in Zangwu County, Guangxi, China. Br J Cancer 69(3): 508–514.

^7.Burt RD, Vaughan TL, McKnight B (1992) Descriptive epidemiology and survival analysis of nasopharyngeal carcinoma in the United States. Int J Cancer 52(4):549–556.

^8.Parkin DM, Whelan SL, et al (eds) (2002) Cancer incidence in five continents, vol. VIII. IARC scientific publications, Lyon,IARC.

^9.Luce D, et al (2002) Sinonasal cancer and occupational exposures: a pooled analysis of 12 case-control studies. Cancer Causes Control 13(2):147–157.

^10.Partanen T (1993) Formaldehyde exposure and respiratory cancer–a meta-analysis of the epidemiologic evidence. Scand J Work Environ Health 19(1):8–15.

^*Yu-Bei et al., (2014) A bird’s eye view of the air pollution-cancer link in China. Chin J Cancer. 33(4): 176–188.

^*Friborg JT, et al (2007) A prospective study of tobacco and alcohol use as risk factors for pharyngeal carcinomas in Singapore Chinese. Cancer 109(6):1183–1191.

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Am I at risk for developing NPC (Nasopharyngeal Carcinoma)?

You should know

This survey is intended to provide you with a general assessment of NPC risks for your own educational purposes. The information provided has been referenced from scientific journals and publications as cited.
This survey looks at relative risks only. Please consult further with your physician and discuss which NPC monitoring program is best for you.
Your risk can change over time. We recommend taking the survey every six months to see if your risk changes.

I agree

You must agree to the above disclaimer in order to start the survey, please check off “I agree”.

Age & Gender

Why is it important?

What is Your Gender?

Male	Female

Age & Gender

Why is it important?

How old are you?

Under the age of 25 Between 25 to 35 Between 35 to 55	Between 55 to 65 Over 65

Family History

Has any first degree relative (e.g., parents and siblings) ever been diagnosed with Nasopharyngeal Cancer (NPC)?

Yes	No

Family History

Has any second degree relative (e.g., cousins, nieces or nephews) ever been diagnosed with Nasopharyngeal Cancer (NPC)?

Yes	No

Ethnic Background

Why is it important?

Where were your parents born?

North America Central America Caribbean South America Western Europe Africa Middle East	Eastern Europe East Asia South Asia Southeast Asia Australia & New Zeland Pacific Islanders Arctic Region

Ethnic Background

Are you from Brazil?

Yes	No

Ethnic Background

Are you from:

Mediterranean Coast Spain Portugal	Greenland None of the above

Ethnic Background

Are you from:

North Africa Nigeria	Kenya South Africa

Ethnic Background

Which part of China are you from?

North China Northeast China East China	Southern Central China Southwest China Northwest China

Ethnic Background

Are you from Northern India?

Yes	No

Environmental Factors

Do you have exposure to either wood dust or formaldehyde insulation in your home or work place?

Yes	No

Environmental Factors

How would you rate the air quality in your living environment? ^*

Good	Moderate	Bad

Environmental Factors

Do you regularly (two or more times per week) consume salted fish or other preserved foods in your diet?

Yes	No

Environmental Factors

Do you use Traditional Chinese Medicine (TCM) on occasion?

Yes	No

Environmental Factors

Do you regularly (two or more times per week) drink alcohol? ^*

Yes	No

Environmental Factors

Do you smoke?

Yes	No

Viral Infection

Why is it important?

Yes	No	I don’t know

Please choose a selection

	YOUR RISK: HIGH RISK You are considered to be in the high risk patient group for Nasopharyngeal Cancer (NPC), and should speak to your doctor about annual screening for this type of cancer. YOUR RISK: MODERATE RISK You are considered moderate patient group, consult your doctor about annual screening for this type of cancer. YOUR RISK: LOW RISK You are considered to be among the low risk patient group. This will not exclude your chances of developing Nasopharyngeal Cancer (NPC), but you are in the generally low risk population of 1 out of 100,000.
	Remember: These results do not mean you will always be at a much higher than average risk or will or will not develop cancer at some point in your life. But this report can help you understand what may be putting you at risk for developing nasopharyngeal cancer and what you can do to help lower your risk. If you make changes, come back in the future to see how your risk may have changed. Your results were calculated based on your age, sex and the answer you provided. These results are based on best available current information but cancer is a complex disease and not all factors that may affect a person’s risk are known or can be measured. If you are under 30 or have had cancer, these results may be less accurate. For more information about this and other cancers, and/or how to improve your health, talk to your doctor or nurse practitioner.
	What are the main factors raising your risk? You smoke cigars and cigarettes.¹ You have a family history of nasopharyngeal cancer.² You are from the high risk NPC endemic areas.³ You are from the moderate risk area. Please consult with your physician if regular monitoring is right for you.³ You consume salted fish or other preserved foods regularly in your diet.^4,⁵ You use Traditional Chinese Medicine on occasion.⁶ Your age group is in the moderate to high range, as the risk of Nasopharyngeal Cancer (NPC) sharply increases after age 30. The age range of NPC has been shown to be as young as 4 to over 90. However, NPC incidence seems to begin at 25 to 30 years of age.⁷ You are in the peak range for Nasopharyngeal Cancer (NPC). The risk factor is considered very high in this age group. NPC incidence rises sharply from the age of 30 and peaks around 55 years of age. Statistics show that over 60-80% of cases occur in the 30-70 age group.⁷ Your age group’s risk is considered very high as Nasopharyngeal Cancer (NPC) incidence peak around 55-60 range. The age range of Nasopharyngeal Cancer (NPC) has been shown to be as young as 4 to over 90. NPC incidence starts to decrease from peak around 60 years.⁷ A male’s risk is 3 times higher than that of a female’s.⁸ You have occupational exposure to wood dust and formaldehyde.^9,¹⁰
	What are the main factors keeping your risk down? Your age group is considered low. The age range of Nasopharyngeal Cancer (NPC) diagnosis has been shown to be as young as 4 and as old as over 90. However, majority of NPC cases seems to begin after 25-30 years of age. If your children are young (less than 25), their chances of developing NPC are likely very low, but they can still be at risk.⁷ Your age group is considered low. The age range of Nasopharyngeal Cancer (NPC) has been shown to be as young as 4 to as old as over 90. After the peak ages of 35 to 55, NPC incidence begins to decrease around 60 years of age.⁷ The male to female ratio is approximately 3 to 1. So compared to men, a woman’s risk is considered moderate.⁸ Environmental Factors is not a risk factor to you. However, keep in mind that some of the known environmental trigger for Nasopharyngeal Cancer (NPC) are consumption of salted fish and preserved foods, occupational exposures to wood dust and chronic smoking. You are from the low risk region of the world. Normally the risk of having Nasopharyngeal Cancer (NPC) is less than 1 person per 100,000.³ Protect yourself Screening saves lives. Regular screening is the most important thing you can do to stay protected from nasopharyngeal cancer (NPC). In fact, if nasopharyngeal cancer (NPC) is caught early, there is a 90% chance it can be cured. Regardless of your overall risk level, because you have reported a first degree family member with a history of nasopharyngeal cancer, you are in a special category of individuals who should talk to their family doctor about nasopharyngeal cancer screening. Studies have shown that the risk of developing nasopharyngeal cancer (NPC) is 2-15 times greater compared to the general population in endemic regions or very common for a person with a first-, second-, or third-degree relative diagnosed with NPC. Make changes to help lower your risk Limit or avoid consumption of salted fish or other preserved foods. One of the most potent and confirmed risk factors for Nasopharyngeal Cancer (NPC) is salty fish consumption. Certain foods (particularly fish and food preserved in salt) contain a known carcinogen (cancer causing) N-nitrosamine, and other related substances. Commit to quit smoking. Smoking is the main risk factor for squamous cell carcinoma, a form of nasopharyngeal cancer (NPC). Results from a number of prospective epidemiological studies of the occurrence and risks in certain groups revealed that chronic smoking was a risk factor to NPC. Most studies performed in China and the United States showed that drinking alcohol did not have a significant role in the development of NPC. Limit or avoid the use of Traditional Chinese Medicine. The use of Traditional Chinese Medicine (TCM) has been associated with a 2-4 times increase in the incidence of Nasopharyngeal Cancer (NPC). Some of the elements in the traditional medicines can activate latent or hidden Epstein-Barr Virus (EBV) in the cells. Factors that may be affecting your risk You have a family history of nasopharyngeal cancer (NPC). Having a first degree relative with nasopharyngeal cancer (NPC) increases the risk of being diagnosed for NPC approximately 2 to 15 times, compared to the general population in endemic or very common regions. In fact, 30% of affected family members are usually parents, while 70% are siblings. The period between the affected parent and child being diagnosed is about 25 years. The period between affected siblings being diagnosed is about 5 years. Keep in mind that regular screening for nasopharyngeal cancer may help to reduce your risk by catching pre-cancerous and cancerous changes early. You have Epstein-Barr virus (EBV) infection. The Epstein-Barr Virus (EBV) associated with nasopharyngeal cancer (NPC) is transmitted through saliva or mucus and lives in the nose and throat. EBV infection is very common throughout the world, often occurring in childhood. 50% of kids are infected before the age of 5. You may not be aware, but you could be likely to have EBV in your system just like 95% of the adult population around the world. EBV was classified by the International Agency for Cancer Research (IARC) as a Class I carcinogen for NPC in 1997; however, EBV alone is not sufficient to cause NPC. NPC has a multifactorial etiology, which means it has many causes involving viral, genetic and environmental factors that can contribute to the development of NPC. While there’s nothing you can do about having EBV, you can help reduce your risk of NPC by making lifestyle changes, as much as possible.

Risk Factor

Gender:

Age Group:

Family History:

Ethnic Origin:

Environmental
Factors:

Viral Infection:

Keep a record of your result

^1.Hsu WL, et al (2009) Independent effect of EBV and cigarette smoking on nasopharyngeal carcinoma: a 20-year followup study on 9,622 males without family history in Taiwan. Cancer Epidemiol Biomarkers Prev 18(4):1218–1226.

^2.Jia WH, et al (2005) Complex segregation analysis of nasopharyngeal carcinoma in Guangdong, China: evidence for a multifactorial mode of inheritance (complex segregation analysis of NPC in China). Eur J Hum Genet 13(2):248–252.

^3.Muir C, Waterhouse J, Mack T, et al (eds) (1987) Cancer incidence in five continents, vol. V. IARC scientific publications, Lyon, IARC.

^4.Lee HP, et al (1994) Preserved foods and nasopharyngeal carcinoma: a case-control study among Singapore Chinese. Int J Cancer 59(5):585–590.

^5.Yu MC, Huang TB, Henderson BE (1989) Diet and nasopharyngeal carcinoma: a case-control study in Guangzhou, China. Int J Cancer 43(6):1077–1082.

^6.Zheng YM, et al (1994) Environmental and dietary risk factors for nasopharyngeal carcinoma: a case-control study in Zangwu County, Guangxi, China. Br J Cancer 69(3): 508–514.

^7.Burt RD, Vaughan TL, McKnight B (1992) Descriptive epidemiology and survival analysis of nasopharyngeal carcinoma in the United States. Int J Cancer 52(4):549–556.

^8.Parkin DM, Whelan SL, et al (eds) (2002) Cancer incidence in five continents, vol. VIII. IARC scientific publications, Lyon,IARC.

^9.Luce D, et al (2002) Sinonasal cancer and occupational exposures: a pooled analysis of 12 case-control studies. Cancer Causes Control 13(2):147–157.

^10.Partanen T (1993) Formaldehyde exposure and respiratory cancer–a meta-analysis of the epidemiologic evidence. Scand J Work Environ Health 19(1):8–15.

^*Yu-Bei et al., (2014) A bird’s eye view of the air pollution-cancer link in China. Chin J Cancer. 33(4): 176–188.

^*Friborg JT, et al (2007) A prospective study of tobacco and alcohol use as risk factors for pharyngeal carcinomas in Singapore Chinese. Cancer 109(6):1183–1191.

Facebook

Twitter

Am I at risk for developing NPC (Nasopharyngeal Carcinoma)?

You should know

This survey is intended to provide you with a general assessment of NPC risks for your own educational purposes. The information provided has been referenced from scientific journals and publications as cited.
This survey looks at relative risks only. Please consult further with your physician and discuss which NPC monitoring program is best for you.
Your risk can change over time. We recommend taking the survey every six months to see if your risk changes.

I agree

You must agree to the above disclaimer in order to start the survey, please check off “I agree”.

Age & Gender

Why is it important?

What is Your Gender?

Male
Female

Age & Gender

Why is it important?

How old are you?

Under the age of 25
Between 25 to 35
Between 35 to 55
Between 55 to 65
Over 65

Family History

Has any first degree relative (e.g., parents and siblings) ever been diagnosed with Nasopharyngeal Cancer (NPC)?

Yes
No

Family History

Has any second degree relative (e.g., cousins, nieces or nephews) ever been diagnosed with Nasopharyngeal Cancer (NPC)?

Yes
No

Ethnic Background

Why is it important?

Where were your parents born?

North America
Central America
Caribbean
South America
Western Europe
Africa
Middle East
Eastern Europe
East Asia
South Asia
Southeast Asia
Australia & New Zeland
Pacific Islanders
Arctic Region

Ethnic Background

Are you from Brazil?

Yes
No

Ethnic Background

Are you from:

Mediterranean Coast
Spain
Portugal
Greenland
None of the above

Ethnic Background

Are you from:

North Africa
Nigeria
Kenya
South Africa

Ethnic Background

Which part of China are you from?

North China
Northeast China
East China
Southern Central China
Southwest China
Northwest China

Ethnic Background

Are you from Northern India?

Yes
No

Environmental Factors

Do you have exposure to either wood dust or formaldehyde insulation in your home or work place?

Yes
No

Environmental Factors

How would you rate the air quality in your living environment?

Good
Moderate
Bad

Environmental Factors

Do you regularly (two or more times per week) consume salted fish or other preserved foods in your diet?

Yes
No

Environmental Factors

Do you use Traditional Chinese Medicine (TCM) on occasion?

Yes
No

Environmental Factors

Do you regularly (two or more times per week) drink alcohol?

Yes
No

Environmental Factors

Do you smoke?

Yes
No

Viral Infection

Why is it important?

Yes
No
I don’t know

Please choose a selection

	YOUR RISK: HIGH RISK You are considered to be in the high risk patient group for Nasopharyngeal Cancer (NPC), and should speak to your doctor about annual screening for this type of cancer. YOUR RISK: MODERATE RISK You are considered moderate patient group, consult your doctor about annual screening for this type of cancer. YOUR RISK: LOW RISK You are considered to be among the low risk patient group. This will not exclude your chances of developing Nasopharyngeal Cancer (NPC), but you are in the generally low risk population of 1 out of 100,000.
	Remember: These results do not mean you will always be at a much higher than average risk or will or will not develop cancer at some point in your life. But this report can help you understand what may be putting you at risk for developing nasopharyngeal cancer and what you can do to help lower your risk. If you make changes, come back in the future to see how your risk may have changed. Your results were calculated based on your age, sex and the answer you provided. These results are based on best available current information but cancer is a complex disease and not all factors that may affect a person’s risk are known or can be measured. If you are under 30 or have had cancer, these results may be less accurate. For more information about this and other cancers, and/or how to improve your health, talk to your doctor or nurse practitioner.
	What are the main factors raising your risk? You smoke cigars and cigarettes.¹ You have a family history of nasopharyngeal cancer.² You are from the high risk NPC endemic areas.³ You are from the moderate risk area. Please consult with your physician if regular monitoring is right for you.³ You consume salted fish or other preserved foods regularly in your diet.^4,⁵ You use Traditional Chinese Medicine on occasion.⁶ Your age group is in the moderate to high range, as the risk of Nasopharyngeal Cancer (NPC) sharply increases after age 30. The age range of NPC has been shown to be as young as 4 to over 90. However, NPC incidence seems to begin at 25 to 30 years of age.⁷ You are in the peak range for Nasopharyngeal Cancer (NPC). The risk factor is considered very high in this age group. NPC incidence rises sharply from the age of 30 and peaks around 55 years of age. Statistics show that over 60-80% of cases occur in the 30-70 age group.⁷ Your age group’s risk is considered very high as Nasopharyngeal Cancer (NPC) incidence peak around 55-60 range. The age range of Nasopharyngeal Cancer (NPC) has been shown to be as young as 4 to over 90. NPC incidence starts to decrease from peak around 60 years.⁷ A male’s risk is 3 times higher than that of a female’s.⁸ You have occupational exposure to wood dust and formaldehyde.^9,¹⁰
	What are the main factors keeping your risk down? Your age group is considered low. The age range of Nasopharyngeal Cancer (NPC) diagnosis has been shown to be as young as 4 and as old as over 90. However, majority of NPC cases seems to begin after 25-30 years of age. If your children are young (less than 25), their chances of developing NPC are likely very low, but they can still be at risk.⁷ Your age group is considered low. The age range of Nasopharyngeal Cancer (NPC) has been shown to be as young as 4 to as old as over 90. After the peak ages of 35 to 55, NPC incidence begins to decrease around 60 years of age.⁷ The male to female ratio is approximately 3 to 1. So compared to men, a woman’s risk is considered moderate.⁸ Environmental Factors is not a risk factor to you. However, keep in mind that some of the known environmental trigger for Nasopharyngeal Cancer (NPC) are consumption of salted fish and preserved foods, occupational exposures to wood dust and chronic smoking. You are from the low risk region of the world. Normally the risk of having Nasopharyngeal Cancer (NPC) is less than 1 person per 100,000.³ Protect yourself Screening saves lives. Regular screening is the most important thing you can do to stay protected from nasopharyngeal cancer (NPC). In fact, if nasopharyngeal cancer (NPC) is caught early, there is a 90% chance it can be cured. Regardless of your overall risk level, because you have reported a first degree family member with a history of nasopharyngeal cancer, you are in a special category of individuals who should talk to their family doctor about nasopharyngeal cancer screening. Studies have shown that the risk of developing nasopharyngeal cancer (NPC) is 2-15 times greater compared to the general population in endemic regions or very common for a person with a first-, second-, or third-degree relative diagnosed with NPC. Make changes to help lower your risk Limit or avoid consumption of salted fish or other preserved foods. One of the most potent and confirmed risk factors for Nasopharyngeal Cancer (NPC) is salty fish consumption. Certain foods (particularly fish and food preserved in salt) contain a known carcinogen (cancer causing) N-nitrosamine, and other related substances. Commit to quit smoking. Smoking is the main risk factor for squamous cell carcinoma, a form of nasopharyngeal cancer (NPC). Results from a number of prospective epidemiological studies of the occurrence and risks in certain groups revealed that chronic smoking was a risk factor to NPC. Most studies performed in China and the United States showed that drinking alcohol did not have a significant role in the development of NPC. Limit or avoid the use of Traditional Chinese Medicine. The use of Traditional Chinese Medicine (TCM) has been associated with a 2-4 times increase in the incidence of Nasopharyngeal Cancer (NPC). Some of the elements in the traditional medicines can activate latent or hidden Epstein-Barr Virus (EBV) in the cells. Factors that may be affecting your risk You have a family history of nasopharyngeal cancer (NPC). Having a first degree relative with nasopharyngeal cancer (NPC) increases the risk of being diagnosed for NPC approximately 2 to 15 times, compared to the general population in endemic or very common regions. In fact, 30% of affected family members are usually parents, while 70% are siblings. The period between the affected parent and child being diagnosed is about 25 years. The period between affected siblings being diagnosed is about 5 years. Keep in mind that regular screening for nasopharyngeal cancer may help to reduce your risk by catching pre-cancerous and cancerous changes early. You have Epstein-Barr virus (EBV) infection. The Epstein-Barr Virus (EBV) associated with nasopharyngeal cancer (NPC) is transmitted through saliva or mucus and lives in the nose and throat. EBV infection is very common throughout the world, often occurring in childhood. 50% of kids are infected before the age of 5. You may not be aware, but you could be likely to have EBV in your system just like 95% of the adult population around the world. EBV was classified by the International Agency for Cancer Research (IARC) as a Class I carcinogen for NPC in 1997; however, EBV alone is not sufficient to cause NPC. NPC has a multifactorial etiology, which means it has many causes involving viral, genetic and environmental factors that can contribute to the development of NPC. While there’s nothing you can do about having EBV, you can help reduce your risk of NPC by making lifestyle changes, as much as possible.

Risk Factor

Gender:

Age Group:

Family History:

Ethnic Origin:

Environmental
Factors:

Viral Infection:

^1.Hsu WL, et al (2009) Independent effect of EBV and cigarette smoking on nasopharyngeal carcinoma: a 20-year followup study on 9,622 males without family history in Taiwan. Cancer Epidemiol Biomarkers Prev 18(4):1218–1226.

^2.Jia WH, et al (2005) Complex segregation analysis of nasopharyngeal carcinoma in Guangdong, China: evidence for a multifactorial mode of inheritance (complex segregation analysis of NPC in China). Eur J Hum Genet 13(2):248–252.

^3.Muir C, Waterhouse J, Mack T, et al (eds) (1987) Cancer incidence in five continents, vol. V. IARC scientific publications, Lyon, IARC.

^4.Lee HP, et al (1994) Preserved foods and nasopharyngeal carcinoma: a case-control study among Singapore Chinese. Int J Cancer 59(5):585–590.

^5.Yu MC, Huang TB, Henderson BE (1989) Diet and nasopharyngeal carcinoma: a case-control study in Guangzhou, China. Int J Cancer 43(6):1077–1082.

^6.Zheng YM, et al (1994) Environmental and dietary risk factors for nasopharyngeal carcinoma: a case-control study in Zangwu County, Guangxi, China. Br J Cancer 69(3): 508–514.

^7.Burt RD, Vaughan TL, McKnight B (1992) Descriptive epidemiology and survival analysis of nasopharyngeal carcinoma in the United States. Int J Cancer 52(4):549–556.

^8.Parkin DM, Whelan SL, et al (eds) (2002) Cancer incidence in five continents, vol. VIII. IARC scientific publications, Lyon,IARC.

^9.Luce D, et al (2002) Sinonasal cancer and occupational exposures: a pooled analysis of 12 case-control studies. Cancer Causes Control 13(2):147–157.

^10.Partanen T (1993) Formaldehyde exposure and respiratory cancer–a meta-analysis of the epidemiologic evidence. Scand J Work Environ Health 19(1):8–15.

^*Yu-Bei et al., (2014) A bird’s eye view of the air pollution-cancer link in China. Chin J Cancer. 33(4): 176–188.

^*Friborg JT, et al (2007) A prospective study of tobacco and alcohol use as risk factors for pharyngeal carcinomas in Singapore Chinese. Cancer 109(6):1183–1191.

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Am I at risk for developing NPC (Nasopharyngeal Carcinoma)?

You should know

This survey is intended to provide you with a general assessment of NPC risks for your own educational purposes. The information provided has been referenced from scientific journals and publications as cited.
This survey looks at relative risks only. Please consult further with your physician and discuss which NPC monitoring program is best for you.
Your risk can change over time. We recommend taking the survey every six months to see if your risk changes.

I agree

You must agree to the above disclaimer in order to start the survey, please check off “I agree”.

Age & Gender

Why is it important?

What is Your Gender?

Male
Female

Age & Gender

Why is it important?

How old are you?

Under the age of 25
Between 25 to 35
Between 35 to 55
Between 55 to 65
Over 65

Family History

Has any first degree relative (e.g., parents and siblings) ever been diagnosed with Nasopharyngeal Cancer (NPC)?

Yes
No

Family History

Has any second degree relative (e.g., cousins, nieces or nephews) ever been diagnosed with Nasopharyngeal Cancer (NPC)?

Yes
No

Ethnic Background

Why is it important?

Where were your parents born?

North America
Central America
Caribbean
South America
Western Europe
Africa
Middle East
Eastern Europe
East Asia
South Asia
Southeast Asia
Australia & New Zeland
Pacific Islanders
Arctic Region

Ethnic Background

Are you from Brazil?

Yes
No

Ethnic Background

Are you from:

Mediterranean Coast
Spain
Portugal
Greenland
None of the above

Ethnic Background

Are you from:

North Africa
Nigeria
Kenya
South Africa

Ethnic Background

Which part of China are you from?

North China
Northeast China
East China
Southern Central China
Southwest China
Northwest China

Ethnic Background

Are you from Northern India?

Yes
No

Environmental Factors

Do you have exposure to either wood dust or formaldehyde insulation in your home or work place?

Yes
No

Environmental Factors

How would you rate the air quality in your living environment?

Good
Moderate
Bad

Environmental Factors

Do you regularly (two or more times per week) consume salted fish or other preserved foods in your diet?

Yes
No

Environmental Factors

Do you use Traditional Chinese Medicine (TCM) on occasion?

Yes
No

Environmental Factors

Do you regularly (two or more times per week) drink alcohol?

Yes
No

Environmental Factors

Do you smoke?

Yes
No

Viral Infection

Why is it important?

Yes
No
I don’t know

Please choose a selection

	YOUR RISK: HIGH RISK You are considered to be in the high risk patient group for Nasopharyngeal Cancer (NPC), and should speak to your doctor about annual screening for this type of cancer. YOUR RISK: MODERATE RISK You are considered moderate patient group, consult your doctor about annual screening for this type of cancer. YOUR RISK: LOW RISK You are considered to be among the low risk patient group. This will not exclude your chances of developing Nasopharyngeal Cancer (NPC), but you are in the generally low risk population of 1 out of 100,000.
	Remember: These results do not mean you will always be at a much higher than average risk or will or will not develop cancer at some point in your life. But this report can help you understand what may be putting you at risk for developing nasopharyngeal cancer and what you can do to help lower your risk. If you make changes, come back in the future to see how your risk may have changed. Your results were calculated based on your age, sex and the answer you provided. These results are based on best available current information but cancer is a complex disease and not all factors that may affect a person’s risk are known or can be measured. If you are under 30 or have had cancer, these results may be less accurate. For more information about this and other cancers, and/or how to improve your health, talk to your doctor or nurse practitioner.
	What are the main factors raising your risk? You smoke cigars and cigarettes.¹ You have a family history of nasopharyngeal cancer.² You are from the high risk NPC endemic areas.³ You are from the moderate risk area. Please consult with your physician if regular monitoring is right for you.³ You consume salted fish or other preserved foods regularly in your diet.^4,⁵ You use Traditional Chinese Medicine on occasion.⁶ Your age group is in the moderate to high range, as the risk of Nasopharyngeal Cancer (NPC) sharply increases after age 30. The age range of NPC has been shown to be as young as 4 to over 90. However, NPC incidence seems to begin at 25 to 30 years of age.⁷ You are in the peak range for Nasopharyngeal Cancer (NPC). The risk factor is considered very high in this age group. NPC incidence rises sharply from the age of 30 and peaks around 55 years of age. Statistics show that over 60-80% of cases occur in the 30-70 age group.⁷ Your age group’s risk is considered very high as Nasopharyngeal Cancer (NPC) incidence peak around 55-60 range. The age range of Nasopharyngeal Cancer (NPC) has been shown to be as young as 4 to over 90. NPC incidence starts to decrease from peak around 60 years.⁷ A male’s risk is 3 times higher than that of a female’s.⁸ You have occupational exposure to wood dust and formaldehyde.^9,¹⁰
	What are the main factors keeping your risk down? Your age group is considered low. The age range of Nasopharyngeal Cancer (NPC) diagnosis has been shown to be as young as 4 and as old as over 90. However, majority of NPC cases seems to begin after 25-30 years of age. If your children are young (less than 25), their chances of developing NPC are likely very low, but they can still be at risk.⁷ Your age group is considered low. The age range of Nasopharyngeal Cancer (NPC) has been shown to be as young as 4 to as old as over 90. After the peak ages of 35 to 55, NPC incidence begins to decrease around 60 years of age.⁷ The male to female ratio is approximately 3 to 1. So compared to men, a woman’s risk is considered moderate.⁸ Environmental Factors is not a risk factor to you. However, keep in mind that some of the known environmental trigger for Nasopharyngeal Cancer (NPC) are consumption of salted fish and preserved foods, occupational exposures to wood dust and chronic smoking. You are from the low risk region of the world. Normally the risk of having Nasopharyngeal Cancer (NPC) is less than 1 person per 100,000.³ Protect yourself Screening saves lives. Regular screening is the most important thing you can do to stay protected from nasopharyngeal cancer (NPC). In fact, if nasopharyngeal cancer (NPC) is caught early, there is a 90% chance it can be cured. Regardless of your overall risk level, because you have reported a first degree family member with a history of nasopharyngeal cancer, you are in a special category of individuals who should talk to their family doctor about nasopharyngeal cancer screening. Studies have shown that the risk of developing nasopharyngeal cancer (NPC) is 2-15 times greater compared to the general population in endemic regions or very common for a person with a first-, second-, or third-degree relative diagnosed with NPC. Make changes to help lower your risk Limit or avoid consumption of salted fish or other preserved foods. One of the most potent and confirmed risk factors for Nasopharyngeal Cancer (NPC) is salty fish consumption. Certain foods (particularly fish and food preserved in salt) contain a known carcinogen (cancer causing) N-nitrosamine, and other related substances. Commit to quit smoking. Smoking is the main risk factor for squamous cell carcinoma, a form of nasopharyngeal cancer (NPC). Results from a number of prospective epidemiological studies of the occurrence and risks in certain groups revealed that chronic smoking was a risk factor to NPC. Most studies performed in China and the United States showed that drinking alcohol did not have a significant role in the development of NPC. Limit or avoid the use of Traditional Chinese Medicine. The use of Traditional Chinese Medicine (TCM) has been associated with a 2-4 times increase in the incidence of Nasopharyngeal Cancer (NPC). Some of the elements in the traditional medicines can activate latent or hidden Epstein-Barr Virus (EBV) in the cells. Factors that may be affecting your risk You have a family history of nasopharyngeal cancer (NPC). Having a first degree relative with nasopharyngeal cancer (NPC) increases the risk of being diagnosed for NPC approximately 2 to 15 times, compared to the general population in endemic or very common regions. In fact, 30% of affected family members are usually parents, while 70% are siblings. The period between the affected parent and child being diagnosed is about 25 years. The period between affected siblings being diagnosed is about 5 years. Keep in mind that regular screening for nasopharyngeal cancer may help to reduce your risk by catching pre-cancerous and cancerous changes early. You have Epstein-Barr virus (EBV) infection. The Epstein-Barr Virus (EBV) associated with nasopharyngeal cancer (NPC) is transmitted through saliva or mucus and lives in the nose and throat. EBV infection is very common throughout the world, often occurring in childhood. 50% of kids are infected before the age of 5. You may not be aware, but you could be likely to have EBV in your system just like 95% of the adult population around the world. EBV was classified by the International Agency for Cancer Research (IARC) as a Class I carcinogen for NPC in 1997; however, EBV alone is not sufficient to cause NPC. NPC has a multifactorial etiology, which means it has many causes involving viral, genetic and environmental factors that can contribute to the development of NPC. While there’s nothing you can do about having EBV, you can help reduce your risk of NPC by making lifestyle changes, as much as possible.

Risk Factor

Gender:

Age Group:

Family History:

Ethnic Origin:

Environmental
Factors:

Viral Infection:

^1.Hsu WL, et al (2009) Independent effect of EBV and cigarette smoking on nasopharyngeal carcinoma: a 20-year followup study on 9,622 males without family history in Taiwan. Cancer Epidemiol Biomarkers Prev 18(4):1218–1226.

^2.Jia WH, et al (2005) Complex segregation analysis of nasopharyngeal carcinoma in Guangdong, China: evidence for a multifactorial mode of inheritance (complex segregation analysis of NPC in China). Eur J Hum Genet 13(2):248–252.

^3.Muir C, Waterhouse J, Mack T, et al (eds) (1987) Cancer incidence in five continents, vol. V. IARC scientific publications, Lyon, IARC.

^4.Lee HP, et al (1994) Preserved foods and nasopharyngeal carcinoma: a case-control study among Singapore Chinese. Int J Cancer 59(5):585–590.

^5.Yu MC, Huang TB, Henderson BE (1989) Diet and nasopharyngeal carcinoma: a case-control study in Guangzhou, China. Int J Cancer 43(6):1077–1082.

^6.Zheng YM, et al (1994) Environmental and dietary risk factors for nasopharyngeal carcinoma: a case-control study in Zangwu County, Guangxi, China. Br J Cancer 69(3): 508–514.

^7.Burt RD, Vaughan TL, McKnight B (1992) Descriptive epidemiology and survival analysis of nasopharyngeal carcinoma in the United States. Int J Cancer 52(4):549–556.

^8.Parkin DM, Whelan SL, et al (eds) (2002) Cancer incidence in five continents, vol. VIII. IARC scientific publications, Lyon,IARC.

^9.Luce D, et al (2002) Sinonasal cancer and occupational exposures: a pooled analysis of 12 case-control studies. Cancer Causes Control 13(2):147–157.

^10.Partanen T (1993) Formaldehyde exposure and respiratory cancer–a meta-analysis of the epidemiologic evidence. Scand J Work Environ Health 19(1):8–15.

^*Yu-Bei et al., (2014) A bird’s eye view of the air pollution-cancer link in China. Chin J Cancer. 33(4): 176–188.

^*Friborg JT, et al (2007) A prospective study of tobacco and alcohol use as risk factors for pharyngeal carcinomas in Singapore Chinese. Cancer 109(6):1183–1191.

Am I at risk for developing NPC (Nasopharyngeal Carcinoma)?

Am I at risk for developing NPC (Nasopharyngeal Carcinoma)?

Am I at risk for developing NPC (Nasopharyngeal Carcinoma)?

Am I at risk for developing NPC (Nasopharyngeal Carcinoma)?

June 6, 2015

May 2, 2015