ArticleCancer medicine2019
Smoking can increase nasopharyngeal carcinoma risk by repeatedly reactivating Epstein-Barr Virus: An analysis of a prospective study in southern China.
Article in Cancer medicine, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 28 papers, 1 of them a synthesis that pooled it.
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Who cites it
28 citing papers in PubMed, 1 synthesis or guideline pooled it, 32 citations in OpenAlex.
- Smoking and nasopharyngeal cancer: individual data meta-analysis of six prospective studies on 334 935 men.International journal of epidemiology · 2021Pooled it
- Nasopharyngeal carcinoma: epidemiology, risk factors, signaling pathways, clinical features, diagnosis, and management.Molecular biomedicine · 2026Review
- Viral associations in multiple sclerosis: pathogenetic mechanisms and therapeutic implications.Virology journal · 2026Review
- Achieving control of nasopharyngeal carcinoma: the role of Epstein-Barr virus-based screening and vaccines.Nature reviews. Clinical oncology · 2026Review
- Epstein-Barr virus infection and vitamin D deficiency are both "causal" for multiple sclerosis (MS) - could the common denominator be their effects on hepcidin levels?Metabolic brain disease · 2025Review
- Multiple sclerosis and infection: history, EBV, and the search for mechanism.Microbiology and molecular biology reviews : MMBR · 2025Review
- Impact of lifestyle factors post-infectious mononucleosis on multiple sclerosis risk.European journal of epidemiology · 2025Article
- Nasopharyngeal Carcinoma in Southeast Asia: Current Landscape and Future Priorities.British journal of biomedical science · 2025Review
- Epidemiology of nasopharyngeal carcinoma: current insights and future outlook.Cancer metastasis reviews · 2024Review
- The lung-brain axis in multiple sclerosis: Mechanistic insights and future directions.Brain, behavior, & immunity - health · 2024Article
- Association between Epstein-Barr virus reactivation and severe malaria in pregnant women living in a malaria-endemic region of Cameroon.PLOS global public health · 2024Article
- Predicting risk factors for Epstein-Barr virus reactivation using Bayesian network analysis: a population-based study of high-risk areas for nasopharyngeal cancer.Frontiers in oncology · 2024Article
- Article
- Risk factors for multiple sclerosis in the context of Epstein-Barr virus infection.Frontiers in immunology · 2023Review
- Associations between serum trace elements and the risk of nasopharyngeal carcinoma: a multi-center case-control study in Guangdong Province, southern China.Frontiers in nutrition · 2023Article
- Article
- Environmental Factors for Epstein-Barr Virus Reactivation in a High-Risk Area of Nasopharyngeal Carcinoma: A Population-Based Study.Open forum infectious diseases · 2022Article
- Interplay between Epstein-Barr virus infection and environmental xenobiotic exposure in cancer.Infectious agents and cancer · 2021Review
- Plasma Epstein-Barr virus DNA and risk of nasopharyngeal carcinoma in a prospective seropositive population.BMC cancer · 2021Observational
- Survival benefit of induction chemotherapy for locally advanced nasopharyngeal carcinoma: prognosis based on a new risk estimation model.BMC cancer · 2021Article
Corrections and comments
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Authors and funding
9 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe association between smoking and nasopharyngeal carcinoma (NPC) is still uncertain. The aim of this study was to validate smoking effect on NPC and explore if smoking can induce NPC by persistently reactivating EBV in long-term based on a prospective cohort design.
methodsA NPC screening cohort with 10 181 eligible residents in Sihui city, southern China was conducted from 2008 to 2015. The smoking habit was investigated through the trained interviewers and EBV antibodies (VCA-IgA, EBNA1-IgA) as screening markers were tested periodically. New NPC cases were identified through local cancer registry. Cox's regression model was used to estimate the adjusted hazard ratios (aHRs) of smoking on NPC incidence. In the non-NPC participants, the associations between smoking and EBV seropositivity in different periods were assessed by logistic regression and generalized estimating equations (GEE).
resultsWith a median of 7.54 years, 71 NPCs were diagnosed ≥1 year after recruitment. Compared with never smokers, the aHRs of developing NPC among ever smokers were 3.00 (95%CI: 1.46-6.16). Stratified by sex, the HRs of ever smoking were 2.59 (95%CI: 1.07-6.23) for male and 3.75 (95%CI: 1.25-11.20) for female, respectively. Among the non-NPC individuals, ever smoking was not only associated with EBV seropositivity at baseline, but also in the 3-5 years of follow up, with adjusted odds ratios (aORs) of 1.68 (95%CI: 1.29-2.18) for VCA-IgA and 1.92 (95%CI: 1.42-2.59) for EBNA1-IgA. Among the smokers who were tested EBV antibodies at least twice, the similar results were obtained using GEE.
conclusionSmoking could significantly increase the long-term risk of NPC in southern China, partly by persistently reactivating EBV.
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