title: Quantification of familial risk of nasopharyngeal carcinoma in a high-incidence area.
abstract: BACKGROUND
  To the authors' knowledge, no studies to date have explored familial risks of nasopharyngeal carcinoma (NPC) in detail and quantified its lifetime risk in high-incidence populations.
  
  
  METHODS
  The authors conducted a population-based case-control study of 2499 NPC cases and 2576 controls randomly selected in southern China from 2010 through 2014. Unconditional logistic regression was used to estimate multivariable-adjusted odds ratios (ORs) with 95% confidence intervals (95% CIs) associated with a family history of NPC. In addition, the authors compiled a reconstructed cohort comprising 40,781 first-degree relatives of cases and controls to calculate the lifetime cumulative risk of NPC.
  
  
  RESULTS
  Individuals with a first-degree family history of NPC were found to be at a >4-fold risk of NPC (OR, 4.6; 95% CI, 3.5-6.1) compared with those without such a history, but had no excess risk of other malignancies. The excess risk was higher for a maternal than a paternal history and was slightly stronger for a sibling compared with a parental history, and for a sororal than a fraternal history. Among relatives of cases, the cumulative risk of NPC up to age 74 years was 3.7% (95% CI, 3.3%-4.2%), whereas that among relatives of controls was 0.9% (95% CI, 0.7%-1.2%). Cumulative risk was higher in siblings than in parents among relatives of cases, whereas no such difference was noted among relatives of controls.
  
  
  CONCLUSIONS
  Individuals with a family history of NPC have a substantially higher risk of NPC. These relative and cumulative risk estimates can guide the development of strategies for early detection and clinical consultation in populations with a high incidence of NPC. Cancer 2017;123:2716-25. © 2017 American Cancer Society.
authors.affiliation: Department of Medical Epidemiology and Biostatistics, Karolinska Institute, Stockholm, Sweden.
authors.forename: Zhiwei
authors.initials: Z
authors.lastname: Liu
authors.affiliation: Exponent Inc, Health Sciences Practice, Menlo Park, California.|Division of Epidemiology, Department of Health Research and Policy, Stanford University School of Medicine, Stanford, California.
authors.forename: Ellen T
authors.initials: ET
authors.lastname: Chang
authors.affiliation: Department of Cancer Prevention Center, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong, China.|State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong, China.
authors.forename: Qing
authors.initials: Q
authors.lastname: Liu
authors.affiliation: Department of Clinical Laboratory, Wuzhou Red Cross Hospital, Wuzhou, Guangxi, China.|Wuzhou Health System Key Laboratory for Nasopharyngeal Carcinoma Etiology and Molecular Mechanism, Wuzhou, Guangxi, China.
authors.forename: Yonglin
authors.initials: Y
authors.lastname: Cai
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China.|Key Laboratory of High-Incidence Tumor Prevention and Treatment, Guangxi Medical University, Ministry of Education, Nanning, Guangxi, China.
authors.forename: Zhe
authors.initials: Z
authors.lastname: Zhang
authors.affiliation: State Key Laboratory for Infectious Diseases Prevention and Control, Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China.
authors.forename: Guomin
authors.initials: G
authors.lastname: Chen
authors.affiliation: Sihui Cancer Institute Sihui, Guangdong, China.
authors.forename: Qi-Hong
authors.initials: QH
authors.lastname: Huang
authors.affiliation: Department of Cancer Prevention Center, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong, China.|State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong, China.
authors.forename: Shang-Hang
authors.initials: SH
authors.lastname: Xie
authors.affiliation: Department of Cancer Prevention Center, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong, China.|State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong, China.
authors.forename: Su-Mei
authors.initials: SM
authors.lastname: Cao
authors.affiliation: State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong, China.
authors.forename: Jian-Yong
authors.initials: JY
authors.lastname: Shao
authors.affiliation: State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong, China.
authors.forename: Wei-Hua
authors.initials: WH
authors.lastname: Jia
authors.affiliation: Department of Clinical Laboratory, Wuzhou Red Cross Hospital, Wuzhou, Guangxi, China.|Wuzhou Health System Key Laboratory for Nasopharyngeal Carcinoma Etiology and Molecular Mechanism, Wuzhou, Guangxi, China.
authors.forename: Yuming
authors.initials: Y
authors.lastname: Zheng
authors.affiliation: Cangwu Institute for Nasopharyngeal Carcinoma Control and Prevention, Wuzhou, Guangxi, China.
authors.forename: Jian
authors.initials: J
authors.lastname: Liao
authors.affiliation: Key Laboratory of High-Incidence Tumor Prevention and Treatment, Guangxi Medical University, Ministry of Education, Nanning, Guangxi, China.
authors.forename: Yufeng
authors.initials: Y
authors.lastname: Chen
authors.affiliation: Key Laboratory of High-Incidence Tumor Prevention and Treatment, Guangxi Medical University, Ministry of Education, Nanning, Guangxi, China.
authors.forename: Longde
authors.initials: L
authors.lastname: Lin
authors.affiliation: Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts.|Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, Massachusetts.
authors.forename: Liming
authors.initials: L
authors.lastname: Liang
authors.affiliation: Department of Microbiology, Tumor and Cell Biology Karolinska Institute, Stockholm, Sweden.
authors.forename: Ingemar
authors.initials: I
authors.lastname: Ernberg
authors.affiliation: Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, Washington.|Department of Epidemiology, University of Washington, Seattle, Washington.
authors.forename: Thomas L
authors.initials: TL
authors.lastname: Vaughan
authors.affiliation: Department of Medical Epidemiology and Biostatistics, Karolinska Institute, Stockholm, Sweden.|Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts.
authors.forename: Hans-Olov
authors.initials: HO
authors.lastname: Adami
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China.|Key Laboratory of High-Incidence Tumor Prevention and Treatment, Guangxi Medical University, Ministry of Education, Nanning, Guangxi, China.
authors.forename: Guangwu
authors.initials: G
authors.lastname: Huang
authors.affiliation: State Key Laboratory for Infectious Diseases Prevention and Control, Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China.
authors.forename: Yi
authors.initials: Y
authors.lastname: Zeng
authors.affiliation: State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong, China.|Beijing Hospital, Beijing, China.
authors.forename: Yi-Xin
authors.initials: YX
authors.lastname: Zeng
authors.affiliation: Department of Medical Epidemiology and Biostatistics, Karolinska Institute, Stockholm, Sweden.
authors.forename: Weimin
authors.initials: W
authors.lastname: Ye
mesh_terms: D000328:Adult; D000368:Aged; D002277:Carcinoma / Q000453:epidemiology* / Q000235:genetics; D016022:Case-Control Studies; D002681:China / Q000453:epidemiology; D015331:Cohort Studies; D005260:Female; D020022:Genetic Predisposition to Disease; D006801:Humans; D015994:Incidence; D016015:Logistic Models; D008297:Male; D008487:Medical History Taking; D008875:Middle Aged; D015999:Multivariate Analysis; D000077274:Nasopharyngeal Carcinoma; D009303:Nasopharyngeal Neoplasms / Q000453:epidemiology* / Q000235:genetics; D016017:Odds Ratio; D018570:Risk Assessment; D012307:Risk Factors; D012737:Sex Factors; D055815:Young Adult
keywords: case-control study; family history; nasopharyngeal carcinoma (NPC); relative and cumulative risk; southern China