Nose Cancer Screening
What is Nose Cancer (Nasopharyngeal carcinoma)?
Nasopharyngeal carcinoma (NPC) is cancer that arises from the back of the nasal cavity. It is one of the most common head and neck cancers and it is prevalent in Southeast Asia.
Studies have shown that the five countries with the highest number of NPC patients are Malaysia, Singapore, Indonesia, Vietnam and Brunei. 
What are the risk factors for Nose Cancer?
- Lifestyle and Environment: Smoking and constant exposure to air pollutants.
- Dietary Practices: consuming preserved food (e.g. salted fish) and certain traditional Chinese medical herbs.
- Family history of NPC, especially those with first-degree relatives suffering from NPC (e.g. parents, siblings).
- Male patients are found to have a higher incidence of NPC
Patients with a positive family history of NPC are recommended for screening tests.
What are the common presenting complaints of Nose Cancer?
Common presenting complaints include:
- Block nose
- Double vision
- Neck lumps
- Blood stained saliva
- Loss of hearing
Nose Cancer Screening
What are the available screening blood tests?
Laboratory blood tests like EBV viral DNA and EBV IgA serology tests are performed in the screening of NPC for recommended patients.
EBV has been found to have a close association with NPC. Thus it has been used as a marker for the detection of NPC.
The EBV viral DNA test is known for both its high sensitivity and specificity above 97% and 98% respectively. 
Hence, this makes the EBV Viral DNA a good screening test for NPC patients who do not show any symptoms.
Another blood test like the anti-EBV IgA serology is available as well. Although this is commonly performed, it has been found to have lower sensitivity in evaluating patients who are suspected to have NPC. 
Detection of NPC in its early stages of the disease has a good prognosis after treatment. Studies have shown that there is a higher 5-year survival rate when NPC is detected and treated at its early stages. 
How is it done?
It is a fuss-free process. A simple non-fasting blood test is normally performed and sent to the lab for analysis. The report will be available shortly within 3-5 working days.
Patients with a positive result for the EBV DNA test are recommended to repeat the test at a later date. 
If the result is again positive, it is recommended that he or she consult with an ENT specialist.
Otherwise, patients with negative results are recommended to do annual screening tests subsequently for early detection of NPC.