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Blood EBV DNA screening for nasopharyngeal cancer across southern China and Southeast Asia

Nasopharyngeal cancer is common in southern China and is caused by a virus. A blood test for viral DNA finds it early, and a large study showed better survival. Scale it up.

Plasma EBV DNA screening detected nasopharyngeal carcinoma at earlier stage with improved progression-free survival in a 20,000-man Hong Kong study. Propose programme rollout in high-incidence regions with two-time-point confirmation, endoscopy for persistent positives, and mortality evaluation via registries.

Hypothesis
Programme screening reduces nasopharyngeal cancer mortality by at least 30% in screened men aged 40-62 in high-incidence regions.
Rationale
A strong single-cancer test with a clear cause; high-incidence regions make positive predictive value acceptable.
What would test it
Cluster-randomised implementation in Guangdong or Guangxi with registry follow-up.
Maturity
being tested at scale
Who has to act
policy
Cost to try
Medium ($1M to $50M)
Years to first evidence
6
Bottlenecks it attacks

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