Epstein Barr virus antibody and cancer risk in two prospective cohorts in Southern China
Mingfang Ji, Yong‐Qiao He, Minzhong Tang, Wen‐Qiong Xue, Yu Xia, Hua Diao, Da-Wei Yang, Zhi‐Ming Mai, Io Hong Cheong, Zhi-Yang Zhao, Biaohua Wu, Fugui Li, Jiyun Zhan, Changling Huang, Haitao Ma, Jun Li, yuanfei li, Tongmin Wang, Ying Liao, Xue‐Yin Chen, Zhiheng Liang, Shifeng Lian, Yun Du, Xuejun Liang, Zisis Kozlakidis, Jun Ma, Wei‐Hua Jia
Abstract
Epstein-Barr virus (EBV) has been implicated in several human cancers, but its broader cancer risk remains unclear. We investigated the association between EBV VCA-IgA antibody levels and cancer risk in two large prospective cohorts from Southern China, comprising 73,939 adults. During around 8-10 years follow-up, 964 and 1026 incident cancer cases were identified in the Zhongshan and Wuzhou cohorts. VCA-IgA seropositivity was associated with higher age-standardized incidence rates for total cancer significantly. In pooled analyses, VCA-IgA seropositive individuals had higher risks of total cancer (HR 4.88, 95% CI: 2.84-8.37), lung cancer (1.76, 1.23-2.54), liver cancer (1.70, 1.10-2.63), nasopharyngeal carcinoma (26.05, 11.77-57.65), and lymphoma (3.20, 1.46-6.99) compared to seronegative individuals. The associations showed an increased dose-response pattern, and keep persistent even up to ten years prior to diagnosis. The population-attributable risk percentage for total cancer due to VCA-IgA seropositivity is estimated at 7.8%. These findings provide prospective evidence that EBV seropositivity is associated with increased risks of multiple cancers. This association results in a heightened attributed cancer burden in Southern China.