Risks and causes of nasopharyngeal cancer

Nasopharyngeal cancer is rare in the UK. Smoking certain substances and a history of Epstein-Barr virus (EBV) are some of the risks and causes of nasopharyngeal cancer.

There are some other risk factors that can increase your risk of developing nasopharyngeal cancer.

What is a risk factor?

Anything that can increase your risk of getting a disease is called a risk factor.

Different cancers have different risk factors.­ Having one or more of these risk factors doesn't mean you will definitely get that cancer.

Nasopharyngeal cancer is rare in the UK. It is more common in men than women.

Epstein Barr virus

You can’t catch cancer, but some viruses can increase the risk of developing cancer.

Epstein Barr virus (EBV) is a very common virus that can increase the risk of nasopharyngeal cancer. Most people carry EBV and it does them no harm. It doesn’t normally cause any symptoms or problems. But, in rare cases, the infection will go on to cause cancer. This virus is linked to other cancers including Hodgkin lymphoma.

EBV can cause genetic changes in cells that make them more likely to become cancerous in the future. In the UK, 80 out of 100 cases of nasopharyngeal cancer (80%) are caused by EBV. But many people will be infected with EBV and not develop cancer.

Smoking

People who smoke or used to smoke are at an increased risk of nasopharyngeal cancer. In the UK, 25 out of 100 cases of nasopharyngeal cancer (25%) are caused by smoking. People who smoke more heavily and over a longer time have a higher risk.

Diet

Nasopharyngeal cancer is more common in parts of Asia and Northern Africa than it is in Europe. Diets high in salted fish are more common in some of these places. These foods can be very high in nitrates and nitrites. These can react with proteins to form nitrosamines.

The International Agency for Research on Cancer (IARC) lists eating salted fish (Chinese style) as a cause of nasopharyngeal cancer. It has higher amounts of nitrosamines than other types of salted fish. Some nitrosamines may increase the risk of cancer if people are exposed to high levels over a long time.

Inherited risk

The risk of nasopharyngeal cancer is higher in people who have a close relative who has had it. This increased risk might be due to inherited genes as well as environmental and lifestyle factors.

Occupational risk

People exposed to wood dust through their work have an increased risk of nasopharyngeal cancer. We don’t know exactly how it increases cancer risk. It could be from breathing in chemicals from treated wood.

People exposed to formaldehyde also have a small increased risk of nasopharyngeal cancer. Formaldehyde is an industrial chemical used to make other chemicals and building materials. Less than 1 out of 100 cases of nasopharyngeal cancer in Great Britain (less than 1%) is linked to exposure to formaldehyde at work.

Factors where there isn't clear evidence

Human papilloma virus (HPV) may be a risk factor for developing nasopharyngeal cancer. This means some researchers think this might be a risk factor, but more evidence is needed to be sure.

Other possible causes

There are often stories about potential causes in the media. It isn’t always clear which ideas are supported by evidence. There might be things you have heard of that we haven’t included here. This is because either there is no evidence about them or it is less clear.

More information on risk factors for head and neck cancer

We have more detailed information about head and neck cancer risks and causes.

Reducing your risk

There are ways you can reduce your risk of cancer.

  • Head and Neck Cancers risk
    Statistical Information Team at Cancer Research UK, accessed May 2024 

  • Cigarette smoking and the risk of nasopharyngeal carcinoma: a meta-analysis of epidemiological studies

    Mengjuan Long and others

    BMJ Open, 2017. Volume 7, Issue 10

  • ESMO–EURACAN Clinical Practice Guideline update for nasopharyngeal carcinoma: adjuvant therapy and first-line treatment of recurrent/metastatic disease

    P. Bossi and others

    Annals of Oncology, 2023. Volume 34, Issue 3

  • Nasopharyngeal cancer

    H Kang and J Chan,

    BMJ Best Practice, Accessed  March 2024 

  • The information on this page is based on literature searches and specialist checking. We used many references and there are too many to list here. If you need additional references for this information please contact patientinformation@cancer.org.uk with details of the particular risk or cause you are interested in.

Last reviewed: 
21 May 2024
Next review due: 
21 May 2027

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