Risk factors for nasopharyngeal cancer

A risk factor is something that increases the risk of developing cancer. It could be a behaviour, substance or condition. Most cancers are the result of many risk factors. The most important risk factor for developing nasopharyngeal cancer is Southeast Asian or Chinese ancestry, particularly Cantonese ancestry.

Nasopharyngeal cancer is more common in men than women. The risk for this cancer increases with age. The highest rate of nasopharyngeal cancer is in people older than 50 years of age. Having a low socio-economic status is also linked with a higher risk.

Risk factors are generally listed in order from most to least important. But in most cases, it is impossible to rank them with absolute certainty.

Risk factors

Ancestry and where you live

Eating salt-cured fish and meat

Epstein-Barr virus

Smoking tobacco


Wood dust

There is convincing evidence that the following factors increase your risk for nasopharyngeal cancer.

Ancestry and where you live

The highest rates of nasopharyngeal cancer in the world are in Hong Kong, southern China and Southeast Asia. In North America, nasopharyngeal cancer rates are highest among the Inuit.

People of Southeast Asian and Chinese ancestry, particularly Cantonese ancestry, have high rates of nasopharyngeal cancer. Rates of this cancer are also high in second-generation people with these ancestries who have moved to areas where the rate of nasopharyngeal cancer is low.

Nasopharyngeal cancer is rare in Caucasians. The rate of this cancer is higher in Caucasians born in areas where the rate is high, such as in China.

Eating salt-cured fish and meat

Salt-cure fish and meats are made by coating them with dry salt or by putting them in a salt solution. A diet high in salt-cured fish, meat or both is common in Southeast Asia, Southern China and northern Africa. It is also common among Inuit people in the Alaskan and Canadian Arctic.

Rates of nasopharyngeal cancer are high in areas where eating salt-cured foods, especially Chinese-style salted fish, is very common. People who were fed salt-cured fish when they were children, especially when they were weaning, also have a higher risk of developing nasopharyngeal cancer.

Epstein-Barr virus

Epstein-Barr virus (EBV) is a type of herpes virus that causes infectious mononucleosis (a very contagious disease that causes fever, fatigue, malaise and sore throat). Infection with EBV usually occurs in childhood. Most people develop only mild or no symptoms. Many people diagnosed with nasopharyngeal cancer have a high level of antibodies to EBV in their blood.

Although many people with nasopharyngeal cancer have an EBV infection, not all people with an EBV infection develop nasopharyngeal cancer. EBV may cause nasopharyngeal cancer in people who also have other risk factors, such as ancestry or diet.

Find out more about Epstein-Barr virus (EBV).

Smoking tobacco

Smoking tobacco increases your risk of nasopharyngeal cancer. The risk increases with the amount and length of time you smoke.


Breathing in formaldehyde at work increases the risk of nasopharyngeal cancer. The longer you come into contact with formaldehyde, the greater your risk for developing the disease.

Wood dust

Breathing in wood dust at work increases the risk of nasopharyngeal cancer. The longer you come into contact with wood dust, the greater your risk.

Possible risk factors

A diet low in vegetables and fruit is a possible risk factor for nasopharyngeal cancer. This means that it has been linked with nasopharyngeal cancer, but there is not enough evidence to show for sure that it is a risk factor.

Questions to ask your healthcare team

To make the decisions that are right for you, ask your healthcare team questions about risks.

Expert review and references

  • Hu K, Chan A, Costantino P, Harrison L . Cancer of the nasopharynx: General principles and management. Harrison LB, Sessions RB, Kies MS (eds.). Head and Neck Cancer: A Multidisciplinary Approach. 4th ed. Philadelphia: Wolters Kluwer/Lippincott Williams & Wilkins; 2014: 22A: 588 - 617.
  • International Agency for Research on Cancer (IARC). Volume 100C: Arsenic, metals, fibres and dusts: a review of human carcinogens. 2012: http://monographs.iarc.fr/ENG/Monographs/vol100C/mono100C.pdf.
  • International Agency for Research on Cancer (IARC). Volume 100E: Personal Habits and Indoor Combustions. 2012: http://monographs.iarc.fr/ENG/Monographs/vol100E/mono100E.pdf.
  • International Agency for Research on Cancer (IARC). Volume 100F: Chemical Agents and Related Occupations: A Review of Human Carcinogens. 2012: http://monographs.iarc.fr/ENG/Monographs/vol100F/index.php.
  • Mayne, S. T., Morse, D.E. & Winn, D.M . Cancers of the oral cavity and pharynx. Schottenfeld, D. & Fraumeni, J. F. Jr. (Eds.). Cancer Epidemiology and Prevention. 3rd ed. New York: Oxford University Press; 2006: 35:674-693.
  • Mendenhall WM, Werning JW, Pfister DG . Cancer of the head and neck. DeVita VT Jr, Lawrence TS, & Rosenberg SA. Cancer: Principles and Practice of Oncology. 10th ed. Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins; 2015: 38: 422-473.
  • National Toxicology Program . 14th Report on Carcinogens . Department of Health and Human Services ; 2016 .
  • Ng WT, Ngan RKC, Chan SH, et al . Management of nasopharyngeal carcinoma. Bernier J (ed.). Head and Neck Cancer: Multimodality Management. Springer; 2016: 26: 445 - 473.

Reducing your risk for nasopharyngeal cancer

Ways of reducing your risk for nasopharyngeal cancer include limiting intake of salted fish or pickled food and not smoking tobacco. Learn how to lower your risk of developing nasopharyngeal cancer.

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