Nested case-control study on the risk of nasopharyngeal carcinoma in the high background radiation areas of Yangjiang, China

Objective: To identify the major determinants of nasopharyngeal carcinoma (NPC) in the high-background radiation areas (HBRA) in Yangjiang, China. Methods: A nested case-control study was conducted based on 106517 subjects. 98 cases that died of NPC were detected during a follow-up program for 9 years. Univariate analysis and multivariate non-conditional logistic regression were used to analyze associations between the exposure factors and NPC. Results: Multivariate conditional logistic regression analysis revealed that education levels, salted fish intake, the history of chronic rhinitis and the family history of NPC were independent risk factors of NPC. Tobacco smoking and alcohol consumption were not significantly related to NPC risk. The ORs of NPC risk comparing HBRA and a nearby control area before and after adjustment for the major risk determinants identified in the present study was 0.86 and 0.87, respectively. Conclusion: Salted fish intake was a strong risk factor of NPC. Education, the history of chronic rhinitis and the family history of NPC were also related to NPC risk. The exposure to high background radiation in HBRA of Yangjiang was not related to NPC risk with or without the adjustment for those major risk determinants of NPC