The distinctive racial/ethnic and geographic distribution of NPC worldwide suggests that both environmental factors and genetic traits contribute to its development. Well-established risk factors for NPC include elevated antibody titers against the EBV, circulating EBV DNA, consumption of salt-preserved fish, and a family history of NPC. Consumption of other preserved foods, tobacco smoking, a history of chronic respiratory tract conditions, and certain HLA genotypes may be associated with elevated NPC risk, whereas consumption of fresh fruits and vegetables and other HLA genotypes may be associated with decreased risk. Evidence for a causal role of various inhalants, herbal medicines, and occupational exposures is inconsistent. Other than dietary modification, no concrete preventive measures for NPC exist. Comprehending how viral, genetic, and environmental factors interact to cause NPC will illuminate the pathways by which this malignancy develops, as well as how it may be prevented.
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