Closing the Screening Gap: A Perspective on Nasopharyngeal Carcinoma in First-Degree Relatives in North Sumatra, Indonesia

Farhat, Farhat; Ming, Lim Chwee; Lubis, Inke Nadia Diniyanti; Yudhistira, Ashri; Chrestella, Jessy; Daulay, Elvita Rahmi; Syari, Raudah Putri

doi:10.31557/APJCP.2026.27.10.3513

Closing the Screening Gap: A Perspective on Nasopharyngeal Carcinoma in First-Degree Relatives in North Sumatra, Indonesia

Document Type : Perspective

Authors

¹ Department of Ear, Nose & Throat, Head & Neck Surgery, Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia.

² Department of Otolaryngology – Head and Neck Surgery, Singapore General Hospital, Singapore.

³ Department of Paediatrics, Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia.

⁴ Department of Anatomy Pathology, Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia.

⁵ Department of Radiology, Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia.

⁶ Biomedical Sciences, Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia.

10.31557/APJCP.2026.27.10.3513

Abstract

Objective: Indonesia ranks second in the world in NPC incidence and mortality after China. Screening high-risk populations, particularly first-degree relatives of patients, is important to reduce NPC morbidity and mortality. However, gaps in cancer screening remain in Indonesia, including in North Sumatra. Although NPC is a malignant disease with a clear geographic distribution and evidence of an association between NPC incidence and ethnicity, there have been no studies on NPC screening and its application to first-degree relatives in North Sumatra. Methods: This perspective reviews factors influencing the limitations of NPC screening, including suboptimal screening methods, patient and healthcare professional awareness and knowledge regarding NPC, and a suboptimal cancer registry. Results: Given the evident ethnic influence on NPC, it is important to explore the unique genetic and environmental interactions within each ethnic group or region to determine appropriate screening methods. In high-risk regions like North Sumatra, more studies on risk-based screening, outreach to increase awareness and knowledge among patients and healthcare workers, and support for health policies are needed to reduce NPC morbidity and mortality. Conclusion: A future direction for this improvement is the implementation of a national screening program, as has been implemented in China.

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