Why is nasopharyngeal cancer so common in Singapore?

NPC is much more common in Singapore than in Western countries because of its strong link to people of Southern Chinese ancestry, who make up a large share of the population. The causes combine genetics, the Epstein-Barr virus, and historically high consumption of salted and preserved foods. Rates have been falling as diets and exposures change.

What is the earliest and most common sign of NPC?

The most common presenting sign is a painless lump in the neck, caused by a swollen lymph node. Other early clues include blood-stained saliva or nasal discharge, a persistently blocked nose, and a blocked ear, ringing or hearing loss on one side. Any of these lasting more than a couple of weeks should be checked by a doctor.

Does eating salted fish cause nose cancer?

Frequent consumption of salted fish and other salted or preserved foods, especially from a young age, is one recognised risk factor for NPC, as these foods contain nitrosamines. It is not the only cause - genetics and the Epstein-Barr virus also play major roles - but reducing these foods is a sensible, modifiable step.

Why are one-sided ear symptoms a warning sign?

A tumour in the nasopharynx can block the Eustachian tube on one side, causing a blocked ear, ringing or hearing loss in that single ear, often with fluid behind the eardrum. Persistent one-sided ear symptoms - especially with a neck lump or blood-stained saliva - should be assessed promptly by an ENT specialist.

Is nasopharyngeal cancer curable?

Yes, especially when caught early. NPC is very sensitive to radiotherapy, which is the main treatment, often combined with chemotherapy for more advanced disease. Outcomes are significantly better the earlier it is found, which is why acting on persistent neck, nose or one-sided ear symptoms is so important.

Nasopharyngeal Cancer (NPC) in Singapore: Symptoms, Causes & Treatment

Written & reviewed by the BestDoctors.sg editorial team · Last updated 2 Jul 2026 · General information, not medical advice

Quick answer. Nasopharyngeal cancer (NPC, sometimes called ‘Cantonese cancer’ or nose cancer) is notably common in Singapore, especially among Chinese men of Southern Chinese descent. It is linked to the Epstein-Barr virus (EBV), genetics and a diet high in salted and preserved foods. Key warning signs are a painless lump in the neck, blood-stained saliva or nosebleeds, a blocked nose or ear, and hearing loss or ringing in one ear. Because the nasopharynx sits hidden behind the nose, NPC is often found late, so early checks matter. The main treatment is radiotherapy, often with chemotherapy, and NPC responds well to radiation, especially when caught early.

Nasopharyngeal cancer (NPC), also known as nose cancer or historically ‘Cantonese cancer’, arises in the nasopharynx – the space behind the nose and above the throat. It is far more common in Singapore than in most Western countries, with a particular concentration among Chinese men of Southern Chinese ancestry. It also tends to affect a relatively younger age group than many other cancers.

Because the nasopharynx is hidden from view, early symptoms are easy to dismiss, and many cases are found at a later stage. The encouraging news is that NPC is very sensitive to radiotherapy and is highly treatable when caught early. This guide explains the causes, the warning signs to act on, and how NPC is diagnosed and treated. It is general information and not a substitute for medical advice.

At a glance

Nasopharyngeal cancer (NPC) at a glance (Singapore)
Aspect	Detail	Note
Who is affected	More common in Chinese men of Southern Chinese descent	Can affect a younger age group than many cancers
Main causes	Epstein-Barr virus (EBV), genetics, salted/preserved foods	Risk is a combination of factors
Key red flags	Painless neck lump, blood-stained saliva/nosebleed, one-sided blocked/ringing ear	One-sided ear or nose symptoms are an important clue
Treatment	Radiotherapy, often with chemotherapy	NPC is very radiosensitive; early detection improves outcomes

What is NPC and how common is it in Singapore?

Nasopharyngeal cancer develops in the lining of the nasopharynx, the passage behind the nose connecting to the throat. Singapore has one of the higher rates of NPC in the world. It is among the more common cancers in men here, predominantly affecting the Chinese community – particularly those of Southern Chinese descent (such as Cantonese, Teochew and Hokkien dialect groups) – and affects more men than women. Unlike many cancers, NPC notably affects some younger and middle-aged adults, which is one reason awareness matters.

Causes and risk factors

NPC results from a combination of factors rather than a single cause:

Epstein-Barr virus (EBV) – a very common virus strongly associated with NPC
Ethnicity and genetics – higher incidence in people of Southern Chinese ancestry and those with a family history
Diet – frequent consumption of salted fish and salted/preserved foods (high in nitrosamines), especially from a young age
Smoking and other environmental exposures

Most people with EBV never develop NPC, and you cannot change your ancestry – but reducing salted and preserved foods is a sensible, modifiable step, and rates have fallen as diets have changed.

Symptoms and red flags: why one-sided signs matter

NPC symptoms can be subtle and are easy to mistake for a cold or ear infection. See a doctor – ideally an ENT specialist – if you have, especially on one side or lasting more than a couple of weeks:

A painless lump in the neck (a swollen lymph node) – this is the most common presenting sign
Blood-stained saliva or sputum, or blood-stained nasal discharge / nosebleeds
A blocked or stuffy nose that does not clear up
A persistent blocked ear, ringing (tinnitus) or hearing loss, often on one side
Headache, facial pain or numbness, or double vision (in more advanced cases)

A painless neck lump or one-sided ear and nose symptoms that persist should never be ignored. Getting these checked early is the single most useful thing you can do.

Why early detection matters

Because the nasopharynx sits out of sight, NPC is often diagnosed at a later stage, when a neck lump has already appeared. Yet early-stage NPC is highly treatable, and outcomes are significantly better the earlier it is found. This is why the persistent symptoms above – particularly a one-sided blocked ear, blood-stained saliva or a painless neck lump – deserve prompt attention rather than a wait-and-see approach. There is no national population screening programme for NPC, so symptom awareness and acting early are key.

How NPC is diagnosed

If NPC is suspected, an ENT specialist may carry out:

Nasoendoscopy – a thin flexible camera passed through the nose to inspect the nasopharynx
Biopsy – taking a small tissue sample to confirm the diagnosis
Imaging (MRI and/or CT) of the head, neck and lymph nodes to assess extent
Blood tests, including EBV-related markers in some cases

These tests together confirm the diagnosis and the stage, which guides treatment.

Treatment: NPC responds well to radiotherapy

A key and hopeful fact about NPC is that it is very sensitive to radiotherapy, which is the mainstay of treatment:

Radiotherapy alone is often used for early-stage NPC
Chemoradiation (radiotherapy combined with chemotherapy) is standard for more advanced disease and improves outcomes
Chemotherapy may also be given before or after, and immunotherapy is an emerging option being studied in Singapore for recurrent or advanced cases
Surgery is generally reserved for cancer that comes back after radiotherapy

Treatment is planned by a multidisciplinary team, and because NPC is so radiosensitive, many patients – especially those diagnosed early – have good outcomes.

Related guides

Best Oncology Clinics in Singapore — our editorial shortlist
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Colorectal (bowel) cancer
Prostate cancer
Lung cancer

Sources

Last updated 22 June 2026. Prices are typical market ranges gathered from the cited sources and vary by clinic, doctor and individual case — they are not quotes. This guide is general information, not medical advice; always consult a qualified, MOH-accredited doctor before any treatment.

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