Table 2.

Comparison of modalities for NPC screening and early diagnosis.

Screening Procedure	Swab Cytology	Serological Test	Circulating EBV-DNA	Cell Free DNA Methylation	Nasopharyngeal Endoscopy
Benefits	Easy sampling	Most popular methods	Higher sensitivity and specificity	Higher sensitivity and specificity	Higher positive predictive value of approximately 90%
	Quick detection	Possible combination of multiple antibody types	Higher positive predictive value but still <20%	Higher positive predictive value of approximately 90%	Combination of deep learning model improve accuracy
				Applicable for EBV negative NPC	Applicable for EBV negative NPC
Drawbacks	Influenced by sample quality, physician’s skill, cytologist’s skill	Low level of positive predictive value (10%)	Influenced by laboratory skill	More advanced technique required	Large scale screening is not possible
			Not globally standardized	Lack of large-scale study	Higher cost
			Higher cost