Aetiology

♦ Genetic susceptibility—major histocompatability complex profile, H2, BW46, B17 antigens

♦ Dietary-salty fish—contain nitrosamines

♦ Chinese herbal medicine contains esters—tumour promoters, reactivate EBV infection

♦ Lack of dietary vitamin C

♦ EBV infection—reactivated 18-60 months before detectable tumour

♦ EBV copies inside malignant cells

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