**6. Conclusions and future directions**

Due to the hidden location of NPC, it is difficult to diagnose early. Strengthening the publicity of NPC prevention and control, popularizing basic knowledge of it, and making residents cooperate with screening projects will be way helpful to improve the accuracy of early diagnosis rate of NPC. At present, the above screening methods have positive significance, but they also have limitations regrettably. How to make better use of their advantages and disadvantages to carry out local screening schemes in different regions is worthy to further exploration. And developing faster, simpler, higher true-positive rate and lower false-positive rate screening methods and more effective treatment were important ways to improve the survival rate and life quality of NPC patients.

Currently, there are few reports from randomized controlled trials (RCT) and controlled clinical trials (CCT) to determine the efficacy of screening for NPC or the cost-effectiveness of a screening strategy. Future studies with long-term follow-up need to systematically assess the impact of the screening methods in mortality, assess their ability to detect NPC, evaluate the impact on quality of life and cost-effectiveness.
