In a comparative study of populations at high and low risk of nasopharyngeal carcinoma (NPC), sera from 442 Eskimo and 770 Danish children and adolescents were tested for the presence of antibodies against Epstein-Barr virus (EBV). Eskimo children in Greenland were seropositive at an early age and showed significantly higher titers of IgG antibody to the viral capsid antigen (VCA) (p less than 0.0001) and soluble (S) antigen (p less than 0.005) than Danes matched for age and sex, but had similar levels of IgA antibody to VCA and IgG antibody to the early antigen (EA). The high geometric mean VCA (IgG) titers found in certain age groups of Eskimo children were as high as those previously reported from areas in Africa highly endemic for Burkitt's lymphoma. In Greenland, neither location nor household size was a determining factor for prevalence or titer of VCA (IgG). The high antibody titers among Eskimo children probably reflect exposure to a large inoculum of EBV at the time of primary infection, infection early in life and/or re-exposure due to the higher incidence of EBV infection in Greenland. In view of the high incidence of NPC in Greenland and the known association of this tumor with EBV, we speculate that the time and quantitative aspects of the primary infection are also factors of relevance in the etiology of NPC.

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Greenland Eskimos have one of the highest incidences of nasopharyngeal carcinoma (NPC) in the world. Asian and African areas endemic for NPC show early infection with Epstein-Barr virus (EBV), and few cases of infectious mononucleosis (IM). Among 40 000 Eskimos and 10 000 Caucasians in Greenland there were 82 reported cases of IM from 1963 to 1980. Incidence rates from 1975 to 1980, age adjusted to the "world" population distribution, were 12.0 and 5.2/100 000/yr for males and females, respectively. Comparable Danish data revealed incidence rates of 97.4 and 105.1. From 1970 to 1981 Greenland hospital records verified 16 cases, of which only 2 were in Eskimos. The IM incidence in Eskimos is extremely low, and Danes living in Greenland have a comparatively much higher incidence.

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