Abstract: To evaluate the long-term effects of screening nasopharyngeal carcinoma ( NPC ) with Epstein–Barr viral ( EBV ) serological antibody tests by comparing the long-term survival rates of NPC participants and nonparticipants in a mass screening in Sihui City. Methods: The target population ( 17,786 ), with an age range of 30 to 59 years, from Didou and Jianggu Towns of Sihui City, the high-risk area, were invited to participate in a NPC mass screening in 1992. Serological tests were performed with IgA antibodies against the EBV capsid antigen ( VCA/IgA ) and the early antigen ( EA/IgA ). All subjects ( 17,786 ) were divided into two groups, namely, the participants (10, 665) and the nonparticipants ( 7, 121 ) based on the population screening. The follow-up ended in December 2007, recording the incidence and deaths from NPC. A log-rank test was conducted to compare the long-term survival rates of the NPC patients between the two groups. Results: The 10-year overall survival rate of NPCs among participants and nonparticipants was 38% and 18%, respectively ( χ2 = 4.408, P = 0.036 ). The rate of early diagnosis for NPCs was 55.1% and 31% in the two groups, respectively ( χ2 = 4.727, P = 0.03 ). The former is apparently superior to the latter. Conclusions: Screening for NPC using EBV serological antibody tests as the first line of screening in high-risk area of southern China can improve the long-term survival rate of patients. Screening can improve the early diagnosis rate in the participants, which is critical for longer survival rates of NPC patients.