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The nasopharynx, located behind the nose, includes two openings that lead to the ears. Nasopharyngeal cancer is much more common in Asia, especially southeast China, the Mediterranean region, and Africa than in the US. Nasopharynx cancer is less commonly associated with tobacco and alcohol use than other head and neck cancers. Risk factors for this type of cancer include a diet high in salt-cured fish and infection with Epstein-Barr virus, a member of the herpesvirus family and one of the most common human viruses. The most common sign of nasopharyngeal cancer is a lump in the neck, caused by the spread of cancer to the lymph nodes. Other symptoms may include nasal congestion, pain or ringing in the ears, a persistent sore throat, or frequent nosebleeds.