Case‐control study evaluating the homogeneity and heterogeneity of risk factors between sinonasal and nasopharyngeal cancers

Abstract

Sinonasal cancer and nasopharyngeal cancer may share some risk factors because both are located within the upper aerodigestive tract. They may also have different etiological profiles because of anatomic or pathologic differences. However, the similarities and differences in risk factors have rarely been studied within the same population. We assessed the risk factor profiles of sinonasal and nasopharyngeal cancers, using data from a case-control study. The 2 case groups consisted of men aged 31-59 and diagnosed pathologically with sinonasal cancer (n‫)07؍‬ and nasopharyngeal cancer (n‫,)311؍‬ respectively. Controls were men without these cancers and selected from the same areas (n‫.)0191؍‬ Logistic regression analysis showed that smoking was a risk factor for both sinonasal [odds ratio (OR)‫,5.2؍‬ 95% confidence interval (CI) 1.1-5.4] and nasopharyngeal cancer (OR‫,8.1؍‬ 95%CI 1.1-3.0). However, ever use of barbiturates without a prescription (OR‫,9.4؍‬ 95%CI 1.7-13.8), working with or around cutting oils on a job (OR‫,9.1؍‬ 95%CI 1.1-3.1) and ever having had sinus infections (OR‫,3.2؍‬ 95%CI 1.1-4.6) were associated with nasopharyngeal cancer only. Having received blood products other than a transfusion (OR‫,1.9؍‬ 95%CI 2.2-37.4) and exposure to a pesticide containing 2,4,5-T (OR‫,9.5؍‬ 95%CI 1.5-23.7) were related to sinonasal cancer only. When data analyses were confined to squamous cell type, smoking and exposure to chlorophenols were related to squamous cell tumors at both sites. However, use of barbiturates and sinus problems other than infection only increased the risk of nasopharyngeal carcinoma. Our study suggests that except for smoking and chlorophenol exposure, which are associated with both sites, the risk factor profiles may differ between sinonasal and nasopharyngeal cancers. © 2002 Wiley-Liss, Inc. Key words: case-control studies; nasopharyngeal cancer; risk factors; sinonasal cancer; smokingContiguous sites within a system may be prone to the effect of the same risk factors for cancer because of their common exposures. However, the sites within a system usually differ in anatomical or histologic features and therefore may have different susceptibility to different etiological factors, resulting in different risk factor profiles. Sinonasal cancer (malignancies of the sinus or nasal cavities) and nasopharyngeal cancer (malignancies of the nasopharynx) may share some risk factors because both are located within the upper aerodigestive tract. They may also possess different epidemiological and etiological profiles because of anatomic or pathologic differences. It is known that sinonasal cancer occurs more frequently in individuals in their 60s and in some areas in Japan, France, India and South Africa, 1 while nasopharyngeal cancer is more frequent in Southern China and some African tribes and incidence rates reach a peak during adolescence or during ages 45-55. 2,3 Studies in different regions and different populations have identified distinct risk-factor profiles for sinonasal and nasopharyngeal ...

The Enigmatic Epidemiology of Nasopharyngeal Carcinoma

“…Three studies reported an excess risk of NPC among printing workers (200,203,239), but did not identify specific inks, solvents, or other substances that could be responsible for the association. Although an excess risk of NPC has been observed among agricultural workers (38,186,232), studies assessing overall use of pesticides found no association with NPC risk (141,177,181,200).…”

“…The majority of casecontrol studies examining cigarette smoking and risk of NPC in a variety of populations reported an increased risk of 2-to 6-fold (9,39,40,73,142,(172)(173)(174)(175)(176)(177)(178)(179)(180)(181), establishing tobacco smoke as a consensus risk factor for NPC (182), although some studies found no association (24,38,74,137,141,148,154,(183)(184)(185)(186). Reports of a positive association between domestic exposure to secondhand smoke and risk of NPC (40,146,180) are likewise countered by studies with null findings (39,174).…”

“…Several studies, with some exceptions (180,205,229), found that risk of NPC was elevated among wood workers and other individuals potentially exposed to wood dust, with positive dose-response trends corresponding to longer duration and higher average or cumulative exposure (38,40,186,199,(230)(231)(232)(233)(234)(235). Chronic airway stimulation and inflammation, reduced mucociliary clearance, and epithelial cell changes following deposition of wood dust particles in the nasopharynx may promote the development of NPC (229); exposure to wood solvents and preservatives, such as chlorophenols, may also be involved (179,181,231). In three studies from China, textile workers, who typically have heavy exposure to cotton dust, were at significantly increased NPC risk (186,200,236), which could be attributable to irritation and inflammation of the nasopharynx, either directly or via bacterial endotoxins in cotton dust (237).…”

Prevalence of occupational hazards in patients with different types of epithelial sinonasal cancers

“…Occupational factors are responsible for a huge proportion of epithelial SNC besides other established congenital or acquired risk factors such as previous radiotherapy in the region and tobacco smoking (9) , chromosomal and genetically determined alterations (10,11) , inverted papilloma (12) .…”

Results of Anterior Skull Base Surgery in Pediatric and Young Adult Patients

“…Pediatric and young adult patients lack the typical risk factors for sinonasal malignancies. 5 Young patients are also less likely to have significant comorbidities. So there remains a paucity of data to guide clinical decision making in young patients, particularly with respect to surgical management.…”