Nasal polyps and future risk of head and neck cancer: A nationwide population-based cohort study

• Published in: Journal of allergy and clinical immunology Vol. 144; no. 4; pp. 1004 - 1010.e4
• Main Authors: Kim, Hyun Jung, Ahn, Hyeong Sik, Kang, Taeuk, Bachert, Claus, Song, Woo-Jung
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01-10-2019; Elsevier Limited
• Subjects: Age; Allergic rhinitis; Asthma; Blood pressure; cancer risk; Cohort analysis; Comorbidity; Head & neck cancer; head and neck cancer; Health insurance; Health risks; Heterogeneity; Incidence; Larynx; Medical screening; Medicin och hälsovetenskap; Mortality; Nasal polyps; nasopharyngeal neoplasms; Nose; Paranasal sinus; paranasal sinus neoplasms; Polyps; Population; Population studies; Population-based studies; Quality of life; Rhinitis; Sensitivity analysis; Sinus; Throat cancer; paranasal sinus neoplasms; ICD-10; head and neck cancer; cancer risk; IRR; NHS; SSI; HR; Nasal polyps; NCPS; NHI; nasopharyngeal neoplasms
• ISSN: 0091-6749; 1097-6825; 1097-6825
• DOI: 10.1016/j.jaci.2019.06.024

Nasal polyps are a common condition with a significant effect on quality of life. The association between nasal polyps and future risk of head and neck cancer is unknown.
We sought to investigate the relative risk of nasal cavity and paranasal sinus (NCPS) and nasopharyngeal cancers in a nationwide, population-based, longitudinal retrospective cohort of patients with nasal polyps and matched comparators.
The 2005-2017 National Health Insurance claims and National Health Screening program databases were used to construct a cohort of patients with nasal polyps and matched comparators in Korea. The relative risk of NCPS and nasopharyngeal cancer in patients with nasal polyps was examined.
The study consisted of 453,892 patients with nasal polyps and 4,583,938 matched comparators. The mean duration of follow-up was 6.2 years (range, 2-13 years). The incidence rate ratios of patients with nasal polyps compared with the comparators was 7.00 (95% CI, 5.28-9.25) for NCPS cancer and 1.78 (95% CI, 1.28-2.42) for nasopharyngeal cancer. Increased risks of these cancers were only evident in older subjects (age ≥50 years). There were trends toward weaker associations of nasal polyps with these cancers in younger subjects with comorbid asthma or allergic rhinitis (<50 years).
Although the absolute cancer incidence is very low, the relative risk of NCPS or nasopharyngeal cancers was significantly greater in older patients with nasal polyps. Given the regional and pathologic heterogeneity of nasal polyps, further studies are needed to explore the underlying mechanisms and validate the relationships.
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