Chronic rhinosinusitis and the risk of nasopharyngeal cancer in a Taiwanese health study

Background: Although epidemiological and laboratory studies report that chronic inflammatory conditions contribute to the pathogenesis of cancer, it remains controversial whether chronic rhinosinusitis (CRS) results in nasopharyngeal cancer (NPC). Methods: Retrospective cohort study was performed from the National Health Insurance (NHI) Taiwan database. This study prospectively examined whether CRS or nasal polyposis is associated with NPC risk in the NHI, a population-based cohort of 231,490 Taiwan Chinese individuals with a mean age of 32 years, recruited between 2000 and 2006. We collected information from the Longitudinal Health Insurance Database. Each subject completed an interview including questions about medical conditions, and the NPC occurrence and survival statuses were determined by linkage to population-based NHI registries in Taiwan. In addition, each NPC and CRS subject had completed an interview on medical condition to confirm their diagnosis. Results: After adjustment for age, sex, hypertension, diabetes mellitus, allergic rhinitis, otitis media, coronary artery disease, pharyngitis, and tonsillitis, individuals with rhinosinusitis were found to have a 3.55-fold increased risk of developing NPC compared with individuals without rhinosinusitis (hazard ratio = 3.55; 95% CI = 2.22-5.69). The same results were also observed when the study subjects were analyzed without comorbidities. Conclusion: Adult patients with rhinosinusitis should be followed up with regard to the nasopharynx for at least 3 years, particularly repeat sinusitis patients.