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Are nasal polyps associated with future risk of head and neck cancer?

Published online: July 3, 2019

Nasal polyps are a common condition affecting about 3% of general adult populations. This condition is mostly benign in pathologic nature but poses substantial impacts on life for refractory nasal symptoms and frequent co-existence with difficult-to-treat asthma. However, it is unknown whether nasal polyps are associated with future risk of head and neck cancer. Previous small studies suggested their possible associations, but as overall incidence of head and neck cancer is much lower than that of nasal polyps, a large-scale longitudinal cohort study is warranted.

In an original article recently published in The Journal of Allergy & Clinical Immunology (JACI), Kim and colleagues examined risks of head and neck cancer incidence in a nationwide population-based longitudinal retrospective cohort in Korea. They linked two large national health databases to obtain comprehensive information on disease diagnosis and health behaviors including smoking pack-years from 453,892 nasal polyp patients and 4,583,938 matched comparators. The subjects were followed up for about 6 years (range: 2-13 years).

As expected, absolute cancer incidence was very low even in patients with nasal polyps (with annual incidence rates about less than 3 cancer cases per 100,000 person-year). However, the authors found significantly higher risks of nasal cavity and paranasal sinus (NCPS) and nasopharyngeal cancers among patients with nasal polyps compared to the matched comparators. The risk was about seven times higher for NCPS cancer. Their associations were independent of confounders including smoking history. The cancer risks were evident in older patients (≥ 50 years) but not in younger patients.

There has been a broad perception, based on clinical experiences among experts, that nasal polyps are not related with future risk of cancer. The authors’ findings do not strongly dispute this as absolute number of the cancer incidence is still very low, but they carefully challenge the paradigm as the relative risks were significantly elevated. They suggest that future risk of NCPS or nasopharyngeal cancer might need to be considered when nasal polyps are found in older adults.

The Journal of Allergy and Clinical Immunology (JACI) is an official scientific journal of the AAAAI, and is the most-cited journal in the field of allergy and clinical immunology.

Graphical Abstract