Department of Preventive Medicine, College of Medicine, Korea University, Seoul, Korea.
National Health Insurance Policy Research Institute, Seoul, Korea.
J Allergy Clin Immunol. 2019 Oct;144(4):1004-1010.e4. doi: 10.1016/j.jaci.2019.06.024. Epub 2019 Jul 3.
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.
鼻息肉是一种常见疾病，对生活质量有重大影响。鼻息肉与头颈部癌症未来风险之间的关联尚不清楚。
我们旨在通过一项全国性、基于人群的、纵向回顾性队列研究，调查鼻息肉患者与匹配对照者鼻腔和副鼻窦（NCPS）及鼻咽癌症的相对风险。
利用 2005-2017 年国家健康保险索赔和国家健康筛查计划数据库，构建了韩国鼻息肉患者和匹配对照者的队列。检查了鼻息肉患者 NCPS 和鼻咽癌症的相对风险。
本研究共纳入 453892 例鼻息肉患者和 4583938 例匹配对照者。平均随访时间为 6.2 年（范围 2-13 年）。与对照组相比，鼻息肉患者的发病率比为 NCPS 癌症 7.00（95%CI，5.28-9.25），鼻咽癌症 1.78（95%CI，1.28-2.42）。这些癌症的风险增加仅在年龄较大的患者（年龄≥50 岁）中明显。在年龄较小（<50 岁）且合并哮喘或过敏性鼻炎的患者中，鼻息肉与这些癌症的关联趋势较弱。
尽管绝对癌症发病率非常低，但年龄较大的鼻息肉患者发生 NCPS 或鼻咽癌症的相对风险显著增加。鉴于鼻息肉的区域性和病理异质性，需要进一步研究以探索潜在机制并验证这些关系。
