Risk Factors for Nasal Cavity and Paranasal Sinus Cancers

A risk factor is anything that increases your chances of getting a disease like cancer. Different cancers have different risk factors. Some risk factors, like smoking, can be changed. Others, like a person’s age or family history, can’t be changed.

But risk factors don’t tell us everything. Having a risk factor, or even several, does not mean that you will get the disease. Many people with risk factors never develop these cancers, while people with these cancers may have few or no known risk factors.

Researchers have found a few risk factors that make a person more likely to develop nasal cavity (nose) and paranasal sinus cancer. Most of these are exposures to inhaled substances in the workplace.Other risk factors are similar to those for other cancers in the head and neck area, such as smoking.

Workplace exposures

People who work in certain jobs are more likely to develop nasal cavity and paranasal sinus cancers. The increased risk seems to be related to breathing in certain substances while at work, such as:

  • Wood dusts from carpentry (such as furniture and cabinet builders), sawmills, and other wood-related industries
  • Dusts from textiles (textile plants)
  • Leather dusts (shoemaking)
  • Flour (baking and flour milling)
  • Nickel and chromium dust
  • Mustard gas (a poison used in chemical warfare)
  • Radium (a radioactive element rarely used today)

These workplace exposures have less clear links to nasal and paranasal sinus cancer:

Smoking

Smoking increases the risk of nasal cavity cancer, specifically the squamous cell type.

Human papillomavirus (HPV) infection

The human papillomavirus (HPV) is a group of over 200 related viruses. They are called papilloma viruses because some of them cause a type of benign (not cancer) growth called a papilloma, more commonly known as a wart.

But infection with certain high-risk  types of HPV can cause some forms of cancers, including cancers of the cervix, vagina, anus, vulva, penis, mouth, and throat. HPV has been found in some cancers of the nasal cavity and paranasal sinuses, but because these cancers are rare, more research is needed to show that HPV infection causes them.

Gender

Cancers of the nasal cavity and paranasal sinuses are about 2 times more common in men than women.

Age

About 80% (8 out of 10 people) of people diagnosed with cancer of the nasal cavity or paranasal sinus are older than 55 years of age.   

Race

Cancers of the nasal cavity and paranasal sinuses are much more common among White people than Black people.

Hereditary retinoblastoma treatment

People with the hereditary form of retinoblastoma, a type of eye cancer that typically develops in children, have an increased risk of nasal cavity cancer if the retinoblastoma was treated with radiation.

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Banuchi V, Mallen J, Kraus D. Cancers of the nose, sinus, and skull base. Surg Oncol Clin N Am. 2015;24(3):563-577. 

Bossi P, Farina D, Gatta G, et al. Paranasal sinus cancer. Crit Rev Oncol Hematol. 2016;98:45-61. 

Castellsagué X, Alemany L, Quer M, et al. HPV Involvement in Head and Neck Cancers: Comprehensive Assessment of Biomarkers in 3680 Patients. J Natl Cancer Inst. 2016;108(6):djv403. Published 2016 Jan 28. doi:10.1093/jnci/djv403.

Dutta R, Dubal PM, Svider PF, Liu JK, Baredes S, Eloy JA. Sinonasal malignancies: A population-based analysis of site-specific incidence and survival. Laryngoscope. 2015;125(11):2491-2497. doi:10.1002/lary.25465.

Kılıç S, Kılıç SS, Kim ES, et al. Significance of human papillomavirus positivity in sinonasal squamous cell carcinoma. Int Forum Allergy Rhinol. 2017;7(10):980-989. 

Leeman JE, Katabi N, Wong, RJ, Lee NY, Romesser PB. Chapter 65 - Cancer of the Head and Neck. In: Niederhuber JE, Armitage JO, Doroshow JH, Kastan MB, Tepper JE, eds. Abeloff’s Clinical Oncology. 6th ed. Philadelphia, Pa: Elsevier; 2020.

Marees T, Moll AC, Imhof SM, et al. Risk of second malignancies in survivors of retinoblastoma: More than 40 years of follow-up. J Natl Cancer Inst. 2008;100:1771–1779.

Mendenhall WM, Dziegielewski PT, and Pfister DG. Chapter 45- Cancer of the Head and Neck. In: DeVita VT, Lawrence TS, Rosenberg SA, eds. DeVita, Hellman, and Rosenberg’s Cancer: Principles and Practice of Oncology. 11th ed. Philadelphia, Pa: Lippincott Williams & Wilkins; 2019.

National Cancer Institute. Paranasal Sinus and Nasal Cavity Cancer Treatment (PDQ)–Patient Version. November 06, 2016. Accessed at www.cancer.gov/types/head-and-neck/patient/paranasal-sinus-treatment-pdq on November 10, 2020.

Sanghvi S, Khan MN, Patel NR, Yeldandi S, Baredes S, Eloy JA. Epidemiology of sinonasal squamous cell carcinoma: a comprehensive analysis of 4994 patients. Laryngoscope. 2014;124(1):76-83. doi:10.1002/lary.24264.

Thompson LDR, Franchi A. New tumor entities in the 4th edition of the World Health Organization classification of head and neck tumors: Nasal cavity, paranasal sinuses and skull base. Virchows Arch. 2018;472(3):315-330. doi:10.1007/s00428-017-2116-0.

Turner JH, Reh DD. Incidence and survival in patients with sinonasal cancer: a historical analysis of population-based data. Head Neck. 2012;34(6):877-885. doi:10.1002/hed.21830.

Youlden DR, Cramb SM, Peters S, et al. International comparisons of the incidence and mortality of sinonasal cancer. Cancer Epidemiol. 2013;37(6):770-779. doi:10.1016/j.canep.2013.09.014.

References

Banuchi V, Mallen J, Kraus D. Cancers of the nose, sinus, and skull base. Surg Oncol Clin N Am. 2015;24(3):563-577. 

Bossi P, Farina D, Gatta G, et al. Paranasal sinus cancer. Crit Rev Oncol Hematol. 2016;98:45-61. 

Castellsagué X, Alemany L, Quer M, et al. HPV Involvement in Head and Neck Cancers: Comprehensive Assessment of Biomarkers in 3680 Patients. J Natl Cancer Inst. 2016;108(6):djv403. Published 2016 Jan 28. doi:10.1093/jnci/djv403.

Dutta R, Dubal PM, Svider PF, Liu JK, Baredes S, Eloy JA. Sinonasal malignancies: A population-based analysis of site-specific incidence and survival. Laryngoscope. 2015;125(11):2491-2497. doi:10.1002/lary.25465.

Kılıç S, Kılıç SS, Kim ES, et al. Significance of human papillomavirus positivity in sinonasal squamous cell carcinoma. Int Forum Allergy Rhinol. 2017;7(10):980-989. 

Leeman JE, Katabi N, Wong, RJ, Lee NY, Romesser PB. Chapter 65 - Cancer of the Head and Neck. In: Niederhuber JE, Armitage JO, Doroshow JH, Kastan MB, Tepper JE, eds. Abeloff’s Clinical Oncology. 6th ed. Philadelphia, Pa: Elsevier; 2020.

Marees T, Moll AC, Imhof SM, et al. Risk of second malignancies in survivors of retinoblastoma: More than 40 years of follow-up. J Natl Cancer Inst. 2008;100:1771–1779.

Mendenhall WM, Dziegielewski PT, and Pfister DG. Chapter 45- Cancer of the Head and Neck. In: DeVita VT, Lawrence TS, Rosenberg SA, eds. DeVita, Hellman, and Rosenberg’s Cancer: Principles and Practice of Oncology. 11th ed. Philadelphia, Pa: Lippincott Williams & Wilkins; 2019.

National Cancer Institute. Paranasal Sinus and Nasal Cavity Cancer Treatment (PDQ)–Patient Version. November 06, 2016. Accessed at www.cancer.gov/types/head-and-neck/patient/paranasal-sinus-treatment-pdq on November 10, 2020.

Sanghvi S, Khan MN, Patel NR, Yeldandi S, Baredes S, Eloy JA. Epidemiology of sinonasal squamous cell carcinoma: a comprehensive analysis of 4994 patients. Laryngoscope. 2014;124(1):76-83. doi:10.1002/lary.24264.

Thompson LDR, Franchi A. New tumor entities in the 4th edition of the World Health Organization classification of head and neck tumors: Nasal cavity, paranasal sinuses and skull base. Virchows Arch. 2018;472(3):315-330. doi:10.1007/s00428-017-2116-0.

Turner JH, Reh DD. Incidence and survival in patients with sinonasal cancer: a historical analysis of population-based data. Head Neck. 2012;34(6):877-885. doi:10.1002/hed.21830.

Youlden DR, Cramb SM, Peters S, et al. International comparisons of the incidence and mortality of sinonasal cancer. Cancer Epidemiol. 2013;37(6):770-779. doi:10.1016/j.canep.2013.09.014.

Last Revised: April 19, 2021

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