Sinusitis is a common condition in which the sinuses become inflamed, causing symptoms such as nasal congestion, facial pressure and thick nasal discharge. The condition is considered chronic if it lasts 12 weeks or longer.
All three of the cancers linked with chronic sinusitis are rare, and they include nasopharyngeal cancer (cancer of an area in the upper part of the throat behind the nose), human papillomavirus-related oropharyngeal cancer (which occurs in an area in the middle of the throat, behind the mouth), and nasal cavity and paranasal sinus cavity cancers (the nasal cavity is the space behind the nose where air passes on its way to the throat, and paranasal refers to the spaces in the bones around the nose).
"It`s important for people to recognize that these cancers are rare, so this added risk is very small in absolute terms," said study author Dr. Eric Engels, a senior investigator of cancer epidemiology and genetics at the National Cancer Institute in Bethesda, Maryland. The risk of head and neck cancer was 37 percent higher in older adults with chronic sinusitis, compared with people without the condition. In their paper, the researchers called the risk of head and neck cancer "modestly elevated" among individuals with prior chronic sinusitis, compared with people without the condition.
The findings also suggested that an older person`s increased risk of head and neck cancers was mainly seen within the first year of being diagnosed with chronic sinusitis. Beyond this one-year period, the link between chronic sinusitis and these cancers weakened, according to the findings, published today (Sept. 8) in the journal JAMA Otolaryngology - Head & Neck Surgery. [Infographic: Colds, Allergies or Sinusitis? Here`s How You Can Tell]
The findings may shed light on the role that chronic inflammation may play in the development of cancer, the researchers said. Chronic inflammation is the body`s way of responding to certain infections or reacting to chronic irritants, such as tobacco smoke, Engels said. Over time, this inflammation can also damage healthy cells, which could promote the development of cancer, he added.
But some people with chronic sinusitis may have a mild underlying immune deficiency, which could predispose them to some cancers, Engels said.
Sinusitis-related inflammation and/or a weakened immune response may play, at most, a minor role in the development of certain head and neck cancers, the researchers said. It`s not exactly clear how inflammation or weakened immunity may contribute to these cancers.
And there are also several other reasons why the increased risk of head and neck cancer appears to be elevated in the first year following a diagnosis of chronic sinusitis, the researchers said. In the people in the study who developed these cancers, the cancers had probably been present for a long time, Engels said. It might be that the cancer triggered the development of sinusitis, or it`s possible that doctors may have misdiagnosed these patients with sinusitis when the symptoms were actually caused by a head and neck cancer, he said.
In addition, people with chronic sinusitis may be more likely than people without the condition to get a detailed medical evaluation of their head and neck, which might uncover a cancer that was already present, Engels told Live Science. [Top 10 Cancer-Fighting Foods]
Sinusitis-cancer connection
In the study, the researchers looked at about 484,000 Medicare beneficiaries in the U.S. who received medical care between 2004 and 2011. They analyzed information from a database that links claims from this government health insurance program for older Americans to 18 cancer registries throughout the country.
The study found that about 19,000 older adults were diagnosed with chronic sinusitis, and among these individuals, 783 were found to also have a head and neck cancer.
The most important risk factors for head and neck cancers are smoking and chewing-tobacco use, heavy alcohol use and prior infection with the human papillomavirus (HPV), according to the American Cancer Society.
The findings suggest that the vast majority of older people affected by chronic sinusitis will not develop a head or neck cancer, Engels said.
One of the limitations of the study is that the researchers looked only at people ages 65 and over. They did not look at cancers in younger people, which may be more directly linked with sinus inflammation or immunodeficiency, according to an editorial about the new findings published in the same journal.
In the editorial, Dr. Elisabeth Ference and Dr. Jeffrey Suh, both from the Department of Head and Neck Surgery at the University of California, Los Angeles, said future studies are needed to evaluate whether inflammation in people with sinusitis contributes to cancer development over time, especially in middle-age adults.
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