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Risk factors for nasal cavity and paranasal sinus cancers
A risk factor is something that increases the risk of developing cancer. It could be a behaviour, substance or condition. Most cancers are the result of many risk factors. But most people who get nasal cavity and paranasal sinus cancer do not have any of the known risk factors.
Nasal cavity and paranasal sinus cancer is not common. It is seen more often in older people. Most cases of nasal cavity and paranasal sinus cancer occur in people older than 40 years of age. And more men than women develop it, probably because men have higher rates of exposure at work.
The following are risk factors for nasal cavity and paranasal sinus cancer. Risk factors are generally listed in order from most to least important. But in most cases, it is impossible to rank them with absolute certainty.
|Known risk factors||Possible risk factors|
Known risk factors
There is convincing evidence that the following factors increase your risk for nasal cavity and paranasal sinus cancer.
Being exposed at work to wood dust is an important risk factor for developing nasal cavity and paranasal sinus cancer, especially adenocarcinomas. Exposure to hardwood dust increases the risk more than exposure to softwood dust. The risk is high in industries like furniture and cabinet making, sawmill works and carpentry.
People working in shoe and boot manufacturing have an increased risk of developing nasal cavity and paranasal sinus cancer, especially when they are exposed to leather dust.
Smoking tobacco increases the risk of developing nasal cavity and paranasal sinus cancer. Some studies have shown that second-hand smoke is also linked to an increase in risk but other studies have not shown this link.
Being exposed at work to dust or chemicals from certain nickel compounds (nickel sulphides and oxides) in the nickel-refining industry increases the risk of nasal cavity and paranasal sinus cancer.
Studies show that workers exposed to the strong acid process and chemicals used to make isopropyl alcohol (rubbing alcohol) have an increased risk of nasal cavity and paranasal sinus cancer.
Studies of workers who paint glow-in-the dark watch dials, which contain radium-226, report an increased risk of paranasal sinus cancer.
Infection with the Epstein-Barr virus (EBV)Epstein-Barr virus (EBV)A type of herpes virus that causes mononucleosis (a highly infectious disease that causes fever, fatigue, malaise and sore throat). can cause a rare form of non-Hodgkin lymphoma (NHL) called extranodal NK/T-cell lymphoma, nasal type. This form of NHL can affect the nasal passages and paranasal sinuses.
A nasal papilloma is a non-cancerous growth on the lining of the nasal cavity or paranasal sinus. Some types of papillomas called inverted papillomas may develop into cancer. A small number (up to 10%) of inverted papillomas may develop into an invasive cancer of the nasal cavity or paranasal sinus. Inverted papillomas, which are linked to the human papillomavirus (HPV), may have a higher chance of developing into cancer than papillomas that are not linked to HPV.
Possible risk factors
The following factors have been linked with nasal cavity and paranasal sinus cancer, but there is not enough evidence to show they are known risk factors. Further study is needed to clarify the role of these factors for nasal cavity and paranasal sinus cancer.
A few studies have reported that infection with the human papillomavirus (HPV) is associated with some nasal cavity and paranasal sinus cancers. Inverted papillomas often contain HPV and these have a small chance of changing into a cancerous tumour. But it’s hard to know for sure the role of HPV in this type of cancer because this cancer is very uncommon.
There is limited evidence linking formaldehyde to an increased risk of sinonasal cancer, which includes nasal cavity and paranasal sinus cancer. But it is hard to know for sure if formaldehyde alone increases the risk because people who work with formaldehyde also often work with wood dust, so it may be a co-factor.
Some limited evidence suggests that exposure at work to dust or fumes containing chromium (chromium VI, or hexavalent chromium) increases the risk of developing nasal cavity and paranasal sinus cancer. Workers may be exposed during the production and use of compounds that contain chromium and during welding of metals that contain chromium.
There is limited evidence that people working in the textile industry may be at an increased risk of developing nasal cavity and paranasal sinus cancer. This is because workers are exposed to textile dust during manufacturing.
RetinoblastomaRetinoblastomaA cancerous (malignant) tumour that starts in the retina (the membrane at the back of the eye). is an eye cancer that develops in children. Children with the hereditary form of retinoblastoma have an increased risk of developing second cancers. Treating retinoblastoma with radiation therapy may increase the risk of developing nasal cavity and paranasal sinus cancer later on.
There is an increased risk of respiratory tract cancer in people who produced mustard gas during the Second World War.
Unknown risk factors
It isn’t known whether or not the following factors are linked with nasal cavity and paranasal sinus cancer. It may be that researchers can’t show a definite link or that studies have had different results. Further study is needed to see if the following are risk factors for nasal cavity and paranasal sinus cancer:
- exposure at work to baking and flour dust
- being exposed at work to untreated or mildly treated mineral oils
- nasal and sinus conditions, like chronic inflammation, chronic sinus infection (sinusitis) and nasal polyps
- thorium dioxide (Thorotrast), a radioactive solution that was used as an x-ray contrast mediumcontrast mediumA substance used in some diagnostic procedures to help parts of the body show up better on x-rays or other imaging tests. from the 1930s to the 1950s
- snuff use (a type of smokeless tobacco)
Questions to ask your healthcare team
To make the decisions that are right for you, ask your healthcare team questions about risks.
Thanks to the incredible progress in retinoblastoma research made possible by Canadian Cancer Society funding, my son won’t have to go through what I did.
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