Unmasking the Hidden Cancer Risk in Chronic Rhinosinusitis: Systematic Review and Meta-Analysis

Abstract

Chronic rhinosinusitis (CRS) has a complicated, multifaceted etiology. It is distinguished by inflammation of the nasal and sinus mucosa. We aim to investigate the association between CRS and various malignancies, as well as their underlying mechanisms. We included published studies in five electronic databases using a specific term related to CRS and cancer. All peer-reviewed studies published in any language, irrespective of participant age or sex, were eligible for inclusion. Relative risks (RRs) with 95% confidence intervals (CIs) were estimated using the meta package in R software (version 2023.03.1 + 446). Heterogeneity was assessed using the I-squared score. Fifteen studies (seven case-control and eight cohort studies) were included in the final analysis. The history of CRS was significantly more frequent among patients with nasopharyngeal carcinoma (NPC) (RR = 2.60, 95% CI: 1.56–4.35; p = 0.0003) and sinonasal cancer (RR = 2.42, 95% CI: 1.23–4.75; p = 0.01) than among controls. Compared with people without CRS, patients with CRS had significantly higher risks of head and neck cancer (RR = 1.32, 95% CI: 1.03–1.69; p = 0.03), NPC (RR = 2.15, 95% CI: 1.34–3.43; p = 0.001), lung cancer (RR = 1.32, 95% CI: 1.07–1.63; p = 0.01), thyroid cancer (RR = 1.29, 95% CI: 1.08–1.53; p = 0.005), and bladder cancer (RR = 1.39, 95% CI: 1.12–1.73; p = 0.003). No statistically significant associations were observed for colorectal, liver, or gastric cancers. This meta-analysis found observational associations between CRS and several malignancies, including NPC, sinonasal, thyroid, lung, and bladder cancers. The findings should be interpreted with caution because of potential heterogeneity, detection bias, and residual confounding.