Does chronic rhinosinusitis increase the risk of lung cancer? A population cohort study

Background and Aims: Chronic rhinosinusitis is one of the most common chronic inflammatory diseases of the upper airway. A previous study of chronic rhinosinusitis and the risks of lung cancer was based on a self-reported questionnaire concerning rhinosinusitis. Population-based cohort studies of the correlation between chronic rhinosinusitis and the adenocarcinoma subtype of lung cancer have been limited. Objectives: In the present study, we used a population-based database to investigate the risks related to the adenocarcinoma subtype of lung cancer among patients with chronic rhinosinusitis. Methods: We identified 13 072 patients who were diagnosed with chronic rhinosinusitis in 1998–2010 as the exposure group. There were 52 288 randomly selected patients as the comparison cohort. We used data from the Taiwan National Health Insurance Research Database; the Taiwan National Health Insurance programme offers health-care services to 99% of the 23 million people residing in Taiwan. We compared the incidence of the adenocarcinoma subtype of lung cancer between the two cohorts. The cumulative incidence and hazard ratios of developing the adenocarcinoma subtype of lung cancer were calculated. Results: This study included 13 072 participants with chronic rhinosinusitis and 52 288 participants with non-chronic rhinosinusitis. The risk of the adenocarcinoma subtype of lung cancer was higher in the chronic rhinosinusitis cohort than in the non-chronic rhinosinusitis cohort, with an adjusted hazard ratio of 3.52 after controlling for age and gender. Conclusion: This large population-based cohort study demonstrated that patients in Taiwan with previous chronic rhinosinusitis are at greater risk of developing the adenocarcinoma subtype of lung cancer.