Risks and causes of nasal and sinus cancers

Cancer of the nasal cavity and sinuses is rare.  Only about 450 cases are diagnosed in the UK each year.  Compared with around 40,000 cases of bowel cancer diagnosed each year, you can see how rare it is.

We do know that a few things can increase your risk, including

• Smoking
• Exposure to some chemicals
• Radiotherapy for hereditary retinoblastoma

Smoking

Smoking tobacco (cigarettes, cigars and pipes) increases your risk of nasal cavity cancer. If you smoke regularly you are at a higher than average risk of developing this type of cancer.

Cigarettes contain nitrosamines and other chemicals that cause cancer. When you smoke, the smoke may pass through your nasal cavity on its way to your lungs. Your risk increases the longer you smoke. If you smoke a lot, you increase your risk even more. If you give up smoking, your risk gradually falls.

Remember - cancers of the nasal cavity are quite rare, even in people who smoke. But if you do smoke, you are much more likely to develop a head and neck cancer than someone who doesn’t.

There is more about cancer risk and smoking on the Cancer Research UK website.

Exposure to some chemicals

Through your job, you could be exposed to harmful chemicals that can increase the risk of nasal cavity and paranasal sinus cancers. If you have been regularly exposed to wood dust over some years, you may be at an increased risk of adenocarcinomas of the nasal cavity and paranasal sinuses. There is a range of chemicals in treated wood, and we don’t know which ones are responsible for the increased risk. Other substances that have been linked to nasal cavity and paranasal sinus cancer in some studies include

• Leather dust
• Nickel
• Chromium dust
• Formaldehyde - an industrial chemical used to make other chemicals, building materials, and household products

If these irritants are around you, you are likely to breathe in and swallow small amounts. Chemicals in these substances can irritate the lining of your nose, mouth, throat and larynx (voice box).

Radiotherapy for hereditary retinoblastoma

A long term follow up study has shown a greatly increased risk of nasal cancer in people treated with radiotherapy for hereditary retinoblastoma. There is no increased risk if the retinoblastoma was not hereditary.

There are also possible risk factors. This means some researchers suspect they may be risk factors, but there isn’t enough evidence to be sure. These include

• Benign nose conditions
• Human papilloma virus (HPV)
• Passive smoking
• Work exposure to asbestos and textile dust
• Previous non Hodgkin's lymphoma

Benign nose conditions

Some studies have shown an increased risk of nasal and sinus cancer in people with a history of sinus or nose problems. However, it is possible these conditions are an early sign of nasal and sinus cancer rather than increasing the risk of developing the cancer. A few studies show an increased risk of nasal and sinus cancer in people with a history of nasal polyps.

Human Papilloma Virus (HPV)

HPV is a common virus that can cause small growths or warts. There are lots of different strains of HPV and some are high risk for other types of cancer, such as cervical cancer. There is evidence that HPV is involved in the development of some types of nasal polyps. A small proportion of these growths will develop into cancers. There isn’t enough evidence at the moment to say whether HPV infection is a direct cause of nasal and sinus cancer or not.

Passive smoking

Although smokers are at increased risk of developing nasal and sinus cancer, as yet there is limited evidence that passive smoking increases the risk of getting these cancers.

Work exposure to asbestos or textile dust

The fibres in asbestos are known to cause cancer if they reach the lung. A large study shows that risk of nasal cancer is also increased in men exposed to asbestos through their work. Some studies show an increased risk of nasal cancer in women exposed to cloth fibres (textiles) through their work.

Previous non Hodgkin's lymphoma

One large study has shown that people who have had non Hodgkin's lymphoma have roughly double the risk of nasal cavity cancer of the general population.

Cancers of the nasal cavity and paranasal sinuses are rare. People often worry that they are at a higher risk of cancer because someone in their family has it. This may be true of some types of cancers, but is not true for nasal cavity and paranasal sinus cancers. We don’t know exactly what causes most of these types of cancers.