1. CAREX Canada at http://www.carexcanada.ca
Sinonasal cancers in Ontario reflect smoking and occupational exposures
Rates of sinonasal cancers are decreasing, likely due to declines in cases of smoking-related squamous cell carcinomas.
Rates of adenocarcinomas do not show a similar decline; this may be attributed to a number of occupational exposures.
Sinonasal cancers are rare cancers of the nasal cavities and surrounding sinuses. Squamous cell carcinomas are the most common subtype, while adenocarcinomas and other forms are rarer.1 Between 1981 and 2007 there were 1,973 cases (1,154 or 58% in men and 819 or 42% in women) of sinonasal cancer in Ontario. Over half (51%) of cases were squamous cell carcinomas, 15% of cases were adenocarcinomas, and the remaining cases were other subtypes or unspecified.
During this time period, overall rates of sinonasal cancers decreased by an average of 0.8% per year. This decrease is primarily due to changes in rates of squamous cell carcinomas, which decreased by an average of 1.6% per year. Adenocarcinomas were stable between 1981 and 1996, and began to decline thereafter. Other subtypes and unspecified sinonasal cancers were stable throughout this period.
Risk factors for sinonasal cancers include smoking, particularly for squamous cell carcinoma, drinking alcohol and eating smoked foods.1,2 Occupational risk factors are also important, particularly for adenocarcinomas.3,4 These include exposure to dusts from wood (e.g., through manufacturing of wood products) or leather (e.g., through shoe manufacturing and repair), and exposure to nickel or chromium dusts and fumes (e.g., through refining and welding).1,2,3
Decreases in rates of overall sinonasal cancers and squamous cell carcinomas are likely due to reductions in smoking. Rates of adenocarcinomas did not decline in the same way, suggesting that occupational risk factors such as wood dust exposure may be important causal factors. In an analysis of measurements of wood dust exposure levels in Ontario workplaces from 1981 to 1996, 72% exceeded current occupational standards.5
The Occupational Cancer Research Centre continues to work to identify workplace-related causes of sinonasal cancers. Ongoing analyses will compare incidence of subtypes of sinonasal cancer between provinces in Canada and internationally because the prevalence of occupational risk factors varies by region.
For more information on occupational exposure to wood dust and other carcinogens, see:
CAREX Canada at
Occupational Cancer Research Centre at
References
Littman AJ, Vaughan TL. Cancers of the Nasal Cavity and Paranasal Sinuses. In: Schottenfeld D, Fraumeni JF, Jr., eds. Cancer Epidemiology and Prevention, 3rd Edition. New York City: Oxford University Press; 2006:603–19.
Straif K, Baan R, Secretan B et al. Special Report: Policy. A review of human carcinogens-PartC: metals, arsenic, dusts, and fibres. Lancet Oncology 2010;10:453–4.
‘t Mannetje A, Kogevinas M, Luce D, Demers PA, Bégin D, Bolm-Audorf U, Colin D, Comba P, Gérin M, Hardell L, Hayes R, Leclerc A, Magnani C, Merler E, Tobías A, Boffetta P. Sino-nasal cancer, occupation, and tobacco smoking in European women and men. Am J Ind Med 1999;36(1):101–7.
Demers PA, Kogevinas M, Boffetta P, et al. Wood Dust and Sinonasal Cancer - Pooled Reanalysis of 12 Case-Control Studies. Am J Ind Med 1995;28:151–66.
Arrandale V, Hall A, Peters C, Demers PA. Historical Exposure to Wood Dust in Ontario from 1981–1996. Occupational Cancer Research Centre Research Day Toronto, Ontario. Available at
Citation: Cancer Care Ontario. Cancer Fact: Sinonasal cancers in Ontario reflect smoking and occupational exposures. May 2011.
Available at
Prepared by staff in the Occupational Cancer Research Centre in Prevention and Cancer Control.