Objective Sino-nasal cancer (SNC) is a rare and potentially fatal disease with a high occupational attributable fraction, being wood, leather dust, metals and solvents well recognised carcinogenic agents. The importance of occupational exposure varies across different histological subtypes and is disputed for tumors different from adenocarcinoma (AC). We quantified the etiological role of occupational exposure in a large hospital based cohort.
Methods We systematically evaluate 100 consecutive SNC cases after surgical treatment in Varese Hospital (Feb-2010/Oct-2012) through a standardised and validated questionnaire developed with the National Registry for SNC cases.
Results We evaluated 62 AC, 22 squamous-cell-carcinoma, 16 other (29% women). Mean age at diagnosis was 63. Aprevious occupational exposure was recognised for 59% of cases. The proportion of occupational cases was sensibly higher for AC (83%) than for all other histotypes (19%). For AC the recognized risk factors in the great majority of cases were leather and wood dusts (46% both).
Conversely, for others histotypes different and less common exposures, such as chromium and formaldehyde, resulted more important. In particular we recognised 3 professional cases previously in the photolithographic industry. Mean latency period, 50 years (min 20-max 72), and mean duration of exposure = 26y (min 4-max 54) were similar across histotypes.
Conclusions Occupational exposure plays a key role in the etiopathogenesis of SNC, not only for AC (with wood and leather dust that confirmed their impact in term of public health) but also for other histotypes with formaldehyde and chromium as important and often misrecognised occupational factors.
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