Abstract
Although it is known that inflammatory processes elevate the risk of cancer, to date the association between chronic tonsillitis and tonsil cancer remains unknown. This study aimed to evaluate the association of chronic tonsillitis with tonsil cancer based on a population-based database in Taiwan. We retrieved data for this study from the Longitudinal Health Insurance Database 2005. This case-control study included 489 patients with tonsil cancer and 2445 matched controls. We used conditional logistic regression analyses to calculate the odds ratio (OR) and corresponding 95% confidence interval (CI) for having been previously diagnosed with chronic tonsillitis between patients with tonsil cancer and the controls. We found that of the 2934 sampled patients, 22 (0.75%) had received a diagnosis of chronic tonsillitis. A Chi-squared test further revealed that there was a significant difference in the prevalences of prior chronic tonsillitis between tonsil cancer patients and controls (2.45% vs. 0.41%, p<0.001). The conditional logistic regression suggested that after adjusting for hypertension, diabetes, hyperlipidemia, obesity, tobacco use disorder, and alcohol abuse/alcohol dependency syndrome, the OR of having previously been diagnosed with chronic tonsillitis for patients with tonsil cancer was 8.07 (95% CI: 3.32∼19.64; p<0.001) compared to controls. It is also noteworthy that alcohol abuse/alcohol dependency syndrome was significantly associated with TC (adjusted OR=9.88). We demonstrated that patients with chronic tonsillitis were more likely to have tonsil cancer, and our findings support tonsillitis as a possible risk factor for tonsil cancer.
Highlights
The global incidence of lip, oral cavity, and pharyngeal cancers was reported to be 529,500 in 2012, corresponding to 3.8% of all cancer cases, and it is predicted to rise by 62% to 856,000 cases by 2035 because of changes in demographics [1]
It is noteworthy that alcohol abuse/alcohol dependency syndrome was significantly associated with tonsil cancer (TC)
We demonstrated that patients with chronic tonsillitis were more likely to have tonsil cancer, and our findings support tonsillitis as a possible risk factor for tonsil cancer
Summary
The global incidence of lip, oral cavity, and pharyngeal cancers was reported to be 529,500 in 2012, corresponding to 3.8% of all cancer cases, and it is predicted to rise by 62% to 856,000 cases by 2035 because of changes in demographics [1]. The incidence of oropharyngeal cancers, including tonsil cancer (TC), is increasing in the United States, while the incidence of oral cavity cancers has declined [2, 3]. This change in disease patterns has generated interest in understanding the etiology and pathogenesis of www.impactjournals.com/oncotarget the development of oropharyngeal cancers. Most of the emphasis has been on the human papillomavirus (HPV), and it was found that increases in the population-level incidence of oropharyngeal cancers in the United States since 1984 were caused by HPV infection [4]. The phenomenon is supported by our previous studies regarding associations between the development of nasopharyngeal carcinoma and surrounding inflammatory conditions [7, 8]
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