0
We're unable to sign you in at this time. Please try again in a few minutes.
Retry
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
Retry
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
Invited Commentary |

Can Chronic Sinusitis Cause Cancer? ONLINE FIRST

Elisabeth H. Ference, MD, MPH1; Jeffrey D. Suh, MD1
[+] Author Affiliations
1Department of Head and Neck Surgery, University of California–Los Angeles
JAMA Otolaryngol Head Neck Surg. Published online September 08, 2016. doi:10.1001/jamaoto.2016.2649
Text Size: A A A
Published online

Extract

Can the inflammation associated with chronic rhinosinusitis (CRS) contribute to the development of head and neck cancer, especially nasal cavity or paranasal sinus cancer? Or is any association between CRS due to reverse causation because nasal and sinus cancer can present initially with sinusitis symptoms?

Inflammatory insults in other areas of the body have a well-established etiologic link with malignancy. For example, gastroesophageal reflux disease may lead to Barrett metaplasia and esophageal cancer, and ulcerative colitis has been associated with colon cancer. The infiltration of immune cells into tissues may lead to the production of small molecules, such as cytokines, chemokines, and growth factors, which promote carcinogenesis and allow tumor cells to evade host immune response.1 High levels of proinflammatory cytokines are known to play a role in the development of head and neck squamous cell carcinoma,2 but a possible pathway between inflammation associated with CRS and the development and progression of cancer is still being elucidated. For example, interleukin 6 (IL-6) is known to be an important proinflammatory cytokine expressed during CRS.3 Recent studies have showed that Epstein-Barr virus (EBV)-infected nasopharyngeal epithelial cells often acquire an enhanced response to IL-6–induced signal transduction and transcription activation to promote their growth and invasive properties.4 Therefore, a cytokine receptor–mediated mechanism may be involved in the relation between inflammation and nasopharyngeal cancer (NPC).5 Moreover, oxidative stress increases during CRS, and genes involved in nitric oxide and reactive oxygen species regulation are altered, which may lead to DNA damage and decrease in the local immune response, which also favor tumorigenesis.6

Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

First Page Preview

View Large
First page PDF preview

Figures

Tables

References

Correspondence

CME
Also Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Please click the checkbox indicating that you have read the full article in order to submit your answers.
Your answers have been saved for later.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.

Multimedia

Some tools below are only available to our subscribers or users with an online account.

184 Views
0 Citations
×

Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

Related Content

Customize your page view by dragging & repositioning the boxes below.

See Also...
Articles Related By Topic
Related Collections
PubMed Articles
Jobs
JAMAevidence.com

The Rational Clinical Examination: Evidence-Based Clinical Diagnosis
Breast Cancer

The Rational Clinical Examination: Evidence-Based Clinical Diagnosis
Cancer, Family History

brightcove.createExperiences();