0169 Sinonasal cancers: is intestinal type adenocarcinoma the only related to occupational exposures? Results from an Italian case-control study

OBJECTIVES: Epithelial sinonasal cancers (SNC) are rare, severe diseases associated to the exposure to several well-established carcinogens (IARC). The etiologic role of these carcinogens in different histological subtypes is still disputed, with several studies focusing on intestinal-type adenocarcinoma (ITAC) as the most (and maybe the only) occupational-related subtype. To assess the role of occupational exposures in SNC aetiology we designed a case control study, in which occupational exposures prevalence in two group of ITAC cases and non-ITAC were compared to controls. METHOD: In a large Italian hospital we enrolled 50 consecutive surgical non-ITAC cases (mainly squamous-cell carcinoma), 50 consecutives ITAC cases and 50 non-neoplastic patients (controls). Previous occupational exposures to wood and leather dust, solvents, metals, formaldehyde were investigated through a standardised interview. Gender, age, residence area and smoking were collected as potential confounders. Multivariate logistic regression was applied. RESULTS: Considering all tumours together, we observed large increased risks for wood exposure (OR=6.9, 95% CI=3.0-16.3) and leather (prevalence 24% in tumours, 0% among controls) only. Compared to controls, we observed an increased risk for wood exposure [OR=7.7 (95% CI=2.6-22.5)] in ITAC cases, but not in non-ITAC cases [OR=0.8 (95% CI=0.2-3.1)]. Prevalence of leather exposure was 42% among ITAC and 6% in non-ITAC. CONCLUSIONS: Our case control study confirmed that ITAC cases but not other histotypes were strongly related to occupational exposures, and in particular to leather and wood dusts. Grouping together all SNC types reduce the causal role of occupation exposures. Larger samples size are needed to investigate other work-related carcinogens.