Nasal sinus cancer registry of the province of Brescia

Sinonasal cancers (SNC) are neoplasm uncommon; although strictly related to occupational risk factors, in the Brescia province the professional SNC was unknown to the Occupational Health Service until short time ago. During the first nineties, a retrospective study has carried out to detect SNC and it has showed several occupational SNC cases. A local SNC population based Register was subsequently set up in 1994, covering 1,044,544 inhabitants. Between 1981 and 2000 104 SNC, occurred to 74 men and 30 women, have been collected; 98% of them was histologically diagnosed and 87.4% was of epithelial type. 36% of cases is located on maxillary sinus and the 31.7% on the ethmoidal sinus; 43% is the squamous cell carcinoma and 13.7% is the intestinal adenocarcinoma. The annual standardised incidence rates (on the Italian population, census 1981, x 100,000) on 1990-1995 and 1996-2000 are respectively 1 and 1 in men, 0.3 and 0.4 in women, in accordance with those esteemed in others industrialised provinces. In 1990-1995 the survival observed after 1, 3 and 5 years are respectively 83.8%, 67.7% and 48.3%. Anamneses were collected on 83 SNC cases among the epithelial type cancer. In men the 33% was exposed to occupational risk factors: wood (13 cases), leather (6 cases) and chromium (1 case) dusts. Among works probably related to SNC, agriculture, construction and textile reached respectively the 20.5% for both sex, 16.4% for men and 18% for women. As for non occupational risk factors suggested by literature, smoke appear to be the most relevant, related to the 52% of all cases and reaching the 64% in men. Among the women, polyps and inverted papillomas (31%), and also chronic rhinitis and sinusitis (13.6%) are more frequently observed. Some problems still limiting the work and its usefulness are discussed.