Association of sinonasal cancer incidence with occupation in the Nordic countries – elevated risk especially among woodworkers

Authors

  • Alexandra Schindele Department of Clinical Sciences, Otorhinolaryngology, Umeå University, Östersund, Sweden https://orcid.org/0000-0003-0007-8716
  • Lalle Hammarstedt‐Nordenvall Division of Ear, Nose and Throat Diseases, Department of Clinical Sciences; Intervention and Technology, Karolinska Institutet and Karolinska Hospital, Stockholm, Sweden https://orcid.org/0000-0003-1660-9737
  • Antti Mäkitie Division of Ear, Nose and Throat Diseases, Department of Clinical Sciences; Intervention and Technology, Karolinska Institutet and Karolinska Hospital, Stockholm, Sweden; Department of Otorhinolaryngology – Head and Neck Surgery, University of Helsinki and Helsinki University Hospital, Helsinki, Finland; Research Program in Systems Oncology, Faculty of Medicine, University of Helsinki, Helsinki, Finland https://orcid.org/0000-0002-0451-2404
  • Jan Ivar Martinsen Department of Research, Cancer Registry, Norwegian Institute of Public Health, Oslo, Norway https://orcid.org/0000-0002-5684-2878
  • Sanna Lappi-Heikkinen Finnish Cancer Registry, Institute for Statistical and Epidemiological Cancer Research, Helsinki, Finland https://orcid.org/0000-0001-9995-5605
  • Johnni Hansen Danish Cancer Institute, Danish Cancer Society, Copenhagen, Denmark https://orcid.org/0000-0002-9342-2725
  • Elsebeth Lynge Department of Public Health, University of Copenhagen, Denmark https://orcid.org/0000-0003-4785-5236
  • Jenny Selander Institute of Environmental Medicine, IMM Karolinska Institutet, Stockholm, Sweden https://orcid.org/0000-0002-5995-3346
  • Ingrid Sivesind Mehlum Department of Public Health, University of Copenhagen, Denmark; National Institute of Occupational Health (STAMI), Oslo, Norway; Department of Occupational and Environmental Medicine, Copenhagen University Hospital – Bispebjerg and Frederiksberg, Copenhagen, Denmark https://orcid.org/0000-0003-0830-284X
  • Jóhanna Eyrun Torfadottir Centre of Public Health Sciences, University of Iceland, Reykjavik, Iceland https://orcid.org/0000-0002-9721-0105
  • Marcin W. Wojewodzic Department of Research, Cancer Registry, Norwegian Institute of Public Health, Oslo, Norway; Department of Chemical Toxicology, Norwegian Institute of Public Health, Oslo, Norway https://orcid.org/0000-0003-2501-5201
  • Eero Pukkala Finnish Cancer Registry, Institute for Statistical and Epidemiological Cancer Research, Helsinki, Finland; Health Sciences Unit, Faculty of Social Sciences, Tampere University, Tampere, Finland https://orcid.org/0000-0001-9536-6440

DOI:

https://doi.org/10.2340/1651-226X.2025.44875

Keywords:

Nose Neoplasms, Paranasal Sinus Neoplasms, Head and Neck Neoplasms, Head and Neck Squamous Cell Carcinomas, Adenocarcinoma, Occupational risk, Incidence

Abstract

Background and purpose: The study aims to assess the occupational variation of sinonasal cancer (SNC) incidence in the Nordic population. SNC is an aggressive disease with poor prognosis and a strong connection with occupational exposure, hence, assessing occupational risk for SNC is an essential aspect in the efforts of cancer prevention.

Patients/material and methods: Standardized incidence ratios (SIR) with 95% confidence intervals (CI) for SNC were calculated for 54 occupational categories from data based on population censuses and cancer registries in the five Nordic countries Denmark, Finland, Iceland, Norway, and Sweden.

Results: During 1961–2005, 5,799 SNC cases were registered, 61% men and 39% women. Male woodworkers had an SIR of 1.84 for SNC (95% CI 1.66–2.04) with 355 cases, a finding consistent across all Nordic countries. The SIR for the histological subgroup sinonasal adenocarcinoma (SNAC) among male woodworkers was 5.50 (95% CI 4.56–6.56) with 122 cases. Female woodworkers also had an elevated SIR for SNC of 1.88 (95% CI 0.90–3.46), but based on only 10 cases. Country-specific elevated SIRs for SNC in men were noted in Denmark for shoe and leather workers (SIR 3.62, 95% CI 1.33–7.87), and in Norway for smelting workers (SIR 2.24, 95% CI 1.41–3.39). Reduced SIRs were observed for male military personnel, teachers, gardeners and farmers, and female religious workers.

Interpretation: According to these Nordic registry data, woodworking, which is normally based on soft wood in the Nordic countries, is a high-risk occupation for SNC and particularly for SNAC.

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Published

2025-12-15

How to Cite

Schindele, A., Hammarstedt‐Nordenvall , L., Mäkitie, A., Martinsen, J. I., Lappi-Heikkinen, S., Hansen, J., … Pukkala, E. (2025). Association of sinonasal cancer incidence with occupation in the Nordic countries – elevated risk especially among woodworkers. Acta Oncologica, 64, 1672–1678. https://doi.org/10.2340/1651-226X.2025.44875

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