Cancer risk following surgical removal of tonsils and adenoids — a population-based, sibling-controlled cohort study in Sweden

BMC Medicine

Research Article

Li Yin¹  Weimin Ye¹  Hans-Olov Adami²  Zhe Zhang³  Xue Xiao⁴  Jinfeng Liang⁴  Yanping Yang⁴  Yi Huang⁴  Fatemeh Sadeghi⁵  Fang Fang⁵ 

[1] Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden;Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden;Clinical Effectiveness Group, Institute of Health and Society, University of Oslo, Oslo, Norway;Department of Otolaryngology-Head & Neck Surgery, First Affiliated Hospital of Guangxi Medical University, 22# Shuangyong Road, 530021, Nanning, Guangxi, China;Department of Otolaryngology-Head & Neck Surgery, First Affiliated Hospital of Guangxi Medical University, 22# Shuangyong Road, 530021, Nanning, Guangxi, China;Key Laboratory of Early Prevention and Treatment for Regional High-Frequency Tumor (Guangxi Medical University), Ministry of Education, Guangxi Key Laboratory of Early Prevention and Treatment for Regional High Frequency Tumor, Guangxi Medical University, Nanning, Guangxi, China;Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden;

关键词: Tonsillectomy;    Adenoidectomy;    Adenotonsillectomy;    Cancer;    Risk;    Sibling comparison;   

DOI  :  10.1186/s12916-023-02902-x

 received in 2023-01-17, accepted in 2023-05-16,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundRemoval of tonsils and adenoids is among the most common surgical procedures worldwide. Evidence of increased risk of cancer following such surgery is, however, inconclusive.MethodsWe conducted a population-based, sibling-controlled cohort study of 4,953,583 individuals in Sweden with a follow-up during 1980–2016. History of tonsillectomy, adenotonsillectomy, and adenoidectomy was identified from the Swedish Patient Register whereas incident cases of cancer during follow-up were identified from the Swedish Cancer Register. We used Cox models to calculate hazard ratios (HR) with 95% confidence intervals (CI) of cancer in both a population and a sibling comparison. The sibling comparison was used to assess the potential impact of familial confounding, due to shared genetic or non-genetic factors within a family.ResultsWe found a modestly increased risk for any cancer following tonsillectomy, adenoidectomy, or adenotonsillectomy in both the population (HR 1.10; 95%CI 1.07–1.12) and sibling (HR 1.15; 95%CI 1.10–1.20) comparisons. The association did not differ greatly by type of surgery, age at surgery, or potential indication for surgery, and persisted more than two decades after surgery. An excess risk was consistently observed for cancer of the breast, prostate, thyroid, and for lymphoma in both population and sibling comparisons. A positive association was observed for pancreatic cancer, kidney cancer, and leukemia in the population comparison whereas a positive association was observed for esophageal cancer in the sibling comparison.ConclusionsSurgical removal of tonsils and adenoids is associated with a modestly increased risk of cancer during the decades following the surgery. The association is unlikely attributed to confounding due to shared genetic or non-genetic factors with a family.

【 授权许可】

CC BY   
© The Author(s) 2023

【 图 表 】

Fig. 8