Cancer in persons diagnosed with facial nerve paresis: A hospital-based cohort study in Denmark

Holly Elser; Dóra Körmendiné Farkas; Lindsay J. Collin; Malene Risager Lykke; Cecilia Hvitfeldt Fuglsang; Henrik Toft Sørensen

doi:10.1016/j.canep.2025.102863

Cancer in persons diagnosed with facial nerve paresis: A hospital-based cohort study in Denmark

Holly Elser^*, Dóra Körmendiné Farkas, Lindsay J. Collin, Malene Risager Lykke, Cecilia Hvitfeldt Fuglsang, Henrik Toft Sørensen

^*Corresponding author af dette arbejde

Institut for Klinisk Medicin - Klinisk Epidemiologisk Afdeling

Publikation: Bidrag til tidsskrift/Konferencebidrag i tidsskrift /Bidrag til avis › Tidsskriftartikel › Forskning › peer review

Abstract

Background: Neoplasms can compress or infiltrate the facial nerve, leading to facial nerve paresis or palsy (FNP). As evidence regarding cancers outside the head, neck, and nervous system in persons initially diagnosed with FNP remains limited, we examined the overall and site-specific cancer rates among all patients diagnosed with FNP in Denmark over a 29-year study period. Methods: We conducted a hospital-based cohort study in Denmark, 1994–2022, identifying FNP from inpatient, outpatient, or emergency room visits. We computed absolute risks (AR), and age- and sex-standardized incidence ratios (SIR) with corresponding 95 % confidence intervals (CIs) for all cancers, cancer groups, and site-specific cancers diagnosed <1 year and ≥1 after FNP diagnosis. Results: There were 27,147 recorded diagnoses of FNP. For cancers diagnosed <1 year after FNP, the AR was 1.67 % (95 %CI: 1.53,1.83) and the SIR was 2.62 (95 %CI: 2.38,2.87) with strong associations for cancers of the nervous system (SIR=14.7, 95 %CI: 12.1,17.7) and head and neck (SIR = 8.37, 95 %CI: 6.41,10.7). For cancers diagnosed ≥1 year after FNP, the AR was 20.2 % (95 %CI: 18.0,22.6) and the SIR was 1.08 (95 %CI: 1.04,1.13) with persistent associations for cancers of the salivary gland (SIR=2.43, 95 %CI: 1.11,4.62), brain (SIR = 1.48, 95 %CI: 1.16,1.86), spinal cord, cranial nerves, and other parts of the central nervous system (SIR = 1.83, 95 %CI: 1.22,2.62), liver (SIR = 2.02, 95 %CI: 1.50,2.65), and anus (SIR = 1.94, 95 %CI: 1.09,3.20). Conclusion: Rates of local cancers remained persistently elevated among persons diagnosed with FNP as compared with the Danish general population, as did rates of distant cancers implying a key role for metastatic disease as an underlying cause of FNP. Research that explores these associations by cancer stage may yield additional insight into these observed associations.

Originalsprog	Engelsk
Artikelnummer	102863
Tidsskrift	Cancer Epidemiology
Vol/bind	97
ISSN	1877-7821
DOI	https://doi.org/10.1016/j.canep.2025.102863
Status	Udgivet - aug. 2025

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@article{6821839ec2594e78a95f08bd8ea5b2f3,

title = "Cancer in persons diagnosed with facial nerve paresis: A hospital-based cohort study in Denmark",

abstract = "Background: Neoplasms can compress or infiltrate the facial nerve, leading to facial nerve paresis or palsy (FNP). As evidence regarding cancers outside the head, neck, and nervous system in persons initially diagnosed with FNP remains limited, we examined the overall and site-specific cancer rates among all patients diagnosed with FNP in Denmark over a 29-year study period. Methods: We conducted a hospital-based cohort study in Denmark, 1994–2022, identifying FNP from inpatient, outpatient, or emergency room visits. We computed absolute risks (AR), and age- and sex-standardized incidence ratios (SIR) with corresponding 95 % confidence intervals (CIs) for all cancers, cancer groups, and site-specific cancers diagnosed <1 year and ≥1 after FNP diagnosis. Results: There were 27,147 recorded diagnoses of FNP. For cancers diagnosed <1 year after FNP, the AR was 1.67 % (95 %CI: 1.53,1.83) and the SIR was 2.62 (95 %CI: 2.38,2.87) with strong associations for cancers of the nervous system (SIR=14.7, 95 %CI: 12.1,17.7) and head and neck (SIR = 8.37, 95 %CI: 6.41,10.7). For cancers diagnosed ≥1 year after FNP, the AR was 20.2 % (95 %CI: 18.0,22.6) and the SIR was 1.08 (95 %CI: 1.04,1.13) with persistent associations for cancers of the salivary gland (SIR=2.43, 95 %CI: 1.11,4.62), brain (SIR = 1.48, 95 %CI: 1.16,1.86), spinal cord, cranial nerves, and other parts of the central nervous system (SIR = 1.83, 95 %CI: 1.22,2.62), liver (SIR = 2.02, 95 %CI: 1.50,2.65), and anus (SIR = 1.94, 95 %CI: 1.09,3.20). Conclusion: Rates of local cancers remained persistently elevated among persons diagnosed with FNP as compared with the Danish general population, as did rates of distant cancers implying a key role for metastatic disease as an underlying cause of FNP. Research that explores these associations by cancer stage may yield additional insight into these observed associations.",

keywords = "Cancer, Cohort study, Facial nerve paresis, Standardized incidence ratio",

author = "Holly Elser and Farkas, {D{\'o}ra K{\"o}rmendin{\'e}} and Collin, {Lindsay J.} and Lykke, {Malene Risager} and Fuglsang, {Cecilia Hvitfeldt} and S{\o}rensen, {Henrik Toft}",

year = "2025",

month = aug,

doi = "10.1016/j.canep.2025.102863",

language = "English",

volume = "97",

journal = "Cancer Epidemiology",

issn = "1877-7821",

publisher = "Elsevier Ltd",

}

TY - JOUR

T1 - Cancer in persons diagnosed with facial nerve paresis

T2 - A hospital-based cohort study in Denmark

AU - Elser, Holly

AU - Farkas, Dóra Körmendiné

AU - Collin, Lindsay J.

AU - Lykke, Malene Risager

AU - Fuglsang, Cecilia Hvitfeldt

AU - Sørensen, Henrik Toft

PY - 2025/8

Y1 - 2025/8

N2 - Background: Neoplasms can compress or infiltrate the facial nerve, leading to facial nerve paresis or palsy (FNP). As evidence regarding cancers outside the head, neck, and nervous system in persons initially diagnosed with FNP remains limited, we examined the overall and site-specific cancer rates among all patients diagnosed with FNP in Denmark over a 29-year study period. Methods: We conducted a hospital-based cohort study in Denmark, 1994–2022, identifying FNP from inpatient, outpatient, or emergency room visits. We computed absolute risks (AR), and age- and sex-standardized incidence ratios (SIR) with corresponding 95 % confidence intervals (CIs) for all cancers, cancer groups, and site-specific cancers diagnosed <1 year and ≥1 after FNP diagnosis. Results: There were 27,147 recorded diagnoses of FNP. For cancers diagnosed <1 year after FNP, the AR was 1.67 % (95 %CI: 1.53,1.83) and the SIR was 2.62 (95 %CI: 2.38,2.87) with strong associations for cancers of the nervous system (SIR=14.7, 95 %CI: 12.1,17.7) and head and neck (SIR = 8.37, 95 %CI: 6.41,10.7). For cancers diagnosed ≥1 year after FNP, the AR was 20.2 % (95 %CI: 18.0,22.6) and the SIR was 1.08 (95 %CI: 1.04,1.13) with persistent associations for cancers of the salivary gland (SIR=2.43, 95 %CI: 1.11,4.62), brain (SIR = 1.48, 95 %CI: 1.16,1.86), spinal cord, cranial nerves, and other parts of the central nervous system (SIR = 1.83, 95 %CI: 1.22,2.62), liver (SIR = 2.02, 95 %CI: 1.50,2.65), and anus (SIR = 1.94, 95 %CI: 1.09,3.20). Conclusion: Rates of local cancers remained persistently elevated among persons diagnosed with FNP as compared with the Danish general population, as did rates of distant cancers implying a key role for metastatic disease as an underlying cause of FNP. Research that explores these associations by cancer stage may yield additional insight into these observed associations.

AB - Background: Neoplasms can compress or infiltrate the facial nerve, leading to facial nerve paresis or palsy (FNP). As evidence regarding cancers outside the head, neck, and nervous system in persons initially diagnosed with FNP remains limited, we examined the overall and site-specific cancer rates among all patients diagnosed with FNP in Denmark over a 29-year study period. Methods: We conducted a hospital-based cohort study in Denmark, 1994–2022, identifying FNP from inpatient, outpatient, or emergency room visits. We computed absolute risks (AR), and age- and sex-standardized incidence ratios (SIR) with corresponding 95 % confidence intervals (CIs) for all cancers, cancer groups, and site-specific cancers diagnosed <1 year and ≥1 after FNP diagnosis. Results: There were 27,147 recorded diagnoses of FNP. For cancers diagnosed <1 year after FNP, the AR was 1.67 % (95 %CI: 1.53,1.83) and the SIR was 2.62 (95 %CI: 2.38,2.87) with strong associations for cancers of the nervous system (SIR=14.7, 95 %CI: 12.1,17.7) and head and neck (SIR = 8.37, 95 %CI: 6.41,10.7). For cancers diagnosed ≥1 year after FNP, the AR was 20.2 % (95 %CI: 18.0,22.6) and the SIR was 1.08 (95 %CI: 1.04,1.13) with persistent associations for cancers of the salivary gland (SIR=2.43, 95 %CI: 1.11,4.62), brain (SIR = 1.48, 95 %CI: 1.16,1.86), spinal cord, cranial nerves, and other parts of the central nervous system (SIR = 1.83, 95 %CI: 1.22,2.62), liver (SIR = 2.02, 95 %CI: 1.50,2.65), and anus (SIR = 1.94, 95 %CI: 1.09,3.20). Conclusion: Rates of local cancers remained persistently elevated among persons diagnosed with FNP as compared with the Danish general population, as did rates of distant cancers implying a key role for metastatic disease as an underlying cause of FNP. Research that explores these associations by cancer stage may yield additional insight into these observed associations.

KW - Cancer

KW - Cohort study

KW - Facial nerve paresis

KW - Standardized incidence ratio

UR - http://www.scopus.com/inward/record.url?scp=105007611429&partnerID=8YFLogxK

U2 - 10.1016/j.canep.2025.102863

DO - 10.1016/j.canep.2025.102863

M3 - Journal article

C2 - 40505214

AN - SCOPUS:105007611429

SN - 1877-7821

VL - 97

JO - Cancer Epidemiology

JF - Cancer Epidemiology

M1 - 102863

ER -

Cancer in persons diagnosed with facial nerve paresis: A hospital-based cohort study in Denmark

Abstract

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