title: Chronic rhinosinusitis, race, and ethnicity.
abstract: BACKGROUND
  Little is known regarding the epidemiology of chronic rhinosinusitis (CRS) in racial and ethnic minorities in the United States. This study was designed to comprehensively evaluate the current prevalence of CRS across various treatment settings to identify possible  disparities in health care access and use between racial and ethnic populations.
  
  
  METHODS
  The National Health Interview Survey (NHIS), National Ambulatory Medical Care Survey (NAMCS), and National Hospital Ambulatory Medical Care Survey (NHAMCS) database registries were  extracted to identify the national prevalence of CRS in race/ethnic populations and resource use in ambulatory care settings. Systematic literature review identified studies reporting treatment outcomes in minority patients electing endoscopic sinus surgery (ESS). Data were supplemented using  a multi-institutional cohort of patients undergoing surgical treatment.
  
  
  RESULTS
  National survey data suggest CRS is a significant health condition for all major race/ethnic groups in the United States, accounting for a sizable portion of office, emergency, and outpatient  visits. Differences in insurance status, work absenteeism, and resource use were found between race/ethnic groups. Despite its prevalence, few published studies include information regarding minority patients with CRS. Most (90%) cohort studies did not provide details of race/ethnicity for  ESS outcomes. Prospective cohort analysis indicated that minority surgical patients accounted for only 18%, when compared with national census estimates (35%).
  
  
  CONCLUSIONS
  CRS is an important health condition for all major race/ethnic groups in the United States. Significant  differences may exist across racial and ethnic categories with regard to CRS health status and health care use. Given current demographic shifts in the United States, specific attention should be given to understanding CRS within the context of racial and ethnic populations. Public clinical  trial registration (www.clinicaltrials.gov) I.D. No. NCT00799097.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, South Carolina, USA.
authors.forename: Zachary M
authors.initials: ZM
authors.lastname: Soler
authors.forename: Jess C
authors.initials: JC
authors.lastname: Mace
authors.forename: Jamie R
authors.initials: JR
authors.lastname: Litvack
authors.forename: Timothy L
authors.initials: TL
authors.lastname: Smith
mesh_terms: D000328:Adult; D002908:Chronic Disease; D015331:Cohort Studies; D004724:Endoscopy; D005006:Ethnicity; D019538:Health Care Surveys; D054625:Healthcare Disparities / Q000706:statistics & numerical data; D006801:Humans; D019458:Insurance Coverage / Q000706:statistics & numerical data; D054525:Minority Health / Q000706:statistics & numerical data; D010256:Paranasal Sinuses / Q000601:surgery; D015995:Prevalence; D011446:Prospective Studies; D044469:Racial Groups; D012220:Rhinitis / Q000208:ethnology*; D012852:Sinusitis / Q000208:ethnology*; D016896:Treatment Outcome; D014481:United States / Q000453:epidemiology / Q000208:ethnology