∗Department of Otolaryngology–Head and Neck Surgery, Kansai Medical University, Hirakata

†Department of Health Administration and Policy, Tohoku University School of Medicine

‡Division of Molecular Epidemiology, Environment and Genome Research Center, Tohoku University Graduate School of Medicine

§Department of Preventive Medicine and Epidemiology, Tohoku Medical Megabank Organization, Tohoku University

∥Department of Pharmaceutical Sciences, Tohoku University Hospital, Sendai

¶Department of Health Policy and Informatics, Tokyo Medical and Dental University Graduate School of Medicine, Tokyo, Japan

Address correspondence and reprint requests to Hiroshi Hidaka, M.D., Ph.D., Department of Otolaryngology–HNS, Kansai Medical University, 2-3-1 Shinmachi, Hirakata City, Osaka 573-1191, Japan; E-mail: [email protected]

Sources of support and disclosure of funding: A portion of this study was supported by Grant-in-Aid No. 20K09699 (to H.H.) from the Ministry of Education, Science, and Culture of Japan, and Grant-in-Aid No. 22AA2003 (to K.F.) from the Ministry of Health, Labour and Welfare, Japan.

The authors disclose no conflicts of interest.

Contributions: H.H. designed and supervised the study. K.T., F.K., and K.F. acquired all clinical data. All authors performed data analysis and interpretation. O.T. and S.A. assisted in the statistical analyses. H.H. and H.I. wrote the manuscript. All authors read and approved the final manuscript.