Background: Chronic rhinosinusitis (CRS) is believed to create a substantial population-level disease burden in the United States due to its high prevalence and significant disease morbidity, but many studies of CRS epidemiology are based on administrative or historical record sources rather than primary population sources. Objective: To characterize CRS symptoms, burden, and patient characteristics by using a primary U.S. population-based representative sample. Methods: A demographically and geographically representative sample of 10,336 U.S. adults recruited from a general panel of 4.3 million were obtained by using three-stage randomization. Data collected included a range of respondent-reported CRS symptoms, symptom impact and severity, symptom duration, and treatment. Results: Approximately 11.5% of the respondents (n = 1189) reported defining symptom and duration criteria for CRS. A previous diagnosis of nasal polyps was reported by ∼10% of this population. The remaining respondents reported severe (7.3%) or moderate (3.1%) symptom severity. The most frequently reported defining symptoms were nasal congestion and/or obstruction (94-97%) and drainage (89-92%). CRS participants reported a high average degree of symptom burden (e.g., on a 0-10 scale, 8.2 for CRS with nasal polyps, 8.4 for CRS without nasal polyps with severe symptoms, and 6.4 for CRS without nasal polyps with moderate symptoms). The participants with CRS reported high health-care use for CRS, adverse effects of CRS symptoms on multiple areas of daily life, and high dissatisfaction with currently available treatments. Conclusion: More than 10% of the general U.S. adult population have CRS symptoms. Most report severe symptoms, lack of satisfaction with current treatment options, and a substantial adverse impact on daily functioning.

CRS is a high-prevalence chronic inflammatory condition producing significant burden of illness, comparable to serious conditions like CHF, COPD, and Parkinson’s disease. CRS has been reported to drive substantial healthcare utilization and significant antibiotic prescriptions. Most U.S. epidemiological data on CRS are derived from administrative healthcare databases rather than primary population sources. Population-based survey of 10,336 adults randomly sampled from a U.S.-representative general panel (4.3 million). Information collected included nasal symptoms (including CRS diagnostic symptom criteria), frequency, duration, severity/bother, healthcare use and treatments. Among people reporting CRS diagnostic symptom criteria with or without nasal polyps (CRSw/sNP), 87%-99% visited a doctor/took prescription medication (for nasal symptoms) in the prior 12 months; most visited ≥3 times. In the past year, conventional steroid nasal sprays (CRSwNP, 92.5%; CRSsNP, 86.9%) and oral steroids (CRSwNP, 71.2%; CRSsNP, 36.3%) were commonly used. History of surgery was frequent (CRSwNP, 52.2%; CRSsNP, 14.1%). Despite available interventions, 41% of CRSwNP and 33% of CRSsNP remained ‘extremely’ bothered by symptoms; overall, only 54% believed symptoms were controlled and 79% were concerned about flare-ups. Flares occurred often (CRSwNP, 75%; CRSsNP, 78%). 87% of CRSwNP and 82% of CRSsNP were dissatisfied or only somewhat satisfied with current intranasal corticosteroids (INCS): 80% were frustrated with inadequate symptom relief; drip out (38-58%), throat drip (43-67%) and dysgeusia (36-43%) were frequently cited. In a representative U.S. population sample, CRSw/sNP produces significant healthcare resource utilization, but patients often continue to suffer meaningfully and are notably dissatisfied with conventional INCS, especially due to lack of efficacy.