Guha Neela, Boffetta Paolo, Wünsch Filho Victor, Eluf Neto Jose, Shangina Oxana, Zaridze David, Curado Maria Paula, Koifman Sergio, Matos Elena, Menezes Ana, Szeszenia-Dabrowska Neonila, Fernandez Leticia, Mates Dana, Daudt Alexander W, Lissowska Jolanta, Dikshit Rajesh, Brennan Paul
International Agency for Research on Cancer, Lyon, France.
Am J Epidemiol. 2007 Nov 15;166(10):1159-73. doi: 10.1093/aje/kwm193. Epub 2007 Aug 30.
Poor oral health has been reported as a risk factor in the etiology of head and neck cancer. Data on oral health were ascertained as part of two multicenter case-control studies comprising 924 cases and 928 controls in central Europe and 2,286 cases and 1,824 controls in Latin America. Incident cases of squamous cell carcinoma of the head and neck (oral cavity, pharynx, larynx) and esophagus, as well as age (in quinquennia)- and sex frequency-matched controls, were enrolled from 1998 to 2003. Poor condition of the mouth (central Europe: odds ratio (OR) = 2.89, 95% confidence interval (CI): 1.74, 4.81; Latin America: OR = 1.89, 95% CI: 1.47, 2.42), lack of toothbrush use (Latin America: OR = 2.36, 95% CI: 1.28, 4.36), and daily mouthwash use (Latin America: OR = 3.40, 95% CI: 1.96, 5.89) emerged as risk factors for head and neck cancer, independent of tobacco use and alcohol consumption. Missing between six and 15 teeth was an independent risk factor for esophageal cancer (central Europe: OR = 2.84, 95% CI: 1.26, 6.41; Latin America: OR = 2.18, 95% CI: 1.04, 4.59). These results indicate that periodontal disease (as indicated by poor condition of the mouth and missing teeth) and daily mouthwash use may be independent causes of cancers of the head, neck, and esophagus.
据报道，口腔健康状况不佳是头颈癌病因中的一个风险因素。作为两项多中心病例对照研究的一部分，收集了关于口腔健康的数据，这两项研究在中欧包括924例病例和928例对照，在拉丁美洲包括2286例病例和1824例对照。1998年至2003年纳入了头颈（口腔、咽、喉）和食管鳞状细胞癌的新发病例，以及年龄（以五年计）和性别频率匹配的对照。口腔状况不佳（中欧：比值比（OR）=2.89，95%置信区间（CI）：1.74，4.81；拉丁美洲：OR = 1.89，95% CI：1.47，2.42）、不使用牙刷（拉丁美洲：OR = 2.36，95% CI：1.28，4.36）和每天使用漱口水（拉丁美洲：OR = 3.40，95% CI：1.96，5.89）成为头颈癌的风险因素，与吸烟和饮酒无关。缺失6至15颗牙齿是食管癌的独立风险因素（中欧：OR = 2.84，95% CI：1.26，6.41；拉丁美洲：OR = 2.18，95% CI：1.04，4.59）。这些结果表明，牙周病（如口腔状况不佳和缺牙所示）和每天使用漱口水可能是头颈和食管癌的独立病因。
