Institute of Medicine, Chung Shan Medical University, Taichung 402, Taiwan.
Department of Dentistry, Changhua Christian Hospital, Changhua 500, Taiwan.
Int J Environ Res Public Health. 2020 Dec 22;18(1):8. doi: 10.3390/ijerph18010008.
This study investigated the association between periodontitis and the risk of pharyngeal cancer in Taiwan. For this population-based nested case-control study using the Longitudinal Health Insurance Database derived from Taiwan's National Health Insurance Research Database, we identified patients ( = 1292) who were newly diagnosed with pharyngeal cancer between 2005 and 2013 and exactly paired them with propensity score matched control subjects ( = 2584). Periodontitis and scaling and root planing (SRP) were identified before the index date. Pharyngeal cancer was subdivided into 3 subgroups on the basis of anatomic location: nasopharyngeal cancer, oropharyngeal cancer, and hypopharyngeal cancer. A multiple conditional logistic regression model was applied to analyze the adjusted odds ratio (aOR). Periodontitis was associated with an increased risk of pharyngeal cancer (aOR, 1.57; 95% confidence interval (CI), 1.17 to 2.10), especially oropharyngeal cancer (aOR, 2.22; 95% CI, 1.07 to 4.60). We found a decreased risk of pharyngeal cancer in patients who had undergone SRP (aOR, 0.77; 95% CI, 0.61 to 0.96). In conclusion, this study showed that periodontitis was associated with an increased risk of pharyngeal cancer and SRP exerted a protective effect against pharyngeal cancer. Our results suggest that treating periodontitis and performing SRP, which are modifiable factors in oral health, in clinical practice may provide an opportunity to decrease the disease burden of pharyngeal cancer in Taiwan.
本研究旨在探讨牙周炎与台湾地区咽癌风险之间的关联。本研究采用基于人群的巢式病例对照研究设计，基于来自台湾全民健康保险研究数据库的纵向健康保险数据库，我们确定了 2005 年至 2013 年间新诊断为咽癌的患者（n=1292），并将其与倾向评分匹配的对照个体（n=2584）进行精确匹配。牙周炎和刮治（SRP）在指数日期之前被确定。根据解剖位置将咽癌分为 3 个亚组：鼻咽癌、口咽癌和下咽癌。采用多条件逻辑回归模型分析调整后的优势比（aOR）。牙周炎与咽癌风险增加相关（aOR，1.57；95%置信区间（CI），1.17 至 2.10），尤其是口咽癌（aOR，2.22；95%CI，1.07 至 4.60）。我们发现，接受 SRP 治疗的患者咽癌风险降低（aOR，0.77；95%CI，0.61 至 0.96）。总之，本研究表明牙周炎与咽癌风险增加相关，而 SRP 对咽癌具有保护作用。我们的研究结果表明，在临床实践中治疗牙周炎和进行 SRP（口腔健康的可改变因素）可能为降低台湾地区咽癌的疾病负担提供机会。
