Division of Cancer Epidemiology and Genetics, NCI, NIH, Bethesda, Maryland.
Liver and Pancreatobiliary Diseases Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran.
Cancer Prev Res (Phila). 2021 Jul;14(7):709-718. doi: 10.1158/1940-6207.CAPR-20-0577. Epub 2021 Mar 17.
Tooth loss and periodontal disease have been associated with several cancers, and poor oral health may be an important risk factor for upper gastrointestinal (UGI, i.e., esophageal and gastric) cancers. We assessed the relationship between oral health and UGI cancers using a large prospective study of over 50,000 adults living in Golestan Province, Iran, a high-incidence area for these cancers. Hazard ratios (HRs) and 95% confidence intervals (CI) were estimated for the association between three different measures of oral health [frequency of tooth brushing; number of missing teeth; and the sum of decayed, missing, and filled teeth (DMFT)] and UGI cancers. During a median follow-up duration of 13 years, there were 794 incident UGI cancers (396 esophageal and 398 gastric cancers). Daily tooth brushing was associated with a decreased risk of developing both esophageal (HR = 0.670; 95% CI: 0.486-0.924) and gastric (HR = 0.741; 95% CI: 0.544-1.01) cancers (combined UGI cancer HR = 0.697; 95% CI: 0.558-0.871) compared with never brushing. Tooth loss in excess of the loess smoothed, age- and sex-specific median number of teeth lost was significantly associated with esophageal (HR = 1.64; 95% CI: 1.08-2.47) and gastric cancers (HR = 1.58; 95% CI: 1.05-2.38). There were some adverse associations between DMFT and UGI cancers but most were not statistically significant. These results suggest increased risk of developing UGI cancers among individuals with poor oral health, and those who do not perform regular oral hygiene. PREVENTION RELEVANCE: Poor oral health is associated with the risk of upper gastrointestinal cancers, and oral hygiene practices may help prevent these cancers.
牙齿缺失和牙周病与多种癌症有关，口腔健康状况不佳可能是上消化道（即食管和胃）癌症的一个重要危险因素。我们使用伊朗戈勒斯坦省的一项大型前瞻性研究评估了口腔健康与 UGI 癌症之间的关系，该省是这些癌症的高发地区。在对 50,000 多名成年人进行的中位随访时间为 13 年的研究中，我们评估了三种不同口腔健康指标（刷牙频率、缺牙数和龋齿、缺失和补牙数（DMFT））与 UGI 癌症之间的关联。在研究期间，共发生了 794 例 UGI 癌症（396 例食管癌和 398 例胃癌）。与从不刷牙者相比，每天刷牙与患食管癌（HR = 0.670；95%CI：0.486-0.924）和胃癌（HR = 0.741；95%CI：0.544-1.01）的风险降低相关（合并 UGI 癌症 HR = 0.697；95%CI：0.558-0.871）。超出洛厄尔平滑、年龄和性别特异性中位数的牙齿缺失与食管癌（HR = 1.64；95%CI：1.08-2.47）和胃癌（HR = 1.58；95%CI：1.05-2.38）显著相关。DMFT 与 UGI 癌症之间存在一些不利关联，但大多数没有统计学意义。这些结果表明，口腔健康状况不佳和不进行常规口腔卫生的个体患 UGI 癌症的风险增加。预防相关性：口腔健康状况不佳与上消化道癌症的风险相关，口腔卫生习惯可能有助于预防这些癌症。
