Department of Radiation Oncology, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul, Korea.
Section of Dentistry Medicine, Department of Periodontology, Seoul National University Bundang Hospital, Seongnam, Korea.
Cancer Res Treat. 2022 Jul;54(3):709-718. doi: 10.4143/crt.2021.834. Epub 2021 Oct 22.
Poor oral health is associated with head and neck cancer (HNC). We evaluated whether a national oral health screening program (OHSP) could reduce the risk of HNC.
Data from 408,247 healthy individuals aged ≥ 40 years from the National Health Insurance System-National Health Screening program during 2003 and 2004 in Korea were analyzed. The risk of HNC was compared between subjects who underwent OHSP (HEALS-Dental+, n=165,292) and routine health check-ups only (HEALS-Dental‒, n=242,955). The impact of individual oral health-related factors on HNC risk was evaluated in HEALS-Dental+.
A total of 1,650 HNC cases were diagnosed. The 10-year HNC-free rate was 99.684% with a median follow-up of 11 years. The risk of all HNC (hazard ratio [HR], 1.16; 95% confidence interval [CI], 1.03 to 1.29; p=0.011) and oropharyngeal cancer (HR, 1.48; 95% CI, 1.13 to 1.94; p=0.005) was significantly higher in HEALS-Dental‒ than in HEALS-Dental+. In HEALS-Dental+, oral cavity cancer was marginally reduced (p=0.085), and missing teeth was a significant factor for HNC (HR, 1.24; 95% CI, 1.02 to 1.50; p=0.032). Toothbrushing was a significant factor in univariate analysis (p=0.028), but not in multivariate analysis (p=0.877).
The National OHSP significantly reduced the long-term HNC risk, particularly the incidence of oropharyngeal cancer. Routine OHSP should be considered at the population level.
口腔健康状况不佳与头颈部癌症（HNC）有关。我们评估了国家口腔健康筛查计划（OHSP）是否可以降低 HNC 的风险。
分析了韩国国家健康保险系统-国家健康筛查计划 2003 年至 2004 年间 408247 名≥40 岁的健康个体的数据。比较了接受 OHSP（HEALS-Dental+，n=165292）和仅常规健康检查（HEALS-Dental-，n=242955）的受试者之间的 HNC 风险。评估了 HEALS-Dental+中个体口腔健康相关因素对 HNC 风险的影响。
共诊断出 1650 例 HNC 病例。10 年 HNC 无病率为 99.684%，中位随访时间为 11 年。所有 HNC（风险比[HR]，1.16；95%置信区间[CI]，1.03 至 1.29；p=0.011）和口咽癌（HR，1.48；95%CI，1.13 至 1.94；p=0.005）的风险在 HEALS-Dental-中明显高于 HEALS-Dental+。在 HEALS-Dental+中，口腔癌略有降低（p=0.085），缺牙是 HNC 的一个重要因素（HR，1.24；95%CI，1.02 至 1.50；p=0.032）。刷牙在单因素分析中是一个显著因素（p=0.028），但在多因素分析中不是（p=0.877）。
国家 OHSP 显著降低了长期 HNC 风险，特别是口咽癌的发病率。应在人群层面考虑常规 OHSP。
