Department of Internal Medicine, Korea University Guro Hospital, Korea University College of Medicine, 148, Gurodong-Ro, Guro-Gu, Seoul, 08308, Republic of Korea.
Smart Healthcare Center, Korea University Guro Hospital, 148, Gurodong-Ro, Guro-Gu, Seoul, 08308, Republic of Korea.
BMC Oral Health. 2023 Jun 23;23(1):418. doi: 10.1186/s12903-023-02997-x.
Poor dental health is correlated with an increased risk of cancer. Using a nationwide population cohort database, we investigated which cancer is highly associated with poor dental health and which dental indicator mostly influences cancer risk.
This study was conducted using the National Health Checkups (NHC) and National Health Insurance System (NHIS) database in Korea. NHC in Korea includes dental examinations. We retrieved subjects who underwent NHC between 2002 and 2003 and their medical information in NHIS database was followed until December 31,2015.
Data for 200,170 who participated in the NHC between 2002 and 2003 were analysed. During the maximum follow-up period of 13 years, 15,506 (7.75%) subjects were diagnosed with cancer. The median time to cancer diagnosis after the dental examination was 87 months (range, 51-119 months). The proportion of people with missing teeth was higher in the cancer-diagnosed group than in the non-diagnosed group (26.27% vs. 22.59%, p < 0.001). Among several dental health factors, missing teeth were significantly associated with higher cancer risk. Subjects with missing teeth showed a 12% increased cancer risk compared to those without missing teeth (odds ratio [OR] 1.12, 95% confidence interval [CI], 1.08-1.16). The risk was significantly higher, especially in lung, head and neck, pancreatic, liver, biliary, and esophageal cancers (OR 1.27 [95% CI, 1.14-1.41], 1.32 [95% CI, 1.13-1.55], 1.27 [95% CI, 1.02-1.58], 1.24 [95% CI, 1.1-1.4], 1.28 [95% CI, 1.03-1.6], 1.4 [95% CI, 1.04-1.88], respectively).
Missing teeth were the most important dental indicator associated with cancer risk. Korean adults with missing teeth should be cautious about the risk of several cancers, particularly head and neck, lung, gastrointestinal, hepatobiliary, and pancreatic cancer.
口腔健康状况不佳与癌症风险增加相关。本研究利用全国人群队列数据库，探讨了哪种癌症与口腔健康不良高度相关，以及哪种口腔指标对癌症风险影响最大。
本研究使用韩国国民健康检查（NHC）和国民健康保险系统（NHIS）数据库进行。韩国的 NHC 包括口腔检查。我们检索了 2002 年至 2003 年间接受 NHC 的受试者，并在 NHIS 数据库中跟踪他们的医疗信息，直到 2015 年 12 月 31 日。
对 200170 名 2002 年至 2003 年间参加 NHC 的受试者进行了分析。在最长 13 年的随访期间，有 15506 名（7.75%）受试者被诊断患有癌症。口腔检查后癌症诊断的中位时间为 87 个月（范围 51-119 个月）。在癌症诊断组中，缺失牙齿的比例高于未诊断组（26.27% vs. 22.59%，p<0.001）。在几个口腔健康因素中，缺失牙齿与更高的癌症风险显著相关。与无缺失牙齿的受试者相比，缺失牙齿的受试者癌症风险增加 12%（优势比[OR]1.12，95%置信区间[CI]1.08-1.16）。风险显著增加，尤其是肺癌、头颈部癌、胰腺癌、肝癌、肝胆癌和食管癌（OR 1.27[95%CI，1.14-1.41]，1.32[95%CI，1.13-1.55]，1.27[95%CI，1.02-1.58]，1.24[95%CI，1.1-1.4]，1.28[95%CI，1.03-1.6]，1.4[95%CI，1.04-1.88]）。
缺失牙齿是与癌症风险最相关的最重要的口腔指标。韩国有缺失牙齿的成年人应警惕多种癌症的风险，尤其是头颈部、肺癌、胃肠道、肝胆和胰腺癌。
