Abstract
Objective
Recent reports have linked oral health and periodontal disease indicators with increased risk of squamous cell carcinoma of head and neck (SCCHN). Thus far, evidence has been inconclusive; our objective was to study the association between oral health and SCCHN risk in the context of a large population-based study.
Methods
A population-based case–control study of incident SCCHN, the Carolina Head and Neck Cancer Study was carried out in 2002–2006 in 46 counties in North Carolina. Controls (n = 1,361) were frequency matched with cases (n = 1,289) on age, race, and gender. Oral health was assessed using interview data on tooth loss and mobility, mouthwash use, and frequency of dental visits.
Results
Subjects were 26–80 years old (median age = 61). The distribution of tooth loss among controls was 0–5 teeth = 60%; 5–14 = 15%; and 16–28 = 25%. After controlling for covariates, tooth loss did not yield any notable association with SCCHN (16–28 vs. 0–5 lost teeth: OR: 1.21, 95% CI: 0.94, 1.56). Self-reported history of tooth mobility was moderately associated with increased SCCHN risk (OR: 1.33, 95% CI: 1.07, 1.65); however, the association did not persist among never smokers. Routine dental visits were associated with 30% risk reduction (OR: 0.68, 95% CI: 0.53, 0.87).
Conclusions
These data provide support for a possible modest association of periodontal disease, as measured by self-reported tooth loss indicators, but not tooth loss per se, with SCCHN risk.
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Abbreviations
- CHANCE:
-
Carolina Head and Neck Cancer Study
- CI:
-
Confidence interval
- HR:
-
Hazard ratio
- ICR:
-
Interaction contrast ratio
- OR:
-
Odds ratio
- OPC:
-
Oral/oropharyngeal cancer
- SCCHN:
-
Squamous cell carcinoma of the head and neck
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Acknowledgments
This study was supported in part by grants R01-CA90731 from the National Cancer Institute and P30ES10126 from National Institute of Environmental Health Sciences.
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Divaris, K., Olshan, A.F., Smith, J. et al. Oral health and risk for head and neck squamous cell carcinoma: the Carolina Head and Neck Cancer Study. Cancer Causes Control 21, 567–575 (2010). https://doi.org/10.1007/s10552-009-9486-9
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DOI: https://doi.org/10.1007/s10552-009-9486-9