Oral Health and Risk of Squamous Cell Carcinoma of the Head and Neck and Esophagus: Results of Two Multicentric Case-Control Studies

Abstract

Poor oral health has been reported as a risk factor in the etiology of head and neck cancer. Data on oral health were ascertained as part of two multicenter case-control studies comprising 924 cases and 928 controls in central Europe and 2,286 cases and 1,824 controls in Latin America. Incident cases of squamous cell carcinoma of the head and neck (oral cavity, pharynx, larynx) and esophagus, as well as age (in quinquennia)- and sex frequency-matched controls, were enrolled from 1998 to 2003. Poor condition of the mouth (central Europe: odds ratio (OR) = 2.89, 95% confidence interval (CI): 1.74, 4.81; Latin America: OR = 1.89, 95% CI: 1.47, 2.42), lack of toothbrush use (Latin America: OR = 2.36, 95% CI: 1.28, 4.36), and daily mouthwash use (Latin America: OR = 3.40, 95% CI: 1.96, 5.89) emerged as risk factors for head and neck cancer, independent of tobacco use and alcohol consumption. Missing between six and 15 teeth was an independent risk factor for esophageal cancer (central Europe: OR = 2.84, 95% CI: 1.26, 6.41; Latin America: OR = 2.18, 95% CI: 1.04, 4.59). These results indicate that periodontal disease (as indicated by poor condition of the mouth and missing teeth) and daily mouthwash use may be independent causes of cancers of the head, neck, and esophagus.

Dietary patterns and risk of oral and pharyngeal cancer: a case-control study in Rio de Janeiro, Brazil

“…Other potential limitation was the lack of control for oral health, as poor oral hygiene seems to cause additional cancer risks 29 . As low socio-economical status is also associated with poor oral hygiene conditions, which is an acknowledged risk factor for oral cancer 30 , we adjusted the analysis for educational level, as a proxy variable, in a attempt to control this effect, despite the fact that residual confounding might persist. Genetic susceptibility is another important related condition to the studied tumors 31 , but was not considered in the present study.…”

Reviewed evidence about the safety of the daily use of alcohol-based mouthrinses

“…Another explanation is that the alcohol could act by a systemic mechanism. 23,27 The relationship between alcohol and oral cancer may be even more complex, involving liver damage and increase in DNA transcription errors during cell regeneration, and additional factors such as the severe dietary deficiencies very common among alcohol abusers. 23 Several epidemiological and experimental studies have been published in the last three decades about alcohol-based mouthrinses and oral cancer 23,24,[28][29][30][31][32][33][34][35] ( Table 1) besides other review papers and Official Statements.…”

Esophageal Cancer Mortality during 2004-2009 in Yanting County, China

“…Agestandardized mortalities during the 6 year time periods were calculated based on the world standard population in 2000 (Guha et al, 2007). The data were analyzed by using SPSS 16.0 software.…”