Smoking, alcohol, diet, dentition and sexual practices in the epidemiology of oral cancer in Poland

Abstract

The effect of smoking, drinking, diet, dental care and sexual habits on the risk of oral and pharyngeal cancer was investigated in a case-control study conducted in Warsaw, Poland. The study comprised 122 patients (including 44 females) aged 23-80 years with histologically confirmed cancer of oral cavity and pharynx. Controls were 124 subjects (including 52 females) admitted to the hospital for different non-neoplastic conditions unrelated to tobacco and alcohol consumption, with frequency matched to cases by age and sex. Smoking and drinking were strongly associated with an increased risk of oral cancer. Among consumers of both products, risks of oral cancer tended to combine in a multiplicative fashion and were increased more than 14-fold among those who consumed more than 15 cigarettes and seven or more drinks per day. Cessation of smoking was associated with reduced risk of this cancer. The risks varied by type of cigarettes smoked, being lower among those consuming filtered cigarettes only (OR = 1.6) than nonfilter (OR = 6.5) or mixed (OR = 4.2) cigarettes. High fruit intake was associated with significantly decreased risk (OR = 0.4) with the strongest significant inverse association found for fruit juices and citrus fruits ( < 0.01). After adjustment for tobacco smoking and alcohol drinking, poor dentition as evidenced by missing teeth, frequency of dental check-ups and frequency of teeth brushing emerged as a strong risk factor. Number of missing teeth and frequency of dental check-ups and frequency of tooth brushing showed increased ORs of 9.8, 11.9 and 3.2, respectively. Denture wearing did not affect oral cancer risk. No differences were detected in sexual practices (including oral sex and intercourse with prostitutes). In terms of attributable risk, smoking accounted for 57% of oral cancer cases in Poland, alcohol for 31% and low fruit intake for 12%. Attributable risks for low frequency of tooth brushing and dental check-ups were 56% and 47%, respectively. In conclusion, smoking and drinking cessation and increase of fresh fruit intake are likely to be effective preventive measures against oral cancer. These findings indicate also that poor oral hygiene may be an independent risk factor.

Oral health, hygiene practices and oral cancer

“…10 No association was seen between complete dental prosthesis and oral cancer, corroborating other studies. 8,11,12 On the other hand, high association of frequent gum bleeding during toothbrushing and oral cancer was found. Maier et al 12 reported among oral cancer cases that 40.9% had 3 mm or more dental calculus or tartar and 28% had chronic gingival infl ammation, thus indicating that patients with oral cancer could have poorer oral care and health.…”

“…This fi nding is similar to that found in studies in Germany 12 and Poland. 11 Those who have frequent dental visits are generally more careful about their oral hygiene, and this behavior could be considered an indicator of good oral care, which can help eliminate or prevent mucosa exposure to certain carcinogens.…”

Molecular mechanisms of head and neck cancer

“…A diet rich in fruits and vegetables has been shown to reduce the risk of OSCC, in patients with and without a history of tobacco and/or alcohol abuse [6,[15][16][17][18][19][20][21][22].…”

Diet and body mass, and oral and oropharyngeal squamous cell carcinomas: Analysis from the IARC multinational case–control study

“…A food frequency questionnaire was used to examine weekly consumption of several foods, including, milk, yoghurt, bread, pasta or rice, maize dishes, meat, fish, ham and salami and sausage, egg, cheese, potatoes, raw green vegetables and salads, cruciferae (broccoli, cabbage and brussel sprouts), carrots, fresh tomatoes, pulses, fresh fruit juice, apples or pears, citrus fruit, bananas, cakes and desserts. Dietary findings from the largest participating centres have been reported (Italy, 21 India, 22 Cuba, 23 Spain 24 and Poland 25 ).…”