Association between poor oral health and gastric cancer: A prospective cohort study

Abstract

Poor oral health may be involved in the pathogenesis of gastric cancer, however, some aspects have not been explored. Further, for previously studied aspects, for example, tooth-loss, the findings are inconsistent. We conducted a prospective cohort study of 19,831 participants from Uppsala, Sweden, cancer-free at baseline in 1973-1974 and followed until 2012 through linkage to national registers. We found that individuals with fewest teeth at baseline had an increased risk of gastric cancer relative to subjects with all examined teeth present (p = 1.75e-2). Presence of denture-associated lesions was also associated with an increased risk of gastric cancer (p = 1.00e-4). However, these excess risks significantly varied with attained age; estimated hazard ratio (HR) at attained age 50 for tooth loss was 4.24 [95% confidence interval (CI) 1.83-9.80] and 5.91 (95% CI 2.76-12.63) for denture-associated lesions, decreasing at an estimated 4% and 6% per year respectively, resulting in HR of 1.54 (95% CI 0.90-2.64) for tooth loss and HR 1.29 (95% CI 0.90-1.85) for denture-associated lesions at attained age 75. No increased risk of gastric cancer was found for individuals with higher levels of dental plaque, or with Candida-related or tongue lesions. In conclusion, tooth-loss and denture-associated lesions are associated with increased risks of gastric cancer. Previous conflicting findings of tooth-loss and gastric cancer risk may partly be explained by the age-varying relative risk of gastric cancer.

Oral health and gastrointestinal cancer: A nationwide cohort study

“…Although it is difficult to provide clear evidence, furthermore, even though our result was statistically significant, the HR for frequent (≥3 times/day) toothbrushing was lower than those reported in previous studies (Ndegwa et al., 2018; Sato et al., 2011). We excluded a large number of subjects because of missing data for their oral health status (Table 1, Tables and ), which limits our assessment of the relationship between oral health behaviours and the risk for GI cancer.…”

“…Moreover, in the Nurses’ Health Study, women with fewer teeth, which that study used as an identification of periodontal disease, had a higher risk than others of colorectal cancer (Momen‐Heravi et al., 2017). In a Swedish cohort study, poor oral hygiene indicators, such as tooth loss and denture‐associated lesions, were associated with an increased risk of gastric cancer (Ndegwa et al., 2018). A pooled analysis of data from the Atherosclerosis Risk in Communities study showed that periodontitis was associated with an elevated risk of lung cancer and colorectal cancer (Michaud et al., 2018).…”

Temporal trend of gastric cancer burden along with its risk factors in China from 1990 to 2019, and projections until 2030: comparison with Japan, South Korea, and Mongolia

“…Catherine and colleagues estimated 0.81 million cancers, mainly non-cardia GC, were caused by H. pylori in 2018 [ 54 ]. In addition, alcohol consumption, low intake of fruits and vegetables, obesity, poor oral health, low socioeconomic level, Epstein-Barr virus infection, radiation exposure, and family history of GC may increase the incidence of GC [ 2 , 53 , 55 ].…”

Oral Bacterial Microbiota in Digestive Cancer Patients: A Systematic Review

“…Moreover, other confounders, such as oral hygiene habits [71], periodontal health status and severity of periodontitis, presence of other oral diseases, and dietary patterns [72], were disregarded. Tooth loss has been linked to an increased risk of GC development [73] and to an overall increased mortality rate [40]. Poor oral hygiene and tooth loss have also been linked to an increased risk of CRA occurrence [74,75].…”