Gastric atrophy and oesophageal squamous cell carcinoma: possible interaction with dental health and oral hygiene habit

Nasrollahzadeh, Dariush; Malekzadeh, Reza; Aghcheli, K; Sotoudeh, Masoud; Merat, Shahin; Islami, Farhad; Kamangar, Farin; Abnet, Christian C.; Shakeri, Ramin; Pourshams, Akram; Semnani, Shahryar; Boffetta, Paolo; Dawsey, Sanford M.; Ye, W

doi:10.1038/bjc.2012.332

Cited by 27 publications

(33 citation statements)

References 30 publications

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“…Recently, associations between indicators of poor oral health and ESCC risk have been reported in studies from several high‐risk areas including China, India and Iran, as well as other areas such as Latin America and Japan . Furthermore, poor oral health was reported to be a risk factor for the precursor lesion of ESCC, i.e., esophageal squamous dysplasia, and it might act synergistically with other risk factors ( e.g., gastric atrophy) to increase the risk of ESCC . There is thus evidence to support the hypothesis that poor oral health and/or poor oral hygiene practices are critical risk factors for ESCC in high‐risk areas.…”

Section: Introductionmentioning

confidence: 96%

Poor oral health is associated with an increased risk of esophageal squamous cell carcinoma - a population-based case-control study in China

et al. 2016

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To further examine the association between oral hygiene and esophageal squamous cell carcinoma (ESCC) risk and the effect modification of other exposures, we conducted a population-based case-control study between 2010 and 2012 in Taixing, China, a high-risk area for ESCC. Cases were primarily recruited from endoscopy units at local hospitals, supplemented by linkage to the local Cancer Registry. Control subjects were frequency matched to cases by sex and age (5-year groups) and were randomly selected from the Taixing Population Registry. For the current analysis, data from 616 histopathologically confirmed cases and 770 controls with complete information on oral hygiene were analyzed. Unconditional logistic regression models, including oral hygiene indicators and potential behavioral confounders, were used to derive odds ratios (ORs) and 95% confidence intervals (CIs). Tooth loss was only marginally significantly associated with ESCC risk (yes vs. no, OR = 1.29, 95% CI 0.94-1.74). However, the excess risk increased with increasing numbers of lost teeth (more than 6 teeth lost vs. none, OR = 1.48, 95% CI 1.04-2.11). Tooth brushing once or less per day, compared with tooth brushing twice or more per day, was associated with a 1.81-fold increased risk of ESCC. In the stratification analyses, the increased risks associated with these indicators of oral health were more pronounced in older subjects (age ≥ 70 years), women, non-smokers, and non-drinkers. Further studies are warranted to verify these findings and to explore the underlying mechanisms, e.g., changed oral microbiota, associated with poor oral hygiene.

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Section: Introductionmentioning

confidence: 96%

Poor oral health is associated with an increased risk of esophageal squamous cell carcinoma - a population-based case-control study in China

et al. 2016

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“…45 Also in another study in this area, researchers showed that coexistence of poor oral hygiene habit with gastric atrophy elevated the risk of ESCC eight times (OR=8.65, 95% CI: 3.65- 20.46). 46 …”

Section: Introductionmentioning

confidence: 99%

Esophageal Cancer in Golestan Province, Iran: A Review of Genetic Susceptibility and Environmental Risk Factors

Gholipour¹,

Islami²,

Roshandel³

et al. 2016

Middle East J Dig Dis

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Esophageal squamous cell carcinoma (ESCC) is an aggressive tumor that is typically diagnosed only when the tumor has gained remarkable size, extended to peripheral tissues, and led to dysphagia. Five-year survival of advanced cancer is still very poor (19%), even with improved surgical techniques and adjuvant chemoradiation therapy. Therefore, early detection and prevention are the most important strategies to reduce the burden of ESCC. Our review will focus on the studies conducted in Golestan province, an area with a high prevalence of ESCC in northern Iran. We review three aspects of the research literature on ESCC: epidemiological features, environmental factors (including substance abuse, environmental contaminants, dietary factors, and human papillomavirus [HPV]), and molecular factors (including oncogenes, tumor suppressor genes, cell cycle regulatory proteins, and other relevant biomarkers). Epidemiological and experimental data suggest that some chemicals and lifestyle factors, including polycyclic aromatic hydrocarbons (PAHs), cigarette smoking, opium use, and hot tea drinking are associated with the development of ESCC in Golestan. HPV infects the esophageal epithelium, but so far, no firm evidence of its involvement in esophageal carcinogenesis has been provided. Some of these factors, notably hot tea drinking, may render the esophageal mucosa more susceptible to injury by other carcinogens. There are few studies at molecular level on ESCC in Golestan. Increasing awareness about the known risk factors of ESCC could potentially reduce the burden of ESCC in the region. Further studies on risk factors, identifying high risk populations, and early detection are needed.

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“…Some recent epidemiologic studies have demonstrated an association between poor oral health or hygiene and cancers of different organs, including cancers of the oral cavity and oropharynx (9), esophagus (10–12), pancreas (13, 14), kidney (15), and lung (16), and also with other chronic diseases such as cardiovascular disease (17) and diabetes (18). At least two previous studies have also examined the association between poor oral health and gastric cancer, overall and by its anatomic subtypes, i.e., cardia and noncardia (11, 19).…”

Section: Introductionmentioning

confidence: 99%

Association of Tooth Loss and Oral Hygiene with Risk of Gastric Adenocarcinoma

Shakeri

Malekzadeh

Etemadi

et al. 2013

Cancer Prevention Research

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Introduction Poor oral health and tooth loss have been proposed as possible risk factors for some chronic diseases, including gastric cancer. However only a small number of studies have tested these associations. Method We conducted a case-control study in Golestan Province, Iran, that enrolled 309 cases diagnosed with gastric adenocarcinoma (118 noncardia, 161 cardia, and 30 mixed-locations) and 613 sex, age and neighborhood matched controls. Data on oral health were obtained through physical examination and questionnaire including tooth loss, the number of decayed, missing, and filled teeth, and frequency of tooth brushing. Odds ratios (ORs) and 95% confidence intervals (95% CIs) were obtained using conditional logistic regression models adjusted for potential confounders. Standard one degree-of-freedom linear trend test and a multiple degree of freedom global test of the effect of adding oral hygiene variables to the model were also calculated. Results Our results showed apparent associations between tooth loss and DMFT score with risk of gastric cancer, overall and at each anatomic subsite. However, these associations were not monotonic and were strongly confounded by age. The results also showed that subjects who brushed their teeth less than daily were at significantly higher risk for gastric cardia adenocarcinoma OR (95% CI) of 5.6 (1.6–19.3). Discussion We found evidence for an association between oral health and gastric cancer, but the non- monotonic association, the relatively strong effect of confounder adjustment, and inconsistent results across studies must temper the strength of any conclusions.

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Gastric atrophy and oesophageal squamous cell carcinoma: possible interaction with dental health and oral hygiene habit

Cited by 27 publications

References 30 publications

Poor oral health is associated with an increased risk of esophageal squamous cell carcinoma - a population-based case-control study in China

Poor oral health is associated with an increased risk of esophageal squamous cell carcinoma - a population-based case-control study in China

Esophageal Cancer in Golestan Province, Iran: A Review of Genetic Susceptibility and Environmental Risk Factors

Association of Tooth Loss and Oral Hygiene with Risk of Gastric Adenocarcinoma

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