Tooth loss is associated with increased risk of esophageal cancer: evidence from a meta-analysis with dose-response analysis

Abstract

Epidemiological studies have revealed the association between tooth loss and the risk of esophageal cancer (EC); however, consistent results were not obtained from different single studies. Therefore, we conducted the present meta-analysis to evaluate the association between tooth loss and EC. We conducted electronic searches of PubMed until to February 10, 2015 to identify relevant observational studies that examined the association between tooth loss and the risk of EC. Study selection and data extraction from eligible studies were independently performed by two authors. The meta-analysis was conducted using Stata 12.0 software. Finally eight eligible publications with ten studies involving 3 cohort studies, 5 case-control studies, and 1 cross-sectional study were yielded. Meta-analysis identified tooth loss increased risk of EC 1.30 times (Relative risk = 1.30, 95% confidence interval = 1.06–1.60, I2 = 13.5%). Dose-response analysis showed linear relationship between tooth loss and risk of EC (RR = 1.01, 95%CI = 1.00–1.03; P for non-linearity test was 0.45). Subgroup analysis proved similar results and publication bias was not detected. In conclusion, tooth loss could be considered to be a significant and dependent risk factor for EC based on the current evidence.

Individual and Combined Effects of Environmental Risk Factors for Esophageal Cancer Based on Results From the Golestan Cohort Study

“…42,43 Different indicators of poor oral health have been also linked to ESCC and its precursor lesion, esophageal squamous dysplasia, in studies from Golestan and other regions. 8,44,45 Persistent low-grade systemic inflammation that is associated with periodontal disease and the accumulation of altered oral microbiota that produce potentially carcinogenic metabolites such as acetaldehyde and nitrite (a precursor of nitrosamines) are among the proposed mechanisms for the association of poor oral health and increased ESCC risk. 8,[44][45][46][47] Drinking unpiped water has been linked to increased risk of upper GI cancers in high-incidence regions, including China 14,15 and Iran.…”

“…8,44,45 Persistent low-grade systemic inflammation that is associated with periodontal disease and the accumulation of altered oral microbiota that produce potentially carcinogenic metabolites such as acetaldehyde and nitrite (a precursor of nitrosamines) are among the proposed mechanisms for the association of poor oral health and increased ESCC risk. 8,[44][45][46][47] Drinking unpiped water has been linked to increased risk of upper GI cancers in high-incidence regions, including China 14,15 and Iran. 11,48 Although we did not have data on the quality of drinking water in the current study, another study in Golestan showed higher concentrations of nitrates and some minerals in the unpiped drinking water in areas with higher ESCC incidence and mortality rates.…”

Microbiome and Cancers of the Esophagus: A Review

“…Regular tooth brushing has been shown to have a protective effect against ESCC in various studies [ 71 , 72 , 73 , 74 ]. Recent meta-analyses suggest an odds ratio (OR) of 1.3 to 1.5 comparing the highest versus lowest number of teeth lost [ 79 , 80 , 81 ] and an OR of around 0.60 when comparing high- versus low-frequency of tooth brushing [ 79 , 82 ] for overall EC risk (estimates were slightly weaker for tooth loss [ 79 , 80 ] and slightly stronger for tooth brushing [ 79 ] when the analysis was restricted to ESCC). Periodontal disease has also been associated with an increase in overall EC risk (no histological distinctions) [ 83 , 84 ].…”

Androgen receptor gene polymorphisms and risk of prostate cancer: a meta-analysis

“…First, the evidence of between study heterogeneity was apparent, and the heterogeneity might distort the conclusion of the current meta-analysis676869. Additionally, the meta-regression analysis failed to identify the source of heterogeneity.…”