Tooth loss and lack of regular oral hygiene are associated with higher risk of esophageal squamous cell carcinoma.
We tested the association between tooth loss and oral hygiene and the risk of esophageal squamous cell carcinoma (ESCC) in people living in a high-risk area of Iran. We used a case-control study of pathologically confirmed ESCC cases (n = 283) and controls (n = 560) matched on sex, age, and neighborhood. Subjects with ESCC had significantly more decayed, missing, or filled teeth (DMFT) with a median (interquartile range) of 31 (23-32) compared with controls 28 (16-32; P = 0.0045). Subjects with ESCC were significantly more likely than controls to fail to practice regular oral hygiene (78% versus 58%). In multivariate-adjusted conditional logistic regression models, having 32 DMFT compared with < or = 15 conferred an odds ratio (95% confidence interval) of 2.10 (1.19-3.70). Compared with daily tooth brushing, practicing no regular oral hygiene conferred an odds ratio (95% confidence interval) of 2.37 (1.42-3.97). Restricting the analysis to subjects that had never smoked tobacco did not materially alter these results. We found significant associations between two markers of poor oral hygiene, a larger number of DMFT and lack of daily tooth brushing, and risk of ESCC in a population at high risk for ESCC where many cases occur in never smokers. Our results are consistent with several previous analyses in other high-risk populations.
Abnet
Christian C
CC
Nutritional Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Executive Plaza South, Room 320, 6120 Executive Boulevard, MSC 7232, Rockville, MD 20852, USA. abnetc@mail.nih.gov
Kamangar
Farin
F
Islami
Farhad
F
Nasrollahzadeh
Dariush
D
Brennan
Paul
P
Aghcheli
Karim
K
Merat
Shahin
S
Pourshams
Akram
A
Marjani
Haj Amin
HA
Ebadati
Abdolhakim
A
Sotoudeh
Masoud
M
Boffetta
Paolo
P
Malekzadeh
Reza
R
Dawsey
Sanford M
SM
D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000453:epidemiology / Q000209:etiology*; D016022:Case-Control Studies; D016009:Chi-Square Distribution; D004938:Esophageal Neoplasms / Q000453:epidemiology / Q000209:etiology*; D005260:Female; D006801:Humans; D007492:Iran / Q000453:epidemiology; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009909:Oral Health; D010808:Physical Examination; D011230:Precancerous Conditions; D012307:Risk Factors; D011795:Surveys and Questionnaires; D016388:Tooth Loss / Q000150:complications*