title: Tooth loss and lack of regular oral hygiene are associated with higher risk of esophageal squamous cell carcinoma.
abstract: 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.
authors.affiliation: 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
authors.forename: Christian C
authors.initials: CC
authors.lastname: Abnet
authors.forename: Farin
authors.initials: F
authors.lastname: Kamangar
authors.forename: Farhad
authors.initials: F
authors.lastname: Islami
authors.forename: Dariush
authors.initials: D
authors.lastname: Nasrollahzadeh
authors.forename: Paul
authors.initials: P
authors.lastname: Brennan
authors.forename: Karim
authors.initials: K
authors.lastname: Aghcheli
authors.forename: Shahin
authors.initials: S
authors.lastname: Merat
authors.forename: Akram
authors.initials: A
authors.lastname: Pourshams
authors.forename: Haj Amin
authors.initials: HA
authors.lastname: Marjani
authors.forename: Abdolhakim
authors.initials: A
authors.lastname: Ebadati
authors.forename: Masoud
authors.initials: M
authors.lastname: Sotoudeh
authors.forename: Paolo
authors.initials: P
authors.lastname: Boffetta
authors.forename: Reza
authors.initials: R
authors.lastname: Malekzadeh
authors.forename: Sanford M
authors.initials: SM
authors.lastname: Dawsey
mesh_terms: 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*