title: Association of tooth loss and oral hygiene with risk of gastric adenocarcinoma.
abstract: Poor oral health and tooth loss have been proposed as possible risk factors for some chronic diseases, including gastric cancer. However, a small number of studies have tested these associations. 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. ORs and 95% confidence intervals (95% CI) 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. Our results showed apparent associations between tooth loss and decayed, missing, filled teeth (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 ORs (95% CI) of 5.6 (1.6-19.3). We found evidence for an association between oral health and gastric cancer, but the nonmonotonic association, the relatively strong effect of confounder adjustment, and inconsistent results across studies must temper the strength of any conclusions.
authors.affiliation: Digestive Disease Research Centre, Tehran University of Medical Sciences, Shariati Hospital, 1411713135, Tehran, Iran.
authors.forename: Ramin
authors.initials: R
authors.lastname: Shakeri
authors.forename: Reza
authors.initials: R
authors.lastname: Malekzadeh
authors.forename: Arash
authors.initials: A
authors.lastname: Etemadi
authors.forename: Dariush
authors.initials: D
authors.lastname: Nasrollahzadeh
authors.forename: Behnoush
authors.initials: B
authors.lastname: Abedi-Ardekani
authors.forename: Masoud
authors.initials: M
authors.lastname: Khoshnia
authors.forename: Farhad
authors.initials: F
authors.lastname: Islami
authors.forename: Akram
authors.initials: A
authors.lastname: Pourshams
authors.forename: Michael
authors.initials: M
authors.lastname: Pawlita
authors.forename: Paolo
authors.initials: P
authors.lastname: Boffetta
authors.forename: Sanford M
authors.initials: SM
authors.lastname: Dawsey
authors.forename: Farin
authors.initials: F
authors.lastname: Kamangar
authors.forename: Christian C
authors.initials: CC
authors.lastname: Abnet
mesh_terms: D000230:Adenocarcinoma / Q000209:etiology* / Q000473:pathology; D000328:Adult; D000368:Aged; D016022:Case-Control Studies; D003817:Dentition; D005260:Female; D005500:Follow-Up Studies; D016481:Helicobacter Infections / Q000150:complications* / Q000473:pathology / Q000821:virology; D016480:Helicobacter pylori / Q000472:pathogenicity; D006801:Humans; D008297:Male; D008875:Middle Aged; D009909:Oral Health; D009910:Oral Hygiene / Q000009:adverse effects*; D011379:Prognosis; D013274:Stomach Neoplasms / Q000209:etiology* / Q000473:pathology; D016388:Tooth Loss / Q000150:complications*