title: Oral lesions, chronic diseases and the risk of head and neck cancer.
abstract: OBJECTIVE
  The aim of our study is to explore the role of the history of oral lesions and chronic diseases on the risk of head and neck cancer in a Chinese population.
  
  
  METHODS
  Our case-control study included 921 head and neck cancer cases and 806 controls. We obtained medical history information by administering questionnaires to both cases and controls. We used unconditional logistic regression to estimate odds ratios for oral lesions and chronic conditions.
  
  
  RESULTS
  Oral submucous fibrosis (OR=24.24, 95% CI=7.39-79.52), oral leukoplakia (OR=4.05, 95% CI=2.44-6.71) and repetitive dental ulcers (OR=5.12, 95% CI=3.17-8.28) increased the risk of HNC. Depression was associated with HNC risk when adjusted for several covariates (OR=2.10, 95% CI=1.06-4.15), but the association was not statistically significant after adjusting for smoking and alcohol drinking (OR=1.53, 95% CI=0.72-3.25). Also, the crude OR suggested an association between diabetes and HNC risk (OR=1.51, 95% CI=1.09-2.11), but it was not significant after adjusting for confounders.
  
  
  CONCLUSIONS
  Our study reported on strong associations between HNC risk and oral leukoplakia, oral submucous fibrosis, which is consistent with prior research. We also observed repetitive dental ulcer to be associated with HNC risk. Future studies may focus on studying the association between depression and HNC, using medical records or psychological evaluation results to get more accurate information about depression, with careful assessment of tobacco and alcohol history.
authors.affiliation: Division of Public Health, Department of Family and Preventive Medicine and Huntsman Cancer Institute, University of Utah School of Medicine, Salt Lake City, UT, USA.
authors.forename: Shuang
authors.initials: S
authors.lastname: Li
authors.affiliation: Division of Public Health, Department of Family and Preventive Medicine and Huntsman Cancer Institute, University of Utah School of Medicine, Salt Lake City, UT, USA.
authors.forename: Yuan-chin Amy
authors.initials: YC
authors.lastname: Lee
authors.affiliation: Department of Preventive Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
authors.forename: Qian
authors.initials: Q
authors.lastname: Li
authors.affiliation: Genomics Research Center, Academia Sinica, Taipei, Taiwan; Graduate Institute of Epidemiology and Preventive Medicine, National Taiwan University, Taipei, Taiwan.
authors.forename: Chien-Jen
authors.initials: CJ
authors.lastname: Chen
authors.affiliation: Genomics Research Center, Academia Sinica, Taipei, Taiwan.
authors.forename: Wan-Lun
authors.initials: WL
authors.lastname: Hsu
authors.affiliation: Department of Otolaryngology, National Taiwan University Hospital, Taipei, Taiwan.
authors.forename: Pen-Jen
authors.initials: PJ
authors.lastname: Lou
authors.affiliation: Department of Epidemiology and Biostatistics, West China Center of Medical Sciences, Sichuan University, Chengdu, China.
authors.forename: Cairong
authors.initials: C
authors.lastname: Zhu
authors.affiliation: Department of Oral Surgery, West China Hospital of Stomatology, Sichuan University, Sichuan, China.
authors.forename: Jian
authors.initials: J
authors.lastname: Pan
authors.affiliation: Department of Epidemiology and Biostatistics, Jiangsu Key Lab of Cancer Biomarkers, Prevention and Treatment, Collaborative Innovation Center for Cancer Personalized Medicine, School of Public Health, Nanjing Medical University, China.
authors.forename: Hongbing
authors.initials: H
authors.lastname: Shen
authors.affiliation: Department of Epidemiology and Biostatistics, Jiangsu Key Lab of Cancer Biomarkers, Prevention and Treatment, Collaborative Innovation Center for Cancer Personalized Medicine, School of Public Health, Nanjing Medical University, China.
authors.forename: Hongxia
authors.initials: H
authors.lastname: Ma
authors.affiliation: Department of Epidemiology and Biostatistics, School of Public Health, Fujian Medical University, Fujian, China.
authors.forename: Lin
authors.initials: L
authors.lastname: Cai
authors.affiliation: Department of Epidemiology and Biostatistics, School of Public Health, Fujian Medical University, Fujian, China.
authors.forename: Baochang
authors.initials: B
authors.lastname: He
authors.affiliation: Department of Head and Neck Surgery, Fudan University Shanghai Cancer Center, Shanghai, China; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China.
authors.forename: Yu
authors.initials: Y
authors.lastname: Wang
authors.affiliation: Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China; Department of Pathology, Fudan University Shanghai Cancer Center, Shanghai, China.
authors.forename: Xiaoyan
authors.initials: X
authors.lastname: Zhou
authors.affiliation: Department of Head and Neck Surgery, Fudan University Shanghai Cancer Center, Shanghai, China; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China.
authors.forename: Qinghai
authors.initials: Q
authors.lastname: Ji
authors.affiliation: Department of Epidemiology, School of Public Health, China Medical University, Liaoning, China.
authors.forename: Baosen
authors.initials: B
authors.lastname: Zhou
authors.affiliation: Department of Epidemiology, School of Public Health, China Medical University, Liaoning, China.
authors.forename: Wei
authors.initials: W
authors.lastname: Wu
authors.affiliation: Department of Head & Neck Oncology, Henan Cancer Hospital, Henan, China.
authors.forename: Jie
authors.initials: J
authors.lastname: Ma
authors.affiliation: Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York City, NY, USA.
authors.forename: Paolo
authors.initials: P
authors.lastname: Boffetta
authors.affiliation: Department of Epidemiology and Center for Environmental Genomics, UCLA Fielding School of Public Health, Los Angeles, CA, USA.
authors.forename: Zuo-Feng
authors.initials: ZF
authors.lastname: Zhang
authors.affiliation: National Office of Cancer Prevention & Control Cancer Institute & Hospital, and Chinese Academy of Medical Sciences, Beijing, China.
authors.forename: Min
authors.initials: M
authors.lastname: Dai
authors.affiliation: Division of Public Health, Department of Family and Preventive Medicine and Huntsman Cancer Institute, University of Utah School of Medicine, Salt Lake City, UT, USA. Electronic address: mia.hashibe@utah.edu.
authors.forename: Mia
authors.initials: M
authors.lastname: Hashibe
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000428:Alcohol Drinking / Q000453:epidemiology; D001249:Asthma / Q000453:epidemiology; D016022:Case-Control Studies; D002681:China / Q000453:epidemiology; D002908:Chronic Disease; D003866:Depressive Disorder / Q000453:epidemiology; D003919:Diabetes Insipidus / Q000453:epidemiology; D005260:Female; D006258:Head and Neck Neoplasms / Q000453:epidemiology*; D006801:Humans; D006967:Hypersensitivity / Q000453:epidemiology; D007972:Leukoplakia, Oral / Q000453:epidemiology; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009914:Oral Submucous Fibrosis / Q000453:epidemiology; D019226:Oral Ulcer / Q000453:epidemiology; D012307:Risk Factors; D012907:Smoking / Q000453:epidemiology; D011795:Surveys and Questionnaires; D013624:Taiwan / Q000453:epidemiology; D014376:Tuberculosis / Q000453:epidemiology; D055815:Young Adult
keywords: Depression; Diabetes; Head and neck cancer; Oral precancer