title: Periodontal diseases and risk of oral cancer in Southern India: Results from the HeNCe Life study.
abstract: Some studies suggest that periodontal diseases increase the risk of oral cancer, but contradictory results also exist. Inadequate control of confounders, including life course exposures, may have influenced prior findings. We estimate the extent to which high levels of periodontal diseases, measured by gingival inflammation and recession, are associated with oral cancer risk using a comprehensive subset of potential confounders and applying a stringent adjustment approach. In a hospital-based case-control study, incident oral cancer cases (N = 350) were recruited from two major referral hospitals in Kerala, South India, from 2008 to 2012. Controls (N = 371), frequency-matched by age and sex, were recruited from clinics at the same hospitals. Structured interviews collected information on several domains of exposure via a detailed life course questionnaire. Periodontal diseases, as measured by gingival inflammation and gingival recession, were evaluated visually by qualified dentists following a detailed protocol. The relationship between periodontal diseases and oral cancer risk was assessed by unconditional logistic regression using a stringent empirical selection of potential confounders corresponding to a 1% change-in-estimates. Generalized gingival recession was significantly associated with oral cancer risk (Odds Ratio = 1.83, 95% Confidence Interval: 1.10-3.04). No significant association was observed between gingival inflammation and oral cancer. Our findings support the hypothesis that high levels of periodontal diseases increase the risk of oral cancer.
authors.affiliation: Department of Oncology, Division of Cancer Epidemiology, McGill University, Montreal, QC, Canada.|Division of Oral Health and Society, Faculty of Dentistry, McGill University, Montreal, QC, Canada.
authors.forename: Claudie
authors.initials: C
authors.lastname: Laprise
authors.affiliation: Division of Oral Health and Society, Faculty of Dentistry, McGill University, Montreal, QC, Canada.
authors.forename: Hameed Puthiyannal
authors.initials: HP
authors.lastname: Shahul
authors.affiliation: Division of Oral Health and Society, Faculty of Dentistry, McGill University, Montreal, QC, Canada.|Epidemiology and Biostatistics Unit, INRS-Institut Armand-Frappier, Laval, QC, Canada.
authors.forename: Sreenath Arekunnath
authors.initials: SA
authors.lastname: Madathil
authors.affiliation: Division of Oral Health and Society, Faculty of Dentistry, McGill University, Montreal, QC, Canada.
authors.forename: Akhil Soman
authors.initials: AS
authors.lastname: Thekkepurakkal
authors.affiliation: Division of Oral Health and Society, Faculty of Dentistry, McGill University, Montreal, QC, Canada.
authors.forename: Geneviève
authors.initials: G
authors.lastname: Castonguay
authors.affiliation: Kerala University of Health Sciences, Medical College PO, Thrissur, Kerala, India.
authors.forename: Ipe
authors.initials: I
authors.lastname: Varghese
authors.affiliation: Oral Pathology, Government Dental College, Medical College Campus, Kozhikode 8, Kerala, India.
authors.forename: Shameena
authors.initials: S
authors.lastname: Shiraz
authors.affiliation: Department of Oncology, Division of Cancer Epidemiology, McGill University, Montreal, QC, Canada.|Division of Oral Health and Society, Faculty of Dentistry, McGill University, Montreal, QC, Canada.
authors.forename: Paul
authors.initials: P
authors.lastname: Allison
authors.affiliation: Department of Epidemiology and Population Health, Albert Einstein College of Medicine, NY.
authors.forename: Nicolas F
authors.initials: NF
authors.lastname: Schlecht
authors.affiliation: Division of Oral Health and Society, Faculty of Dentistry, McGill University, Montreal, QC, Canada.|Epidemiology and Biostatistics Unit, INRS-Institut Armand-Frappier, Laval, QC, Canada.
authors.forename: Marie-Claude
authors.initials: MC
authors.lastname: Rousseau
authors.affiliation: Department of Oncology, Division of Cancer Epidemiology, McGill University, Montreal, QC, Canada.|Division of Oral Health and Society, Faculty of Dentistry, McGill University, Montreal, QC, Canada.
authors.forename: Eduardo L
authors.initials: EL
authors.lastname: Franco
authors.affiliation: Department of Oncology, Division of Cancer Epidemiology, McGill University, Montreal, QC, Canada.|Division of Oral Health and Society, Faculty of Dentistry, McGill University, Montreal, QC, Canada.
authors.forename: Belinda
authors.initials: B
authors.lastname: Nicolau
mesh_terms: D016022:Case-Control Studies; D005260:Female; D005889:Gingival Recession / Q000453:epidemiology*; D005891:Gingivitis / Q000453:epidemiology*; D006801:Humans; D007194:India / Q000453:epidemiology; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009062:Mouth Neoplasms / Q000453:epidemiology*
keywords: India; case-control study; gingivitis; mouth neoplasms; oral cancer; oral health; periodontal diseases; periodontitis