D Hashim1, S Sartori2, P Brennan3, M P Curado4, V Wünsch-Filho5, K Divaris6, A F Olshan7, J P Zevallos8, D M Winn9, S Franceschi3, X Castellsagué10, J Lissowska11, P Rudnai12, K Matsuo13, H Morgenstern14, C Chen15, T L Vaughan15, J N Hofmann16, G D'Souza17, R I Haddad18, H Wu2, Y-C Lee19, M Hashibe19, C La Vecchia20, P Boffetta21. 1. The Institute for Translational Epidemiology, Icahn School of Medicine at Mount Sinai, New York, USA dana.hashim@mssm.edu. 2. The Institute for Translational Epidemiology, Icahn School of Medicine at Mount Sinai, New York, USA. 3. International Agency for Research on Cancer, Lyon, France. 4. Epidemiology-CIPE/ACCAMARGO, Sao Paulo. 5. School of Public Health, University of São Paulo, São Paulo, Brazil. 6. Department of Pediatric Dentistry. 7. Department of Epidemiology, University of North Carolina School of Public Health, Chapel Hill. 8. Department of Otolaryntology/Head and Neck Surgery, University of North Carolina at Chapel Hill, Chapel Hill. 9. Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, USA. 10. Catalan Institute of Oncology (ICO)-IDIBELL, L'Hospitalet de Llobregat, Catalonia CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain. 11. Department of Cancer Epidemiology and Prevention, The M. Sklasodowska-Curie Memorial Cancer Center and Institute of Oncology, Warsaw, Poland. 12. National Public Health Center, Budapest, Hungary. 13. Division of Molecular Medicine, Aichi Cancer Center Research Institute, Nagoya, Japan. 14. Department of Epidemiology Department of Environmental Health Sciences, School of Public Health and Comprehensive Cancer Center, University of Michigan, Ann Arbor. 15. Fred Hutchinson Cancer Research Center, Seattle. 16. Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda. 17. Johns Hopkins Bloomberg School of Public Health, Baltimore. 18. Dana Farber Cancer Institute, Harvard Medical School, Boston. 19. Division of Public Health, Department of Family and Preventive Medicine and Huntsman Cancer Institute, University of Utah School of Medicine, Salt Lake City, USA. 20. Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy. 21. The Institute for Translational Epidemiology, Icahn School of Medicine at Mount Sinai, New York, USA The Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, USA.
Abstract
BACKGROUND: Poor oral hygiene has been proposed to contribute to head and neck cancer (HNC) risk, although causality and independency of some indicators are uncertain. This study investigates the relationship of five oral hygiene indicators with incident HNCs. METHODS: In a pooled analysis of 8925 HNC cases and 12 527 controls from 13 studies participating in the International Head and Neck Cancer Epidemiology Consortium, comparable data on good oral hygiene indicators were harmonized. These included: no denture wear, no gum disease (or bleeding), <5 missing teeth, tooth brushing at least daily, and visiting a dentist ≥once a year. Logistic regression was used to estimate the effects of each oral hygiene indicator and cumulative score on HNC risk, adjusting for tobacco smoking and alcohol consumption. RESULTS: Inverse associations with any HNC, in the hypothesized direction, were observed for <5 missing teeth [odds ratio (OR) = 0.78; 95% confidence interval (CI) 0.74, 0.82], annual dentist visit (OR = 0.82; 95% CI 0.78, 0.87), daily tooth brushing (OR = 0.83, 95% CI 0.79, 0.88), and no gum disease (OR = 0.94; 95% CI 0.89, 0.99), and no association was observed for wearing dentures. These associations were relatively consistent across specific cancer sites, especially for tooth brushing and dentist visits. The population attributable fraction for ≤ 2 out of 5 good oral hygiene indicators was 8.9% (95% CI 3.3%, 14%) for oral cavity cancer. CONCLUSION: Good oral hygiene, as characterized by few missing teeth, annual dentist visits, and daily tooth brushing, may modestly reduce the risk of HNC.
BACKGROUND: Poor oral hygiene has been proposed to contribute to head and neck cancer (HNC) risk, although causality and independency of some indicators are uncertain. This study investigates the relationship of five oral hygiene indicators with incident HNCs. METHODS: In a pooled analysis of 8925 HNC cases and 12 527 controls from 13 studies participating in the International Head and Neck Cancer Epidemiology Consortium, comparable data on good oral hygiene indicators were harmonized. These included: no denture wear, no gum disease (or bleeding), <5 missing teeth, tooth brushing at least daily, and visiting a dentist ≥once a year. Logistic regression was used to estimate the effects of each oral hygiene indicator and cumulative score on HNC risk, adjusting for tobacco smoking and alcohol consumption. RESULTS: Inverse associations with any HNC, in the hypothesized direction, were observed for <5 missing teeth [odds ratio (OR) = 0.78; 95% confidence interval (CI) 0.74, 0.82], annual dentist visit (OR = 0.82; 95% CI 0.78, 0.87), daily tooth brushing (OR = 0.83, 95% CI 0.79, 0.88), and no gum disease (OR = 0.94; 95% CI 0.89, 0.99), and no association was observed for wearing dentures. These associations were relatively consistent across specific cancer sites, especially for tooth brushing and dentist visits. The population attributable fraction for ≤ 2 out of 5 good oral hygiene indicators was 8.9% (95% CI 3.3%, 14%) for oral cavity cancer. CONCLUSION: Good oral hygiene, as characterized by few missing teeth, annual dentist visits, and daily tooth brushing, may modestly reduce the risk of HNC.
Authors: Neela Guha; Paolo Boffetta; Victor Wünsch Filho; Jose Eluf Neto; Oxana Shangina; David Zaridze; Maria Paula Curado; Sergio Koifman; Elena Matos; Ana Menezes; Neonila Szeszenia-Dabrowska; Leticia Fernandez; Dana Mates; Alexander W Daudt; Jolanta Lissowska; Rajesh Dikshit; Paul Brennan Journal: Am J Epidemiol Date: 2007-08-30 Impact factor: 4.897
Authors: Mine Tezal; Maureen A Sullivan; Mary E Reid; James R Marshall; Andrew Hyland; Thom Loree; Cheryl Lillis; Linda Hauck; Jean Wactawski-Wende; Frank A Scannapieco Journal: Arch Otolaryngol Head Neck Surg Date: 2007-05
Authors: Jacques Ferlay; Isabelle Soerjomataram; Rajesh Dikshit; Sultan Eser; Colin Mathers; Marise Rebelo; Donald Maxwell Parkin; David Forman; Freddie Bray Journal: Int J Cancer Date: 2014-10-09 Impact factor: 7.396
Authors: Tatiana Natasha Toporcov; Ariana Znaor; Zuo-Feng Zhang; Guo-Pei Yu; Deborah M Winn; Qingyi Wei; Marta Vilensky; Thomas Vaughan; Peter Thomson; Renato Talamini; Neonila Szeszenia-Dabrowska; Erich M Sturgis; Elaine Smith; Oxana Shangina; Stephen M Schwartz; Stimson Schantz; Peter Rudnai; Lorenzo Richiardi; Heribert Ramroth; Mark P Purdue; Andrew F Olshan; José Eluf-Neto; Joshua Muscat; Raquel Ajub Moyses; Hal Morgenstern; Ana Menezes; Michael McClean; Keitaro Matsuo; Dana Mates; Tatiana V Macfarlane; Jolanta Lissowska; Fabio Levi; Philip Lazarus; Carlo La Vecchia; Pagona Lagiou; Sergio Koifman; Kristina Kjaerheim; Karl Kelsey; Ivana Holcatova; Rolando Herrero; Claire Healy; Richard B Hayes; Silvia Franceschi; Leticia Fernandez; Eleonora Fabianova; Alexander W Daudt; Otávio Alberto Curioni; Luigino Dal Maso; Maria Paula Curado; David I Conway; Chu Chen; Xavier Castellsague; Cristina Canova; Gabriella Cadoni; Paul Brennan; Stefania Boccia; José Leopoldo Ferreira Antunes; Wolfgang Ahrens; Antonio Agudo; Paolo Boffetta; Mia Hashibe; Yuan-Chin Amy Lee; Victor Wünsch Filho Journal: Int J Epidemiol Date: 2015-01-22 Impact factor: 7.196
Authors: Bo-Young Hong; Michel V Furtado Araujo; Linda D Strausbaugh; Evimaria Terzi; Effie Ioannidou; Patricia I Diaz Journal: PLoS One Date: 2015-05-18 Impact factor: 3.240
Authors: Douglas R Farquhar; Kimon Divaris; Angela L Mazul; Mark C Weissler; Jose P Zevallos; Andrew F Olshan Journal: Oral Oncol Date: 2017-10 Impact factor: 5.337
Authors: Prerna Khetan; Paolo Boffetta; Daniele Luce; Isabelle Stucker; Maria Paula Curado; Ana Menezes; Victor Wunsch-Filho; Wolfgang Ahrens; Pagona Lagiou; Diego Serraino; Lorenzo Richiardi; Kristina Kjaerheim; David Conway; Peter Thomson; Joshua Muscat; Dana Mates; Heribert Ramroth; Gwenn Menvielle; Thomas L Vaughan; Hermann Brenner; Yuan-Chin Amy Lee; Carlo La Vecchia; Mia Hashibe; Dana Hashim Journal: J Occup Environ Med Date: 2019-05 Impact factor: 2.162
Authors: Angela L Mazul; James M Taylor; Kimon Divaris; Mark C Weissler; Paul Brennan; Devasena Anantharaman; Behnoush Abedi-Ardekani; Andrew F Olshan; Jose P Zevallos Journal: Cancer Date: 2016-08-29 Impact factor: 6.860
Authors: Francesca Bravi; Yuan-Chin Amy Lee; Mia Hashibe; Paolo Boffetta; David I Conway; Monica Ferraroni; Carlo La Vecchia; Valeria Edefonti Journal: Oral Dis Date: 2020-07-16 Impact factor: 3.511