Tooth loss and cancer mortality in Cancer Prevention Study-I Open Access

Kramer, Joan (Fall 2019)

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Background: Oral health has been associated with cancer risk, but prospective data are limited, and residual confounding by smoking remains a concern.

Methods: Cox proportional hazard regression was used to estimate multivariable-adjusted hazard ratios (HRs) for tooth loss associated with death from specific cancer types among 879,595 Cancer Prevention Study I participants who provided information about tobacco use and tooth loss and were cancer free at baseline in 1959.

Results: During follow up through 1972, there were 29,711 cancer-related deaths, including 14,041 in never smokers. Loss of eight teeth was associated with a higher risk of dying from cancers of the head and neck (HR=1.13; 95% confidence interval (CI), 1.07-1.20), esophagus (HR=1.12; 95%CI, 1.04-1.22), stomach (HR=1.06; 95%CI, 1.02-1.10), liver (HR=1.16; 95%CI, 1.08-1.24), pancreas (HR=1.04; 95%CI, 1.01-1.08), lung (HR=1.12; 95% CI, 1.10-1.15), cervix (HR=1.10; 95%CI, 1.02-1.19), and bladder (HR=1.13; 95%CI, 1.07-1.20). Among nonsmokers, tooth loss was positively associated with death from cancer of the head and neck (per 8 teeth lost, HR=1.13; 95% CI, 0.99-1.28), esophageal cancer (per 8 teeth, HR=1.22; 95%CI, 1.04-1.43), liver cancer (HR=1.11; 95%CI, 1.00-1.22), and lung cancer (per 8 teeth, HR=1.06; 95%CI: 1.00-1.12).   

Conclusions: Our results support an association, independent of smoking, between tooth loss and death from cancers of esophagus, head and neck, liver, and possibly lung. Increasing evidence that oral health affects cancer risk and mortality may indicate a possible role of dental care in the prevention of cancer. 

Table of Contents

Chapter 1: Background and Introduction                                                                 1-10

Chapter 2: Tooth Loss and Cancer Mortality in Cancer Prevention Study-I     11-25

Chapter 3: Public Health Implications                                                                      26

Tables                                                                                                                        27-33

References                                                                                                                 34-51

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