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<title xml:lang="en">Tooth loss and lack of regular oral hygiene are associated with higher risk of esophageal squamous cell carcinoma</title>
<author>
<name sortKey="Abnet, Christian C" sort="Abnet, Christian C" uniqKey="Abnet C" first="Christian C." last="Abnet">Christian C. Abnet</name>
<affiliation>
<nlm:aff id="A1">Nutritional Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, United States of America</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Kamangar, Farin" sort="Kamangar, Farin" uniqKey="Kamangar F" first="Farin" last="Kamangar">Farin Kamangar</name>
<affiliation>
<nlm:aff id="A1">Nutritional Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, United States of America</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Islami, Farhad" sort="Islami, Farhad" uniqKey="Islami F" first="Farhad" last="Islami">Farhad Islami</name>
<affiliation>
<nlm:aff id="A2">Digestive Disease Research Center, Tehran University of Medical Sciences, Tehran, Iran</nlm:aff>
</affiliation>
<affiliation>
<nlm:aff id="A3">International Agency for Research on Cancer, Lyon, France</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Nasrollahzadeh, Dariush" sort="Nasrollahzadeh, Dariush" uniqKey="Nasrollahzadeh D" first="Dariush" last="Nasrollahzadeh">Dariush Nasrollahzadeh</name>
<affiliation>
<nlm:aff id="A3">International Agency for Research on Cancer, Lyon, France</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Brennan, Paul" sort="Brennan, Paul" uniqKey="Brennan P" first="Paul" last="Brennan">Paul Brennan</name>
<affiliation>
<nlm:aff id="A3">International Agency for Research on Cancer, Lyon, France</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Aghcheli, Karim" sort="Aghcheli, Karim" uniqKey="Aghcheli K" first="Karim" last="Aghcheli">Karim Aghcheli</name>
<affiliation>
<nlm:aff id="A2">Digestive Disease Research Center, Tehran University of Medical Sciences, Tehran, Iran</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Merat, Shahin" sort="Merat, Shahin" uniqKey="Merat S" first="Shahin" last="Merat">Shahin Merat</name>
<affiliation>
<nlm:aff id="A2">Digestive Disease Research Center, Tehran University of Medical Sciences, Tehran, Iran</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Pourshams, Akram" sort="Pourshams, Akram" uniqKey="Pourshams A" first="Akram" last="Pourshams">Akram Pourshams</name>
<affiliation>
<nlm:aff id="A2">Digestive Disease Research Center, Tehran University of Medical Sciences, Tehran, Iran</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Marjani, Haj Amin" sort="Marjani, Haj Amin" uniqKey="Marjani H" first="Haj Amin" last="Marjani">Haj Amin Marjani</name>
<affiliation>
<nlm:aff id="A2">Digestive Disease Research Center, Tehran University of Medical Sciences, Tehran, Iran</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Ebadati, Abdolhakim" sort="Ebadati, Abdolhakim" uniqKey="Ebadati A" first="Abdolhakim" last="Ebadati">Abdolhakim Ebadati</name>
<affiliation>
<nlm:aff id="A2">Digestive Disease Research Center, Tehran University of Medical Sciences, Tehran, Iran</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Sotoudeh, Masoud" sort="Sotoudeh, Masoud" uniqKey="Sotoudeh M" first="Masoud" last="Sotoudeh">Masoud Sotoudeh</name>
<affiliation>
<nlm:aff id="A2">Digestive Disease Research Center, Tehran University of Medical Sciences, Tehran, Iran</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Boffetta, Paolo" sort="Boffetta, Paolo" uniqKey="Boffetta P" first="Paolo" last="Boffetta">Paolo Boffetta</name>
<affiliation>
<nlm:aff id="A3">International Agency for Research on Cancer, Lyon, France</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Malekzadeh, Reza" sort="Malekzadeh, Reza" uniqKey="Malekzadeh R" first="Reza" last="Malekzadeh">Reza Malekzadeh</name>
<affiliation>
<nlm:aff id="A2">Digestive Disease Research Center, Tehran University of Medical Sciences, Tehran, Iran</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Dawsey, Sanford M" sort="Dawsey, Sanford M" uniqKey="Dawsey S" first="Sanford M." last="Dawsey">Sanford M. Dawsey</name>
<affiliation>
<nlm:aff id="A1">Nutritional Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, United States of America</nlm:aff>
</affiliation>
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<idno type="pmid">18990747</idno>
<idno type="pmc">2586052</idno>
<idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2586052</idno>
<idno type="RBID">PMC:2586052</idno>
<idno type="doi">10.1158/1055-9965.EPI-08-0558</idno>
<date when="2008">2008</date>
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<title xml:lang="en" level="a" type="main">Tooth loss and lack of regular oral hygiene are associated with higher risk of esophageal squamous cell carcinoma</title>
<author>
<name sortKey="Abnet, Christian C" sort="Abnet, Christian C" uniqKey="Abnet C" first="Christian C." last="Abnet">Christian C. Abnet</name>
<affiliation>
<nlm:aff id="A1">Nutritional Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, United States of America</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Kamangar, Farin" sort="Kamangar, Farin" uniqKey="Kamangar F" first="Farin" last="Kamangar">Farin Kamangar</name>
<affiliation>
<nlm:aff id="A1">Nutritional Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, United States of America</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Islami, Farhad" sort="Islami, Farhad" uniqKey="Islami F" first="Farhad" last="Islami">Farhad Islami</name>
<affiliation>
<nlm:aff id="A2">Digestive Disease Research Center, Tehran University of Medical Sciences, Tehran, Iran</nlm:aff>
</affiliation>
<affiliation>
<nlm:aff id="A3">International Agency for Research on Cancer, Lyon, France</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Nasrollahzadeh, Dariush" sort="Nasrollahzadeh, Dariush" uniqKey="Nasrollahzadeh D" first="Dariush" last="Nasrollahzadeh">Dariush Nasrollahzadeh</name>
<affiliation>
<nlm:aff id="A3">International Agency for Research on Cancer, Lyon, France</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Brennan, Paul" sort="Brennan, Paul" uniqKey="Brennan P" first="Paul" last="Brennan">Paul Brennan</name>
<affiliation>
<nlm:aff id="A3">International Agency for Research on Cancer, Lyon, France</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Aghcheli, Karim" sort="Aghcheli, Karim" uniqKey="Aghcheli K" first="Karim" last="Aghcheli">Karim Aghcheli</name>
<affiliation>
<nlm:aff id="A2">Digestive Disease Research Center, Tehran University of Medical Sciences, Tehran, Iran</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Merat, Shahin" sort="Merat, Shahin" uniqKey="Merat S" first="Shahin" last="Merat">Shahin Merat</name>
<affiliation>
<nlm:aff id="A2">Digestive Disease Research Center, Tehran University of Medical Sciences, Tehran, Iran</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Pourshams, Akram" sort="Pourshams, Akram" uniqKey="Pourshams A" first="Akram" last="Pourshams">Akram Pourshams</name>
<affiliation>
<nlm:aff id="A2">Digestive Disease Research Center, Tehran University of Medical Sciences, Tehran, Iran</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Marjani, Haj Amin" sort="Marjani, Haj Amin" uniqKey="Marjani H" first="Haj Amin" last="Marjani">Haj Amin Marjani</name>
<affiliation>
<nlm:aff id="A2">Digestive Disease Research Center, Tehran University of Medical Sciences, Tehran, Iran</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Ebadati, Abdolhakim" sort="Ebadati, Abdolhakim" uniqKey="Ebadati A" first="Abdolhakim" last="Ebadati">Abdolhakim Ebadati</name>
<affiliation>
<nlm:aff id="A2">Digestive Disease Research Center, Tehran University of Medical Sciences, Tehran, Iran</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Sotoudeh, Masoud" sort="Sotoudeh, Masoud" uniqKey="Sotoudeh M" first="Masoud" last="Sotoudeh">Masoud Sotoudeh</name>
<affiliation>
<nlm:aff id="A2">Digestive Disease Research Center, Tehran University of Medical Sciences, Tehran, Iran</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Boffetta, Paolo" sort="Boffetta, Paolo" uniqKey="Boffetta P" first="Paolo" last="Boffetta">Paolo Boffetta</name>
<affiliation>
<nlm:aff id="A3">International Agency for Research on Cancer, Lyon, France</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Malekzadeh, Reza" sort="Malekzadeh, Reza" uniqKey="Malekzadeh R" first="Reza" last="Malekzadeh">Reza Malekzadeh</name>
<affiliation>
<nlm:aff id="A2">Digestive Disease Research Center, Tehran University of Medical Sciences, Tehran, Iran</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Dawsey, Sanford M" sort="Dawsey, Sanford M" uniqKey="Dawsey S" first="Sanford M." last="Dawsey">Sanford M. Dawsey</name>
<affiliation>
<nlm:aff id="A1">Nutritional Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, United States of America</nlm:aff>
</affiliation>
</author>
</analytic>
<series>
<title level="j">Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology</title>
<idno type="ISSN">1055-9965</idno>
<idno type="eISSN">1538-7755</idno>
<imprint>
<date when="2008">2008</date>
</imprint>
</series>
</biblStruct>
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</teiHeader>
<front>
<div type="abstract" xml:lang="en">
<p id="P1">We tested the association between tooth loss and oral hygiene and the risk of esophageal squamous cell carcinoma (ESCC) in people living in a high risk area of Iran. We used a case-control study of pathologically-confirmed ESCC cases (N=283) and controls (N=560) matched on sex, age, and neighborhood. Subjects with ESCC had significantly more decayed, missing, or filled teeth with a median (interquartile range) of 31 (
<xref ref-type="bibr" rid="R23">23</xref>
-
<xref ref-type="bibr" rid="R32">32</xref>
) compared to controls 28 (
<xref ref-type="bibr" rid="R2">2</xref>
-
<xref ref-type="bibr" rid="R32">32</xref>
) (P=0.0045). And subjects with ESCC were significantly more likely than controls to fail to practice regular oral hygiene, 78% versus 58%. In multivariate adjusted conditional logistic regression models having 32 decayed, missing, or filled teeth compared to ≤15 conferred an OR (95% CI) of 2.10 (1.19-3.70). Compared to daily tooth brushing, practicing no regular oral hygiene conferred an OR (95% CI) of 2.37 (1.42-3.97). Restricting the analysis to subjects that had never smoked tobacco did not materially alter these results. We found significant associations between two markers of poor oral hygiene, a larger number of decayed, missing, or filled teeth and lack of daily tooth brushing, and risk of ESCC in a population at high risk for ESCC where many cases occur in never smokers. Our results are consistent with several previous analyses in other high risk populations.</p>
</div>
</front>
</TEI>
<pmc article-type="research-article" xml:lang="EN">
<pmc-comment>The publisher of this article does not allow downloading of the full text in XML form.</pmc-comment>
<pmc-dir>properties manuscript</pmc-dir>
<front>
<journal-meta>
<journal-id journal-id-type="nlm-journal-id">9200608</journal-id>
<journal-id journal-id-type="pubmed-jr-id">2299</journal-id>
<journal-id journal-id-type="nlm-ta">Cancer Epidemiol Biomarkers Prev</journal-id>
<journal-title>Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology</journal-title>
<issn pub-type="ppub">1055-9965</issn>
<issn pub-type="epub">1538-7755</issn>
</journal-meta>
<article-meta>
<article-id pub-id-type="pmid">18990747</article-id>
<article-id pub-id-type="pmc">2586052</article-id>
<article-id pub-id-type="doi">10.1158/1055-9965.EPI-08-0558</article-id>
<article-id pub-id-type="manuscript">NIHMS77997</article-id>
<article-categories>
<subj-group subj-group-type="heading">
<subject>Article</subject>
</subj-group>
</article-categories>
<title-group>
<article-title>Tooth loss and lack of regular oral hygiene are associated with higher risk of esophageal squamous cell carcinoma</article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname>Abnet</surname>
<given-names>Christian C.</given-names>
</name>
<xref rid="A1" ref-type="aff">1</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Kamangar</surname>
<given-names>Farin</given-names>
</name>
<xref rid="A1" ref-type="aff">1</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Islami</surname>
<given-names>Farhad</given-names>
</name>
<xref rid="A2" ref-type="aff">2</xref>
<xref rid="A3" ref-type="aff">3</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Nasrollahzadeh</surname>
<given-names>Dariush</given-names>
</name>
<xref rid="A3" ref-type="aff">3</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Brennan</surname>
<given-names>Paul</given-names>
</name>
<xref rid="A3" ref-type="aff">3</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Aghcheli</surname>
<given-names>Karim</given-names>
</name>
<xref rid="A2" ref-type="aff">2</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Merat</surname>
<given-names>Shahin</given-names>
</name>
<xref rid="A2" ref-type="aff">2</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Pourshams</surname>
<given-names>Akram</given-names>
</name>
<xref rid="A2" ref-type="aff">2</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Marjani</surname>
<given-names>Haj Amin</given-names>
</name>
<xref rid="A2" ref-type="aff">2</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Ebadati</surname>
<given-names>Abdolhakim</given-names>
</name>
<xref rid="A2" ref-type="aff">2</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Sotoudeh</surname>
<given-names>Masoud</given-names>
</name>
<xref rid="A2" ref-type="aff">2</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Boffetta</surname>
<given-names>Paolo</given-names>
</name>
<xref rid="A3" ref-type="aff">3</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Malekzadeh</surname>
<given-names>Reza</given-names>
</name>
<xref rid="A2" ref-type="aff">2</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Dawsey</surname>
<given-names>Sanford M.</given-names>
</name>
<xref rid="A1" ref-type="aff">1</xref>
</contrib>
</contrib-group>
<aff id="A1">
<label>1</label>
Nutritional Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, United States of America</aff>
<aff id="A2">
<label>2</label>
Digestive Disease Research Center, Tehran University of Medical Sciences, Tehran, Iran</aff>
<aff id="A3">
<label>3</label>
International Agency for Research on Cancer, Lyon, France</aff>
<author-notes>
<corresp id="FN1">Corresponding author: Christian Abnet, PhD, MPH, Investigator, Nutritional Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Executive Plaza South, Room 320, 6120 Executive Blvd, MSC 7232, Rockville, MD 20852, V: (301) 594-1511, F: (301) 496-6829,
<email>abnetc@mail.nih.gov</email>
</corresp>
</author-notes>
<pub-date pub-type="nihms-submitted">
<day>12</day>
<month>11</month>
<year>2008</year>
</pub-date>
<pub-date pub-type="ppub">
<month>11</month>
<year>2008</year>
</pub-date>
<pub-date pub-type="pmc-release">
<day>1</day>
<month>11</month>
<year>2009</year>
</pub-date>
<volume>17</volume>
<issue>11</issue>
<fpage>3062</fpage>
<lpage>3068</lpage>
<abstract>
<p id="P1">We tested the association between tooth loss and oral hygiene and the risk of esophageal squamous cell carcinoma (ESCC) in people living in a high risk area of Iran. We used a case-control study of pathologically-confirmed ESCC cases (N=283) and controls (N=560) matched on sex, age, and neighborhood. Subjects with ESCC had significantly more decayed, missing, or filled teeth with a median (interquartile range) of 31 (
<xref ref-type="bibr" rid="R23">23</xref>
-
<xref ref-type="bibr" rid="R32">32</xref>
) compared to controls 28 (
<xref ref-type="bibr" rid="R2">2</xref>
-
<xref ref-type="bibr" rid="R32">32</xref>
) (P=0.0045). And subjects with ESCC were significantly more likely than controls to fail to practice regular oral hygiene, 78% versus 58%. In multivariate adjusted conditional logistic regression models having 32 decayed, missing, or filled teeth compared to ≤15 conferred an OR (95% CI) of 2.10 (1.19-3.70). Compared to daily tooth brushing, practicing no regular oral hygiene conferred an OR (95% CI) of 2.37 (1.42-3.97). Restricting the analysis to subjects that had never smoked tobacco did not materially alter these results. We found significant associations between two markers of poor oral hygiene, a larger number of decayed, missing, or filled teeth and lack of daily tooth brushing, and risk of ESCC in a population at high risk for ESCC where many cases occur in never smokers. Our results are consistent with several previous analyses in other high risk populations.</p>
</abstract>
<kwd-group>
<kwd>Tooth loss</kwd>
<kwd>tooth brushing</kwd>
<kwd>esophagus</kwd>
<kwd>squamous</kwd>
<kwd>cancer</kwd>
</kwd-group>
<contract-num rid="CP1">Z01 CP000185-03</contract-num>
<contract-sponsor id="CP1">Division of Cancer Epidemiology and Genetics : NCI</contract-sponsor>
</article-meta>
</front>
</pmc>
</record>

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