Periodontal Disease and Tooth Loss as Risks for Cancer: A Systematic Review of the Literature
Identifieur interne : 000471 ( Pmc/Curation ); précédent : 000470; suivant : 000472Periodontal Disease and Tooth Loss as Risks for Cancer: A Systematic Review of the Literature
Auteurs : M. Sadighi Shamami [Iran] ; M. Sadighi Shamami [Iran] ; S. Amini [Iran]Source :
- Iranian Journal of Cancer Prevention [ 2008-2398 ] ; 2011.
Abstract
Periodontal disease is a chronic destructive disease which occurs in adults, young people, and children. Periodontal disease and periodontal pathogens have been associated with several systemic diseases and more recently, several studies have suggested the relationship between periodontal disease and cancer. Studies with adjustment for the effect of smoking exposure, have found significant positive associations with different cancer sites. This review has outlined recent epidemiologic researches pointing to a possible role for tooth loss and periodontal disease in carcinogenesis.
In this review, articles were selected from PubMed between1995 and June 2010 including human. Amongst 5,984 articles identified from the electronic search, 17 articles were selected for a full-text reading based on the inclusion and the exclusion criteria.
Nine out of 10 case-control studies reported a significant increase in the risk of oral cancer in patients with periodontitis and one with no significant association. Among 6 studies examining esophageal cancer and periodontal disease, 5 studies found a significant association between them and one study failed to find a significant increased risk of cancer. Also amongst 5 studies which focused on upper gastrointestinal, gastric cancer, and periodontal disease, 4 studies found an increased risk of cancer while one study did not report any relationship. In lung cancer evaluations, 3 out of 4 studies showed some levels of association between lung cancer and periodontal disease but after adjustment for smoking, no relationship were found. Three cohort studies have evaluated overall cancer rates in periodontal patients; two of them found small but significant association between cancers and periodontal disease.
The results indicate that there is a possible link between cancer and severe periodontal disease after adjustment for smoking and drinking habits.
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PubMed: 26322197
PubMed Central: 4551290
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<front><div type="abstract" xml:lang="en"><sec id="st1"><title>Background</title>
<p>Periodontal disease is a chronic destructive disease which occurs in adults, young people, and children. Periodontal disease and periodontal pathogens have been associated with several systemic diseases and more recently, several studies have suggested the relationship between periodontal disease and cancer. Studies with adjustment for the effect of smoking exposure, have found significant positive associations with different cancer sites. This review has outlined recent epidemiologic researches pointing to a possible role for tooth loss and periodontal disease in carcinogenesis.</p>
</sec>
<sec id="st2"><title>Methods</title>
<p>In this review, articles were selected from PubMed between1995 and June 2010 including human. Amongst 5,984 articles identified from the electronic search, 17 articles were selected for a full-text reading based on the inclusion and the exclusion criteria.</p>
</sec>
<sec id="st3"><title>Results</title>
<p>Nine out of 10 case-control studies reported a significant increase in the risk of oral cancer in patients with periodontitis and one with no significant association. Among 6 studies examining esophageal cancer and periodontal disease, 5 studies found a significant association between them and one study failed to find a significant increased risk of cancer. Also amongst 5 studies which focused on upper gastrointestinal, gastric cancer, and periodontal disease, 4 studies found an increased risk of cancer while one study did not report any relationship. In lung cancer evaluations, 3 out of 4 studies showed some levels of association between lung cancer and periodontal disease but after adjustment for smoking, no relationship were found. Three cohort studies have evaluated overall cancer rates in periodontal patients; two of them found small but significant association between cancers and periodontal disease.</p>
</sec>
<sec id="st4"><title>Conclusion</title>
<p>The results indicate that there is a possible link between cancer and severe periodontal disease after adjustment for smoking and drinking habits.</p>
</sec>
</div>
</front>
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</TEI>
<pmc article-type="review-article"><pmc-dir>properties open_access</pmc-dir>
<front><journal-meta><journal-id journal-id-type="nlm-ta">Iran J Cancer Prev</journal-id>
<journal-id journal-id-type="iso-abbrev">Iran J Cancer Prev</journal-id>
<journal-id journal-id-type="publisher-id">IJCP</journal-id>
<journal-title-group><journal-title>Iranian Journal of Cancer Prevention</journal-title>
</journal-title-group>
<issn pub-type="ppub">2008-2398</issn>
<issn pub-type="epub">2008-2401</issn>
<publisher><publisher-name>Cancer Research Center, Shahid Beheshti University of Medical Sciences</publisher-name>
</publisher>
</journal-meta>
<article-meta><article-id pub-id-type="pmid">26322197</article-id>
<article-id pub-id-type="pmc">4551290</article-id>
<article-id pub-id-type="publisher-id">IJCP-05-189</article-id>
<article-categories><subj-group subj-group-type="heading"><subject>Review Article</subject>
</subj-group>
</article-categories>
<title-group><article-title>Periodontal Disease and Tooth Loss as Risks for Cancer: A Systematic Review of the Literature</article-title>
</title-group>
<contrib-group><contrib contrib-type="author"><name><surname>Sadighi Shamami</surname>
<given-names>M</given-names>
</name>
<xref ref-type="aff" rid="af1-IJCP-05-189">1</xref>
<xref rid="c1-IJCP-05-189" ref-type="corresp"></xref>
</contrib>
<contrib contrib-type="author"><name><surname>Sadighi Shamami</surname>
<given-names>M</given-names>
</name>
<xref ref-type="aff" rid="af2-IJCP-05-189">2</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Amini</surname>
<given-names>S</given-names>
</name>
<xref ref-type="aff" rid="af1-IJCP-05-189">1</xref>
</contrib>
</contrib-group>
<aff id="af1-IJCP-05-189"><label>1</label>
Department of Periodontology, Faculty of Dentistry, Islamic Azad University Khorasgan Brunch, Isfahan, Iran</aff>
<aff id="af2-IJCP-05-189"><label>2</label>
Department of Periodontology, Faculty of Dentistry, Tabriz University of Medical Sciences, Tabriz, Iran</aff>
<author-notes><corresp id="c1-IJCP-05-189">Corresponding Author: Mehrnaz Sadighi Shamami, DDS Post Graduate Student of
Periodontology
Tel: (+98) 411 33 13 440
Email: <email xlink:href="mz_si_82@yahoo.com">mz_si_82@yahoo.com</email>
</corresp>
</author-notes>
<pub-date pub-type="ppub"><season>Autumn</season>
<year>2011</year>
</pub-date>
<volume>4</volume>
<issue>4</issue>
<fpage>189</fpage>
<lpage>198</lpage>
<history><date date-type="received"><day>15</day>
<month>5</month>
<year>2011</year>
</date>
<date date-type="accepted"><day>28</day>
<month>8</month>
<year>2011</year>
</date>
</history>
<permissions><copyright-statement>© 2015 Cancer Research Center, Shahid Beheshti University of Medical Sciences</copyright-statement>
<copyright-year>2015</copyright-year>
<license xlink:href="http://creativecommons.org/licenses/by-nc/3.0/" license-type="open-access"><license-p>This work is licensed under a Creative Commons Attribution-NonCommercial 3.0 Unported License which allows users to read, copy, distribute and make derivative works for non-commercial purposes from the material, as long as the author of the original work is cited properly.</license-p>
</license>
</permissions>
<abstract><sec id="st1"><title>Background</title>
<p>Periodontal disease is a chronic destructive disease which occurs in adults, young people, and children. Periodontal disease and periodontal pathogens have been associated with several systemic diseases and more recently, several studies have suggested the relationship between periodontal disease and cancer. Studies with adjustment for the effect of smoking exposure, have found significant positive associations with different cancer sites. This review has outlined recent epidemiologic researches pointing to a possible role for tooth loss and periodontal disease in carcinogenesis.</p>
</sec>
<sec id="st2"><title>Methods</title>
<p>In this review, articles were selected from PubMed between1995 and June 2010 including human. Amongst 5,984 articles identified from the electronic search, 17 articles were selected for a full-text reading based on the inclusion and the exclusion criteria.</p>
</sec>
<sec id="st3"><title>Results</title>
<p>Nine out of 10 case-control studies reported a significant increase in the risk of oral cancer in patients with periodontitis and one with no significant association. Among 6 studies examining esophageal cancer and periodontal disease, 5 studies found a significant association between them and one study failed to find a significant increased risk of cancer. Also amongst 5 studies which focused on upper gastrointestinal, gastric cancer, and periodontal disease, 4 studies found an increased risk of cancer while one study did not report any relationship. In lung cancer evaluations, 3 out of 4 studies showed some levels of association between lung cancer and periodontal disease but after adjustment for smoking, no relationship were found. Three cohort studies have evaluated overall cancer rates in periodontal patients; two of them found small but significant association between cancers and periodontal disease.</p>
</sec>
<sec id="st4"><title>Conclusion</title>
<p>The results indicate that there is a possible link between cancer and severe periodontal disease after adjustment for smoking and drinking habits.</p>
</sec>
</abstract>
<kwd-group><kwd>Periodontitis</kwd>
<kwd>Tooth loss</kwd>
<kwd>Oral hygiene</kwd>
<kwd>Mouth neoplasm</kwd>
</kwd-group>
</article-meta>
</front>
<floats-group><fig id="f1-IJCP-05-189" position="float"><label>Figure 1</label>
<caption><p>Odds ratio ranges of cancers</p>
</caption>
<graphic xlink:href="IJCP-05-189f1"></graphic>
</fig>
<table-wrap id="t1-IJCP-05-189" position="float"><label>Table 1</label>
<caption><p>Validation of studies on association of periodontal disease and cancers</p>
</caption>
<table frame="hsides" rules="rows"><thead><tr valign="middle"><th align="left" rowspan="1" colspan="1">Cancer site</th>
<th rowspan="1" colspan="1">Number of study</th>
<th rowspan="1" colspan="1">Systematic reviews of RCTs</th>
<th rowspan="1" colspan="1">Randomized controlled trial</th>
<th rowspan="1" colspan="1">Prospective studies</th>
<th rowspan="1" colspan="1">Retrospective studies</th>
<th rowspan="1" colspan="1">Range of the sample sizes in studies</th>
<th rowspan="1" colspan="1">Scientific validation</th>
</tr>
</thead>
<tbody><tr><td rowspan="1" colspan="1">Oral cancer</td>
<td align="center" rowspan="1" colspan="1">10</td>
<td align="center" rowspan="1" colspan="1">0</td>
<td align="center" rowspan="1" colspan="1">0</td>
<td align="center" rowspan="1" colspan="1">4</td>
<td align="center" rowspan="1" colspan="1">6</td>
<td align="center" rowspan="1" colspan="1">≥100</td>
<td align="center" rowspan="1" colspan="1">CWD</td>
</tr>
<tr><td rowspan="1" colspan="1">gastric cancer</td>
<td align="center" rowspan="1" colspan="1">5</td>
<td align="center" rowspan="1" colspan="1">0</td>
<td align="center" rowspan="1" colspan="1">0</td>
<td align="center" rowspan="1" colspan="1">2</td>
<td align="center" rowspan="1" colspan="1">3</td>
<td align="center" rowspan="1" colspan="1">≥100</td>
<td align="center" rowspan="1" colspan="1">CWD</td>
</tr>
<tr><td rowspan="1" colspan="1">Lung cancer</td>
<td align="center" rowspan="1" colspan="1">3</td>
<td align="center" rowspan="1" colspan="1">0</td>
<td align="center" rowspan="1" colspan="1">0</td>
<td align="center" rowspan="1" colspan="1">1</td>
<td align="center" rowspan="1" colspan="1">2</td>
<td align="center" rowspan="1" colspan="1">≥100</td>
<td align="center" rowspan="1" colspan="1">CWD</td>
</tr>
<tr><td rowspan="1" colspan="1">Upper GI and Esophageal Cancer</td>
<td align="center" rowspan="1" colspan="1">7</td>
<td align="center" rowspan="1" colspan="1">0</td>
<td align="center" rowspan="1" colspan="1">0</td>
<td align="center" rowspan="1" colspan="1">2</td>
<td align="center" rowspan="1" colspan="1">5</td>
<td align="center" rowspan="1" colspan="1">≥100</td>
<td align="center" rowspan="1" colspan="1">CWD</td>
</tr>
<tr><td rowspan="1" colspan="1">Total cancer</td>
<td align="center" rowspan="1" colspan="1">3</td>
<td align="center" rowspan="1" colspan="1">0</td>
<td align="center" rowspan="1" colspan="1">0</td>
<td align="center" rowspan="1" colspan="1">0</td>
<td align="center" rowspan="1" colspan="1">3</td>
<td align="center" rowspan="1" colspan="1">≥100</td>
<td align="center" rowspan="1" colspan="1">CWD</td>
</tr>
</tbody>
</table>
<table-wrap-foot><fn id="tfn1-IJCP-05-189"><p>CWD=Clinically Well Documented, RCTs=Randomized Clinical Trials</p>
</fn>
</table-wrap-foot>
</table-wrap>
<table-wrap id="t2-IJCP-05-189" position="float"><label>Table 2</label>
<caption><p>Studies support association cancer with periodontal disease.</p>
</caption>
<table frame="hsides" rules="rows"><thead><tr valign="middle"><th align="left" rowspan="1" colspan="1">Cancer site</th>
<th rowspan="1" colspan="1">Author</th>
<th rowspan="1" colspan="1">Population</th>
<th rowspan="1" colspan="1">Study design</th>
<th rowspan="1" colspan="1">Risk estimate</th>
<th rowspan="1" colspan="1">Oral health status</th>
<th rowspan="1" colspan="1">Adjusted factor</th>
<th rowspan="1" colspan="1">Result</th>
</tr>
</thead>
<tbody><tr><td rowspan="1" colspan="1">Oral cancer</td>
<td rowspan="1" colspan="1">Bundgaard et al. [<xref rid="b23-IJCP-05-189" ref-type="bibr">23</xref>
]</td>
<td rowspan="1" colspan="1">161cases, 400 controls; Denmark Baseline age range: 45 to75
</td>
<td rowspan="1" colspan="1">Case-control</td>
<td rowspan="1" colspan="1">OR: 1.73 (1.23, 2.43)</td>
<td rowspan="1" colspan="1">Loss of teeth and dental condition by exam (good, average, poor)</td>
<td rowspan="1" colspan="1">Age, gender, tobacco and alcohol consumption</td>
<td rowspan="1" colspan="1">Significantly increased risk of esophageal cancer when missing
between 6 and 15 teeth controlled for smoking</td>
</tr>
<tr><td rowspan="1" colspan="1">Oral cancer</td>
<td rowspan="1" colspan="1">De Rezende et al.[<xref rid="b24-IJCP-05-189" ref-type="bibr">24</xref>
]</td>
<td rowspan="1" colspan="1">150 patients with oral and oropharyngeal squamous cell carcinoma
</td>
<td rowspan="1" colspan="1">Case–control</td>
<td rowspan="1" colspan="1">No OR calculated</td>
<td rowspan="1" colspan="1">CPITNB and DMFTC</td>
<td rowspan="1" colspan="1">Age and sex, smoking and drinking habits</td>
<td rowspan="1" colspan="1">76% of subjects in cancer group showed >6mm pockets compared to
10% of control group</td>
</tr>
<tr><td rowspan="1" colspan="1">Oral cancer</td>
<td rowspan="1" colspan="1">Garrote et al. [<xref rid="b25-IJCP-05-189" ref-type="bibr">25</xref>
]</td>
<td rowspan="1" colspan="1">200 case/control pairs; Cuba Baseline age range: 25–91</td>
<td rowspan="1" colspan="1">Case–control</td>
<td rowspan="1" colspan="1">OR: 2.74 (1.23, 6.12) <16 teeth lost</td>
<td rowspan="1" colspan="1">Missing teeth</td>
<td rowspan="1" colspan="1">Age, gender , education (years), smoking and drinking habits</td>
<td rowspan="1" colspan="1">Significantly increased risk of oral cancer for patients missing
16 or more teeth after smoking/ETOH adjustment</td>
</tr>
<tr><td rowspan="1" colspan="1">Oral and esophageal cancer</td>
<td rowspan="1" colspan="1">Guha et al .[<xref rid="b26-IJCP-05-189" ref-type="bibr">26</xref>
]</td>
<td rowspan="1" colspan="1">924 cases head and neck and esophageal SCCA/928 controls in
Europe</td>
<td rowspan="1" colspan="1">Case–control</td>
<td rowspan="1" colspan="1">Europe OR 2.89</td>
<td rowspan="1" colspan="1">Dental condition by exam (good, average, Poor)</td>
<td rowspan="1" colspan="1">Sex , gender, alcohol and smoking</td>
<td rowspan="1" colspan="1">Poor oral condition significant increased risk of head and neck
cancer</td>
</tr>
<tr><td rowspan="1" colspan="1">Oral, Lung, esophageal and gastric cancer</td>
<td rowspan="1" colspan="1">Hiraki et al. [<xref rid="b27-IJCP-05-189" ref-type="bibr">27</xref>
]</td>
<td rowspan="1" colspan="1">429 cases head and neck cancer out of 5240 cancer patients and
10,480 control patients in Japan</td>
<td rowspan="1" colspan="1">Case–control</td>
<td rowspan="1" colspan="1">OR 1.68 for 0 remaining teeth</td>
<td rowspan="1" colspan="1">Loss of teeth</td>
<td rowspan="1" colspan="1">Sex, age, tobacco and alcohol consumption</td>
<td rowspan="1" colspan="1">Significantly increased risk of head and neck cancer to
decreased number remaining teeth</td>
</tr>
<tr><td rowspan="1" colspan="1">Oral cancer</td>
<td rowspan="1" colspan="1">Marshall, et al. [<xref rid="b28-IJCP-05-189" ref-type="bibr">28</xref>
]</td>
<td rowspan="1" colspan="1">290
case/control pairs; Western New York, USA</td>
<td rowspan="1" colspan="1">Case–control</td>
<td rowspan="1" colspan="1">OR: 2.7 (1.1, 6.5) <11 teeth lost</td>
<td rowspan="1" colspan="1">Missing teeth</td>
<td rowspan="1" colspan="1">Age, gender,
smoking and alcohol consumption</td>
<td rowspan="1" colspan="1">Significantly increased risk of oral cancer with loss of 11 or
more teeth after smoking and alcohol adjustment</td>
</tr>
<tr><td rowspan="1" colspan="1">Oral cancer</td>
<td rowspan="1" colspan="1">Rosenquist et al. [<xref rid="b30-IJCP-05-189" ref-type="bibr">30</xref>
]</td>
<td rowspan="1" colspan="1">132 cases, 320 controls; Southern Sweden Baseline age range:
33–89</td>
<td rowspan="1" colspan="1">Case–control</td>
<td rowspan="1" colspan="1">OR: 5.3 (2.5, 11.3)</td>
<td rowspan="1" colspan="1">Missing teeth, Panoramic radiograph</td>
<td rowspan="1" colspan="1">Age, gender, county, tobacco and alcohol consumption</td>
<td rowspan="1" colspan="1">Significantly increased risk of oral and oropharyngeal cancer
for missing over 20 teeth after adjustment for smoking and EtOH</td>
</tr>
<tr><td rowspan="1" colspan="1">Oral cancer</td>
<td rowspan="1" colspan="1">Tezal et al. [<xref rid="b31-IJCP-05-189" ref-type="bibr">31</xref>
]</td>
<td rowspan="1" colspan="1">151 cases and 54 controls in the United States</td>
<td rowspan="1" colspan="1">Case–control</td>
<td rowspan="1" colspan="1">OR :5.23</td>
<td rowspan="1" colspan="1">mm of alveolar bone loss</td>
<td rowspan="1" colspan="1">Sex , age and smoking and alcohol consumption</td>
<td rowspan="1" colspan="1">Significantly increased risk of tongue
Cancer with each mm of bone lost after sex, age and smoking
adjustment</td>
</tr>
<tr><td rowspan="1" colspan="1">Oral cancer</td>
<td rowspan="1" colspan="1">Zheng et al. [<xref rid="b32-IJCP-05-189" ref-type="bibr">32</xref>
]</td>
<td rowspan="1" colspan="1">404 case–control pairs; Beijing, Baseline age range: 18–80</td>
<td rowspan="1" colspan="1">Case–control</td>
<td rowspan="1" colspan="1">OR: 2.7 (1.1, 6.5)
</td>
<td rowspan="1" colspan="1">Missing teeth</td>
<td rowspan="1" colspan="1">Age, gender, smoking, alcohol consumption</td>
<td rowspan="1" colspan="1">Significantly increased risk of tongue cancer with each mm of
bone lost after smoking adjustment</td>
</tr>
<tr><td rowspan="1" colspan="1">Esophageal and gastric cancer</td>
<td rowspan="1" colspan="1">Abnet et al. [<xref rid="b34-IJCP-05-189" ref-type="bibr">34</xref>
]</td>
<td rowspan="1" colspan="1">283 esophageal SCCA and 560
Controls in Iran</td>
<td rowspan="1" colspan="1">Cohort</td>
<td rowspan="1" colspan="1">OR 2.10</td>
<td rowspan="1" colspan="1">DMFT and poor hygiene, Loss of teeth</td>
<td rowspan="1" colspan="1">Age,
gender tobacco and alcohol consumption</td>
<td rowspan="1" colspan="1">Significantly increased risk of esophageal SCCA with 32 DMFT
compared to <15
Also found significant risk with poor oral hygiene and
increasing numbers of teeth lost</td>
</tr>
<tr><td rowspan="1" colspan="1">Esophageal cancer</td>
<td rowspan="1" colspan="1">Abnet et al. [<xref rid="b35-IJCP-05-189" ref-type="bibr">35</xref>
]</td>
<td rowspan="1" colspan="1">28,790 person cohort; People’s Republic of China 2,625 upper GI
deaths Baseline age range: 40–69</td>
<td rowspan="1" colspan="1">Cohort</td>
<td rowspan="1" colspan="1">OR: 1.35 (1.14, 1.59) Upper GI cancer mortality</td>
<td rowspan="1" colspan="1">Missing teeth</td>
<td rowspan="1" colspan="1">Age, gender, tobacco (never vs. Ever used regularly for 6
months)drinking habits</td>
<td rowspan="1" colspan="1">Significant increase in risk of upper GI deaths with increasing
loss of teeth especially in a younger age controlled for smoking
and EtOH</td>
</tr>
<tr><td rowspan="1" colspan="1">Upper GI
and Gastric cancer</td>
<td rowspan="1" colspan="1">Watabe et al. [<xref rid="b36-IJCP-05-189" ref-type="bibr">36</xref>
]</td>
<td rowspan="1" colspan="1">242 cases, 484 controls; Japan
Baseline age range: 40–79</td>
<td rowspan="1" colspan="1">Case–control</td>
<td rowspan="1" colspan="1">OR: 1.73 (1.23, 2.43) <10 teeth lost</td>
<td rowspan="1" colspan="1">Missing teeth</td>
<td rowspan="1" colspan="1">Age, gender, residential area, smoking and drinking habits</td>
<td rowspan="1" colspan="1">Significant increased risk of gastric cancer with more than 20
teeth lost when compared to none lost</td>
</tr>
<tr><td rowspan="1" colspan="1">Total cancer, Lung cancer, esophageal and Gastric cancer</td>
<td rowspan="1" colspan="1">Michaud et al. [<xref rid="b38-IJCP-05-189" ref-type="bibr">38</xref>
]</td>
<td rowspan="1" colspan="1">11,328 person cohort; USA
191 lung and bronchus cancer deaths
Baseline age range: 25–74</td>
<td rowspan="1" colspan="1">Cohort</td>
<td rowspan="1" colspan="1">OR: 1.64 (1.19, 2.26) History of
Periodontal disease</td>
<td rowspan="1" colspan="1">Missing teeth and history of periodontal disease</td>
<td rowspan="1" colspan="1">Age, smoking and drinking habits profession, race, geographic
location, physical activity, </td>
<td rowspan="1" colspan="1">Significantly increased risk of overall cancer for patients with
a history of periodontal disease after controlling for smoking</td>
</tr>
</tbody>
</table>
<table-wrap-foot><fn id="tfn2-IJCP-05-189"><p>DMFT = Decayed, missing, or filled teeth, mm= millimeter, SCCA=Squamous cell carcinoma, GI=Gastrointestinal , OR= Odd Ratio</p>
</fn>
</table-wrap-foot>
</table-wrap>
<table-wrap id="t3-IJCP-05-189" position="float"><label>Table 3</label>
<caption><p>Studies did not support association cancer with periodontal disease</p>
</caption>
<table frame="hsides" rules="rows"><thead><tr valign="middle"><th rowspan="1" colspan="1">Cancer site</th>
<th rowspan="1" colspan="1">Author</th>
<th rowspan="1" colspan="1">Population</th>
<th rowspan="1" colspan="1">Study design</th>
<th rowspan="1" colspan="1">Risk estimate</th>
<th rowspan="1" colspan="1">Oral health status</th>
<th rowspan="1" colspan="1">Adjusted factor</th>
<th rowspan="1" colspan="1">Result</th>
</tr>
</thead>
<tbody><tr><td rowspan="1" colspan="1">Oral cancer</td>
<td rowspan="1" colspan="1">Talamini et al. [29]</td>
<td rowspan="1" colspan="1">132 cases, 148 controls; Italy Baseline age range: 27–86</td>
<td rowspan="1" colspan="1">Case–control</td>
<td rowspan="1" colspan="1">OR: 1.4 (0.6, 3.1) <16 teeth lost</td>
<td rowspan="1" colspan="1">Missing teeth</td>
<td rowspan="1" colspan="1">Age, gender, fruit and vegetable intake, smoking and drinking habits</td>
<td rowspan="1" colspan="1">No significant increase in risk of oral cancer to increased missing
16 or more teeth found but poor condition of mouth was associated
after smoking and EtOH control</td>
</tr>
<tr><td rowspan="1" colspan="1">Esophageal and gastric cancer</td>
<td rowspan="1" colspan="1">Abnet et al. [33]</td>
<td rowspan="1" colspan="1">179 gastric noncardia cases
66 esophageal/gastric cardia cases ,49 esophageal cases
Baseline age range: 50–69</td>
<td rowspan="1" colspan="1">Cohort</td>
<td rowspan="1" colspan="1">OR: 1.46 (0.97, 2.21)
</td>
<td rowspan="1" colspan="1">Missing teeth</td>
<td rowspan="1" colspan="1">Age, education, smoking and drinking habits</td>
<td rowspan="1" colspan="1">No significant association seen for esophageal or gastric cardia
cancer with increased loss of teeth</td>
</tr>
<tr><td rowspan="1" colspan="1">Lung cancer and Total cancer</td>
<td rowspan="1" colspan="1">Tu et al.[37]</td>
<td rowspan="1" colspan="1">12,223 person cohort; Glasgow, Scotland
549 cancer deaths
Baseline age range: B30 years</td>
<td rowspan="1" colspan="1">Cohort</td>
<td rowspan="1" colspan="1">OR: 1.00 (0.98, 1.02) </td>
<td rowspan="1" colspan="1">Missing teeth
Missing teeth and history of periodontal disease Missing teeth</td>
<td rowspan="1" colspan="1">Age, year of birth, gender, smoking and drinking habits</td>
<td rowspan="1" colspan="1">No significant increase in risk between cancer deaths and increased
missing teeth</td>
</tr>
<tr><td rowspan="1" colspan="1">Total cancer</td>
<td rowspan="1" colspan="1">Cabrera et al. [39]</td>
<td rowspan="1" colspan="1">1,462 women; Gothenburg, Sweden
68 cancer deaths
Baseline age range: 38–60</td>
<td rowspan="1" colspan="1">Cohort</td>
<td rowspan="1" colspan="1">OR: 1.16 (0.90, 1.49)
</td>
<td rowspan="1" colspan="1">Missing teeth</td>
<td rowspan="1" colspan="1">Age, smoking, age at first birth, parity, smoking and drinking
habits</td>
<td rowspan="1" colspan="1">No significant association between cancer mortality and increased
number of missing teeth</td>
</tr>
</tbody>
</table>
</table-wrap>
</floats-group>
</pmc>
</record>
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