The association of clinically determined periodontal disease and edentulism with total cancer mortality: The National Health and Nutrition Examination Survey III. Issue 6 (20th March 2020)

• Record Type: Journal Article
• Authors: Huang, Yuhan; Michaud, Dominique S.; Lu, Jiayun; Platz, Elizabeth A.
• Is Part Of: International journal of cancer. Volume 147:Issue 6(2020)
• Page Start: 1587
• Page End: 1596
• Publication Date: 2020-03-20
• Subjects: periodontal disease -- edentulism -- cancer -- mortality; Cancer -- Periodicals; Cancer -- Prevention -- Periodicals; 616.994
• DOI: 10.1002/ijc.32941
• Languages: English
• ISSNs: 0020-7136

Abstract

Abstract : Increasing evidence supports a positive association between periodontal disease and total cancer risk. We evaluated the association of clinically assessed periodontal disease and a consequence, edentulism with total cancer mortality in participants without a prior cancer diagnosis in a U.S. nationally representative population. Included were 6, 034 participants aged ≥40 years without a prior cancer diagnosis who participated in the National Health and Nutrition Examination Survey III. Periodontal health was measured by trained dentists. Cancer deaths ( n = 702) were ascertained during a median of 21.3 years of follow‐up. Cox proportional hazards regression was used to estimate the association of periodontal disease and edentulism with total cancer mortality using no periodontal disease/dentate as the reference and adjusting for potential demographic, lifestyle including smoking and social factor confounders. Fifteen percent had periodontitis and 17% were edentulous. Periodontitis was not statistically significantly associated with risk of total cancer death after multivariable adjustment. Edentulism was associated with an increased risk of cancer mortality (hazard ratio = 1.50, 95% confidence interval = 1.12–2.00) after multivariable adjustment, including in men and women and in each racial/ethnic group studied. The positive association was observed in overweight/obese participants but not participants with normal body mass index, more strongly in prediabetic/diabetic participants than in participants without diabetes and in ever cigarette smokers but not in never cigarette smokers. In this U.S. nationally representative population, those with edentulism, but not periodontal disease, had a higher risk of total cancer death, especially in those with shared risk factors for periodontal disease and cancer. Abstract : What's new? Increasing evidence supports a positive association between periodontal disease and total cancer risk. Here, for the first time, the authors studied the association between periodontal disease, edentulism, and total cancer mortality by using a standardized clinical dental examination in a U.S. nationally representative population and adjusting for social and shared risk factors for cancer and periodontal disease. Participants with edentulism, but not periodontal disease, had a higher risk of cancer death even after taking into account demographics, shared risk factors, and social factors. This study supports the growing literature on the importance of dental health for cancer prevention and control.