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Chiewwit P, Khovidhunkit SOP, Tantipoj C, Worakhajit P, Klongnoi B. A study of risk factors associated with the presence of oral potentially malignant disorders: a community-based study from Northeastern Thailand. BMC Oral Health 2024; 24:932. [PMID: 39129030 PMCID: PMC11317011 DOI: 10.1186/s12903-024-04554-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2024] [Accepted: 07/01/2024] [Indexed: 08/13/2024] Open
Abstract
BACKGROUND The principal objective of this study is to ascertain the connections between well-known risk factors of oral cancer, including smoking (cigarette and tobacco), alcohol consumption, betel quid chewing, irritations in the oral cavity, history of head and neck cancer, and history of working outdoor more than 4 days/week, and the presence of OPMDs within the Thai population. METHOD 349,318 subjects were recruited for initial screening, then 1,483 subjects who had at least 1 risk factor and a suspicious lesion underwent comprehensive oral examinations followed by a clinical diagnosis and then received initial treatment from either oral surgeons or oral medicine specialists. Among these subjects, individuals with at least 1 risk factor and with a clinical diagnosis of OPMDs were classified as cases, while those with at least 1 risk factor but without OPMDs were categorized as controls. The case group comprised a total of 487 subjects, whereas the control group consisted of 996 subjects. Exclusion criteria were known cases of currently having oral cancer or OPMDs. RESULTS The outcomes of the multivariate analysis revealed that among the variables assessed, betel quid (adjusted OR 5.12 [3.93-6.68], p < 0.001) and smoking (adjusted OR 1.46 [1.08-1.97], p = 0.013), there were an association with the presence of OPMDs. Conversely, alcohol drinking, having irritations in the oral cavity, a history of head and neck cancer, and a history of working outdoors more than 4 days/week were not associated with the presence of OPMDs. Furthermore, we also study the synergistic effect of alcohol drinking, irritations in the oral cavity, history of head and neck cancer, and history of working outdoors more than 4 days/week using subgroup analysis. The analysis showed that alcohol consumption combined with smoking or betel quid chewing expressed a significantly increased risk of OPMDs, from 1.46 to 2.03 (OR 2.03 [1.16-3.56], p = 0.014) and from 5.12 to 7.20 (OR 7.20 [3.96-13.09], p < 0.001). CONCLUSION Smoking and exposure to betel quid were a significant risk factors for the presence of OPMDs. The combination of alcohol with smoking or betel quid chewing was also found to increase the risk of OPMDs in this Thai northeastern population.
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Affiliation(s)
- Pim Chiewwit
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Mahidol University, Bangkok, Thailand
| | | | - Chanita Tantipoj
- Department of Advance General Dentistry, Faculty of Dentistry, Mahidol University, Bangkok, Thailand
| | - Prangtip Worakhajit
- Department of Advance General Dentistry, Faculty of Dentistry, Mahidol University, Bangkok, Thailand
| | - Boworn Klongnoi
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Mahidol University, Bangkok, Thailand.
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Unlu O, Demirci M, Paksoy T, Eden AB, Tansuker HD, Dalmizrak A, Aktan C, Senel F, Sunter AV, Yigit O, Cakir BO, Kantarci A. Oral microbial dysbiosis in patients with oral cavity cancers. Clin Oral Investig 2024; 28:377. [PMID: 38884817 PMCID: PMC11182825 DOI: 10.1007/s00784-024-05770-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2024] [Accepted: 06/10/2024] [Indexed: 06/18/2024]
Abstract
OBJECTIVES The pathogenesis of oral cavity cancers is complex. We tested the hypothesis that oral microbiota dysbiosis is associated with oral cavity cancer. MATERIALS AND METHODS Patients with primary oral cavity cancer who met the inclusion and exclusion criteria were included in the study. Matching healthy individuals were recruited as controls. Data on socio-demographic and behavioral factors, self-reported periodontal measures and habits, and current dental status were collected using a structured questionnaire and periodontal chartings. In addition to self-reported oral health measures, each participant received a standard and detailed clinical examination. DNA was extracted from saliva samples from patients and healthy controls. Next-generation sequencing was performed by targeting V3-V4 gene regions of the 16 S rRNA with subsequent bioinformatic analyses. RESULTS Patients with oral cavity cancers had a lower quality of oral health than healthy controls. Proteobacteria, Aggregatibacter, Haemophilus, and Neisseria decreased, while Firmicutes, Bacteroidetes, Actinobacteria, Lactobacillus, Gemella, and Fusobacteria increased in oral cancer patients. At the species level, C. durum, L. umeaens, N. subflava, A. massiliensis, and V. dispar were significantly lower, while G. haemolysans was significantly increased (p < 0.05). Major periodontopathogens associated with periodontal disease (P. gingivalis and F.nucleatum) increased 6.5- and 2.8-fold, respectively. CONCLUSION These data suggested that patients with oral cancer had worse oral health conditions and a distinct oral microbiome composition that is affected by personal daily habits and may be associated with the pathogenicity of the disease and interspecies interactions. CLINICAL RELEVANCE This paper demonstrates the link between oral bacteria and oral cancers, identifying mechanistic interactions between species of oral microbiome.
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Affiliation(s)
- Ozge Unlu
- Faculty of Medicine, Department of Medical Microbiology, Istanbul Atlas University, Istanbul, Turkey.
- ADA Forsyth Institute, Cambridge, MA, USA.
| | - Mehmet Demirci
- Faculty of Medicine, Department of Medical Microbiology, Kırklareli University, Kırklareli, Turkey
| | - Tugce Paksoy
- Faculty of Dentistry, Department of Periodontology, University of Health Sciences, Istanbul, Turkey
| | - Arzu Baygul Eden
- Faculty of Medicine, Department of Biostatistics, Koc University, Istanbul, Turkey
| | - Hasan Deniz Tansuker
- Faculty of Medicine, Department of Otolaryngology, Yeditepe University, Istanbul, Turkey
| | - Aysegul Dalmizrak
- Faculty of Medicine, Department of Medical Biology, Balıkesir University, Balıkesir, Turkey
| | - Cagdas Aktan
- Faculty of Medicine, Department of Medical Biology, Bandirma University, Balıkesir, Turkey
| | - Firdevs Senel
- Faculty of Dentistry, Department of Oral & Maxillofacial Surgery, Beykent University, Istanbul, Turkey
| | - Ahmet Volkan Sunter
- Department of Ear, Nose and Throat Diseases, Istanbul Sisli Hamidiye Etfal Research and Training Hospital, Istanbul, Turkey
| | - Ozgur Yigit
- Department of Ear, Nose and Throat Diseases, Istanbul Sisli Hamidiye Etfal Research and Training Hospital, Istanbul, Turkey
| | - Burak Omur Cakir
- Faculty of Medicine, Department of Ear, Nose and Throat Diseases, Istanbul Aydin University, Istanbul, Turkey
| | - Alpdogan Kantarci
- ADA Forsyth Institute, Cambridge, MA, USA
- School of Dental Medicine, Harvard University, Boston, MA, USA
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Ma Y, Tuerxun N, Maimaitili G. Periodontitis and the risk of oral cancer: a meta-analysis of case-control studies. Acta Odontol Scand 2024; 83:40478. [PMID: 38742908 PMCID: PMC11302657 DOI: 10.2340/aos.v83.40478] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2023] [Accepted: 02/29/2024] [Indexed: 05/16/2024]
Abstract
OBJECTIVE The current studies have yielded inconclusive findings regarding the connection between periodontitis and oral cancer (OC). Therefore, our goal is to elucidate this relationship. MATERIALS AND METHODS We conducted a thorough search of electronic databases (EMBASE, PubMed, Web of Science, and Cochrane Library) up to September 2023. The Newcastle-Ottawa Scale (NOS) was applied to assess study quality. To evaluate potential publication bias, both a funnel plot and Egger's test were employed. Additionally, a sensitivity analysis was conducted to explore the source of heterogeneity when the I2 statistic exceeded 50%. RESULTS This systematic review encompassed 16 studies, involving a total of 6,032 OC patients and 7,432 healthy controls. Our meta-analysis, incorporating data from nine studies, revealed a significant correlation between periodontitis and the risk of OC (OR [odds ratio] = 2.94, 95% CI [confidence interval] (2.13, 4.07); five studies, 6,927 participants; low certainty of evidence). Findings also suggested that individuals with more than 15 missing teeth may have a heightened risk of OC (OR = 1.91, 95% CI (1.01, 3.62)). Furthermore, clinical attachment loss (CAL) and decayed, missing, and filled teeth (DMFT) in OC patients were more pronounced compared to the control group (CAL, SMD = 1.94, 95% CI (0.22, 3.66); DMFT, SMD = 0.65, 95% CI (0.12, 1.18)). CONCLUSION Periodontitis may serve as a potential risk factor for OC. However, caution is warranted in interpreting these findings due to the substantial level of heterogeneity.
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Affiliation(s)
- Yan Ma
- Department of Stomatology Xinjiang Medical University, Affiliated Hospital 2, Urumqi, Xinjiang 830063, China
| | - Nijiati Tuerxun
- Department of Stomatology Xinjiang Medical University, Affiliated Hospital 2, Urumqi, Xinjiang 830063, China
| | - Gulibaha Maimaitili
- Department of Stomatology Xinjiang Medical University, Affiliated Hospital 2, Urumqi, Xinjiang 830063, China.
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Chang KW, Mazul AL, Lander DP, Wahle BM, Yan EZ, Thorstad WL, Puram SV, Jackson RS, Pipkorn P, Paniello RC, Zolkind PA, Olshan AF, Zevallos JP. Poor Dental Health as a Risk Factor for Alveolar Ridge Malignancies. Otolaryngol Head Neck Surg 2024; 170:1081-1090. [PMID: 38219743 DOI: 10.1002/ohn.647] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2023] [Revised: 04/15/2023] [Accepted: 05/01/2023] [Indexed: 01/16/2024]
Abstract
OBJECTIVE To determine the association between poor dental health and risk of oral cavity squamous cell cancer (OCSCC) at individual tumor subsites. STUDY DESIGN Case-control and cross-sectional METHODS: A case-control study was performed using a population-based cohort in North Carolina (Carolina Head and Neck Cancer Epidemiology Study [CHANCE]). A secondary cross-sectional analysis was performed with an institutional cohort (WashU/Siteman). Cases were adults with primary OCSCC and an identifiable tumor subsite. In the CHANCE cohort, controls were adults without head and neck cancer. In the Washington University/Siteman cohort, patients with tongue cancer served as the comparator group. We used number of missing teeth (categorized 0-6, 7-24, 25-28) as a surrogate for poor dental health, which was self-reported in CHANCE and measured on a pretreatment computed tomography scan in the WashU/Siteman study. Adjusted odds ratios (aORs) for missing teeth were estimated for each tumor subsite using binomial logistic regression models. RESULTS Near complete tooth loss (25-28 teeth) was associated with a 3.5-fold increased risk of alveolar ridge malignancy (aOR: 3.51; 95% confidence interval [CI]: 1.14-11.01, P = .03) in the CHANCE study. This association was confirmed in our cross-sectional analysis (WashU/Siteman study) where missing 25-28 teeth was associated with an increased risk of alveolar ridge compared to tongue cancer (aOR: 4.60; 95% CI: 1.97-11.10, P = .001). CONCLUSIONS This study suggests an association between poor dental health and risk of alveolar ridge cancer independent of smoking, alcohol use, age, race, and sex. Future prospective and translational studies are needed to confirm this association and elucidate the mechanism of dental disease in alveolar ridge malignancies.
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Affiliation(s)
- Katherine W Chang
- Department of Otolaryngology-Head and Neck Surgery, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Angela L Mazul
- Department of Otolaryngology-Head and Neck Surgery, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Daniel P Lander
- Department of Otolaryngology-Head and Neck Surgery, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Benjamin M Wahle
- Department of Otolaryngology-Head and Neck Surgery, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Emily Z Yan
- Washington University School of Medicine, St. Louis, Missouri, USA
| | - Wade L Thorstad
- Department of Radiation Oncology, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Sidharth V Puram
- Department of Otolaryngology-Head and Neck Surgery, Washington University School of Medicine, St. Louis, Missouri, USA
- Department of Genetics, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Ryan S Jackson
- Department of Otolaryngology-Head and Neck Surgery, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Patrik Pipkorn
- Department of Otolaryngology-Head and Neck Surgery, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Randal C Paniello
- Department of Otolaryngology-Head and Neck Surgery, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Paul A Zolkind
- Department of Otolaryngology-Head and Neck Surgery, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Andrew F Olshan
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Jose P Zevallos
- Department of Otolaryngology-Head and Neck Surgery, University of Pittsburgh Medical Center, Pittsburg, Pennsylvania, USA
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Khoo A, Boyer M, Jafri Z, Makeham T, Pham T, Khachigian LM, Floros P, Dowling E, Fedder K, Shonka D, Garneau J, O'Meara CH. Human Papilloma Virus Positive Oropharyngeal Squamous Cell Carcinoma and the Immune System: Pathogenesis, Immunotherapy and Future Perspectives. Int J Mol Sci 2024; 25:2798. [PMID: 38474047 DOI: 10.3390/ijms25052798] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2024] [Revised: 02/14/2024] [Accepted: 02/16/2024] [Indexed: 03/14/2024] Open
Abstract
Oropharyngeal squamous cell carcinoma (OPSCC), a subset of head and neck squamous cell carcinoma (HNSCC), involves the palatine tonsils, soft palate, base of tongue, and uvula, with the ability to spread to adjacent subsites. Personalized treatment strategies for Human Papillomavirus-associated squamous cell carcinoma of the oropharynx (HPV+OPSCC) are yet to be established. In this article, we summarise our current understanding of the pathogenesis of HPV+OPSCC, the intrinsic role of the immune system, current ICI clinical trials, and the potential role of small molecule immunotherapy in HPV+OPSCC.
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Affiliation(s)
- A Khoo
- Department of Otolaryngology, Head & Neck Surgery, Canberra Health Services, Canberra, ACT 2601, Australia
| | - M Boyer
- Chris O'Brien Lifehouse, Camperdown, NSW 2050, Australia
| | - Z Jafri
- Vascular Biology and Translational Research, Department of Pathology, School of Biomedical Sciences, Faculty of Medicine and Health, University of New South Wales, Sydney, NSW 2052, Australia
| | - T Makeham
- Department of Otolaryngology, Head & Neck Surgery, Canberra Health Services, Canberra, ACT 2601, Australia
- ANU School of Medicine & Psychology, Australian National University, Canberra, ACT 0200, Australia
| | - T Pham
- Department of Otolaryngology, Head & Neck Surgery, Canberra Health Services, Canberra, ACT 2601, Australia
- ANU School of Medicine & Psychology, Australian National University, Canberra, ACT 0200, Australia
| | - L M Khachigian
- Vascular Biology and Translational Research, Department of Pathology, School of Biomedical Sciences, Faculty of Medicine and Health, University of New South Wales, Sydney, NSW 2052, Australia
| | - P Floros
- St Vincent's Hospital, 390 Victoria Street, Sydney, NSW 2010, Australia
| | - E Dowling
- Department of Otolaryngology, Head & Neck Surgery, University of Virginia School of Medicine, Charlottesville, VA 22903, USA
| | - K Fedder
- Department of Otolaryngology, Head & Neck Surgery, University of Virginia School of Medicine, Charlottesville, VA 22903, USA
| | - D Shonka
- Department of Otolaryngology, Head & Neck Surgery, University of Virginia School of Medicine, Charlottesville, VA 22903, USA
| | - J Garneau
- Department of Otolaryngology, Head & Neck Surgery, University of Virginia School of Medicine, Charlottesville, VA 22903, USA
| | - C H O'Meara
- Department of Otolaryngology, Head & Neck Surgery, Canberra Health Services, Canberra, ACT 2601, Australia
- ANU School of Medicine & Psychology, Australian National University, Canberra, ACT 0200, Australia
- Department of Otolaryngology, Head & Neck Surgery, University of Virginia School of Medicine, Charlottesville, VA 22903, USA
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Qian Y, Cai B, Chi F, Yao C, Zhang L, Qi L, Jiang Y, Wang X. Alveolar bone loss and tooth loss contribute to increase in cancer mortality among older patients. BMC Oral Health 2023; 23:1023. [PMID: 38114973 PMCID: PMC10731843 DOI: 10.1186/s12903-023-03543-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Accepted: 10/15/2023] [Indexed: 12/21/2023] Open
Abstract
BACKGROUND Both cancer and periodontitis are more prevalent with age. Information on their relationship in older patients is limited. This study aims to examine whether periodontitis is associated with increased risk of cancer mortality with a ≥ 75-year age group cohort. METHODS A retrospective cohort study was conducted on 1146 patients who had digital radiographic examinations. Alveolar bone loss and loss of teeth were measured as indicators of periodontitis. Hazard ratio (HR) with 95% confidence interval (CI) were taken as the effect size to summarize the associations between periodontitis and risks of cancer mortality using the multivariate adjusted cox proportional hazards model and competing risk hazard model. RESULTS Totally, 104 total cancer, 28 lip, oral cavity and pharynx (LOP) cancer, 39 digestive cancer and 13 respiratory cancer cases were documented over 10 years of follow-up. Total cancer (HR 1.27, 95% CI 1.06-1.53) displayed statistically significant associations with alveolar bone loss and tooth loss after adjusting for relevant confounding variables. We also observed borderline significant association between alveolar bone loss and LOP cancer (HR 1.45, 95% CI 0.99-2.12). The above associations were consistent with the results observed from the competing risk hazard models. CONCLUSION Our results indicate that older patients suffering from tooth loss or alveolar bone loss are at increased risks of cancer mortality, especially for total cancer and LOP cancer.
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Affiliation(s)
- Yifeng Qian
- Department of Oral and Craniomaxillofacial Surgery, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai JiaoTong University School of Medicine, 639 Zhizaoju Road, Huangpu District, Shanghai, China
- National Clinical Research Center for Oral Diseases, Shanghai, China
- Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, Shanghai, China
- College of Stomatology, Shanghai JiaoTong University School of Medicine, Shanghai, China
| | - Binxin Cai
- Songjiang District Center for Disease Control and Prevention, Shanghai, China
| | - Fangfang Chi
- Songjiang District Center for Disease Control and Prevention, Shanghai, China
| | - Chunxia Yao
- Songjiang District Center for Disease Control and Prevention, Shanghai, China
| | - Lei Zhang
- Department of Oral and Craniomaxillofacial Surgery, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai JiaoTong University School of Medicine, 639 Zhizaoju Road, Huangpu District, Shanghai, China
- National Clinical Research Center for Oral Diseases, Shanghai, China
- Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, Shanghai, China
- College of Stomatology, Shanghai JiaoTong University School of Medicine, Shanghai, China
| | - Lei Qi
- Department of Oral and Craniomaxillofacial Surgery, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai JiaoTong University School of Medicine, 639 Zhizaoju Road, Huangpu District, Shanghai, China
- National Clinical Research Center for Oral Diseases, Shanghai, China
- Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, Shanghai, China
- College of Stomatology, Shanghai JiaoTong University School of Medicine, Shanghai, China
| | - Yonggen Jiang
- Songjiang District Center for Disease Control and Prevention, Shanghai, China
| | - Xudong Wang
- Department of Oral and Craniomaxillofacial Surgery, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai JiaoTong University School of Medicine, 639 Zhizaoju Road, Huangpu District, Shanghai, China.
- National Clinical Research Center for Oral Diseases, Shanghai, China.
- Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, Shanghai, China.
- College of Stomatology, Shanghai JiaoTong University School of Medicine, Shanghai, China.
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Bai X, Cui C, Yin J, Li H, Gong Q, Wei B, Lu Y. The association between oral hygiene and head and neck cancer: a meta-analysis. Acta Odontol Scand 2023; 81:374-395. [PMID: 36538375 DOI: 10.1080/00016357.2022.2158129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Revised: 10/17/2022] [Accepted: 12/06/2022] [Indexed: 12/24/2022]
Abstract
OBJECTIVE Oral hygiene has been suspected to contribute to the aetiology of head and neck cancer (HNC). Based on the meta-analysis, we evaluated the impact of oral hygiene on head and neck cancer (HNC) and its survival. MATERIALS AND METHODS Relevant case-control and cohort studies reporting survival data, oral hygiene data were searched via PubMed, Embase, Cochrane Library, and Web of Science databases. The odds ratios (ORs), hazard ratios (HRs), and 95% confidence intervals (CIs) were used. Subgroup analysis was performed. RESULTS Oral hygiene was associated with HNC. Tooth brushing ≥2 a day, dental floss use, denture wearing, caries ≥3, and dental visit ≥1 reduced the risk of oral cavity cancer while mouth wash use, missing teeth >5, gum bleeding, and periodontal disease increased the risk of oral cavity cancer. For oropharynx cancer, tooth brushing ≥2 and caries ≥3 were associated with reduced risk of it. Tooth brushing ≥2 and dental visits ≥1 decreased the risk of pharynx cancer risk and larynx cancer risk, however, missing teeth >5 increased both of them. CONCLUSION Oral hygiene was associated with HNC and its sub sites. Oral hygiene should be strengthened, a dental floss use and dentist's visits can be recommended.
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Affiliation(s)
- Xue Bai
- Department of Stomatology, The First Medical Center of PLA General Hospital, Beijing, P.R. China
| | - Chunyan Cui
- Department of Stomatology, The First Medical Center of PLA General Hospital, Beijing, P.R. China
| | - Jiajia Yin
- Department of Stomatology, The First Medical Center of PLA General Hospital, Beijing, P.R. China
| | - Hua Li
- Department of Stomatology, The First Medical Center of PLA General Hospital, Beijing, P.R. China
| | - Qiwei Gong
- Department of Stomatology, The First Medical Center of PLA General Hospital, Beijing, P.R. China
| | - Bo Wei
- Department of Stomatology, The First Medical Center of PLA General Hospital, Beijing, P.R. China
| | - Yifan Lu
- Department of Stomatology, The Third Hospital of Shijiazhuang, Shijiazhuang, P.R. China
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Wichmann G, Rudolph J, Henger S, Engel C, Wirkner K, Wenning JR, Zeynalova S, Wiegand S, Loeffler M, Wald T, Dietz A. Is High-Risk Sexual Behavior a Risk Factor for Oropharyngeal Cancer? Cancers (Basel) 2023; 15:3356. [PMID: 37444466 DOI: 10.3390/cancers15133356] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Revised: 05/12/2023] [Accepted: 06/09/2023] [Indexed: 07/15/2023] Open
Abstract
(1) Background: Several lines of evidence established a link between high-risk (HR) sexual behavior (SB), the persistence of human papillomavirus (HPV) DNA in saliva, and the presence of oncogenic HR-HPV subtypes in oropharyngeal squamous cell carcinoma (OPSCC). A highly influential case-control study by D'Souza et al. comparing OPSCC patients and ENT patients with benign diseases (hospital controls) established HR-SB as a putative etiological risk factor for OPSCC. Aiming to replicate their findings in a nested case-control study of OPSCC patients and propensity score (PS)-matched unaffected controls from a large population-based German cohort study, we here demonstrate discrepant findings regarding HR-SB in OPSCC. (2) Methods: According to the main risk factors for HNSCC (age, sex, tobacco smoking, and alcohol consumption) PS-matched healthy controls invited from the population-based cohort study LIFE and HNSCC (including OPSCC) patients underwent interviews, using AUDIT and Fagerström, as well as questionnaires asking for SB categories as published. Afterwards, by newly calculating PSs for the same four risk factors, we matched each OPSCC patient with two healthy controls and compared responses utilizing chi-squared tests and logistic regression. (3) Results: The HNSCC patients and controls showed significant differences in sex distribution, chronologic age, tobacco-smoking history (pack years), and alcohol dependence (based on AUDIT score). However, PS-matching decreased the differences between OPSCC patients and controls substantially. Despite confirming that OPSCC patients were more likely to self-report their first sexual intercourse before age 18, we found no association between OPSCC and HR-SB, neither for practicing oral-sex, having an increased number of oral- or vaginal-sex partners, nor for having casual sex or having any sexually transmitted disease. (4) Conclusions: Our data, by showing a low prevalence of HR-SB in OPSCC patients, confirm findings from other European studies that differ substantially from North American case-control studies. HR-SB alone may not add excess risk for developing OPSCC.
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Affiliation(s)
- Gunnar Wichmann
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Leipzig, Liebigstr. 10-14, 04103 Leipzig, Germany
- LIFE Leipzig Research Center for Civilization Diseases, Leipzig University, Philipp-Rosenthal-Str. 27, 04103 Leipzig, Germany
| | - Jasmin Rudolph
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Leipzig, Liebigstr. 10-14, 04103 Leipzig, Germany
| | - Sylvia Henger
- LIFE Leipzig Research Center for Civilization Diseases, Leipzig University, Philipp-Rosenthal-Str. 27, 04103 Leipzig, Germany
- Institute for Medical Informatics, Statistics and Epidemiology (IMISE), Leipzig University, Härtelstr. 16-18, 04107 Leipzig, Germany
| | - Christoph Engel
- LIFE Leipzig Research Center for Civilization Diseases, Leipzig University, Philipp-Rosenthal-Str. 27, 04103 Leipzig, Germany
- Institute for Medical Informatics, Statistics and Epidemiology (IMISE), Leipzig University, Härtelstr. 16-18, 04107 Leipzig, Germany
| | - Kerstin Wirkner
- LIFE Leipzig Research Center for Civilization Diseases, Leipzig University, Philipp-Rosenthal-Str. 27, 04103 Leipzig, Germany
| | - John Ross Wenning
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Leipzig, Liebigstr. 10-14, 04103 Leipzig, Germany
| | - Samira Zeynalova
- LIFE Leipzig Research Center for Civilization Diseases, Leipzig University, Philipp-Rosenthal-Str. 27, 04103 Leipzig, Germany
- Institute for Medical Informatics, Statistics and Epidemiology (IMISE), Leipzig University, Härtelstr. 16-18, 04107 Leipzig, Germany
| | - Susanne Wiegand
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Leipzig, Liebigstr. 10-14, 04103 Leipzig, Germany
| | - Markus Loeffler
- LIFE Leipzig Research Center for Civilization Diseases, Leipzig University, Philipp-Rosenthal-Str. 27, 04103 Leipzig, Germany
- Institute for Medical Informatics, Statistics and Epidemiology (IMISE), Leipzig University, Härtelstr. 16-18, 04107 Leipzig, Germany
| | - Theresa Wald
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Leipzig, Liebigstr. 10-14, 04103 Leipzig, Germany
| | - Andreas Dietz
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Leipzig, Liebigstr. 10-14, 04103 Leipzig, Germany
- LIFE Leipzig Research Center for Civilization Diseases, Leipzig University, Philipp-Rosenthal-Str. 27, 04103 Leipzig, Germany
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Patini R, Cordaro M, Marchesini D, Scilla F, Gioco G, Rupe C, D'Agostino MA, Lajolo C. Is Systemic Immunosuppression a Risk Factor for Oral Cancer? A Systematic Review and Meta-Analysis. Cancers (Basel) 2023; 15:3077. [PMID: 37370688 DOI: 10.3390/cancers15123077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2023] [Revised: 05/30/2023] [Accepted: 06/01/2023] [Indexed: 06/29/2023] Open
Abstract
Even if the relationship between immunosuppression and increased incidence of systemic cancers is well known, there is less awareness about the risk of developing oral cancer in immunosuppressed patients. The aim of this review was to evaluate the association between immunosuppression and the development of oral cancer. Two authors independently and, in duplicate, conducted a systematic literature review of international journals and electronic databases (MEDLINE via OVID, Scopus, and Web of Science) from their inception to 28 April 2023. The assessment of risk of bias and overall quality of evidence was performed using the Newcastle-Ottawa Scale and GRADE system. A total of 2843 articles was identified, of which 44 met the inclusion criteria and were included in either the qualitative or quantitative analysis. The methodological quality of the included studies was generally high or moderate. The quantitative analysis of the studies revealed that immunosuppression should be considered a risk factor for the development of oral cancer, with a percentage of increased risk ranging from 0.2% to 1% (95% CI: 0.2% to 1.4%). In conclusion, the results suggest that a constant and accurate follow-up should be reserved for all immunosuppressed patients as a crucial strategy to intercept lesions that have an increased potential to evolve into oral cancer.
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Affiliation(s)
- Romeo Patini
- Department of Head, Neck and Sense Organs, School of Dentistry, Catholic University of Sacred Heart, Fondazione Policlinico Universitario "A. Gemelli"-IRCCS Rome, 00135 Rome, Italy
| | - Massimo Cordaro
- Department of Head, Neck and Sense Organs, School of Dentistry, Catholic University of Sacred Heart, Fondazione Policlinico Universitario "A. Gemelli"-IRCCS Rome, 00135 Rome, Italy
| | - Denise Marchesini
- Department of Head, Neck and Sense Organs, School of Dentistry, Catholic University of Sacred Heart, Fondazione Policlinico Universitario "A. Gemelli"-IRCCS Rome, 00135 Rome, Italy
| | - Francesco Scilla
- Department of Head, Neck and Sense Organs, School of Dentistry, Catholic University of Sacred Heart, Fondazione Policlinico Universitario "A. Gemelli"-IRCCS Rome, 00135 Rome, Italy
| | - Gioele Gioco
- Department of Head, Neck and Sense Organs, School of Dentistry, Catholic University of Sacred Heart, Fondazione Policlinico Universitario "A. Gemelli"-IRCCS Rome, 00135 Rome, Italy
| | - Cosimo Rupe
- Department of Head, Neck and Sense Organs, School of Dentistry, Catholic University of Sacred Heart, Fondazione Policlinico Universitario "A. Gemelli"-IRCCS Rome, 00135 Rome, Italy
| | - Maria Antonietta D'Agostino
- Department of Geriatric and Orthopedic Sciences, Catholic University of Sacred Heart, Fondazione Policlinico Universitario "A. Gemelli"-IRCCS Rome, 00135 Rome, Italy
| | - Carlo Lajolo
- Department of Head, Neck and Sense Organs, School of Dentistry, Catholic University of Sacred Heart, Fondazione Policlinico Universitario "A. Gemelli"-IRCCS Rome, 00135 Rome, Italy
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10
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Mahuli AV, Sagar V, Kumar A, Mahuli SA, Kujur A. A Systematic Review and Meta-Analysis Assessing the Role of Oral Health as a Risk Factor in Oral Cancer. Cureus 2023; 15:e39786. [PMID: 37398714 PMCID: PMC10313090 DOI: 10.7759/cureus.39786] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/31/2023] [Indexed: 07/04/2023] Open
Abstract
Oral squamous cell carcinoma is the leading type of cancer in Southeast Asian countries and many parts of the world. Many factors increase the risk of oral cancer, like tobacco, betel nuts, alcohol consumption, sharp teeth, infections, and other factors. Oral health-related issues have been reported in many studies of oral cancer, but there is a need to understand the role of the same as a risk factor. The systematic review and meta-analysis were conducted to assess the role of oral health as a risk factor in oral cancer. The population diagnosed with oral cancer (P) of all age groups and both gender, exposure (E) is oral health (includes poor oral hygiene, periodontal disease, and other oral diseases excluding oral potentially malignant disorders (OPMD)), the comparator (C), is patients without oral health issues, outcome (O) is the role of poor oral health as a risk factor for oral cancer. A systematic review and meta-analysis were conducted. The databases used for the search were PubMed, Cochrane Database, Embase, Scopus, and Google Scholar. The unpublished reports, reviews, and grey literature were considered. Case-control studies were included assessing poor oral health as a risk factor with odds ratio as an effective measure. Newcastle Ottawa Scale for risk of bias in the case-control study was considered. The study results showed that tooth loss odds ratio (OR)=1.13, CI (0.99-1.26), I2 value of 71.7%, Oral hygiene OR=1.29, CI (1.04-1.54), I2 value of 19.7% and in periodontal diseases OR=2.14 CI (1.70-2.58), I2 value of 75.3% had a higher risk of developing oral cancer. The risk factors for tooth loss and periodontal disease showed moderate heterogenicity and less heterogenicity for oral hygiene. Poor oral health factors such as periodontal disease, poor oral hygiene, and loss of teeth show higher odds of oral cancer than the control. The periodontal disease shows the highest odds than other factors. These risk factors can be considered for the primordial prevention of oral cancer.
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Affiliation(s)
- Amit V Mahuli
- Public Health Dentistry and Preventive Dentistry, Dental College, Rajendra Institute of Medical Sciences, Ranchi, IND
| | - Vidya Sagar
- Preventive and Social Medicine, Rajendra Institute of Medical Sciences, Ranchi, IND
| | - Amit Kumar
- Laboratory Medicine, Rajendra institute of Medical Sciences, Ranchi, IND
| | - Simpy A Mahuli
- Dentistry, Rajendra Institute of Medical Sciences, Ranchi, IND
| | - Anit Kujur
- Preventive and Social Medicine, Rajendra Institute of Medical Sciences, Ranchi, IND
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11
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Rathod S, Gonde N, Kolte A, Lathiya V, Ughade S. Association between tooth loss and risk of occurrence of oral cancer – A systematic review and meta-analysis. Dent Res J (Isfahan) 2023. [DOI: 10.4103/1735-3327.367903] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
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12
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Pentenero M, Azzi L, Lodi G, Manfredi M, Varoni E. Chronic mechanical trauma/irritation and oral carcinoma: A systematic review showing low evidence to support an association. Oral Dis 2022; 28:2110-2118. [PMID: 34637589 PMCID: PMC9787889 DOI: 10.1111/odi.14049] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2021] [Revised: 10/03/2021] [Accepted: 10/05/2021] [Indexed: 12/30/2022]
Abstract
BACKGROUND Chronic trauma of oral mucosa, resulting from repeated and persistent mechanical irritative action of an intraoral injury agent, has repeatedly been reported to be possibly implicated in the development of oral squamous cell carcinoma (OSCC). OBJECTIVES The present systematic review aimed to assess whether chronic mechanical trauma can be considered a risk factor for OSCC. DATA SOURCES PubMed, CENTRAL (Cochrane Central Register of Controlled Trials), Scopus; EMBASE, Web of Science. STUDY ELIGIBILITY CRITERIA Cohort studies comparing OSCC incidence among subjects with/without chronic mechanical trauma or case-control or cross-sectional studies comparing chronic mechanical trauma among subjects with/without OSCC. RESULTS Only one prospective case-control study fulfilled the inclusion criteria, but the quality of the evidence provided is not enough to define trauma as a risk factor for OSCC. The main limitation is the presence of only one case-control study at high risk of bias. In the absence of strong evidence supporting the role of trauma in OSCC, a thorough discussion on trauma and carcinogenesis has been performed. CONCLUSIONS Available evidence does not support an active role for chronic trauma in oral carcinogenesis, neither as promoter nor as progressor factor. Prospective cohort studies able to better assess trauma in OSCC are needed.
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Affiliation(s)
- Monica Pentenero
- Department of OncologyOral Medicine and Oral Oncology UnitUniversity of TurinTurinItaly
| | - Lorenzo Azzi
- Department of Medicine and SurgeryUnit of Oral Medicine and PathologyUniversity of InsubriaVareseItaly
| | - Giovanni Lodi
- Department of Biomedical, Surgical and Dental SciencesUniversità degli Studi di MilanoMilanItaly
| | - Maddalena Manfredi
- Department of Medicine and SurgeryDentistry UnitUniversity of ParmaParmaItaly
| | - Elena Varoni
- Department of Biomedical, Surgical and Dental SciencesUniversità degli Studi di MilanoMilanItaly
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13
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Piemonte ED, Lazos JP, Gilligan GM, Panico RL, Werner LC, Yang YH, Warnakulasuriya S. Chronic mechanical irritation enhances the effect of tobacco and alcohol on the risk of oral squamous cell carcinoma: a case-control study in Argentina. Clin Oral Investig 2022; 26:6317-6326. [PMID: 35727376 DOI: 10.1007/s00784-022-04584-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Accepted: 06/09/2022] [Indexed: 11/24/2022]
Abstract
OBJECTIVES Oral squamous cell carcinoma (OSCC) is a multifactorial disease. The individual effect of each risk factor for OSCC may be conditioned by the frequency of other factors. The objective of this study was to identify the association between chronic mechanical irritation (CMI) and OSCC and to analyse the influence of CMI on other important risk factors for OSCC. MATERIALS AND METHODS A prospective and age/sex-matched case-control study was performed in two institutions from Argentina between 2009 and 2019, with consecutive and newly diagnosed OSCC. The frequencies of tobacco, alcohol, and CMI were analysed using conditional logistic regression. Cumulative tobacco consumption and the presence of CMI were analysed using the Mann-Whitney test. RESULTS CMI and OSCC were associated with an OR of 7.02 (95% CI 3.57-13.78, p < 0.001). The combination of CMI and alcohol demonstrated the highest risk of OSCC (OR 53.83, CI 95% 8.04-360, p < 0.0001), followed by the combination of CMI, tobacco, and alcohol (OR 48.06, CI 95% 8.47-272, p < 0.0001). The combination of CMI and tobacco was also significant (OR 5.61, CI 95% 1.07-29.54, p = 0.042). Patients with CMI developed OSCC with less cumulative tobacco use compared with those without CMI. CONCLUSION CMI is an independent risk factor for OSCC, and it could act as a risk modifier among tobacco and alcohol users having an enhancing effect. CLINICAL RELEVANCE Elimination of CMI could decrease the risk of OSCC.
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Affiliation(s)
- Eduardo David Piemonte
- Oral Medicine Department, Dentistry College, Universidad Nacional de Córdoba, Av. Haya de la Torre s/n, Ciudad Universitaria, 5000, Córdoba, Argentina.
| | - Jerónimo Pablo Lazos
- Oral Medicine Department, Dentistry College, Universidad Nacional de Córdoba, Av. Haya de la Torre s/n, Ciudad Universitaria, 5000, Córdoba, Argentina
| | - Gerardo Marcelo Gilligan
- Oral Medicine Department, Dentistry College, Universidad Nacional de Córdoba, Av. Haya de la Torre s/n, Ciudad Universitaria, 5000, Córdoba, Argentina
| | - René Luis Panico
- Oral Medicine Department, Dentistry College, Universidad Nacional de Córdoba, Av. Haya de la Torre s/n, Ciudad Universitaria, 5000, Córdoba, Argentina
| | | | - Yi-Hsin Yang
- National Institute of Cancer Research, National Health Research Institutes, Tainan, Taiwan
| | - Saman Warnakulasuriya
- Faculty of Dentistry, Oral & Craniofacial Sciences, King's College London & WHO Collaborating Centre for Oral Cancer, London, UK
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14
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Dental health in patients with and without HPV-positive oropharyngeal and tongue cancer. PLoS One 2022; 17:e0274813. [PMID: 36137133 PMCID: PMC9499192 DOI: 10.1371/journal.pone.0274813] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Accepted: 09/02/2022] [Indexed: 12/24/2022] Open
Abstract
Background Human papilloma virus is associated with oral and oropharyngeal cancer. Our aim was to examine oral health in patients with oropharyngeal (OPSCC) and oral tongue cancer (OTSCC), expecting better oral health among OPSCC patients. Material and methods Fifty-five OPSCC patients with known HPV status and 59 OTSCC patients were randomly selected from a list of consecutive patients of the Helsinki University Hospital, Finland. Oral health was assessed from panoramic jaw radiographs. Total Dental Index (TDI) summarizing the dental health status was calculated and Finnish population study data were used for comparison. Descriptive statistics were used for analyses. Results Patients with HPV-positive OPSCC had higher periapical lesion index compared with HPV-negative OPSCC patients or with OTSCC patients. Residual roots were more common among OPSCC patients compared with OTSCC patients, because of their higher occurrence among HPV-negative OPSCC patients compared with OTSCC patients. Similarly, modified TDI score was significantly higher among OPSCC patients than among OTSCC patients, because of higher TDI score among HPV-negative OPSCC patients compared with OTSCC patients. OPSCC patients more often used a removable prosthesis than OTSCC patients. Dental health of the cancer patients was poorer when compared with the population data. Conclusions Our study hypothesis was only partly confirmed. Periapical lesions were more prevalent among HPV-positive OPSCC patients, compared with the other groups. The number of residual roots was higher among HPV-negative subgroup. Thus, OPSCC patients had worse oral health parameters than OTSCC patients.
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15
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Jones BM, Villavisanis DF, Lehrer EJ, Dickstein DR, Sindhu KK, Misiukiewicz KJ, Posner M, Liu JT, Gupta V, Sharma S, Roof SA, Teng M, Genden EM, Bakst RL. High Failure Rates in Young Nonsmoker Nondrinkers With Squamous Cell Carcinoma of the Oral Tongue. Laryngoscope 2022; 133:1110-1121. [PMID: 35716359 DOI: 10.1002/lary.30253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Revised: 05/17/2022] [Accepted: 05/21/2022] [Indexed: 11/10/2022]
Abstract
OBJECTIVE(S) There has been a disproportionate increase in the incidence of young patients with squamous cell carcinoma of the oral tongue (SCCOT). The purpose of this study was to compare young patients to older patients with SCCOT without prior drinking or smoking history as this population is poorly characterized in the literature. METHODS A retrospective review of patients presenting to our institution with SCCOT was performed. The clinical and pathologic characteristics, as well as, outcomes were compared between younger patients (age ≤45) and older patients (age >45). Outcome analysis was performed using Kaplan Meier method. Multivariable Cox proportional hazard models were performed for age and stage. RESULTS Eighty-two patients (38 young, 44 old) were included in this study. Median follow-up was 29.4 months. When compared to the older cohort (age >45), the younger cohort (age ≤45) demonstrated lower rates of 5-year locoregional control (LC) (79.6% vs. 52.5%, p = 0.043) and distant metastasis-free survival (88.1% vs. 61.8%, p = 0.006). Both cohorts demonstrated similar overall survival rates (55.5% vs. 58.1%) and disease-specific survival (66.2% vs. 58.1%). Of patients experiencing locoregional failure with available radiation therapy plans and PET scans in younger cohorts (n = 7), 100% demonstrated in-field failures. Multivariable Cox proportional hazards demonstrated age was an independent predictor of DMFS (p = 0.004) and the advanced stage was a predictor of DSS (p = 0.03). CONCLUSIONS Young, nondrinker, nonsmokers with SCCOT demonstrate high rates of locoregional recurrence, distant metastasis, and in-field failures. Future studies are warranted to determine underlying mechanisms driving pathogenesis in this unique cohort. LEVEL OF EVIDENCE 3 Laryngoscope, 2022.
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Affiliation(s)
- Brianna M Jones
- Department of Radiation Oncology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Dillan F Villavisanis
- Department of Radiation Oncology, Icahn School of Medicine at Mount Sinai, New York, New York, USA.,Department of Otolaryngology - Head & Neck Surgery, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Eric J Lehrer
- Department of Radiation Oncology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Daniel R Dickstein
- Department of Radiation Oncology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Kunal K Sindhu
- Department of Radiation Oncology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Krzysztof J Misiukiewicz
- Department of Medicine, Division of Hematology and Medical Oncology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Marshall Posner
- Department of Medicine, Division of Hematology and Medical Oncology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Jerry T Liu
- Department of Radiation Oncology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Vishal Gupta
- Department of Radiation Oncology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Sonam Sharma
- Department of Radiation Oncology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Scott A Roof
- Department of Otolaryngology - Head & Neck Surgery, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Marita Teng
- Department of Otolaryngology - Head & Neck Surgery, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Eric M Genden
- Department of Otolaryngology - Head & Neck Surgery, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Richard L Bakst
- Department of Radiation Oncology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
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16
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Rodriguez-Archilla A, Suarez-Machado R. Influence of sexual habits on human papillomavirus infection risk and oral cancer. SCIENTIFIC DENTAL JOURNAL 2022. [DOI: 10.4103/sdj.sdj_73_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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17
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Gugnacki P, Sierko E. Is There an Interplay between Oral Microbiome, Head and Neck Carcinoma and Radiation-Induced Oral Mucositis? Cancers (Basel) 2021; 13:5902. [PMID: 34885015 PMCID: PMC8656742 DOI: 10.3390/cancers13235902] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Revised: 11/22/2021] [Accepted: 11/22/2021] [Indexed: 02/07/2023] Open
Abstract
Head and neck carcinoma is one of the most common human malignancy types and it ranks as the sixth most common cancer worldwide. Nowadays, a great potential of microbiome research is observed in oncology-investigating the effect of oral microbiome in oncogenesis, occurrence of treatment side effects and response to anticancer therapies. The microbiome is a unique collection of microorganisms and their genetic material, interactions and products residing within the mucous membranes. The aim of this paper is to summarize current research on the oral microbiome and its impact on the development of head and neck cancer and radiation-induced oral mucositis. Human microbiome might determine an oncogenic effect by, among other things, inducing chronic inflammatory response, instigating cellular antiapoptotic signals, modulation of anticancer immunity or influencing xenobiotic metabolism. Influence of oral microbiome on radiation-induced oral mucositis is expressed by the production of additional inflammatory cytokines and facilitates progression and aggravation of mucositis. Exacerbated acute radiation reaction and bacterial superinfections lead to the deterioration of the patient's condition and worsening of the quality of life. Simultaneously, positive effects of probiotics on the course of radiation-induced oral mucositis have been observed. Understanding the impact on the emerging acute radiation reaction on the composition of the microflora can be helpful in developing a multifactorial model to forecast the course of radiation-induced oral mucositis. Investigating these processes will allow us to create optimized and personalized preventive measures and treatment aimed at their formation mechanism. Further studies are needed to better establish the structure of the oral microbiome as well as the dynamics of its changes before and after therapy. It will help to expand the understanding of the biological function of commensal and pathogenic oral microbiota in HNC carcinogenesis and the development of radiation-induced oral mucositis.
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Affiliation(s)
| | - Ewa Sierko
- Department of Oncology, Medical University of Bialystok, 15-025 Bialystok, Poland;
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18
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Lee YC, Young CK, Chien HT, Chin SC, Iandelli A, Liao CT, Tsao CK, Kang CJ, Huang SF. Characteristics and outcome differences in male and female oral cavity cancer patients in Taiwan. Medicine (Baltimore) 2021; 100:e27674. [PMID: 34871246 PMCID: PMC8568378 DOI: 10.1097/md.0000000000027674] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Accepted: 10/12/2021] [Indexed: 01/05/2023] Open
Abstract
Oral cavity squamous cell carcinoma (OSCC) is a leading cause of death in Taiwan. Most of the patients in the literature are male. The risk factors, cancer characteristics, and treatment outcomes were investigated in female patients and compared with male patients in this study.This retrospective study recruited 2046 OSCC patients between 1995 and 2019. The age, tumor subsites, and survival were reviewed and recorded. Overall survival and disease-free survival were the main outcomes.Female patients represented 6.7% of the entire study cohort. Females were diagnosed at an older age and an earlier local stage than male patients (P < .001). Female patients were less exposed to cigarettes, alcohol, and betel-quid (all P < .001). The tongue (55.1%) was the most frequent subsite in females, while the buccal cavity (38.4%) and the tongue (35.3%) were more likely (P < .001) to be associated with the male gender. Female patients in the tongue cancer subgroup presented less frequently with extra-nodal extension compared with male patients (P = .040). No significant differences in recurrence or overall deaths were observed between the genders during the follow-up period.The OSCC male to female ratio in Taiwan was 14:1. Female OSCC occurred more frequently on the tongue, and was diagnosed at an older age and at an earlier tumor stage than in male patients. No survival difference was found between female and male OSCC patients.
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Affiliation(s)
- Yi-Chieh Lee
- Department of Otolaryngology & Head and Neck Surgery, Chang Gung Memorial Hospital, Linkou, Taiwan
| | - Chi-Kuang Young
- Department of Otolaryngology & Head and Neck Surgery, Chang Gung Memorial Hospital, Keelung, Taiwan
- School of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Huei-Tzu Chien
- Department of Nutrition and Health Sciences, Chang Gung University of Science and Technology, Taoyuan, Taiwan
| | - Shy-Chyi Chin
- Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital, Linkou, Taiwan
| | - Andrea Iandelli
- Department of Otolaryngology & Head and Neck Surgery, Chang Gung Memorial Hospital, Linkou, Taiwan
| | - Chun-Ta Liao
- Department of Otolaryngology & Head and Neck Surgery, Chang Gung Memorial Hospital, Linkou, Taiwan
- Department of Nutrition and Health Sciences, Chang Gung University of Science and Technology, Taoyuan, Taiwan
| | - Chung-Kang Tsao
- Department of Nutrition and Health Sciences, Chang Gung University of Science and Technology, Taoyuan, Taiwan
- Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital, Linkou, Taiwan
| | - Chung-Jan Kang
- Department of Otolaryngology & Head and Neck Surgery, Chang Gung Memorial Hospital, Linkou, Taiwan
- Department of Nutrition and Health Sciences, Chang Gung University of Science and Technology, Taoyuan, Taiwan
| | - Shiang-Fu Huang
- Department of Otolaryngology & Head and Neck Surgery, Chang Gung Memorial Hospital, Linkou, Taiwan
- Department of Public Health, Chang Gung University, Taoyuan, Taiwan
- Graduate Institute of Clinical Medical Sciences, Chang Gung University, Taoyuan, Taiwan
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19
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Wee CW, Lee HJ, Lee JR, Lee H, Kwoen MJ, Jeong WJ, Eom KY. Effect of National Oral Health Screening Program on the Risk of Head and Neck Cancer: A Korean National Population-Based. Cancer Res Treat 2021; 54:709-718. [PMID: 34696565 PMCID: PMC9296931 DOI: 10.4143/crt.2021.834] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Accepted: 10/21/2021] [Indexed: 11/21/2022] Open
Abstract
Purpose Poor oral health is associated with head and neck cancer (HNC). We evaluated whether a national oral health screening program (OHSP) could reduce the risk of HNC. Materials and Methods Data from 408,247 healthy individuals aged ≥ 40 years from the National Health Insurance System-National Health Screening program during 2003 and 2004 in Korea were analyzed. The risk of HNC was compared between subjects who underwent OHSP (HEALS-Dental+, n=165,292) and routine health check-ups only (HEALS-Dental‒, n=242,955). The impact of individual oral health-related factors on HNC risk was evaluated in HEALS-Dental+. Results A total of 1,650 HNC cases were diagnosed. The 10-year HNC-free rate was 99.684% with a median follow-up of 11 years. The risk of all HNC (hazard ratio [HR], 1.16; 95% confidence interval [CI], 1.03 to 1.29; p=0.011) and oropharyngeal cancer (HR, 1.48; 95% CI, 1.13 to 1.94; p=0.005) was significantly higher in HEALS-Dental‒ than in HEALS-Dental+. In HEALS-Dental+, oral cavity cancer was marginally reduced (p=0.085), and missing teeth was a significant factor for HNC (HR, 1.24; 95% CI, 1.02 to 1.50; p=0.032). Toothbrushing was a significant factor in univariate analysis (p=0.028), but not in multivariate analysis (p=0.877). Conclusion The National OHSP significantly reduced the long-term HNC risk, particularly the incidence of oropharyngeal cancer. Routine OHSP should be considered at the population level.
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Affiliation(s)
- Chan Woo Wee
- Department of Radiation Oncology, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul, Korea
| | - Hyo-Jung Lee
- Section of Dentistry Medicine, Department of Periodontology, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Jae-Ryun Lee
- Department of Family Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Hyejin Lee
- Department of Family Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Min-Jeong Kwoen
- Section of Dentistry Medicine, Department of Periodontology, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Woo-Jin Jeong
- Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Keun-Yong Eom
- Department of Radiation Oncology, Seoul National University Bundang Hospital, Seongnam, Korea
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20
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Gandolfo MS, Denninghoff V, Avagnina A, Adler LI. Diagnosis of an adenocarcinoma of Müllerian origin made as a result of its metastasis in the mouth floor. BMJ Case Rep 2021; 14:14/6/e240944. [PMID: 34187793 DOI: 10.1136/bcr-2020-240944] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
Metastases derived from primary tumours distant to the oral and maxillofacial region account for only 1% of all malignancies at that location, usually with a poor prognosis. In women, the primary tumours that most frequently metastasise to the oral cavity are breast adenocarcinomas affecting the jawbones and soft tissues (41% and 24%, respectively), followed by adrenal glands and female genital organs to the jawbones (8%), and female genital organs to the soft tissues (15%). Metastatic tumours of the mouth are a challenging diagnosis because of their exceptional occurrence. We report on the case of an 83-year-old woman who consulted for a bleeding ulcerated tumour on the floor of the mouth. A biopsy-confirmed metastasis of an adenocarcinoma of Müllerian origin. The oral lesion was the first sign of undetected cancer. The patient agreed to surgical resection and was further referred to palliative care for her symptoms.
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Affiliation(s)
- Mariana Silva Gandolfo
- Faculty of Dentistry, University of Buenos Aires, Ciudad Autónoma de Buenos Aires, Argentina
| | - Valeria Denninghoff
- Faculty of Dentistry, University of Buenos Aires, Ciudad Autónoma de Buenos Aires, Argentina.,CONICET, Ciudad Autónoma de Buenos Aires, Argentina
| | | | - Lidia Isabel Adler
- Faculty of Dentistry, University of Buenos Aires, Ciudad Autónoma de Buenos Aires, Argentina
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21
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Kavarthapu A, Gurumoorthy K. Linking chronic periodontitis and oral cancer: A review. Oral Oncol 2021; 121:105375. [PMID: 34140233 DOI: 10.1016/j.oraloncology.2021.105375] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Revised: 05/25/2021] [Accepted: 06/02/2021] [Indexed: 01/19/2023]
Abstract
The aim of this article is to survey the accessible writing on the pathogenetic systems engaged with the relationship between oral malignancy and periodontitis. Gingival tissue contains multiple microbiota, which can induce inflammatory reactions. This reaction plays a crucial role in assessing the susceptibility of patients to periodontal diseases. The link between chronic periodontitis and the risk of malignancy through this inflammation of the affected epithelium have been studied thoroughly. Many studies have reported that, chronic periodontitis has systemic influence which has high risk of developing different types of cancers. Also, various confounding factors such as consumption of alcohol, smoking, diet, age and gender have been found to be associated with both chronic periodontitis and oral cancer. An online quest for a wide range of articles distributed was started utilizing MEDLINE/PubMed, with the keywords, for example, 'oral squamous cell carcinoma (OSCC)', 'oral microbiota,' 'microorganisms and malignancy and Porphyromonas gingivalis. This review aimed to study the current literature linking chronic periodontitis and oral cancer.
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Affiliation(s)
- Avinash Kavarthapu
- Department of Periodontics and Implantology, Saveetha Dental College, Saveetha Institute of Medical and Technical Sciences. Chennai, India.
| | - Kaarthikeyan Gurumoorthy
- Department of Periodontics and Implantology, Saveetha Dental College, Saveetha Institute of Medical and Technical Sciences. Chennai, India.
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22
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Vu H, Shin YJ, Kong MS, Kim HD. Smoking and Drinking Adjusted Association between Head and Neck Cancers and Oral Health Status Related to Periodontitis: a Meta-Analysis. J Korean Med Sci 2021; 36:e98. [PMID: 33876587 PMCID: PMC8055512 DOI: 10.3346/jkms.2021.36.e98] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Accepted: 01/29/2021] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND Not so many reports about the association between head and neck cancer (HNC) and oral health status related to periodontitis (OHS-P) has been published in different countries with different methods. So, there is a need for an extensive meta-analysis with the total articles published until 2020. Hence, this study aimed to estimate the association between HNC and OHS-P through a meta-analysis. METHODS Based on Preferred Reporting Items for Systematic Reviews and Meta Analyses guidelines, 22 studies were selected through PubMed and Cochrane Library databases. Meta-analysis using them was performed to evaluate the association. The risk of bias assessment using the Newcastle-Ottawa Scale (NOS) was applied to evaluate the quality of non-randomized studies. Publication bias was evaluated by funnel plot and Egger's regression test. RESULTS Since heterogeneity was significant (I² = 88%, P < 0.001), we adopted the random effect model for 22 studies. Those with bad OHS-P, compared to those with good OHS-P, were more likely to have the risk of HNC by 2.4 times (odds ratio [OR], 2.42; 95% confidence interval [CI], 1.88-3.13) for random effect model. The association included publication bias (Egger's regression, P value < 0.001). The association among five studies (I² = 39%, P = 0.16) using alveolar bone loss (ABL) or clinical attachment level (CAL) for assessing periodontitis increased to OR of 3.85 (CI, 3.04-4.88) in the fixed effect model without publication bias (Egger's regression, P = 0.66). Moreover, the association was higher in 10 fair or good NOS studies (OR, 3.08) and in 7 Asian studies (OR, 2.68), which were from the fixed model without publication bias. CONCLUSION Our meta-analysis showed that bad OHS-P was associated with the risk of HNC. The association was stronger in studies using ABL or CAL for assessing periodontitis.
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Affiliation(s)
- Huong Vu
- Department of Preventive and Social Dentistry, School of Dentistry, Seoul National University, Seoul, Korea
| | - Yoo Jin Shin
- Department of Preventive and Social Dentistry, School of Dentistry, Seoul National University, Seoul, Korea
- Department of Oral and Maxillofacial Surgery, Seoul National University Dental Hospital, Seoul, Korea
| | - Mi Sun Kong
- Department of Preventive and Social Dentistry, School of Dentistry, Seoul National University, Seoul, Korea
| | - Hyun Duck Kim
- Department of Preventive and Social Dentistry, School of Dentistry, Seoul National University, Seoul, Korea
- Dental Research Institute, Seoul National University, Seoul, Korea.
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23
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Tagliabue M, Belloni P, De Berardinis R, Gandini S, Chu F, Zorzi S, Fumagalli C, Santoro L, Chiocca S, Ansarin M. A systematic review and meta-analysis of the prognostic role of age in oral tongue cancer. Cancer Med 2021; 10:2566-2578. [PMID: 33760398 PMCID: PMC8026930 DOI: 10.1002/cam4.3795] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Revised: 01/30/2021] [Accepted: 02/04/2021] [Indexed: 12/18/2022] Open
Abstract
While evidence suggests an increasing incidence of tongue cancer in young adults, published findings regarding the prognostic role of age at diagnosis are inconsistent. We performed a meta-analysis of the literature to highlight key points that might help in understanding the association between age of oral tongue cancer patients at diagnosis and their prognosis. According to age at diagnosis, a systematic literature review of all published cohort studies assessing the recurrence risks and mortality associated with tongue cancer was conducted. We compared the risk estimates between patients aged >45 years and those aged <45 years at diagnosis. Random-effects models were used to calculate summary relative risk estimates (SRRs) according to different clinical outcomes and sources of between-study heterogeneity (I2 ) and bias. We included 31 independent cohort studies published between 1989 and 2019; these studies included a total of 28,288 patients. When risk estimations were not adjusted for confounders, no significant association was found between age at diagnosis and overall survival (OS). Conversely, after adjustment for confounders, older age at diagnosis was associated with a significantly increased risk of mortality. The difference between SRRs for adjusted and unadjusted estimates was significant (p < 0.01). Younger patients had a significantly higher risk of local recurrence. Younger patients with oral tongue cancer have better OS but a greater risk of recurrence than older patients. These findings should be validated in a large prospective cohort study which considers all confounders and prognostic factors.
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Affiliation(s)
- Marta Tagliabue
- Division of Otolaryngology and Head and Neck SurgeryIEOEuropean Institute of Oncology IRCCSMilanItaly
| | - Pietro Belloni
- Department of Experimental OncologyIEOEuropean Institute of Oncology IRCCSMilanItaly
- Department of Statistical SciencesUniversity of PaduaPaduaItaly
| | - Rita De Berardinis
- Division of Otolaryngology and Head and Neck SurgeryIEOEuropean Institute of Oncology IRCCSMilanItaly
| | - Sara Gandini
- Department of Experimental OncologyIEOEuropean Institute of Oncology IRCCSMilanItaly
| | - Francesco Chu
- Division of Otolaryngology and Head and Neck SurgeryIEOEuropean Institute of Oncology IRCCSMilanItaly
| | - Stefano Zorzi
- Division of Otolaryngology and Head and Neck SurgeryIEOEuropean Institute of Oncology IRCCSMilanItaly
| | | | | | - Susanna Chiocca
- Department of Experimental OncologyIEOEuropean Institute of Oncology IRCCSMilanItaly
| | - Mohssen Ansarin
- Division of Otolaryngology and Head and Neck SurgeryIEOEuropean Institute of Oncology IRCCSMilanItaly
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24
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Saka-Herrán C, Jané-Salas E, Estrugo-Devesa A, López-López J. Head and neck cancer and non-steroidal anti-inflammatory drugs: Systematic review and meta-analysis. Head Neck 2021; 43:1664-1682. [PMID: 33682986 DOI: 10.1002/hed.26663] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Revised: 12/14/2020] [Accepted: 02/19/2021] [Indexed: 01/21/2023] Open
Abstract
The objective was to assess the effects of non-steroidal anti-inflammatory drugs (NSAIDs) on head and neck cancer (HNC) outcomes. A systematic review was conducted following the PRISMA guidelines. The MEDLINE and the Cochrane Central Register databases were searched. Risk of bias was assessed by the Cochrane Collaboration's tool and by the Newcastle-Ottawa Scale. Meta-analyses were performed with the RevMan software. Seventeen articles met the inclusion criteria. Quality scores for observational studies ranged between 5 and 8 stars and the RCT was assessed as high risk of bias. NSAIDs use was associated with a 13% risk reduction of HNC (OR: 0.87 95% CI 0.77-0.99). NSAIDs use was associated with a 30% reduced cancer-specific mortality and with a 40% decreased risk on disease-recurrence. NSAIDs may have a modest protective effect on HNC risk and a positive impact on cancer-specific survival and disease-recurrence. The findings do not support a protective role of aspirin on HNC outcomes.
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Affiliation(s)
- Constanza Saka-Herrán
- Department of Odontostomatology, Faculty of Medicine and Health Sciences (Dentistry), University of Barcelona, Barcelona, Spain
| | - Enric Jané-Salas
- Department of Odontostomatology, Faculty of Medicine and Health Sciences (Dentistry), University of Barcelona - Oral Health and Masticatory System Group (Bellvitge Biomedical Research Institute) IDIBELL, Barcelona, Spain
| | - Albert Estrugo-Devesa
- Department of Odontostomatology, Faculty of Medicine and Health Sciences (Dentistry), University of Barcelona - Oral Health and Masticatory System Group (Bellvitge Biomedical Research Institute) IDIBELL, Barcelona, Spain
| | - José López-López
- Department of Odontostomatology, Faculty of Medicine and Health Sciences (Dentistry), University of Barcelona - Oral Health and Masticatory System Group (Bellvitge Biomedical Research Institute) IDIBELL, Barcelona, Spain
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Chen SH, Hsiao SY, Chang KY, Chang JY. New Insights Into Oral Squamous Cell Carcinoma: From Clinical Aspects to Molecular Tumorigenesis. Int J Mol Sci 2021; 22:ijms22052252. [PMID: 33668218 PMCID: PMC7956378 DOI: 10.3390/ijms22052252] [Citation(s) in RCA: 38] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Revised: 02/20/2021] [Accepted: 02/20/2021] [Indexed: 12/12/2022] Open
Abstract
Oral squamous cell carcinoma (SCC) is a prevalent malignant disease worldwide, especially so in Taiwan. Early- or even preclinical-stage detection is critical for reducing morbidity and mortality from oral SCC. Epidemiological and genome association studies are useful for identifying clinicopathological risk factors for preventive, diagnostic, and therapeutic approaches of oral SCC. For advanced oral SCC, effective treatments are critical to prolonging survival and enhancing quality of life. As oral SCC is characteristic of regional invasion with lymph node metastases, understanding the aggressive features of oral SCC, particularly in lymphangiogenesis, is essential for determining effective treatments. Emerging evidence has demonstrated that the tumor microenvironment (TME) plays a pivotal role in tumor growth, invasion, and metastases. Recent clinical successes in immune checkpoint inhibitors either alone or combined with chemotherapy have also supported the therapeutic value of immunotherapy in oral SCC. This review summarizes critical advances in basic knowledge of oral SCC from the perspective of clinicopathological risk factors, molecular tumorigenesis, and the TME. We also highlight our recent investigations on the microbiome, genome association studies, lymphangiogenesis, and immunomodulation in oral SCC. This review may provide new insights for oral SCC treatment by systematically interpreting emerging evidence from various preclinical and clinical studies.
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Affiliation(s)
- Shang-Hung Chen
- National Institute of Cancer Research, National Health Research Institutes, Tainan 70456, Taiwan; (S.-H.C.); (K.-Y.C.)
- Department of Oncology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 70456, Taiwan
| | - Sheng-Yen Hsiao
- Division of Hematology-Oncology, Department of Internal Medicine, Chi Mei Medical Center, Liouying, Tainan 736402, Taiwan;
- Institute of Clinical Medicine, College of Medicine, National Cheng Kung University, Tainan 70101, Taiwan
| | - Kwang-Yu Chang
- National Institute of Cancer Research, National Health Research Institutes, Tainan 70456, Taiwan; (S.-H.C.); (K.-Y.C.)
- Department of Oncology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 70456, Taiwan
| | - Jang-Yang Chang
- Department of Oncology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 70456, Taiwan
- Institute of Biotechnology and Pharmaceutical Research, National Health Research Institutes, Miaoli 35053, Taiwan
- Correspondence:
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26
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Brennan MT, Treister NS, Sollecito TP, Schmidt BL, Patton LL, Yang Y, Lin A, Elting LS, Hodges JS, Lalla RV. Epidemiologic factors in patients with advanced head and neck cancer treated with radiation therapy. Head Neck 2021; 43:164-172. [PMID: 32991009 PMCID: PMC7756563 DOI: 10.1002/hed.26468] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Revised: 08/06/2020] [Accepted: 09/04/2020] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND Approximately 50% of patients with head and neck cancer (HNC) initially were seen with advanced disease. We aimed to evaluate the association of epidemiologic factors with advanced HNC at diagnosis. METHODS The OraRad multicenter prospective cohort study enrolled HNC patients receiving curative-intent radiation therapy. Factors assessed for association with advanced HNC presentation at diagnosis included demographics, social and medical history, cancer characteristics, human papilloma virus (HPV) status, and dental disease measures. RESULTS We enrolled 572 participants; 77% male and mean (SD) age of 61.7 (11.2) years. Oropharyngeal squamous cell carcinomas (88% HPV-related) were seen with smaller tumors, but more frequent nodal involvement. Private medical insurance and no Medicaid were associated with smaller tumors. A higher dental disease burden was associated with larger tumors. CONCLUSIONS Insurance status, cancer type/location, and dental disease are associated with advanced HNC and may represent potentially modifiable factors or factors to be considered in the screening process of new lesions.
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Affiliation(s)
- Michael T. Brennan
- Department of Oral MedicineAtrium Health's Carolinas Medical CenterCharlotteNorth CarolinaUSA
| | - Nathaniel S. Treister
- Division of Oral Medicine and Dentistry, Brigham and Women's HospitalBostonMassachusettsUSA
- Department of Oral Medicine, Infection and ImmunityHarvard School of Dental MedicineBostonMassachusettsUSA
| | - Thomas P. Sollecito
- Department of Oral MedicineUniversity of Pennsylvania School of Dental MedicinePhiladelphiaPennsylvaniaUSA
- Division of Oral MedicineUniversity of Pennsylvania Health SystemPhiladelphiaPennsylvaniaUSA
| | - Brian L. Schmidt
- Department of Oral & Maxillofacial Surgery and Bluestone Center for Clinical ResearchNew York University College of DentistryNew York CityNew YorkUSA
| | - Lauren L. Patton
- Division of Craniofacial and Surgical Care, Adams School of DentistryUniversity of North CarolinaChapel HillNorth CarolinaUSA
| | - Yi Yang
- Division of Biostatistics, School of Public HealthUniversity of MinnesotaMinneapolisMinnesotaUSA
| | - Alexander Lin
- Department of Radiation OncologyUniversity of PennsylvaniaPhiladelphiaPennsylvaniaUSA
| | - Linda S. Elting
- Department of Health Services Research, Division of Division of Cancer Prevention and Population SciencesThe University of Texas MD Anderson Cancer CenterHoustonTexasUSA
| | - James S. Hodges
- Division of Biostatistics, School of Public HealthUniversity of MinnesotaMinneapolisMinnesotaUSA
| | - Rajesh V. Lalla
- Section of Oral MedicineUniversity of Connecticut HealthFarmingtonConnecticutUSA
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27
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Colonia-García A, Gutiérrez-Vélez M, Duque-Duque A, de Andrade CR. Possible association of periodontal disease with oral cancer and oral potentially malignant disorders: a systematic review. Acta Odontol Scand 2020; 78:553-559. [PMID: 32552160 DOI: 10.1080/00016357.2020.1774076] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Background: Periodontitis has been associated with several systemic diseases and medical conditions, including oral cancer (OC). However, most studies reporting an association between OC and periodontal disease have used different clinical and radiographic criteria to define periodontal disease. This review aimed to evaluate the currently available evidence to determine an association between periodontal disease (extension and severity), OC, and oral potentially malignant disorders (OPMDs).Material and methods: A systematic search of studies published up to August 2018 was performed following the PRISMA guidelines in the electronic databases MEDLINE (PubMed) and COCHRANE (OVID). A methodological evaluation was made using the Strengthening the Reporting of Observational studies in Epidemiology (STROBE) checklist.Results: Eight studies (case-control, cross-sectional and cohort) were included. An increased clinical attachment loss, plaque index, bleeding on probing, and radiographic bone loss was found in patients with OC and OPMDs. Differences in the methodological characteristics, case definition used for periodontal diseases, and OC location did not allow estimating the odds ratio required to conduct a meta-analysis.Conclusion: Some studies suggest a positive relationship between periodontal disease, OC, and OPMDs; however, the currently available evidence is insufficient to draw solid conclusions.
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Affiliation(s)
| | | | - Andrés Duque-Duque
- Basic and Clinical Dentistry Group, School of Dentistry, CES University, Medellín, Colombia
| | - Cleverton Roberto de Andrade
- Department of Physiology and Pathology, School of Dentistry, São Paulo State University (UNESP), Araraquara, Brazil
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28
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Niemiec B, Gawor J, Nemec A, Clarke D, McLeod K, Tutt C, Gioso M, Steagall PV, Chandler M, Morgenegg G, Jouppi R. World Small Animal Veterinary Association Global Dental Guidelines. J Small Anim Pract 2020; 61:E36-E161. [PMID: 32715504 DOI: 10.1111/jsap.13132] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Dental, oral, and maxillofacial diseases are some of the most common problems in small animal veterinary practice. These conditions create significant pain as well as localized and potentially systemic infection. As such, the World Small Animal Veterinary Association (WSAVA) believes that un- and under treated oral and dental diseases pose a significant animal welfare concern. Dentistry is an area of veterinary medicine which is still widely ignored and is subject to many myths and misconceptions. Effective teaching of veterinary dentistry in the veterinary school is the key to progression in this field of veterinary medicine, and to the improvement of welfare for all our patients globally. These guidelines were developed to provide veterinarians with the information required to understand best practices for dental therapy and create realistic minimum standards of care. Using the three-tiered continuing education system of WSAVA, the guidelines make global equipment and therapeutic recommendations and highlight the anaesthetic and welfare requirements for small animal patients. This document contains information on common oral and dental pathologies, diagnostic procedures (an easily implementable and repeatable scoring system for dental health, dental radiography and radiology) and treatments (periodontal therapy, extractions). Further, there are sections on anaesthesia and pain management for dental procedures, home dental care, nutritional information, and recommendations on the role of the universities in improving veterinary dentistry. A discussion of the deleterious effects of anaesthesia free dentistry (AFD) is included, as this procedure is ineffective at best and damaging at worst. Throughout the document the negative effects of undiagnosed and/or treated dental disease on the health and well-being of our patients, and how this equates to an animal welfare issue, is discussed.
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29
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Veitía D, Liuzzi J, Ávila M, Rodriguez I, Toro F, Correnti M. Association of viral load and physical status of HPV-16 with survival of patients with head and neck cancer. Ecancermedicalscience 2020; 14:1082. [PMID: 32863876 PMCID: PMC7434508 DOI: 10.3332/ecancer.2020.1082] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Indexed: 01/29/2023] Open
Abstract
Introduction Head and neck cancers (NHCs) are of multifaceted origins, and tobacco and alcohol are the primary risk factors. Currently, other factors associated with the genesis of these tumours are being considered, among these viral infections, especially human papillomavirus (HPV) infection. Objective The objective was to evaluate HPV infection, HPV-16 E6 load and its physical status in patients with squamous cell carcinoma in the head and neck and evaluate its effects in the survival of these patients. Methodology A total of 80 fresh biopsies of HNC were evaluated. The genetic material was extracted using the commercial kit QIAGEN. The detection and classification of HPV were carried out using INNO-LiPA, whereas the quantification and analysis of integration of the viral genome into the host cell were carried out using real-time PCR. Results The average age of the patients included was 60.34 ± 14.48 years, with a predominance of the male gender. The most frequent HPV infection was genotype 16 (52.8%), with an average of 10 copies of the HPV-16 E6/β-globin gene. Furthermore, an integration of the viral genome in the host cell was observed in 86% of cases with a statistically significant relationship between the location of the tumour and the viral load (p < 0.05). Conclusions HPV-16 is the most common infection, and its physical status in the host cell is the determining factor in establishing response to treatment. However, more studies are needed to demonstrate the role of HPV infection in carcinogenesis.
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Affiliation(s)
- Dayahindara Veitía
- Molecular Genetics Laboratory, Oncology and Haematology Institute, Ministry of Popular Power for Health (MPPS), 1053, Venezuela
| | - Juan Liuzzi
- Head and Neck Service, "Padre Machado" Oncology Hospital, Ministry of Popular Power for Health (MPPS), 1053, Venezuela
| | - Maira Ávila
- Molecular Genetics Laboratory, Oncology and Haematology Institute, Ministry of Popular Power for Health (MPPS), 1053, Venezuela
| | - Idamelys Rodriguez
- Molecular Biology Laboratory, Immunology Institute, University of Central Venezuela (UCV), 1053, Venezuela
| | - Felix Toro
- Molecular Biology Laboratory, Immunology Institute, University of Central Venezuela (UCV), 1053, Venezuela
| | - María Correnti
- Molecular Genetics Laboratory, Oncology and Haematology Institute, Ministry of Popular Power for Health (MPPS), 1053, Venezuela
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Qian Y, Yu H, Yuan W, Wu J, Xu Q, Mei N, Wang X, Wang C. Alveolar Bone Loss, Tooth Loss and Oral Cancer Mortality in Older Patients: A Retrospective Cohort Study. Clin Interv Aging 2020; 15:1419-1425. [PMID: 32904647 PMCID: PMC7457387 DOI: 10.2147/cia.s263947] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Accepted: 07/28/2020] [Indexed: 01/07/2023] Open
Abstract
PURPOSE There has been growing interest in the association between periodontitis and systemic disease. In recent years, however, inconsistent results have also been found by case-control studies for the role of periodontitis in the development of oral cancer. This study aimed to examine whether periodontitis was an independent risk factor for oral cancer with a ≥75-year age group cohort. MATERIALS AND METHODS Between January 2010 and December 2014, 1385 patients aged ≥75 years who underwent radiographic examination were included in this retrospective cohort study. We collected demographic information and comorbid health conditions from local health authorities. Participants were followed up until either the occurrence of mortality, or the end of the study on December 31, 2018. Cox proportional hazards regression and competing risk hazard models were used to examine the association between periodontitis and oral cancer mortality. RESULTS Periodontitis and loss of teeth were significantly associated with oral cancer mortality. Compared to oral cancer mortality in healthy subjects, the HR and 95% CI in patients with mild, moderate, and severe periodontitis were 4.46 (0.94-21.06), 5.16 (1.14-23.39), and 6.65 (1.51-29.36), respectively. The HR (95% CI) was 1.05 (1.01-1.09) for tooth loss after controlling for potential confounding factors. All the increases in risk persisted in patients aged ≥80 years. CONCLUSION The present study provides substantial evidence that poor periodontal health is associated with oral cancer mortality. It is necessary to underline the importance of considering periodontitis in the prevention of oral cancer, particularly in the older patients.
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Affiliation(s)
- Yifeng Qian
- Department of Oral and Craniomaxillofacial Surgery, Shanghai Ninth People’s Hospital, College of Stomatology, Shanghai JiaoTong University School of Medicine, Shanghai, People’s Republic of China
- National Clinical Research Center for Oral Diseases, Shanghai, People’s Republic of China
- Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, Shanghai, People’s Republic of China
| | - Huiting Yu
- Shanghai Municipal Center for Disease Control and Prevention, Shanghai, People’s Republic of China
| | - Weijun Yuan
- Department of Oral and Craniomaxillofacial Surgery, Shanghai Ninth People’s Hospital, College of Stomatology, Shanghai JiaoTong University School of Medicine, Shanghai, People’s Republic of China
- National Clinical Research Center for Oral Diseases, Shanghai, People’s Republic of China
- Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, Shanghai, People’s Republic of China
| | - Jiaqing Wu
- College of Stomatology, Shanghai JiaoTong University School of Medicine, Shanghai, People’s Republic of China
| | - Qingyu Xu
- College of Stomatology, Shanghai JiaoTong University School of Medicine, Shanghai, People’s Republic of China
| | - Nianrou Mei
- College of Stomatology, Shanghai JiaoTong University School of Medicine, Shanghai, People’s Republic of China
| | - Xudong Wang
- Department of Oral and Craniomaxillofacial Surgery, Shanghai Ninth People’s Hospital, College of Stomatology, Shanghai JiaoTong University School of Medicine, Shanghai, People’s Republic of China
- National Clinical Research Center for Oral Diseases, Shanghai, People’s Republic of China
- Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, Shanghai, People’s Republic of China
| | - Chunfang Wang
- Shanghai Municipal Center for Disease Control and Prevention, Shanghai, People’s Republic of China
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Nwizu N, Wactawski-Wende J, Genco RJ. Periodontal disease and cancer: Epidemiologic studies and possible mechanisms. Periodontol 2000 2020; 83:213-233. [PMID: 32385885 PMCID: PMC7328760 DOI: 10.1111/prd.12329] [Citation(s) in RCA: 105] [Impact Index Per Article: 26.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Epidemiologic and cancer control studies on the association of periodontal disease and cancer risk mostly suggest a positive association with overall cancer risk and certain specific types of cancer. These findings are generally consistent among cross‐sectional and longitudinal studies. In this paper, we review epidemiologic studies and current knowledge on periodontal disease and cancer, with a focus on those studies conducted in the years following the Joint European Federation of Periodontology/American Academy of Periodontology Workshop on “Periodontitis and Systemic Diseases” in November 2012. This review also explores the role of chronic inflammation as a biologically plausible mechanistic link between periodontal disease and risk of cancer. Furthermore, it highlights studies that have examined the potential importance of certain periodontal pathogens in this association.
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Affiliation(s)
- Ngozi Nwizu
- Department of Diagnostic and Biomedical Sciences, School of Dentistry, The University of Texas Health Science Center at Houston, Houston, USA.,School of Public Health and Health Professions, University at Buffalo, The State University of New York, Buffalo, USA.,Department of Cancer Prevention and Control, Roswell Park Cancer Institute, Buffalo, USA
| | - Jean Wactawski-Wende
- School of Public Health and Health Professions, University at Buffalo, The State University of New York, Buffalo, USA
| | - Robert J Genco
- Department of Oral Biology, University at Buffalo, The State University of New York, Buffalo, USA
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32
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Periodontal Diseases as Putative Risk Factors for Head and Neck Cancer: Systematic Review and Meta-Analysis. Cancers (Basel) 2020; 12:cancers12071893. [PMID: 32674369 PMCID: PMC7409086 DOI: 10.3390/cancers12071893] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Revised: 06/15/2020] [Accepted: 06/15/2020] [Indexed: 02/06/2023] Open
Abstract
Whether "periodontal disease" can be considered as an independent risk factor for head and neck cancer (HNC) remains controversial. The aim of the current meta-analysis was to quantitatively assess this relationship in order to determine whether this represents a true risk factor, with implications for cancer prevention and management. PubMed, Scopus, and Embase databases were systematically searched. Selective studies were reviewed, and meta-analysis was performed to estimate the pooled odds ratio (OR) with 95% confidence intervals (CIs) on eligible studies using a random effects model. In total, 21 eligible observational studies (4 cohorts and 17 case-controls) were identified for qualitative synthesis after a review of 1051 articles. Significant heterogeneity could be identified in measures utilized for reporting of periodontal disease. Meta-analysis performed on nine studies that employed objective measures for reporting periodontal disease demonstrated a significant association between periodontal disease and HNC [OR 3.17, 95% CI, 1.78-5.64]. A diseased periodontium represents an independent risk marker, and a putative risk factor, for HNC. Prospective studies with standardized measures of periodontal disease severity and extent, integrated with microbiological and host susceptibility facets, are needed to elucidate the mechanisms of this positive association and whether treatment of the former influences the incidence and outcomes for HNC.
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Lin NC, Hsu JT, Tsai KY. Difference between Female and Male Patients with Oral Squamous Cell Carcinoma: A Single-Center Retrospective Study in Taiwan. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17113978. [PMID: 32512723 PMCID: PMC7312859 DOI: 10.3390/ijerph17113978] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Revised: 05/30/2020] [Accepted: 06/02/2020] [Indexed: 11/23/2022]
Abstract
There is a distinct male predominance in head and neck cancers. The present study aimed to investigate the clinical and pathological features of male and female patients with oral squamous cell carcinoma (OSCC), and to simultaneously conduct a survival analysis. Patients (n = 2573) were identified between January 2008 and December 2018, and subsequently analyzed for characteristics such as age at squamous cell carcinoma diagnosis, lifestyle factors (smoking habit, betel nut chewing and alcohol consumption), pathological American Joint Committee on Cancer (AJCC) anatomic site, AJCC TNM stage, pathological recurrence factor and interval from first diagnosis to recurrence. A case-matched comparison between female (n = 122) and male (n = 2451) patients was conducted. Significant gender differences were noted in age at diagnosis, anatomic site of the tumor, smoking habit, betel nut chewing and alcohol consumption (p < 0.001). There were no significant gender differences in the other clinical and pathological characteristics and survival conditions. In conclusion, female patients with OSCC were older than male patients with OSCC, and mostly had tumors of the oral tongue. Once patients develop OSCC, there was no difference in survival between men and women in a Taiwanese population.
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Affiliation(s)
- Nan-Chin Lin
- School of Dentistry, China Medical University, Taichung 404, Taiwan; (N.-C.L.); (J.-T.H.)
- Department of Oral and Maxillofacial Surgery, Changhua Christian Hospital, Changhua 500, Taiwan
| | - Jui-Ting Hsu
- School of Dentistry, China Medical University, Taichung 404, Taiwan; (N.-C.L.); (J.-T.H.)
| | - Kuo-Yang Tsai
- Department of Oral and Maxillofacial Surgery, Changhua Christian Hospital, Changhua 500, Taiwan
- College of Nursing and Health Science, Da-Yeh University, Changhua 515, Taiwan
- Correspondence: ; Tel.: +88-693-3127-916
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La Rosa GRM, Gattuso G, Pedullà E, Rapisarda E, Nicolosi D, Salmeri M. Association of oral dysbiosis with oral cancer development. Oncol Lett 2020; 19:3045-3058. [PMID: 32211076 PMCID: PMC7079586 DOI: 10.3892/ol.2020.11441] [Citation(s) in RCA: 44] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2019] [Accepted: 12/04/2019] [Indexed: 12/11/2022] Open
Abstract
Oral squamous cell carcinoma (OSCC) is the leading cause of mortality for oral cancer. Numerous risk factors mainly related to unhealthy habits and responsible for chronic inflammation and infections have been recognized as predisposing factors for oral carcinogenesis. Recently, even microbiota alterations have been associated with the development of human cancers. In particular, some specific bacterial strains have been recognized and strongly associated with oral cancer development (Capnocytophaga gingivalis, Fusobacterium spp., Streptococcus spp., Peptostreptococcus spp., Porphyromonas gingivalis and Prevotella spp.). Several hypotheses have been proposed to explain how the oral microbiota could be involved in cancer pathogenesis by mainly paying attention to chronic inflammation, microbial synthesis of cancerogenic substances, and alteration of epithelial barrier integrity. Based on knowledge of the carcinogenic effects of dysbiosis, it was recently suggested that probiotics may have anti-tumoral activity. Nevertheless, few data exist with regard to probiotic effects on oral cancer. On this basis, the association between the development of oral cancer and oral dysbiosis is discussed focusing attention on the potential benefits of probiotics administration in cancer prevention.
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Affiliation(s)
- Giusy Rita Maria La Rosa
- Department of General Surgery and Surgical-Medical Specialties, University of Catania, I-95125 Catania, Italy.,Department of Biomedical and Biotechnological Sciences, International PhD Program in Basic and Applied Biomedical Sciences, University of Catania, I-95123 Catania, Italy
| | - Giuseppe Gattuso
- Department of Biomedical and Biotechnological Sciences, International PhD Program in Basic and Applied Biomedical Sciences, University of Catania, I-95123 Catania, Italy.,Department of Biomedical and Biotechnological Sciences, University of Catania, I-95123 Catania, Italy
| | - Eugenio Pedullà
- Department of General Surgery and Surgical-Medical Specialties, University of Catania, I-95125 Catania, Italy
| | - Ernesto Rapisarda
- Department of General Surgery and Surgical-Medical Specialties, University of Catania, I-95125 Catania, Italy
| | - Daria Nicolosi
- Department of Biomedical and Biotechnological Sciences, University of Catania, I-95123 Catania, Italy
| | - Mario Salmeri
- Department of Biomedical and Biotechnological Sciences, University of Catania, I-95123 Catania, Italy.,Department of Biomedical and Biotechnological Sciences, Research Center for Prevention, Diagnosis and Treatment of Cancer, University of Catania, I-95123 Catania, Italy
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Chuang WC, Tsang NM, Chuang CC, Chang KP, Pai PC, Chen KH, Chou WC, Tai SF, Liu SC, Lei KF. Association of subcutaneous and visceral adipose tissue with overall survival in Taiwanese patients with bone metastases - results from a retrospective analysis of consecutively collected data. PLoS One 2020; 15:e0228360. [PMID: 31999771 PMCID: PMC6992206 DOI: 10.1371/journal.pone.0228360] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2019] [Accepted: 01/13/2020] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND Growing evidence indicates that measures of body composition may be related to clinical outcomes in patients with malignancies. The aim of this study was to investigate whether measures of regional adiposity-including subcutaneous adipose tissue index (SATI) and visceral adipose tissue index (VATI)-can be associated with overall survival (OS) in Taiwanese patients with bone metastases. METHODS This is a retrospective analysis of prospectively collected data. We examined 1280 patients with bone metastases who had undergone radiotherapy (RT) between March 2005 and August 2013. Body composition (SATI, VATI, and muscle index) was assessed by computed tomography at the third lumbar vertebra and normalized for patient height. Patients were divided into low- and high-adiposity groups (for both SATI and VATI) according to sex-specific median values. RESULTS Both SATI (hazard ratio [HR]: 0.696; P<0.001) and VATI (HR: 0.87; P = 0.037)-but not muscle index-were independently associated with a more favorable OS, with the former showing a stronger relationship. The most favorable OS was observed in women with high SATI (11.21 months; 95% confidence interval: 9.434-12.988; P<0.001). CONCLUSIONS High SATI and VATI are associated with a more favorable OS in Taiwanese patients with bone metastases referred for RT. The question as to whether clinical measures aimed at improving adiposity may improve OS in this clinical population deserves further scrutiny.
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Affiliation(s)
- Wen Ching Chuang
- Chang Gung University, Medicine, Taoyuan, Taiwan
- Chang Gung Memorial Hospital, Linkou Branch, Taoyuan, Taiwan
| | - Ngan Ming Tsang
- Department of Radiation Oncology, Linkou Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan
- School of Traditional Chinese Medicine, Chang Gung University, Taoyuan, Taiwan
- * E-mail:
| | - Chi Cheng Chuang
- Department of Neurosurgery, Chang Gung Memorial Hospital and University at Lin-Kou, Taoyuan, Taiwan
| | - Kai Ping Chang
- Department of Otolaryngology-Head Neck Surgery, Linkou Chang Gung Memorial Hospital and Chang Gung University at Lin-Kou, Taoyuan, Taiwan
| | - Ping Ching Pai
- Department of Radiation Oncology, Linkou Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan
| | - Kuan Hung Chen
- Chang Gung University, Medicine, Taoyuan, Taiwan
- Chang Gung Memorial Hospital, Linkou Branch, Taoyuan, Taiwan
| | - Wen Chi Chou
- Division of Hematology-Oncology, Department of Internal Medicine, Chang Gung Memorial Hospital Linkou Branch, and School of Medicine, Chang Gung, Taoyuan, Taiwan
| | - Shiao Fwu Tai
- Department of Otorhinolaryngology, Chang Gung Memorial Hospital, Linkou Branch, Taoyuan, Taiwan
| | - Shu Chen Liu
- Department of Biomedical Sciences and Engineering, National Central University, Taoyuan, Taiwan
| | - Kin Fong Lei
- Graduate Institute of Biomedical Engineering, Chang Gung University, Taoyuan, Taiwan
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Bjerkli IH, Jetlund O, Karevold G, Karlsdóttir Á, Jaatun E, Uhlin-Hansen L, Rikardsen OG, Hadler-Olsen E, Steigen SE. Characteristics and prognosis of primary treatment-naïve oral cavity squamous cell carcinoma in Norway, a descriptive retrospective study. PLoS One 2020; 15:e0227738. [PMID: 31945122 PMCID: PMC6964975 DOI: 10.1371/journal.pone.0227738] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2019] [Accepted: 12/28/2019] [Indexed: 01/04/2023] Open
Abstract
Objectives Incidence of oral cavity squamous cell carcinomas is rising worldwide, and population characterization is important to follow for future trends. The aim of this retrospective study was to present a large cohort of primary oral cavity squamous cell carcinoma from all four health regions of Norway, with descriptive clinicopathological characteristics and five-year survival outcomes. Materials and methods Patients diagnosed with primary treatment-naïve oral cavity squamous cell carcinomas at all four university hospitals in Norway between 2005–2009 were retrospectively included in this study. Clinicopathological data from the electronic health records were compared to survival data. Results A total of 535 patients with primary treatment-naïve oral cavity squamous cell carcinomas were identified. The median survival follow-up time was 48 months (range 0–125 months) after treatment. The median five-year overall survival was found to be 47%. Median five-year disease-specific survival was 52%, ranging from 80% for stage I to 33% for stage IV patients. For patients given treatment with curative intent, the overall survival was found to be 56% and disease-specific survival 62%. Median age at diagnosis was 67 years (range 24–101 years), 64 years for men and 72 years for women. The male: female ratio was 1.2. No gender difference was found in neither tumor status (p = 0.180) nor node status (p = 0.266), but both factors influenced significantly on survival (p<0.001 for both). Conclusions We present a large cohort of primary treatment-naïve oral cavity squamous cell carcinomas in Norway. Five-year disease-specific survival was 52%, and patients eligible for curative treatment had a five-year disease-specific survival up to 62%.
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Affiliation(s)
- Inger-Heidi Bjerkli
- Department of Otorhinolaryngology, University Hospital of North Norway, Tromsø, Norway
- Department of Medical Biology, UiT The Arctic University of Norway, Tromsø, Norway
| | - Olav Jetlund
- Department of Otorhinolaryngology, Head and Neck Surgery, Division of Head, Neck and Reconstructive Surgery, Oslo University Hospital—Rikshospitalet, Oslo, Norway
| | - Gunnhild Karevold
- Department of Otorhinolaryngology, Head and Neck Surgery, Division of Head, Neck and Reconstructive Surgery, Oslo University Hospital—Rikshospitalet, Oslo, Norway
| | - Ása Karlsdóttir
- Department of Oncology, Haukeland University Hospital, Bergen, Norway
| | - Ellen Jaatun
- Department of Otorhinolaryngology, St. Olavs University Hospital, Trondheim, Norway
- Norwegian University of Science and Technology, Trondheim, Norway
| | - Lars Uhlin-Hansen
- Department of Medical Biology, UiT The Arctic University of Norway, Tromsø, Norway
- Department of Pathology, University Hospital of North Norway, Tromsø, Norway
| | - Oddveig G. Rikardsen
- Department of Otorhinolaryngology, University Hospital of North Norway, Tromsø, Norway
- Department of Medical Biology, UiT The Arctic University of Norway, Tromsø, Norway
| | - Elin Hadler-Olsen
- Department of Medical Biology, UiT The Arctic University of Norway, Tromsø, Norway
- Department of Pathology, University Hospital of North Norway, Tromsø, Norway
- Department of Clinical Dentistry, UiT The Arctic University of Norway, Tromsø, Norway
| | - Sonja E. Steigen
- Department of Medical Biology, UiT The Arctic University of Norway, Tromsø, Norway
- Department of Pathology, University Hospital of North Norway, Tromsø, Norway
- * E-mail:
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Kawecki MM, Nedeva IR, Iloya J, Macfarlane TV. Mouth Cancer Awareness in General Population: Results from Grampian Region of Scotland, United Kingdom. EJOURNAL OF ORAL MAXILLOFACIAL RESEARCH 2019; 10:e3. [PMID: 31402971 PMCID: PMC6683386 DOI: 10.5037/jomr.2019.10203] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/23/2019] [Accepted: 06/25/2019] [Indexed: 01/14/2023]
Abstract
Objectives The purpose of this project was to determine the level of mouth cancer awareness and to investigate the associated factors in a United Kingdom (UK) general population sample. Material and Methods Adult Dental Health Survey (2010) was conducted in a sample of 3,353 adult residents in the Grampian region of the UK (adjusted participation rate 58%). Participants completed a questionnaire consisting of questions on oral health, health behaviour, quality of life and cancer awareness. Results Overall, 81% of participants were aware of mouth cancer. This was associated with younger age, higher levels of education and better general health. Current smokers and alcohol drinkers were more aware of mouth cancer. When asked about risk factors for mouth cancer, the following were identified by the respondents: smoking (84%), poor oral hygiene (60%), drinking alcohol heavily (59%), poor diet (37%), stress (15%), being overweight (6%), drinking hot liquids (5%), eating spicy food (3%), using mouthwash (2%) and kissing someone (1%). Smokers were more likely to identify smoking as a risk factor for mouth cancer. Similarly, those who consumed alcohol almost daily were more likely to identify heavy alcohol drinking as a risk factor. Conclusions Awareness of mouth cancer is high in respondents from the general population, and participants were able to identify the most important risk factors. Knowledge of tobacco and alcohol as risk factors was highest amongst those exposed to them. The study proposed that the prevention strategies should focus not only on increasing knowledge, but also on changing health behaviour.
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Affiliation(s)
- Michal M Kawecki
- NHS Wales, Dental Surgery Department, HaverfordwestUnited Kingdom
| | - Iva R Nedeva
- University of Ulster, School of Bomedical Sciences, ColeraineUnited Kingdom
| | - Jonathan Iloya
- NHS Grampian, Dental Public Health, AberdeenUnited Kingdom
| | - Tatiana V Macfarlane
- NHS Wales, Dental Surgery Department, HaverfordwestUnited Kingdom.,NHS Wales, Dental Surgery Department, HaverfordwestUnited Kingdom
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Zhang Y, He J, He B, Huang R, Li M. Effect of tobacco on periodontal disease and oral cancer. Tob Induc Dis 2019; 17:40. [PMID: 31516483 PMCID: PMC6662776 DOI: 10.18332/tid/106187] [Citation(s) in RCA: 62] [Impact Index Per Article: 12.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2018] [Revised: 04/02/2019] [Accepted: 04/05/2019] [Indexed: 01/09/2023] Open
Abstract
INTRODUCTION Periodontal disease and oral cancer are common health hazards. Epidemiological investigations show that smoking, periodontal disease and oral cancer are closely related. Tobacco is one of the major risk factors for periodontitis and oral cancer. METHODS A systematic literature review was performed. To identify relevant studies, the following online databases were searched using specific keywords: PubMed, Web of Science and CNKI. RESULTS Tobacco not only possesses an addictive effect, but it aggravates periodontal disease by promoting the invasion of pathogenic bacteria, inhibiting autoimmune defense, aggravating the inflammatory reaction, and aggravating the loss of alveolar bone. According to current evidence, tobacco significantly aggravates the development and progression of periodontal disease and oral cancer, and periodontal disease may be related to the prevalence of oral cancer. CONCLUSIONS Clinicians should strongly recommend that smokers undertake a strategy to stop smoking to avoid the exacerbation of nicotine-related periodontal disease and to reduce the incidence of oral cancer.
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Affiliation(s)
- Yixin Zhang
- State Key Laboratory of Oral Diseases, West China School of Stomatology, Sichuan University, Chengdu, China
| | - Jinxiu He
- State Key Laboratory of Oral Diseases, West China School of Stomatology, Sichuan University, Chengdu, China
| | - Bing He
- Protein Section, Laboratory of Metabolism, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, United States
| | - Ruijie Huang
- State Key Laboratory of Oral Diseases, West China School of Stomatology, Sichuan University, Chengdu, China
| | - Mingyun Li
- State Key Laboratory of Oral Diseases, West China School of Stomatology, Sichuan University, Chengdu, China
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Potentially premalignant disorder/lesion versus potentially premalignant patient: Relevance in clinical care. Oral Oncol 2019; 92:57-58. [DOI: 10.1016/j.oraloncology.2019.03.009] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2019] [Accepted: 03/13/2019] [Indexed: 12/26/2022]
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Chronic Inflammation as a Link between Periodontitis and Carcinogenesis. Mediators Inflamm 2019; 2019:1029857. [PMID: 31049022 PMCID: PMC6458883 DOI: 10.1155/2019/1029857] [Citation(s) in RCA: 92] [Impact Index Per Article: 18.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2018] [Accepted: 02/03/2019] [Indexed: 12/16/2022] Open
Abstract
Periodontitis is characterized by a chronic inflammation produced in response to a disease-associated multispecies bacterial community in the subgingival region. Although the inflammatory processes occur locally in the oral cavity, several studies have determined that inflammatory mediators produced during periodontitis, as well as subgingival species and bacterial components, can disseminate from the oral cavity, contributing therefore, to various extraoral diseases like cancer. Interestingly, carcinogenesis associated with periodontal species has been observed in both the oral cavity and in extra oral sites. In this review, several studies were summarized showing a strong association between orodigestive cancers and poor oral health, presence of periodontitis-associated bacteria, tooth loss, and clinical signs of periodontitis. Proinflammatory pathways were also summarized. Such pathways are activated either by mono- or polymicrobial infections, resulting in an increase in the expression of proinflammatory molecules such as IL-6, IL-8, IL-1β, and TNF-α. In addition, it has been shown that several periodontitis-associated species induce the expression of genes related to cell proliferation, cell cycle, apoptosis, transport, and immune and inflammatory responses. Intriguingly, many of these pathways are linked to carcinogenesis. Among them, the activation of Toll-like receptors (TLRs) and antiapoptotic pathways (such as the PI3K/Akt, JAK/STAT, and MAPK pathways), the reduction of proapoptotic protein expression, the increase in cell migration and invasion, and the enhancement in metastasis are addressed. Considering that periodontitis is a polymicrobial disease, it is likely that mixed species promote carcinogenesis both in the oral cavity and in extra oral tissues and probably—as observed in periodontitis—synergistic and/or antagonistic interactions occur between microbes in the community. To date, a good amount of studies has allowed us to understand how monospecies infections activate pathways involved in tumorigenesis; however, more studies are needed to determine the combined effect of oral species in carcinogenesis.
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Chang C, Lee W, Hsiao J, Ou C, Huang C, Tsai S, Chen K, Huang J, Wong T, Lai Y, Wu Y, Hsueh W, Wu S, Yen C, Chang J, Lin C, Weng Y, Yang H, Chen Y, Chang JS. Oral hygiene and the overall survival of head and neck cancer patients. Cancer Med 2019; 8:1854-1864. [PMID: 30865385 PMCID: PMC6488153 DOI: 10.1002/cam4.2059] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2018] [Revised: 02/01/2019] [Accepted: 02/04/2019] [Indexed: 01/04/2023] Open
Abstract
Poor oral hygiene is an established risk factor of head and neck cancer (HNC); however, its role in the survival of HNC patients is unclear. This study evaluated the association between oral hygiene habits, including regular dental visits, frequency of tooth brushing, and use of dental floss, and the overall survival (OS) of HNC patients using interview data collected from 740 HNC patients. In addition, the interactions between oral hygiene and the polymorphisms of TLR2 and TLR4 on the OS of HNC patients were assessed. The analysis indicated that poor oral hygiene was significantly associated with poorer OS of HNC patients (hazard ratio (HR) = 1.38, 95% confidence interval (CI): 1.03‐1.86). This association was modified by a single nucleotide polymorphism, rs11536889, of TLR4. A significant association between poor oral hygiene and worse survival of HNC was observed among those with the CG or CC genotype (HR = 2.32, 95% CI: 1.41‐3.82) but not among those with the GG genotype (HR = 0.95, 95% CI: 0.65‐1.40). Our results suggested that poor oral hygiene is not only a risk factor but may also be a prognostic factor of HNC. Poor oral hygiene was associated with a worse survival of head and neck cancer. TLR4 affected the survival of head and neck cancer due to poor oral hygiene. Poor oral hygiene is both a risk and a prognostic factor of head and neck cancer
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Affiliation(s)
- Chan‐Chi Chang
- Department of OtolaryngologyNational Cheng Kung University Hospital, College of Medicine, National Cheng Kung UniversityTainanTaiwan
- Institute of Clinical Medicine, College of Medicine, National Cheng Kung UniversityTainanTaiwan
| | - Wei‐Ting Lee
- Department of OtolaryngologyNational Cheng Kung University Hospital, College of Medicine, National Cheng Kung UniversityTainanTaiwan
- Institute of Clinical Medicine, College of Medicine, National Cheng Kung UniversityTainanTaiwan
| | - Jenn‐Ren Hsiao
- Department of OtolaryngologyNational Cheng Kung University Hospital, College of Medicine, National Cheng Kung UniversityTainanTaiwan
- Institute of Clinical Medicine, College of Medicine, National Cheng Kung UniversityTainanTaiwan
| | - Chun‐Yen Ou
- Department of OtolaryngologyNational Cheng Kung University Hospital, College of Medicine, National Cheng Kung UniversityTainanTaiwan
| | - Cheng‐Chih Huang
- Department of OtolaryngologyNational Cheng Kung University Hospital, College of Medicine, National Cheng Kung UniversityTainanTaiwan
| | - Sen‐Tien Tsai
- Department of OtolaryngologyNational Cheng Kung University Hospital, College of Medicine, National Cheng Kung UniversityTainanTaiwan
| | - Ken‐Chung Chen
- Department of StomatologyNational Cheng Kung University Hospital, College of Medicine, National Cheng Kung UniversityTainanTaiwan
| | - Jehn‐Shyun Huang
- Department of StomatologyNational Cheng Kung University Hospital, College of Medicine, National Cheng Kung UniversityTainanTaiwan
| | - Tung‐Yiu Wong
- Department of StomatologyNational Cheng Kung University Hospital, College of Medicine, National Cheng Kung UniversityTainanTaiwan
| | - Yu‐Hsuan Lai
- Institute of Clinical Medicine, College of Medicine, National Cheng Kung UniversityTainanTaiwan
- Department of Radiation OncologyNational Cheng Kung University Hospital, College of Medicine, National Cheng Kung UniversityTainanTaiwan
| | - Yuan‐Hua Wu
- Department of Radiation OncologyNational Cheng Kung University Hospital, College of Medicine, National Cheng Kung UniversityTainanTaiwan
| | - Wei‐Ting Hsueh
- Department of Radiation OncologyNational Cheng Kung University Hospital, College of Medicine, National Cheng Kung UniversityTainanTaiwan
| | - Shang‐Yin Wu
- Institute of Clinical Medicine, College of Medicine, National Cheng Kung UniversityTainanTaiwan
- Division of Hematology/Oncology, Department of Internal MedicineNational Cheng Kung University Hospital, College of Medicine, National Cheng Kung UniversityTainanTaiwan
| | - Chia‐Jui Yen
- Institute of Clinical Medicine, College of Medicine, National Cheng Kung UniversityTainanTaiwan
- Division of Hematology/Oncology, Department of Internal MedicineNational Cheng Kung University Hospital, College of Medicine, National Cheng Kung UniversityTainanTaiwan
| | - Jang‐Yang Chang
- Division of Hematology/Oncology, Department of Internal MedicineNational Cheng Kung University Hospital, College of Medicine, National Cheng Kung UniversityTainanTaiwan
- National Institute of Cancer Research, National Health Research InstitutesTainanTaiwan
| | - Chen‐Lin Lin
- Department of NursingNational Cheng Kung University Hospital, College of Medicine, National Cheng Kung UniversityTainanTaiwan
| | - Ya‐Ling Weng
- National Institute of Cancer Research, National Health Research InstitutesTainanTaiwan
| | - Han‐Chien Yang
- National Institute of Cancer Research, National Health Research InstitutesTainanTaiwan
| | - Yu‐Shan Chen
- Department of OtolaryngologyNational Cheng Kung University Hospital, College of Medicine, National Cheng Kung UniversityTainanTaiwan
| | - Jeffrey S. Chang
- National Institute of Cancer Research, National Health Research InstitutesTainanTaiwan
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Shin Y, Choung H, Lee J, Rhyu I, Kim H. Association of Periodontitis with Oral Cancer: A Case-Control Study. J Dent Res 2019; 98:526-533. [DOI: 10.1177/0022034519827565] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
The association between oral squamous cell carcinoma (OSCC) and periodontitis in large hospital cases with cohort controls has yet to be evaluated. The aim of this study was to investigate the association of periodontitis with OSCC across tumor location and tumor-node-metastasis (TNM) stage among Koreans ( N = 424). OSCC cases ( n = 146) were recruited from Seoul National University Dental Hospital and matched by age, sex, and smoking to controls ( n = 278) from the Yangpyeong health and periodontal cohort in Korea. OSCC was diagnosed through biopsy and radiographs, including computed tomography and magnetic resonance imaging. Tumor location and TNM stage were classified after the surgery. Periodontitis was defined by alveolar bone loss with panoramic radiographs following the guidelines of the Fifth European Workshop in Periodontology. Alcohol intake, education, physical activity, obesity by body mass index, hypertension by blood pressure, diabetes by plasma glucose, and hypercholesterolemia by plasma cholesterol were considered as confounders. Information about age, sex, smoking, alcohol intake, education, and physical activity was obtained through interview; body mass index and blood pressure, through physical examination; and preoperative glucose and cholesterol, through laboratory tests. Bivariate analysis was applied with Fisher’s exact chi-square test. Multivariable conditional logistic regression models were applied to evaluate the adjusted association of periodontitis with OSCC after controlling for confounders. Subgroup analyses were explored by OSCC and periodontitis. Participants with periodontitis were 3.7 times more likely to have OSCC (adjusted odds ratio [aOR] = 3.66, 95% CI = 1.46 to 9.23) than participants without periodontitis. The differences in periodontitis were not statistically significant across TNM stages of OSCC ( P > 0.05) and its location ( P > 0.05). The link was highlighted among males (aOR = 6.55), elders aged >60 y (aOR = 4.98), and those with more tooth loss (aOR = 9.99). Our data showed that periodontitis was independently associated with OSCC. Thus, the risk of OSCC could be modulated by reducing periodontitis.
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Affiliation(s)
- Y.J. Shin
- Department of Preventive and Social Dentistry, School of Dentistry, Seoul National University, Seoul, Korea
- Oral Cancer Center and Department of Oral and Maxillofacial Surgery, Seoul National University Dental Hospital, Seoul, Korea
| | - H.W. Choung
- Oral Cancer Center and Department of Oral and Maxillofacial Surgery, Seoul National University Dental Hospital, Seoul, Korea
| | - J.H. Lee
- Oral Cancer Center and Department of Oral and Maxillofacial Surgery, Seoul National University Dental Hospital, Seoul, Korea
- Dental Research Institute, Seoul National University, Seoul, Korea
| | - I.C. Rhyu
- Dental Research Institute, Seoul National University, Seoul, Korea
- Department of Periodontology, Seoul National University Dental Hospital, Seoul, Korea
| | - H.D. Kim
- Department of Preventive and Social Dentistry, School of Dentistry, Seoul National University, Seoul, Korea
- Dental Research Institute, Seoul National University, Seoul, Korea
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43
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Gupta B, Kumar N, Johnson NW. Evidence of past dental visits and incidence of head and neck cancers: a systematic review and meta-analysis. Syst Rev 2019; 8:43. [PMID: 30717784 PMCID: PMC6360721 DOI: 10.1186/s13643-019-0949-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2018] [Accepted: 01/14/2019] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Regular/frequent dental visits, at least annually, can aid in reducing the public health burden of head and neck cancers (HNCs) by facilitating earlier detection of the disease. The aim of this study was to conduct a quantitative assessment of any independent association between past dental visits/check-ups and incidence of cancers of HN/upper aerodigestive tract (UADT) and oral cavity worldwide. METHODS PubMed, CINAHL, and Cochrane databases were searched for all observational studies published until August 2017 in any language that assessed an association of past dental visits/dental check-ups among the incident cases of HNC/UADT cancers. Screening and quality assessment of the articles was performed by two independent reviewers. Three different meta-analyses were conducted: two based on the incident cancer reported in the studies (HNCs/cancers of UADT and oral cavity); another included all studies irrespective of the type of cancer reported with the frequency of past dental visits as subgroups. RESULTS Searches retrieved 3164 titles: after removing duplicates, 1377 remained. Of these, 62 were reviewed in full, but only 38 were eligible for inclusion. Under the random effects model, odds of past never/irregular/not frequent dental visits were greater in HNC cases and oral cancer cases as compared to the hospital-based/population-based controls [HNCs-unadjusted odds ratio (OR) 2.24; 95% confidence interval (CI) 1.89 to 2.65) and (oral cancers-OR 1.93; 95% CI 1.47 to 2.52]. Similar results were observed for all cancers with frequency of past dental visits as subgroup analysis (OR 2.01; 95% CI 1.76 to 2.30). Meta-regression findings indicate that none of the subgroup influenced the effect estimates for incidence of cancers. There was no publication bias in our study. CONCLUSION This systematic review and meta-analysis indicates that individuals with never/irregular/not frequent dental visits are more likely to be incident cases of HNCs/UADT cancers.
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Affiliation(s)
- Bhawna Gupta
- Torrens University, Adelaide, South Australia, 5000, Australia.
| | - Narinder Kumar
- Department of Orthopaedics, Base Hospital, Lucknow, India
| | - Newell W Johnson
- Menzies Health Institute Queensland and School of Dentistry and Oral Health, Griffith University, Gold Coast, Australia
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44
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Hsiao JR, Chang CC, Lee WT, Huang CC, Ou CY, Tsai ST, Chen KC, Huang JS, Wong TY, Lai YH, Wu YH, Hsueh WT, Wu SY, Yen CJ, Chang JY, Lin CL, Weng YL, Yang HC, Chen YS, Chang JS. The interplay between oral microbiome, lifestyle factors and genetic polymorphisms in the risk of oral squamous cell carcinoma. Carcinogenesis 2019; 39:778-787. [PMID: 29668903 DOI: 10.1093/carcin/bgy053] [Citation(s) in RCA: 88] [Impact Index Per Article: 17.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2018] [Accepted: 04/10/2018] [Indexed: 12/14/2022] Open
Abstract
Poor oral hygiene may lead to overgrowth of pathogenic oral bacteria, which may induce chronic inflammation to promote the oncogenesis of oral squamous cell carcinoma (OSCC). This study investigated the association between oral bacterial profile and OSCC risk in a case-control study of 138 OSCC cases and 151 controls (88 cases and 90 controls for the discovery group and 50 cases and 61 controls for the validation group). Oral bacterial profiles were characterized by targeted sequencing of the 16S rRNA gene. Three species of periodontopathogenic bacteria, Prevotella tannerae, Fusobacterium nucleatum, and Prevotella intermedia, were associated with an increased OSCC risk. This association was modified by the genetic polymorphisms of TLR2 and TLR4. Use of alcohol, betel quids and cigarettes and poor oral hygiene were associated with a higher percentage of oral periodontopathogenic bacteria. The association between alcohol and periodontopathogenic bacteria was modified by the genetic polymorphism of ALDH2, with a stronger positive association observed among the ALDH2-deficient individuals. The percentage of periodontopathogenic bacteria was positively correlated with the level of salivary IL1β, an inflammatory cytokine. Overall, our results showed a positive association between periodontopathogenic bacteria and OSCC risk and this relationship may be influenced by lifestyle and genetic factors. Our results provided further biological support for the established association between poor oral hygiene and OSCC risk. This suggested that improving oral hygiene may reduce OSCC risk and should be part of a public health campaign to prevent the occurrence of OSCC.
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Affiliation(s)
- Jenn-Ren Hsiao
- Department of Otolaryngology, National Cheng Kung University Hospital, Taiwan.,Institute of Clinical Medicine, Taiwan
| | - Chan-Chi Chang
- Department of Otolaryngology, National Cheng Kung University Hospital, Taiwan.,Institute of Clinical Medicine, Taiwan
| | - Wei-Ting Lee
- Department of Otolaryngology, National Cheng Kung University Hospital, Taiwan.,Institute of Clinical Medicine, Taiwan
| | - Cheng-Chih Huang
- Department of Otolaryngology, National Cheng Kung University Hospital, Taiwan
| | - Chun-Yen Ou
- Department of Otolaryngology, National Cheng Kung University Hospital, Taiwan
| | - Sen-Tien Tsai
- Department of Otolaryngology, National Cheng Kung University Hospital, Taiwan
| | - Ken-Chung Chen
- Department of Stomatology, National Cheng Kung University Hospital, Taiwan
| | - Jehn-Shyun Huang
- Department of Stomatology, National Cheng Kung University Hospital, Taiwan
| | - Tung-Yiu Wong
- Department of Stomatology, National Cheng Kung University Hospital, Taiwan
| | - Yu-Hsuan Lai
- Institute of Clinical Medicine, Taiwan.,Department of Radiation Oncology, National Cheng Kung University Hospital, Taiwan
| | - Yuan-Hua Wu
- Department of Radiation Oncology, National Cheng Kung University Hospital, Taiwan
| | - Wei-Ting Hsueh
- Department of Radiation Oncology, National Cheng Kung University Hospital, Taiwan
| | - Shang-Yin Wu
- Institute of Clinical Medicine, Taiwan.,Division of Hematology/Oncology, Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Chia-Jui Yen
- Institute of Clinical Medicine, Taiwan.,Division of Hematology/Oncology, Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Jang-Yang Chang
- Division of Hematology/Oncology, Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan.,National Institute of Cancer Research, National Health Research Institutes, Tainan, Taiwan
| | - Chen-Lin Lin
- Department of Nursing, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Ya-Ling Weng
- National Institute of Cancer Research, National Health Research Institutes, Tainan, Taiwan
| | - Han-Chien Yang
- National Institute of Cancer Research, National Health Research Institutes, Tainan, Taiwan
| | - Yu-Shan Chen
- Department of Otolaryngology, National Cheng Kung University Hospital, Taiwan
| | - Jeffrey S Chang
- National Institute of Cancer Research, National Health Research Institutes, Tainan, Taiwan
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45
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Xu S, Zhang G, Xia C, Tan YH. Associations Between Poor Oral Health and Risk of Squamous Cell Carcinoma of the Head and Neck: A Meta-Analysis of Observational Studies. J Oral Maxillofac Surg 2018; 77:2128-2142. [PMID: 30448433 DOI: 10.1016/j.joms.2018.10.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2018] [Revised: 10/11/2018] [Accepted: 10/13/2018] [Indexed: 01/11/2023]
Abstract
PURPOSE Many epidemiologic studies have reported an association of poor oral health, especially periodontal disease (PD) and tooth loss, with the risk of squamous cell carcinoma of the head and neck (SCCHN). However, these studies have yielded inconsistent results. Therefore, the present study investigated whether poor oral health is an independent predictor of SCCHN through a meta-analysis of observational studies. MATERIALS AND METHODS The PubMed, EMBASE, and Cochrane Library databases were systematically searched for relevant observational studies of the association between oral health and risk of SCCHN conducted up to October 2017. The meta-analysis was conducted using STATA 12.0 (StataCorp, College Station, TX). A fixed- or random-effects model was applied to evaluate pooled risk estimates, and sensitivity and subgroup analyses were performed to identify sources of heterogeneity and pooled estimation. Publication bias was assessed using the Begg test, the Egger test, and funnel plots. RESULTS Twenty-seven relevant observational studies were identified, consisting of 24 case-and-control studies, 2 prospective studies, and 1 cross-sectional study, with 26,750 participants. Notably, oral health correlated meaningfully with SCCHN (odds ratio [OR] = 2.24; 95% confidence interval [CI], 1.77-2.82). In subgroup analyses, participants with PD (OR = 2.52; 95% CI, 1.43-4.44) had a higher risk of developing SCCHN than those with tooth loss (OR = 2.13; 95% CI, 1.63-2.78). The risk estimates exhibited substantial heterogeneity. Evidence of publication bias was limited. CONCLUSIONS The results of this meta-analysis suggest that patients with tooth loss or PD might face a substantial and independent risk of SCCHN, even after adjusting for smoking and alcohol consumption. However, the pooled estimates from observational studies could not establish a causative relation among PD, tooth loss, and SCCHN. Additional investigations of this correlation are warranted.
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Affiliation(s)
- Shuai Xu
- Resident, Department of Stomatology, Xinqiao Hospital, Third Military Medical University, Chongqing, China
| | - Gang Zhang
- Associate Professor, Department of Stomatology, Xinqiao Hospital, Third Military Medical University, Chongqing, China
| | - Chao Xia
- Resident, Department of Stomatology, Xinqiao Hospital, Third Military Medical University, Chongqing, China
| | - Ying-Hui Tan
- Professor, Department of Stomatology, Xinqiao Hospital, Third Military Medical University, Chongqing, China.
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46
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Xiao X, Zhang Z, Chang ET, Liu Z, Liu Q, Cai Y, Chen G, Huang QH, Xie SH, Cao SM, Shao JY, Jia WH, Zheng Y, Liao J, Chen Y, Lin L, Ernberg I, Huang G, Zeng Y, Zeng YX, Adami HO, Ye W. Medical History, Medication Use, and Risk of Nasopharyngeal Carcinoma. Am J Epidemiol 2018; 187:2117-2125. [PMID: 29701753 DOI: 10.1093/aje/kwy095] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2018] [Accepted: 04/23/2018] [Indexed: 02/07/2023] Open
Abstract
Because persistent inflammation may render the nasopharyngeal mucosa susceptible to carcinogenesis, chronic ear-nose-throat (ENT) disease and its treatment might influence the risk of nasopharyngeal carcinoma (NPC). Existing evidence is, however, inconclusive and often based on methodologically suboptimal epidemiologic studies. In a population-based case-control study in southern China, we enrolled 2,532 persons with NPC and 2,597 controls, aged 20-74 years, from 2010 to 2014. Odds ratios were estimated for associations between NPC risk and history of ENT and related medications. Any history of chronic ENT disease was associated with a 34% increased risk of NPC. Similarly, use of nasal drops or aspirin was associated with approximately doubled risk of NPC. However, in secondary analyses restricted to chronic ENT diseases and related medication use at least 5 years prior to diagnosis/interview, most results were statistically nonsignificant, except a history of uncured ENT diseases, untreated nasal polyps, and earlier age at first diagnosis of ENT disease and first or most recent aspirin use. Overall, these findings suggest that ENT disease and related medication use are most likely early indications rather than causes of NPC, although the possibility of a modestly increased NPC risk associated with these diseases and related medications cannot be excluded.
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Affiliation(s)
- Xiling Xiao
- Department of Otolaryngology–Head and Neck Surgery, First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Zhe Zhang
- Department of Otolaryngology–Head and Neck Surgery, First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Ellen T Chang
- Exponent, Inc., Center for Health Sciences, Menlo Park, California
- Division of Epidemiology, Department of Health Research and Policy, Stanford University School of Medicine, Stanford, California
| | - Zhiwei Liu
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, Maryland
| | - Qing Liu
- Department of Cancer Prevention Center, Sun Yat-sen University Cancer Center, Guangzhou, China
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, China
| | - Yonglin Cai
- Department of Clinical Laboratory, Wuzhou Red Cross Hospital, Wuzhou, China
- Wuzhou Health System Key Laboratory for Nasopharyngeal Carcinoma Etiology and Molecular Mechanism, Wuzhou, China
| | - Guomin Chen
- State Key Laboratory for Infectious Diseases Prevention and Control, Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | | | - Shang-Hang Xie
- Department of Cancer Prevention Center, Sun Yat-sen University Cancer Center, Guangzhou, China
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, China
| | - Su-Mei Cao
- Department of Cancer Prevention Center, Sun Yat-sen University Cancer Center, Guangzhou, China
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, China
| | - Jian-Yong Shao
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, China
| | - Wei-Hua Jia
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, China
| | - Yuming Zheng
- Department of Clinical Laboratory, Wuzhou Red Cross Hospital, Wuzhou, China
- Wuzhou Health System Key Laboratory for Nasopharyngeal Carcinoma Etiology and Molecular Mechanism, Wuzhou, China
| | - Jian Liao
- Cangwu Institute for Nasopharyngeal Carcinoma Control and Prevention, Wuzhou, China
| | - Yufeng Chen
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Longde Lin
- Key Laboratory of High-Incidence Tumor Prevention and Treatment, Guangxi Medical University, Ministry of Education, Nanning, China
| | - Ingemar Ernberg
- Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Stockholm, Sweden
| | - Guangwu Huang
- Department of Otolaryngology–Head and Neck Surgery, First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Yi Zeng
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, China
- State Key Laboratory for Infectious Diseases Prevention and Control, Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
- Beijing Hospital, Beijing, China
| | - Yi-Xin Zeng
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, China
- Beijing Hospital, Beijing, China
| | - Hans-Olov Adami
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Weimin Ye
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
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47
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Lin YS, Yeh CC, Huang SF, Chou YS, Kuo LT, Sung FC, Muo CH, Su CT, Su FH. Aspirin associated with risk reduction of secondary primary cancer for patients with head and neck cancer: A population-based analysis. PLoS One 2018; 13:e0199014. [PMID: 30133455 PMCID: PMC6104934 DOI: 10.1371/journal.pone.0199014] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2017] [Accepted: 05/30/2018] [Indexed: 12/21/2022] Open
Abstract
As reported by the Taiwan Cancer Registry in 2013 squamous cell carcinoma of head and neck cancer (HNSCC) was the sixth most frequently diagnosed cancer and the 5th most common cause of cancer related death and its incidence and mortality rate is still rising. The co-occurrence of HNSCC and secondary primary cancer (SPC) and the chemopreventive effect of aspirin on certain malignancies had been reported. Therefore we conducted this national study to investigate the use of aspirin associated with risk reduction of secondary primary cancer for patients with head and neck cancer in Taiwan. We searched the Registry for Catastrophic Illness in the National Health Insurance Research Database (NHIRD) for 18,234 patients (3,576 aspirin users and 14,667 non-aspirin users) diagnosed with HNSCC during 2000-2005. The SPC incidence density during follow-up in 2000-2011 was compared between the groups. For HNSCC patients, aspirin use after diagnosis was significantly associated with SPC risk reduction by 25% (adjusted HR, 0.75; 95% CI, 0.63-0.89; p = 0.001) after multivariate analysis. In the subgroup analysis, we found that esophageal cancer and stomach cancer incidence were significantly reduced after aspirin use (adjusted HR, 0.60; 95% CI, 0.41-0.90; p = 0.01 for esophageal cancer; adjusted HR, 0.27; 95% CI, 0.08-0.87; p = 0.03 for stomach cancer). Aspirin use for 1-3 years was associated with SPC risk reduction by 35% (adjusted HR, 0.65; 95% CI, 0.49-0.87; p = 0.003). SPC risk reduction extended continuously for more than 3 years of follow up (adjusted HR, 0.72; 95% CI, 0.53-0.98; p = 0.030). Our data shows aspirin use was associated with reduced SPC incidence for HNSCC patients, attributed mainly to reduced risk of esophageal and stomach cancer.
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Affiliation(s)
- Yu-Shan Lin
- Department of Family Medicine, Taipei Medical University Hospital, Taipei, Taiwan
| | - Chih-Ching Yeh
- School of Public Health, College of Public Health, Taipei Medical University, Taipei, Taiwan
- Department of Public Health, China Medical University, Taichung, Taiwan
| | - Shiang-Fu Huang
- Department of Otolaryngology, Head and Neck Surgery, Chang Gung Memorial Hospital, Linkou, Taiwan
- Department of Public Health, Chang Gung University, Tao-Yuan, Taiwan
| | - Yi-Sheng Chou
- Division of Hematology and Oncology, Department of Medicine, Taipei City Hospital, Renai Branch, Taipei, Taiwan
- School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Li-Tang Kuo
- Division of Cardiology, Department of Internal Medicine, Chang Gung Memorial Hospital, Keelung, Taiwan
| | - Fung-Chang Sung
- Department of Health Services Administration, College of Public Health, China Medical University, Taichung, Taiwan
- Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan
| | - Chih-Hsin Muo
- Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan
| | - Chien-Tien Su
- Department of Family Medicine, Taipei Medical University Hospital, Taipei, Taiwan
- School of Public Health, College of Public Health, Taipei Medical University, Taipei, Taiwan
| | - Fu-Hsiung Su
- School of Medicine, College of Medicine, Fu Jen Catholic University, New Taipei City, Taiwan
- Division of Family Medicine, Department of Community Medicine and Long Term Care, Fu Jen Catholic University Hospital, Fu Jen Catholic University, New Taipei City, Taiwan
- School of Medicine, Flinders University, Bedford Park, Australia
- Department of Family Medicine, Cardinal Tien Hospital, Fu Jen Catholic University, New Taipei City, Taiwan
- * E-mail:
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48
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Ndegwa N, Ploner A, Liu Z, Roosaar A, Axéll T, Ye W. Association between poor oral health and gastric cancer: A prospective cohort study. Int J Cancer 2018; 143:2281-2288. [PMID: 29873081 DOI: 10.1002/ijc.31614] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2017] [Revised: 04/28/2018] [Accepted: 05/09/2018] [Indexed: 01/22/2023]
Abstract
Poor oral health may be involved in the pathogenesis of gastric cancer, however, some aspects have not been explored. Further, for previously studied aspects, for example, tooth-loss, the findings are inconsistent. We conducted a prospective cohort study of 19,831 participants from Uppsala, Sweden, cancer-free at baseline in 1973-1974 and followed until 2012 through linkage to national registers. We found that individuals with fewest teeth at baseline had an increased risk of gastric cancer relative to subjects with all examined teeth present (p = 1.75e-2). Presence of denture-associated lesions was also associated with an increased risk of gastric cancer (p = 1.00e-4). However, these excess risks significantly varied with attained age; estimated hazard ratio (HR) at attained age 50 for tooth loss was 4.24 [95% confidence interval (CI) 1.83-9.80] and 5.91 (95% CI 2.76-12.63) for denture-associated lesions, decreasing at an estimated 4% and 6% per year respectively, resulting in HR of 1.54 (95% CI 0.90-2.64) for tooth loss and HR 1.29 (95% CI 0.90-1.85) for denture-associated lesions at attained age 75. No increased risk of gastric cancer was found for individuals with higher levels of dental plaque, or with Candida-related or tongue lesions. In conclusion, tooth-loss and denture-associated lesions are associated with increased risks of gastric cancer. Previous conflicting findings of tooth-loss and gastric cancer risk may partly be explained by the age-varying relative risk of gastric cancer.
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Affiliation(s)
- Nelson Ndegwa
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Alexander Ploner
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Zhiwei Liu
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Ann Roosaar
- Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Tony Axéll
- Maxillofacial Unit, Halmstad Hospital Halland, Halmstad, Sweden
| | - Weimin Ye
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
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49
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Cohen N, Fedewa S, Chen AY. Epidemiology and Demographics of the Head and Neck Cancer Population. Oral Maxillofac Surg Clin North Am 2018; 30:381-395. [PMID: 30078696 DOI: 10.1016/j.coms.2018.06.001] [Citation(s) in RCA: 197] [Impact Index Per Article: 32.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Head and neck malignancies comprise a heterogeneous group of malignancies that cause significant morbidity to those affected. These malignancies are associated with specific risk factors and exposures, some of which impact prognosis. The most common risk factors for developing head and neck cancers are tobacco and alcohol use. Marijuana and e-cigarettes, occupational exposures, and use of topical substances have also been linked to head and neck cancers. Human papilloma virus has been associated with oropharyngeal cancer. Such measures as oral hygiene, screening, smoking cessation, and vaccination are measures taken to decrease the incidence and morbidity of head and neck cancers.
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Affiliation(s)
- Natasha Cohen
- Department of Otolaryngology-Head and Neck Surgery, Emory University School of Medicine, 550 Peachtree Street. MOT 1135, Atlanta, GA 30308, USA
| | - Stacey Fedewa
- American Cancer Society, 250 Williams Street. NW, Atlanta, GA 30303, USA
| | - Amy Y Chen
- Department of Otolaryngology-Head and Neck Surgery, Emory University School of Medicine, 550 Peachtree Street. MOT 1135, Atlanta, GA 30308, USA.
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50
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Corbella S, Veronesi P, Galimberti V, Weinstein R, Del Fabbro M, Francetti L. Is periodontitis a risk indicator for cancer? A meta-analysis. PLoS One 2018; 13:e0195683. [PMID: 29664916 PMCID: PMC5903629 DOI: 10.1371/journal.pone.0195683] [Citation(s) in RCA: 47] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2018] [Accepted: 03/27/2018] [Indexed: 01/22/2023] Open
Abstract
Background The aim of the present systematic review was to evaluate the hypothesis of an association between periodontitis and the development of cancer. Methods Two reviewers independently screened electronic and manual sources for pertinent articles. Primary outcome measures were the occurrence of neoplasm diagnosis in exposed and non-exposed groups, reported to evaluate association between cancer and periodontitis. Results Of the 490 initially retrieved papers 10 were included in the qualitative synthesis and eight in the quantitative synthesis; the eight papers covered six studies. Considering hazard ratios, a statistically significant association was found for all cancers studied (1.14; CI 95%: 1.04, 1.24), digestive tract cancer (1.34; CI 95%: 1.05, 1.72), pancreatic cancer (1.74; CI 95%: 1.21, 2.52), prostate cancer (1.25; CI 95%: 1.04, 1.51), breast cancer (1.11; CI 95%: 1.00, 1.23), corpus uteri cancer (2.20; CI 95%: 1.16, 4.18), lung cancer (1.24; CI 95%: 1.06, 1.45), hematological cancer (1.30; CI 95%: 1.11, 1.53), esophagus / oropharyngeal cancer pooled together (2.25; CI 95%: 1.30, 3.90) and Non-Hodgkin lymphoma (1.30; CI 95%: 1.11, 1.52). Conclusions Despite the sparse scientific evidence and considering the low statistical power of the results, this systematic review revealed a substantial lack of studies with standardized and comparable methods to speculate about the association between periodontitis and cancer; more studies are need in order to explore further the scientific evidence of such correlation.
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Affiliation(s)
- Stefano Corbella
- IRCCS Istituto Ortopedico Galeazzi, Milan, Italy
- Department of Biomedical, Surgical and Dental Sciences, Università degli Studi di Milano, Milan, Italy
- * E-mail:
| | - Paolo Veronesi
- European Institute of Oncology, Division of Senology, Milan, Italy
- Università degli Studi di Milano, Milan, Italy
| | | | - Roberto Weinstein
- Scientific Director D&S ICH Humanitas Dental Center, Rozzano, Milan, Italy
| | - Massimo Del Fabbro
- IRCCS Istituto Ortopedico Galeazzi, Milan, Italy
- Department of Biomedical, Surgical and Dental Sciences, Università degli Studi di Milano, Milan, Italy
| | - Luca Francetti
- IRCCS Istituto Ortopedico Galeazzi, Milan, Italy
- Department of Biomedical, Surgical and Dental Sciences, Università degli Studi di Milano, Milan, Italy
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