1
|
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.
Collapse
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
| |
Collapse
|
2
|
Laumen JGE, Van Dijck C, Manoharan-Basil SS, de Block T, Abdellati S, Xavier BB, Malhotra-Kumar S, Kenyon C. The effect of daily usage of Listerine Cool Mint mouthwash on the oropharyngeal microbiome: a substudy of the PReGo trial. J Med Microbiol 2024; 73. [PMID: 38833520 DOI: 10.1099/jmm.0.001830] [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] [Indexed: 06/06/2024] Open
Abstract
Introduction. ListerineÒ is a bactericidal mouthwash widely used to prevent oral health problems such as dental plaque and gingivitis. However, whether it promotes or undermines a healthy oral microbiome is unclear.Hypothesis/Gap Statement. We hypothesized that the daily use of Listerine Cool Mint would have a significant impact on the oropharyngeal microbiome.Aim. We aimed to assess if daily usage of Listerine Cool Mint influenced the composition of the pharyngeal microbiome.Methodology. The current microbiome substudy is part of the Preventing Resistance in Gonorrhoea trial. This was a double-blind single-centre, crossover, randomized controlled trial of antibacterial versus placebo mouthwash to reduce the incidence of gonorrhoea/chlamydia/syphilis in men who have sex with men (MSM) taking HIV pre-exposure prophylaxis (PrEP). Fifty-nine MSM taking HIV PrEP were enrolled. In this crossover trial, participants received 3 months of daily Listerine followed by 3 months of placebo mouthwash or vice versa. Oropharyngeal swabs were taken at baseline and after 3 months use of each mouthwash. DNA was extracted for shotgun metagenomic sequencing (Illumina Inc.). Non-host reads were taxonomically classified with MiniKraken and Bracken. The alpha and beta diversity indices were compared between baseline and after each mouthwash use. Differentially abundant bacterial taxa were identified using ANOVA-like differential expression analysis.Results. Streptococcus was the most abundant genus in most samples (n = 103, 61.7 %) with a median relative abundance of 31.5% (IQR 20.6-44.8), followed by Prevotella [13.5% (IQR 4.8-22.6)] and Veillonella [10.0% (IQR 4.0-16.8)]. Compared to baseline, the composition of the oral microbiome at the genus level (beta diversity) was significantly different after 3 months of Listerine (P = 0.006, pseudo-F = 2.29) or placebo (P = 0.003, pseudo-F = 2.49, permutational multivariate analysis of variance) use. Fusobacterium nucleatum and Streptococcus anginosus were significantly more abundant after Listerine use compared to baseline.Conclusion. Listerine use was associated with an increased abundance of common oral opportunistic bacteria previously reported to be enriched in periodontal diseases, oesophageal and colorectal cancer, and systemic diseases. These findings suggest that the regular use of Listerine mouthwash should be carefully considered.
Collapse
Affiliation(s)
- J G E Laumen
- Department of Clinical Sciences, Institute of Tropical Medicine, STI Unit, Antwerp, Belgium
- Laboratory of Medical Microbiology, Vaccine and Infectious Disease Institute, University of Antwerp, Antwerp, Belgium
| | - C Van Dijck
- Department of Clinical Sciences, Institute of Tropical Medicine, STI Unit, Antwerp, Belgium
- Laboratory of Medical Microbiology, Vaccine and Infectious Disease Institute, University of Antwerp, Antwerp, Belgium
| | - S S Manoharan-Basil
- Department of Clinical Sciences, Institute of Tropical Medicine, STI Unit, Antwerp, Belgium
| | - T de Block
- Department of Clinical Sciences, Clinical Reference Laboratory, Institute of Tropical Medicine, Antwerp, Belgium
| | - S Abdellati
- Department of Clinical Sciences, Clinical Reference Laboratory, Institute of Tropical Medicine, Antwerp, Belgium
| | - B B Xavier
- Laboratory of Medical Microbiology, Vaccine and Infectious Disease Institute, University of Antwerp, Antwerp, Belgium
| | - S Malhotra-Kumar
- Laboratory of Medical Microbiology, Vaccine and Infectious Disease Institute, University of Antwerp, Antwerp, Belgium
| | - C Kenyon
- Department of Clinical Sciences, Institute of Tropical Medicine, STI Unit, Antwerp, Belgium
- Department of Medicine, University of Cape Town, Cape Town, South Africa
| |
Collapse
|
3
|
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.
Collapse
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
| |
Collapse
|
4
|
Li R, Hou M, Yu L, Luo W, Liu R, Wang H. Association between periodontal disease and oral squamous cell carcinoma: a systematic review and meta-analysis. Br J Oral Maxillofac Surg 2023; 61:394-402. [PMID: 37308334 DOI: 10.1016/j.bjoms.2023.05.004] [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: 12/14/2022] [Revised: 03/15/2023] [Accepted: 05/07/2023] [Indexed: 06/14/2023]
Abstract
To investigate the relation between periodontal disease (PD) and oral squamous cell carcinoma (OSCC) we systematically searched records published up to August 2022. Odds ratios (OR) and relative risk (RR) with 95% confidence intervals (95% CI) were estimated to evaluate this relation, then sensitivity analysis was performed accordingly. Begg's test and Egger's test were used to detect publication bias. Out of 970 papers from several databases, 13 studies were included. Summary estimates showed that PD was positively associated with the prevalence of OSCC (OR = 3.28, 95% CI: 1.87 to 5.74), especially for severe PD (OR = 4.23, 95% CI: 2.92 to 6.13). No evident publication bias was revealed. No increased OSCC risk among patients with PD was shown according to the combined results (RR = 1.50, 95% CI: 0.93 to 2.42). Patients with OSCC exhibited significant differences in alveolar bone loss, clinical attachment loss, and bleeding on probing, when compared with controls. The systematic review and meta-analysis suggested that there was a positive association between PD and prevalence of OSCC. However, according to the current evidence, a causal relation is unclear.
Collapse
Affiliation(s)
- Rui Li
- Department of Periodontology, School of Stomatology, China Medical University, Nanjing North Street 117, Shenyang, China.
| | - Mengjie Hou
- Department of Periodontology, School of Stomatology, China Medical University, Nanjing North Street 117, Shenyang, China.
| | - Liying Yu
- Department of Periodontology, School of Stomatology, China Medical University, Nanjing North Street 117, Shenyang, China.
| | - Wen Luo
- Department of Periodontology, School of Stomatology, China Medical University, Nanjing North Street 117, Shenyang, China.
| | - Ruihan Liu
- Clinical Medicine, Shenyang Medical College, Huanghe North Street 146, Shenyang, China.
| | - Hongyan Wang
- Department of Periodontology, School of Stomatology, China Medical University, Nanjing North Street 117, Shenyang, China.
| |
Collapse
|
5
|
Sahni V. Is there an association between oral hygiene and head and neck cancer? Evid Based Dent 2023; 24:57-58. [PMID: 37142769 DOI: 10.1038/s41432-023-00879-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2023] [Accepted: 03/16/2023] [Indexed: 05/06/2023]
Abstract
DATA SOURCES PubMed, Web of Science, the Cochrane Library and Embase were utilised as databases from inception till November 2021. STUDY SELECTION The inclusion criteria consisted of cohort and case-control studies published in the English language, which dealt with diagnosed cases of head and neck cancer reporting survival, oral hygiene and comparative data. Studies pertaining to animal experiments along with case reports, conference proceedings, reviews, letters, editorials, errata and protocols were excluded. DATA EXTRACTION AND SYNTHESIS Data such as publication year, authors' names, country, sources, study groups, age, gender, participant number, education, alcohol, tobacco, study quality, cancer site and outcomes were extracted for each included study. A modified Newcastle-Ottawa Scale was utilized to evaluate the quality of these studies. RESULTS A total of forty-four studies were included, of which forty were case-control and four were cohort in nature. These comprised of a total of 52,863 patients of which 33,000 were devoid of head and neck cancer (HNC) while, 19,863 had a confirmed diagnosis of HNC. Oral hygiene and HNC were found to be associated. CONCLUSIONS Poor oral hygiene was concluded to be associated with HNC and the subsites thereof.
Collapse
Affiliation(s)
- Vaibhav Sahni
- Infectious Disease and Immunology, The Forsyth Institute, Cambridge, MA, 02142, USA.
| |
Collapse
|
6
|
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.
Collapse
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
| |
Collapse
|
7
|
Wang K, Zhang Z, Wang Z. Assessment of the association between periodontal disease and total cancer incidence and mortality: a meta-analysis. PeerJ 2022; 10:e14320. [PMID: 36389427 PMCID: PMC9648345 DOI: 10.7717/peerj.14320] [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: 05/18/2022] [Accepted: 10/09/2022] [Indexed: 11/09/2022] Open
Abstract
Background Periodontal disease (PD) is a chronic inflammatory disease that leads to alveolar bone resorption and tooth loss. Many studies have reported the association between periodontal disease and various cancers including oral cancer, lung cancer, breast cancer and so on. However, there is still no specialized meta-analysis that assesses the association between periodontal disease and cancer incidence and mortality in-deepth. Thus, we conducted this meta-analysis. Methods This meta-analysis was registered with PROSPERO: CRD42020183497. We searched five online databases for observational studies about the association between periodontal disease and breast, prostate, lung and bronchial, colorectal, and total cancers by July 2020. Then we evaluated quality of the included studies by the Newcastle-Ottawa scale. Risk ratios (HRs) and their 95% confidence intervals (CIs) were pooled to evaluate the strength of the association between periodontal disease and four cancers, total cancer incidence and mortality. In addition, we analyzed heterogeneity by subgroup analysis and sensitivity analysis. Finally, we inspected publication bias by Begg's and Egger's tests. Results None of the studies included in this meta-analysis were of poor quality. PD is not only related to breast cancer incidence (HR = 1.26,95%CI [1.11-1.43], I 2 = 75.8%, P = 0.000), but also connected with total cancer mortality (HR = 1.40,95%CI [1.24-1.58], I 2 = 0.0%, P = 0.718). Subgroup analyses showed that study population, study design, dental status, follow-up period, adjustment for smoking partially explained the heterogeneity between studies. The results of Begg's test and Egger's test were consistent and indicated that there is no publication bias in this study. Conclusion In conclusion, this meta-analysis revealed a positive relationship between periodontal disease and breast cancer incidence and total cancer mortality. Further well-designed studies with specific inclusion and exclusion criteria are required to strengthen the conclusion of this meta-analysis. However, longer follow-up period, multi-center trials and even multinational studies are required to corroborate the results.
Collapse
Affiliation(s)
- Kaili Wang
- Department of Stomatology, Beijing You ’an Hospital, Capital Medical University, Beijing, China
| | - Zheng Zhang
- Tianjin Stomatological Hospital, School of Medicine, Nankai University, Tianjin, China,Tianjin Key Laboratory of Oral and Maxillofacial Function Reconstruction, Tianjin, China
| | - Zuomin Wang
- Department of Stomatology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China
| |
Collapse
|
8
|
Liu J, Zhang Y. Intratumor microbiome in cancer progression: current developments, challenges and future trends. Biomark Res 2022; 10:37. [PMID: 35642013 PMCID: PMC9153132 DOI: 10.1186/s40364-022-00381-5] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2022] [Accepted: 05/01/2022] [Indexed: 11/29/2022] Open
Abstract
Cancer is a complicated disease attributed to multifactorial changes, which causes difficulties with treatment strategies. Various factors have been regarded as the main contributors, and infectious etiological factors have recently attracted interest. Several microbiomes contribute to carcinogenesis, cancer progression, and modulating cancer treatment by inducing cancerous epithelial cells and chronic inflammation. Most of our knowledge on the role of microbiota in tumor oncogenesis and clinical efficiency is associated with the intestinal microbiome. However, compelling evidence has also confirmed the contribution of the intratumor microbiome in cancer. Indeed, the findings of clinical tumor samples, animal models, and studies in vitro have revealed that many intratumor microbiomes promote tumorigenesis and immune evasion. In addition, the intratumor microbiome participates in regulating the immune response and even affects the outcomes of cancer treatment. This review summarizes the interplay between the intratumor microbiota and cancer, focusing on the contribution and mechanism of intratumor microbiota in cancer initiation, progression, and potential applications to cancer therapy.
Collapse
Affiliation(s)
- Jinyan Liu
- Biotherapy Center and Cancer Center, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Yi Zhang
- Biotherapy Center and Cancer Center, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China. .,State Key Laboratory of Esophageal Cancer Prevention & Treatment, Zhengzhou, Henan, China.
| |
Collapse
|
9
|
Rupe C, Basco A, Schiavelli A, Cassano A, Micciche’ F, Galli J, Cordaro M, Lajolo C. Oral Health Status in Patients with Head and Neck Cancer before Radiotherapy: Baseline Description of an Observational Prospective Study. Cancers (Basel) 2022; 14:cancers14061411. [PMID: 35326564 PMCID: PMC8945997 DOI: 10.3390/cancers14061411] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Revised: 02/23/2022] [Accepted: 03/04/2022] [Indexed: 01/27/2023] Open
Abstract
(1) Background: The general hypothesis that HNC patients show compromised oral health (OH) is generally accepted, but it is not evidence-based. The objective of this baseline report of a prospective observational study was to describe the oral health of a cohort of patients with HNC at the time of dental evaluation prior to radiotherapy (RT). (2) Materials and Methods: Two hundred and thirteen patients affected by HNC who had received an indication for RT were examined with the support of orthopantomography (OPT). The DMFt of all included subjects, their periodontal status and the grade of mouth opening were recorded. (3) Results: A total of 195 patients were ultimately included: 146/195 patients (74.9%) showed poor OH (defined as having a DMFt score ≥ 13 and severe periodontitis). The following clinical characteristics were correlated with poor oral health in the univariate analysis: tumor site, smoking habit and age of the patients (in decades); χ2 test, p < 0.05. (4) Conclusions: This study confirms that the OH of HNC patients is often compromised even before the beginning of cancer treatment and, consequently, highlights how important it is to promptly schedule a dental evaluation at the moment of diagnosis of the cancer.
Collapse
Affiliation(s)
- Cosimo Rupe
- Head and Neck Department, Fondazione Policlinico Universitario A. Gemelli—IRCCS, School of Dentistry, Università Cattolica del Sacro Cuore, Largo A. Gemelli, 8, 00168 Rome, Italy; (C.R.); (A.B.); (M.C.); (C.L.)
| | - Alessia Basco
- Head and Neck Department, Fondazione Policlinico Universitario A. Gemelli—IRCCS, School of Dentistry, Università Cattolica del Sacro Cuore, Largo A. Gemelli, 8, 00168 Rome, Italy; (C.R.); (A.B.); (M.C.); (C.L.)
| | - Anna Schiavelli
- Head and Neck Department, Fondazione Policlinico Universitario A. Gemelli—IRCCS, School of Dentistry, Università Cattolica del Sacro Cuore, Largo A. Gemelli, 8, 00168 Rome, Italy; (C.R.); (A.B.); (M.C.); (C.L.)
- Correspondence:
| | - Alessandra Cassano
- Department of Medical Oncology, Fondazione Policlinico Universitario A. Gemelli—IRCCS, Institute of Radiology, Università Cattolica del Sacro Cuore, Largo A. Gemelli, 8, 00168 Rome, Italy;
| | - Francesco Micciche’
- Department of Radiation Oncology, Fondazione Policlinico Universitario A. Gemelli—IRCCS, Institute of Radiology, Università Cattolica del Sacro Cuore, Largo A. Gemelli, 8, 00168 Rome, Italy;
| | - Jacopo Galli
- Head and Neck Department, Fondazione Policlinico Universitario A. Gemelli—IRCCS, Institute of Otolaryngology, Università Cattolica del Sacro Cuore, Largo A. Gemelli, 8, 00168 Rome, Italy;
| | - Massimo Cordaro
- Head and Neck Department, Fondazione Policlinico Universitario A. Gemelli—IRCCS, School of Dentistry, Università Cattolica del Sacro Cuore, Largo A. Gemelli, 8, 00168 Rome, Italy; (C.R.); (A.B.); (M.C.); (C.L.)
| | - Carlo Lajolo
- Head and Neck Department, Fondazione Policlinico Universitario A. Gemelli—IRCCS, School of Dentistry, Università Cattolica del Sacro Cuore, Largo A. Gemelli, 8, 00168 Rome, Italy; (C.R.); (A.B.); (M.C.); (C.L.)
| |
Collapse
|
10
|
Yuan S, Fang C, Leng WD, Wu L, Li BH, Wang XH, Hu H, Zeng XT. Oral microbiota in the oral-genitourinary axis: identifying periodontitis as a potential risk of genitourinary cancers. Mil Med Res 2021; 8:54. [PMID: 34588004 PMCID: PMC8480014 DOI: 10.1186/s40779-021-00344-1] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Accepted: 09/03/2021] [Indexed: 12/12/2022] Open
Abstract
Periodontitis has been proposed as a novel risk factor of genitourinary cancers: although periodontitis and genitourinary cancers are two totally distinct types of disorders, epidemiological and clinical studies, have established associations between them. Dysbiosis of oral microbiota has already been established as a major factor contributing to periodontitis. Recent emerging epidemiological evidence and the detection of oral microbiota in genitourinary organs indicate the presence of an oral-genitourinary axis and oral microbiota may be involved in the pathogenesis of genitourinary cancers. Therefore, oral microbiota provides the bridge between periodontitis and genitourinary cancers. We have carried out this narrative review which summarizes epidemiological studies exploring the association between periodontitis and genitourinary cancers. We have also highlighted the current evidence demonstrating the capacity of oral microbiota to regulate almost all hallmarks of cancer, and proposed the potential mechanisms of oral microbiota in the development of genitourinary cancers.
Collapse
Affiliation(s)
- Shuai Yuan
- Center for Evidence-Based and Translational Medicine, Zhongnan Hospital of Wuhan University, Wuhan, 430071 Hubei China
| | - Cheng Fang
- Center for Evidence-Based and Translational Medicine, Zhongnan Hospital of Wuhan University, Wuhan, 430071 Hubei China
| | - Wei-Dong Leng
- Department of Stomatology, Taihe Hospital, Hubei University of Medicine, Shiyan, 442000 Hubei China
| | - Lan Wu
- Department of Stomatology, Zhongnan Hospital of Wuhan University, Wuhan, 430071 Hubei China
| | - Bing-Hui Li
- Center for Evidence-Based and Translational Medicine, Zhongnan Hospital of Wuhan University, Wuhan, 430071 Hubei China
- Department of Urology, Zhongnan Hospital of Wuhan University, Wuhan, 430071 Hubei China
| | - Xing-Huan Wang
- Center for Evidence-Based and Translational Medicine, Zhongnan Hospital of Wuhan University, Wuhan, 430071 Hubei China
- Department of Urology, Zhongnan Hospital of Wuhan University, Wuhan, 430071 Hubei China
| | - Hailiang Hu
- Department of Pathology, Duke University School of Medicine, Durham, NC 27710 USA
- School of Medicine, Southern University of Science and Technology, Shenzhen, 518055 China
| | - Xian-Tao Zeng
- Center for Evidence-Based and Translational Medicine, Zhongnan Hospital of Wuhan University, Wuhan, 430071 Hubei China
- Department of Urology, Zhongnan Hospital of Wuhan University, Wuhan, 430071 Hubei China
| |
Collapse
|
11
|
Hostiuc S, Ionescu IV, Drima E. Mouthwash Use and the Risk of Oral, Pharyngeal, and Laryngeal Cancer. A Meta-Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18158215. [PMID: 34360508 PMCID: PMC8345986 DOI: 10.3390/ijerph18158215] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Revised: 07/23/2021] [Accepted: 07/29/2021] [Indexed: 01/05/2023]
Abstract
Objective: The main aim of this study was to test whether the use of mouthwash is associated with subtypes of squamous cell carcinoma of the head and neck (SCCHN) and to test the potential risk of SCCHN depending on the mouthwash use duration, frequency, or alcoholic content. Materials and methods: We performed a meta-analysis using Web of Science and Scopus databases to detect the risk change associated with mouthwash use depending on the alcohol content, duration and frequency of use, and anatomical location. We used a random-effects model with the Sidik–Jonkman estimator for effect size model measures. Results: We included 17 studies in the meta-analysis containing 17,085 cases and 20,032 controls. The risk difference for SCCHN between mouthwash users and non-users was minimal, with a value of −0.02 [−0.05, 0.01]. Alcoholic mouthwash use was associated with a minimal decrease in risk (of −0.01 [−0.07, 0.05]). Frequent usage of mouthwash was associated with a statistically significant risk increase for SCCHN but the risk increase was marginal (0.04, [0.01, 0.06]). Conclusions: Overall, our study failed to show a statistically significant correlation between mouthwash use and the risk of SCCHN. The only statistically significant correlation that we could identify was between frequent usage and SCCHN, potentially caused by prolonged contact between some constituents of mouthwash (possibly alcohol) and the oral epithelium.
Collapse
Affiliation(s)
- Sorin Hostiuc
- Department of Legal Medicine and Bioethics, Faculty of Dental Medicine, Carol Davila University of Medicine and Pharmacy, 042122 Bucharest, Romania
| | - Ioana Victoria Ionescu
- Faculty of Dental Medicine, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania
| | - Eduard Drima
- Clinical Medical Department, Faculty of Medicine and Pharmacy, Dunărea de Jos University, 800654 Galați, Romania
| |
Collapse
|
12
|
Gasparoni LM, Alves FA, Holzhausen M, Pannuti CM, Serpa MS. Periodontitis as a risk factor for head and neck cancer. Med Oral Patol Oral Cir Bucal 2021; 26:e430-e436. [PMID: 33340075 PMCID: PMC8254889 DOI: 10.4317/medoral.24270] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Accepted: 12/08/2020] [Indexed: 01/20/2023] Open
Abstract
Background Periodontitis may be associated with the development of head and neck cancer (HNC). A literature review was conducted to understand the possible association between them.
Material and Methods Articles published in the PubMed database from January 1999 and May 2020 were retrieved. Limitations of the studies and biological mechanisms were discussed.
Results A total of 4,232 articles were found. Of these, 13 were analyzed according to inclusion criteria. Most papers found some association between periodontitis and HNC, although differences in periodontal evaluation, sample size, study design and tumor sites were observed. Porphyromonas gingivalis appears to increase the chance of both diseases, and it may be one of their main potential risk factors. Genetic predisposition is increased by exposure to environmental factors which can directly induce epigenetic changes that contribute to these diseases.
Conclusions Understanding the mechanisms related to periodontitis and HNC has increased, however, well-designed clinical studies are needed for better conclusions. Furthermore, the advent of multiple "omic" technologies will help comprehend their possible association. Key words:Periodontitis, head and neck cancer, oral cancer, risk factors, biological factors.
Collapse
Affiliation(s)
- L-M Gasparoni
- Department of Stomatology A.C.Camargo Cancer Center São Paulo, Brazil
| | | | | | | | | |
Collapse
|
13
|
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.
Collapse
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.
| |
Collapse
|
14
|
Wierzbicka M, Klussmann JP, San Giorgi MR, Wuerdemann N, Dikkers FG. Oral and laryngeal HPV infection: Incidence, prevalence and risk factors, with special regard to concurrent infection in head, neck and genitals. Vaccine 2021; 39:2344-2350. [PMID: 33812740 DOI: 10.1016/j.vaccine.2021.03.047] [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: 10/13/2020] [Revised: 03/09/2021] [Accepted: 03/10/2021] [Indexed: 12/20/2022]
Abstract
This review focuses on the importance of oral and laryngeal HPV infection which is present in majority of sexually active individuals at least once in their lifetime. Despite testing, still little is known about prevalence rates, determinants and, especially, the concurrent HPV infection in head and neck, and genitals. The purpose of this review is to clarify some issues of oral HPV incidence, prevalence, and to demonstrate the difficulties in identification of asymptomatic oral HPV carriers. The main premise to take up this topic is the high and still increasing risk for development of oropharyngeal cancer, and potential benefit from screening strategies, education programs and HPV vaccination. Transmission of HPV to the oral cavity and oropharynx is hypothesized to occur mainly through sexual contact. The exposure of oropharyngeal mucosa to HPV infection with consequence of increased risk for oropharyngeal carcinoma depends on specific sexual behavior. Male gender, older age, race or ethnicity, oral hygiene and current cigarette smoking are independently associated with any prevalent oral HPV infection.
Collapse
Affiliation(s)
- Malgorzata Wierzbicka
- Department of Otolaryngology and Laryngological Oncology, University of Medical Sciences, 49 Stanisława Przybyszewskiego, 60-357 Poznań, Poland
| | - Jens Peter Klussmann
- ENT Clinic of the University Hospital of Cologne, Kerpener Str. 62, 50931 Cologne, Germany
| | - Michel R San Giorgi
- Department of Otorhinolaryngology, Head and Neck Surgery, University Medical Center Groningen, Hanzeplein 1, 9713 GZ Groningen, the Netherlands
| | - Nora Wuerdemann
- ENT Clinic of the University Hospital of Cologne, Kerpener Str. 62, 50931 Cologne, Germany
| | - Frederik G Dikkers
- Amsterdam UMC, University of Amsterdam, Department of Otorhinolaryngology, Head and Neck Surgery, Meibergdreef 9, 1105 AZ Amsterdam, the Netherlands.
| |
Collapse
|
15
|
Spuldaro TR, Rogério Dos Santos Júnior M, Vicentis de Oliveira Fernandes G, Rösing CK. Efficacy of Essential Oil Mouthwashes With and Without Alcohol on the Plaque Formation: A Randomized, Crossover, Double-Blinded, Clinical Trial. J Evid Based Dent Pract 2021; 21:101527. [PMID: 34051963 DOI: 10.1016/j.jebdp.2021.101527] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2020] [Revised: 12/02/2020] [Accepted: 12/22/2020] [Indexed: 11/25/2022]
Abstract
BACKGROUND Essential oil (EO) mouthwash has been considered as one of the effective chemical agents as an adjunct to mechanical plaque control, without adverse effects compared with chlorhexidine (pigmentation, changes of taste, and formation of supragingival calculus), which limits its continuous use. New EO alcohol-based has emerged with questions regarding contraindications for its daily use. OBJECTIVE To compare the efficacy of EO mouthwashes with and without alcohol on the early supragingival and subgingival plaque formation using a plaque-free zone score system. METHODS This study was a crossover, randomized, double-blind clinical trial. Eleven participants, totaling 396 sites of evaluation, remained 4 days with no mechanical oral hygiene control and only used EO mouthwash with (control) and without alcohol (test) during this period. The presence of the plaque-free zone was recorded every 24 hours. Friedman and Wilcoxon tests were used with a 5% significance level. RESULTS The control group showed a more significant number of buccal surfaces free of plaque at 48, 72, and 96 hours compared with the test group. Both groups presented satisfactory efficacy up to 72 hours with a significant difference in favor of the control group. The presence of subgingival plaque on both the proximal and free surfaces was significantly higher in the test group. CONCLUSION EO with alcohol presented better results in retarding the early supragingival and subgingival plaque formation compared with EO without alcohol.
Collapse
Affiliation(s)
- Tobias Rauber Spuldaro
- Faculty of Dentistry, University Center of Serra Gaúcha - FSG, Caxias do Sul, RS, Brazil; Faculty of Dentistry, Catholic University of Portugal, Viseu, Portugal; Interdisciplinary Institute of Health Sciences (CIIS), Portugal; Department of Periodontology, Faculty of Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil.
| | | | | | - Cassiano Kuchenbecker Rösing
- Department of Periodontology, Faculty of Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil
| |
Collapse
|
16
|
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.
Collapse
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
| |
Collapse
|
17
|
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.
Collapse
|
18
|
Cho HM, Lee DW, Park JJ, Choi HM, Cho NP. Risk factors of head and neck cancer mortality compared with those of all-cause and all-cancer mortalities. J Oral Sci 2020; 62:365-370. [PMID: 32624546 DOI: 10.2334/josnusd.19-0368] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
This study aimed to clarify the risk factors of head and neck cancer (HNC) mortality, relative to those of all-cause and all-cancer mortalities, using the Korean National Health Insurance Service-Health Screening Cohort (NHIS-HEALS) data set. Data from 238 HNC deaths, 14,769 all-cancer deaths, and 38,086 all-cause deaths were extracted during a median follow-up period of 9.5 years. Baseline characteristics were assessed via chi-square tests, t tests, and multivariable logistic regression. HNC mortality was found to be positively associated with male sex, past and current smoking habits, moderate-to-heavy alcohol consumption, and being underweight. In addition, serum gamma-glutamyltransferase level was found to be significantly elevated in cases of HNC mortality. In contrast, obesity, a history of diabetes, and fasting blood glucose levels were found to be inversely associated with overall HNC mortality. Among the HNC subtypes, mortality due to laryngeal cancer was most strongly associated with past and heavy cigarette smoking, and mortality due to oro-/hypopharyngeal cancer was most strongly associated with heavy alcohol consumption. The present study demonstrates that this nationwide, population-based NHIS-HEALS data set can provide useful information for health research and policy development.
Collapse
Affiliation(s)
- Hye Min Cho
- Department of Oral Pathology and Institute of Oral Bioscience, School of Dentistry, Jeonbuk National University
| | - Dae-Woo Lee
- Department of Pediatric Dentistry and Institute of Oral Bioscience, School of Dentistry, Jeonbuk National University
| | - Jeong Jae Park
- Regional Cardiovascular Center, Wonkwang University Hospital
| | - Hye Mi Choi
- Department of Statistics, Research Institute of Applied Statistics, Jeonbuk National University
| | - Nam-Pyo Cho
- Department of Oral Pathology and Institute of Oral Bioscience, School of Dentistry, Jeonbuk National University
| |
Collapse
|
19
|
Yosefof E, Hilly O, Stern S, Bachar G, Shpitzer T, Mizrachi A. Squamous cell carcinoma of the oral tongue: Distinct epidemiological profile disease. Head Neck 2020; 42:2316-2320. [DOI: 10.1002/hed.26177] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2020] [Revised: 03/17/2020] [Accepted: 04/03/2020] [Indexed: 01/27/2023] Open
Affiliation(s)
- Eyal Yosefof
- Department of Otolaryngology—Head and Neck Surgery Rabin Medical Center Petah Tikva Israel
- Sackler Faculty of Medicine Tel Aviv University Tel Aviv Israel
| | - Ohad Hilly
- Department of Otolaryngology—Head and Neck Surgery Rabin Medical Center Petah Tikva Israel
- Sackler Faculty of Medicine Tel Aviv University Tel Aviv Israel
| | - Sagit Stern
- Department of Otolaryngology—Head and Neck Surgery Rabin Medical Center Petah Tikva Israel
- Sackler Faculty of Medicine Tel Aviv University Tel Aviv Israel
| | - Gideon Bachar
- Department of Otolaryngology—Head and Neck Surgery Rabin Medical Center Petah Tikva Israel
- Sackler Faculty of Medicine Tel Aviv University Tel Aviv Israel
| | - Thomas Shpitzer
- Department of Otolaryngology—Head and Neck Surgery Rabin Medical Center Petah Tikva Israel
- Sackler Faculty of Medicine Tel Aviv University Tel Aviv Israel
| | - Aviram Mizrachi
- Department of Otolaryngology—Head and Neck Surgery Rabin Medical Center Petah Tikva Israel
- Sackler Faculty of Medicine Tel Aviv University Tel Aviv Israel
| |
Collapse
|
20
|
Aceves Argemí R, González Navarro B, Ochoa García-Seisdedos P, Estrugo Devesa A, López-López JOS. Mouthwash With Alcohol and Oral Carcinogenesis: Systematic Review and Meta-analysis. J Evid Based Dent Pract 2020; 20:101407. [PMID: 32473798 DOI: 10.1016/j.jebdp.2020.101407] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2019] [Revised: 07/25/2019] [Accepted: 07/30/2019] [Indexed: 10/25/2022]
Abstract
BACKGROUND It has been shown that the risk of developing oral cancer is closely related to the intensity and duration of exposure to alcohol and tobacco. Even so, the use of mouthwashes with alcohol in their compositions and the increased risk of oral cancer has been a source of controversy for decades. OBJECTIVE This study proposes a systematic review and a meta-analysis of the literature, to assess the possible relationship between the use of mouthwashes with alcohol and the development of oral and pharyngeal cancers. MATERIALS AND METHODS A systematic search was done using the Medline and PubMed databases. Exclusion criteria were as follows: articles published in languages other than English or Spanish, systematic reviews, and expert opinions. No limitations were used for publication date. RESULTS A total of 14 articles were obtained, 11 case-control studies and 3 clinical trials. Three case-control studies found no statistically significant evidence between the relationship of mouthwash use and oral cancer and the remaining 8 case-control studies found statistically significant evidence. The 3 clinical trials observed a relationship between the use of mouthwashes with alcohol and the possibility of developing cancer due to the genotoxicity and mutagenic capacity of alcohol in chronic contact with oral tissues and mucous membranes. The meta-analysis resulted in an OR = 1.480 and a P-value = .161 (95% CI: 0.855; P-value = 2.561) for the analysis of studies of cancer risk and consumption of mouthwashes with alcohol and OR = 1.057 0.364 (95% CI: 0.951; P-value = 1.174) for studies that related the risk of cancer and mouthwash use without taking into account the presence of alcohol. CONCLUSIONS There is no sufficient evidence to accept the proposition that the use of mouthwashes containing alcohol can influence the development of oral cancer.
Collapse
Affiliation(s)
- Ricard Aceves Argemí
- Department of Oral Medicine, Surgery and Implantology, School of Medicine and Health Sciences (Dentistry) - Dental Hospital, University Campus of Bellvitge, University of Barcelona, Barcelona, Spain
| | - Beatriz González Navarro
- Department of Oral Medicine, Surgery and Implantology, School of Medicine and Health Sciences (Dentistry) - Dental Hospital, University Campus of Bellvitge, University of Barcelona, Barcelona, Spain; Department of Odontostomatolgy, School of Medicine and Health Sciences (Dentistry) - Dental Hospital, University Campus of Bellvitge, University of Barcelona, Barcelona, Spain; Oral Health and Masticatory System Group, Bellvitge Biomedical Research Institute, (IDIBELL), L'Hospitalet de Llobregat, Barcelona, Spain
| | - Paula Ochoa García-Seisdedos
- Department of Oral Medicine, Surgery and Implantology, School of Medicine and Health Sciences (Dentistry) - Dental Hospital, University Campus of Bellvitge, University of Barcelona, Barcelona, Spain
| | - Albert Estrugo Devesa
- Department of Odontostomatology, School of Medicine and Health Sciences (Dentistry) - Oral Health and Masticatory System Group, Bellvitge Biomedical Research Institute, (IDIBELL), L'Hospitalet de Llobregat, Barcelona, Spain
| | - JOSé López-López
- Department of Oral Medicine, Surgery and Implantology, School of Medicine and Health Sciences (Dentistry) - Dental Hospital, University Campus of Bellvitge, University of Barcelona, Barcelona, Spain; Department of Odontostomatolgy, School of Medicine and Health Sciences (Dentistry) - Dental Hospital, University Campus of Bellvitge, University of Barcelona, Barcelona, Spain; Oral Health and Masticatory System Group, Bellvitge Biomedical Research Institute, (IDIBELL), L'Hospitalet de Llobregat, Barcelona, Spain; Clinical Head of the Odontological Hospital University of Barcelona, Barcelona Univertisity, Barcelona, Spain.
| |
Collapse
|
21
|
Falcao A, Bullón P. A review of the influence of periodontal treatment in systemic diseases. Periodontol 2000 2019; 79:117-128. [PMID: 30892764 DOI: 10.1111/prd.12249] [Citation(s) in RCA: 71] [Impact Index Per Article: 14.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
The effects and consequences of periodontal diseases might not be confined to the oral cavity. A great body of evidence has arisen supporting the claim demonstrating an association with several systemic conditions and diseases. With different levels of evidence, an association between periodontal disease and cardiovascular disease, diabetes, psoriasis, rheumatoid arthritis, pregnancy outcomes and respiratory diseases has been established. However, the true nature of this association, if it is causal, still remains elusive. For a better understanding of the complex relationships linking different conditions, interventional studies now begin to focus on the possible outcomes of periodontal treatment in relation to the events, symptoms and biomarkers of several systemic disorders, assessing if periodontal treatment has any impact on them, hopefully reducing their severity or prevalence. Therefore, we proceeded to review the recent literature on the subject, attempting to present a brief explanation of the systemic condition or disease, what proposed mechanisms might give biological plausibility to its association with periodontal disease, and finally and more importantly, what data are currently available pertaining to the effects periodontal treatment may have. Raising awareness and discussing the possible benefits of periodontal treatment on overall systemic health is important, in order to change the perception that periodontal diseases are only limited to the oral cavity, and ultimately providing better and comprehensive care to patients.
Collapse
Affiliation(s)
- Artur Falcao
- Department of Periodontology, Dental School, University of Sevilla, Sevilla, Spain
| | - Pedro Bullón
- Department of Periodontology, Dental School, University of Sevilla, Sevilla, Spain
| |
Collapse
|
22
|
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.
Collapse
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
| |
Collapse
|
23
|
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.
Collapse
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
| |
Collapse
|
24
|
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.
Collapse
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.
| |
Collapse
|
25
|
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.
Collapse
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
| |
Collapse
|
26
|
Fox SA, Currie SS, Dalley AJ, Farah CS. Transcriptome changes induced in vitro by alcohol-containing mouthwashes in normal and dysplastic oral keratinocytes. J Oral Pathol Med 2018; 47:511-518. [PMID: 29504154 DOI: 10.1111/jop.12704] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/24/2018] [Indexed: 12/11/2022]
Abstract
BACKGROUND The role of alcohol-containing mouthwash as a risk factor for the development of oral cancer is a subject of conflicting epidemiological evidence in the literature despite alcohol being a recognised carcinogen. The aim of this study was to use in vitro models to investigate mechanistic and global gene expression effects of exposure to alcohol-containing mouthwash. METHODS Two brands of alcohol-containing mouthwash and their alcohol-free counterparts were used to treat two oral cell lines derived from normal (OKF6-TERT) and dysplastic (DOK) tissues. Genotoxicity was determined by Comet assay. RNA-seq was performed using the Ion Torrent platform. Bioinformatics analysis used R/Bioconductor packages with differential expression using DEseq2. Pathway enrichment analysis used EnrichR with the WikiPathways and Kegg databases. RESULTS Both cell lines displayed dose-dependent DNA damage in response to acute exposure to ethanol and alcohol-containing mouthwashes as well as alcohol-free mouthwashes reconstituted with ethanol as shown by Comet assay. The transcriptomic effects of alcohol-containing mouthwash exposure were more complex with significant differential gene expression ranging from >2000 genes in dysplastic (DOK) cells to <100 genes in normal (OKF6-TERT) cells. Pathway enrichment analysis in DOK cells revealed alcohol-containing mouthwashes showed common features between the two brands used including DNA damage response as well as cancer-associated pathways. In OKF6-TERT cells, the most significantly enriched pathways involved inflammatory signalling. CONCLUSIONS Alcohol-containing mouthwashes are genotoxic in vitro to normal and dysplastic oral keratinocytes and induce widespread changes in gene expression. Dysplastic cells are more susceptible to the transcriptomic effects of mouthwash.
Collapse
Affiliation(s)
- Simon A Fox
- Australian Centre for Oral Oncology Research & Education, UWA Dental School, University of Western Australia, Nedlands, WA, Australia
| | - Sean S Currie
- University of Queensland Centre for Clinical Research, The University of Queensland, Herston, QLD, Australia
| | - Andrew J Dalley
- University of Queensland Centre for Clinical Research, The University of Queensland, Herston, QLD, Australia
| | - Camile S Farah
- Australian Centre for Oral Oncology Research & Education, UWA Dental School, University of Western Australia, Nedlands, WA, Australia.,University of Queensland Centre for Clinical Research, The University of Queensland, Herston, QLD, Australia
| |
Collapse
|
27
|
Kawakita D, Lee YCA, Li Q, Chen Y, Chen CJ, Hsu WL, Lou PJ, Zhu C, Pan J, Shen H, Ma H, Cai L, He B, Wang Y, Zhou X, Ji Q, Zhou B, Wu W, Ma J, Boffetta P, Zhang ZF, Dai M, Hashibe M. Impact of oral hygiene on head and neck cancer risk in a Chinese population. Head Neck 2017; 39:2549-2557. [PMID: 28960766 PMCID: PMC5903450 DOI: 10.1002/hed.24929] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2016] [Revised: 06/22/2017] [Accepted: 07/20/2017] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Although the impact of oral hygiene on head and neck cancer risk has been investigated, few studies have been conducted among the Asian population. METHODS We conducted a multicenter case-control study to investigate this potential association. We performed unconditional multiple logistic regression models adjusted by potential confounders. RESULTS We observed an inverse association of frequency of dental visits with head and neck cancer risk, with an adjusted odds ratio (OR) of 3.70 (95% CI 2.51-5.45) for never dental visits compared with ≥1 time/year (Ptrend < .001). We also observed a positive association between the number of missing teeth and head and neck cancer risk, with an adjusted OR for ≥5 missing teeth compared with <5 missing teeth of 1.49 (95% CI 1.08-2.04). Combining multiple oral hygiene indicators, poor oral hygiene scores increased head and neck cancer risk. CONCLUSION Poor oral hygiene may increase head and neck cancer risk in the Chinese population. Therefore, improving oral hygiene may contribute to reducing the head and neck cancer risk in the Chinese population.
Collapse
Affiliation(s)
- Daisuke Kawakita
- Division of Public Health, Department of Family and Preventive Medicine, and Huntsman Cancer Institute, University of Utah School of Medicine, Salt Lake City, UT, USA
- Department of Otorhinolaryngology, Head and Neck Surgery, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
- Division of Molecular Medicine, Aichi Cancer Center Research Institute, Nagoya, Japan
| | - Yuan-Chin Amy Lee
- Division of Public Health, Department of Family and Preventive Medicine, and Huntsman Cancer Institute, University of Utah School of Medicine, Salt Lake City, UT, USA
| | - Qian Li
- Departments of Preventive Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Yuji Chen
- Division of Public Health, Department of Family and Preventive Medicine, and Huntsman Cancer Institute, University of Utah School of Medicine, Salt Lake City, UT, USA
| | - Chien-Jen Chen
- Genomics Research Center, Academia Sinica, Taipei, Taiwan
- Graduate Institute of Epidemiology and Preventive Medicine, National Taiwan University, Taipei, Taiwan
| | - Wan-Lun Hsu
- Genomics Research Center, Academia Sinica, Taipei, Taiwan
| | - Pei-Jen Lou
- Department of Otolaryngology, National Taiwan University Hospital, Taipei, Taiwan
| | - Cairong Zhu
- Department of Epidemiology and Biostatistics, West China Center of Medical Sciences, Sichuan University, Sichuan, China
| | - Jian Pan
- Department of Oral Surgery, West China Hospital of Stomatology, Sichuan University, Sichuan, China
| | - Hongbing Shen
- Department of Epidemiology and Biostatistics, Jiangsu key lab of Cancer Biomarkers, Prevention and Treatment, Collaborative Innovation Center for Cancer Personalized Medicine, School of Public Health, Nanjing Medical University, Nanjing, China
| | - Hongxia Ma
- Department of Epidemiology and Biostatistics, Jiangsu key lab of Cancer Biomarkers, Prevention and Treatment, Collaborative Innovation Center for Cancer Personalized Medicine, School of Public Health, Nanjing Medical University, Nanjing, China
| | - Lin Cai
- Department of Epidemiology and Biostatistics, School of Public Health, Fujian Medical University, Fuzhou, China
| | - Baochang He
- Department of Epidemiology and Biostatistics, School of Public Health, Fujian Medical University, Fuzhou, China
| | - Yu Wang
- Department of Head and Neck Surgery, Fudan University Shanghai Cancer Center and Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
| | - Xiaoyan Zhou
- Department of Pathology, Fudan University Shanghai Cancer Center, Shanghai, China; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
| | - Qinghai Ji
- Department of Head and Neck Surgery, Fudan University Shanghai Cancer Center and Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
| | - Baosen Zhou
- Department of Epidemiology, School of Public Health, China Medical University, Liaoning, China
| | - Wei Wu
- Department of Epidemiology, School of Public Health, China Medical University, Liaoning, China
| | - Jie Ma
- Department of Head & Neck Oncology, Henan Cancer Hospital, Zhengzhou, China
| | - Paolo Boffetta
- Institute for Translational Epidemiology and Tisch Cancer Institute, Mount Sinai School of Medicine, New York City, NY, USA
| | - Zuo-Feng Zhang
- Department of Epidemiology, and Center for Environmental Genomics, UCLA Fielding School of Public Health, Los Angeles, CA, USA
| | - Min Dai
- National Office of Cancer Prevention & Control Cancer Institute & Hospital, and Chinese Academy of Medical Sciences, Beijing, China
| | - Mia Hashibe
- Division of Public Health, Department of Family and Preventive Medicine, and Huntsman Cancer Institute, University of Utah School of Medicine, Salt Lake City, UT, USA
| |
Collapse
|
28
|
Rollo F, Latini A, Pichi B, Colafigli M, Benevolo M, Sinopoli I, Sperduti I, Laquintana V, Fabbri G, Frasca M, Cristaudo A, Giuliani M, Donà MG. Prevalence and determinants of oral infection by Human Papillomavirus in HIV-infected and uninfected men who have sex with men. PLoS One 2017; 12:e0184623. [PMID: 28910359 PMCID: PMC5599005 DOI: 10.1371/journal.pone.0184623] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2017] [Accepted: 08/28/2017] [Indexed: 12/02/2022] Open
Abstract
Background Oral Human Papillomavirus (HPV) infection is rare in the general population but common in high-risk individuals. Recent data indicate that oral HPV is associated with the development of head and neck carcinomas. HPV16 infection, in particular, increases the risk of oropharyngeal cancer. Methods We evaluated oral HPV prevalence and determinants of infection in cancer-free HIV-infected and uninfected men who have sex with men (MSM) recruited among attendees of an STI/HIV centre. Oral rinse and gargles were collected using a mouthwash and analyzed with the Linear Array HPV Genotyping Test. Socio-demographic and behavioral data were collected through face-to-face interviews. Results Overall, 170 MSM participated: 98 HIV-uninfected and 72 HIV-infected (91.7% under cART). Oral HPV was detected in 17.3% and 27.8% of the subjects, respectively (p = 0.13). Non-carcinogenic HPVs were significantly more common among HIV-infected MSM (18.1% vs. 5.1%, p = 0.01). Prevalence of the HPV types included in the quadrivalent HPV vaccine was similar (6.1% vs. 8.3% for the HIV-negative and positive MSM, respectively, p = 0.76). HPV16 was the most frequent type in HIV-negative (5.1%), and HIV-positive individuals, in the latter group together with HPV18, 72 and 84 (4.2% each). Older age at first sex (AOR: 4.02, 95% CI: 1.17–13.86 for those older than 18 years of age at first intercourse, p = 0.027) and a higher lifetime number of receptive oral sex partners (AOR: 9.14, 95% CI: 2.49–33.62 for those with >50 compared to ≤50 partners, p<0.001) were determinants of oral HPV among HIV-infected MSM. Conclusion Oral HPV infection among MSM attending an urban STI center is very frequent compared to the general population. Sexual behavior appears to be the major determinant of infection among the HIV-infected individuals.
Collapse
Affiliation(s)
- Francesca Rollo
- Pathology Department, Regina Elena National Cancer Institute, IFO, IRCCS, Rome, Italy
| | - Alessandra Latini
- STI/HIV Unit, San Gallicano Dermatologic Institute, IFO, IRCCS, Rome, Italy
| | - Barbara Pichi
- Otolaryngology Head Neck Surgery Department, Regina Elena National Cancer Institute, IFO, IRCCS, Rome, Italy
| | - Manuela Colafigli
- STI/HIV Unit, San Gallicano Dermatologic Institute, IFO, IRCCS, Rome, Italy
| | - Maria Benevolo
- Pathology Department, Regina Elena National Cancer Institute, IFO, IRCCS, Rome, Italy
| | - Ilenia Sinopoli
- Otolaryngology Head Neck Surgery Department, Regina Elena National Cancer Institute, IFO, IRCCS, Rome, Italy
| | - Isabella Sperduti
- Biostatistics Unit, Regina Elena National Cancer Institute, IFO, IRCCS, Rome, Italy
| | - Valentina Laquintana
- Pathology Department, Regina Elena National Cancer Institute, IFO, IRCCS, Rome, Italy
| | - Giulia Fabbri
- Pathology Department, Regina Elena National Cancer Institute, IFO, IRCCS, Rome, Italy
| | - Mirko Frasca
- STI/HIV Unit, San Gallicano Dermatologic Institute, IFO, IRCCS, Rome, Italy
| | - Antonio Cristaudo
- STI/HIV Unit, San Gallicano Dermatologic Institute, IFO, IRCCS, Rome, Italy
| | - Massimo Giuliani
- STI/HIV Unit, San Gallicano Dermatologic Institute, IFO, IRCCS, Rome, Italy
| | - Maria Gabriella Donà
- STI/HIV Unit, San Gallicano Dermatologic Institute, IFO, IRCCS, Rome, Italy
- * E-mail:
| |
Collapse
|
29
|
Mazul AL, Taylor JM, Divaris K, Weissler MC, Brennan P, Anantharaman D, Abedi-Ardekani B, Olshan AF, Zevallos JP. Oral health and human papillomavirus-associated head and neck squamous cell carcinoma. Cancer 2017; 123:71-80. [PMID: 27571516 PMCID: PMC5161679 DOI: 10.1002/cncr.30312] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2016] [Revised: 08/01/2016] [Accepted: 08/05/2016] [Indexed: 11/05/2022]
Abstract
BACKGROUND Indicators of poor oral health, including smoking, have been associated with increased risk of head and neck squamous cell carcinoma, especially oropharyngeal squamous cell carcinoma (OPSCC), yet few studies have examined whether this association is modified by human papillomavirus (HPV) status. METHODS Data from interviews and tumor HPV status from a large population-based case-control study, the Carolina Head and Neck Cancer Study (CHANCE), were used to estimate the association between oral health indicators and smoking among 102 HPV-positive patients and 145 HPV-negative patients with OPSCC and 1396 controls. HPV status was determined by p16INK4a (p16) immunohistochemistry. Unconditional, multinomial logistic regression was used to estimate odds ratios (ORs) for all oral health indictors adjusting for important covariates. RESULTS Routine dental examinations were associated with a decreased risk of both HPV-negative OPSCC (OR, 0.52; 95% confidence interval [CI], 0.35-0.76) and HPV-positive OPSCC (OR, 0.55; 95% CI, 0.36-.86). Tooth mobility (a proxy for periodontal disease) increased the risk of HPV-negative disease (OR, 1.70; 95% CI, 1.18-2.43) slightly more than the risk for HPV-positive disease (OR, 1.45; 95% CI, 0.95-2.20). Ten or more pack-years of cigarette smoking were strongly associated with an increased risk of HPV-negative OPSCC (OR, 4.26; 95% CI, 2.85-6.37) and were associated less with an increased risk of HPV-positive OPSCC (OR, 1.62; 95% CI, 1.10-2.38). CONCLUSIONS Although HPV-positive and HPV-negative HNSCC differ significantly with respect to etiology and tumorigenesis, the current findings suggest a similar pattern of association between poor oral health, frequency of dental examinations, and both HPV-positive and HPV-negative OPSCC. Future research is required to elucidate interactions between poor oral health, tobacco use, and HPV in the development of OPSCC. Cancer 2017;71-80. © 2016 American Cancer Society.
Collapse
Affiliation(s)
- Angela L Mazul
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - James M Taylor
- Department of Otolaryngology/Head and Neck Surgery, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, North Carolina
| | - Kimon Divaris
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
- Department of Pediatric Dentistry, University of North Carolina at Chapel Hill School of Dentistry, Chapel Hill, North Carolina
| | - Mark C Weissler
- Department of Otolaryngology/Head and Neck Surgery, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, North Carolina
| | - Paul Brennan
- International Agency for Research on Cancer, Lyon, France
| | | | | | - Andrew F Olshan
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Jose P Zevallos
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
- Department of Otolaryngology/Head and Neck Surgery, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, North Carolina
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| |
Collapse
|
30
|
Hodge P. Mouthwashes: do they work and should we use them? part 3: safety of mouthwashes. ACTA ACUST UNITED AC 2016. [DOI: 10.12968/denu.2016.43.8.728] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Penny Hodge
- Specialist Periodontist/Honorary Senior Lecturer, University of Glasgow Dental School, 378 Sauchiehall Street, Glasgow G2 3JZ, UK
| |
Collapse
|
31
|
Friemel J, Foraita R, Günther K, Heibeck M, Günther F, Pflueger M, Pohlabeln H, Behrens T, Bullerdiek J, Nimzyk R, Ahrens W. Pretreatment oral hygiene habits and survival of head and neck squamous cell carcinoma (HNSCC) patients. BMC Oral Health 2016; 16:33. [PMID: 26969620 PMCID: PMC4788953 DOI: 10.1186/s12903-016-0185-0] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2015] [Accepted: 02/17/2016] [Indexed: 11/30/2022] Open
Abstract
Background The survival time of patients with head and neck squamous cell carcinoma (HNSCC) is related to health behavior, such as tobacco smoking and alcohol consumption. Poor oral health (OH), dental care (DC) and the frequent use of mouthwash have been shown to represent independent risk factors for head and neck cancerogenesis, but their impact on the survival of HNSCC patients has not been systematically investigated. Methods Two hundred seventy-six incident HNSCC cases recruited for the ARCAGE study were followed through a period of 6–10 years. Interview-based information on wearing of dentures, gum bleeding, teeth brushing, use of floss and dentist visits were grouped into weighted composite scores, i.e. oral health (OH) and dental care (DH). Use of mouthwash was assessed as frequency per day. Also obtained were other types of health behavior, such as smoking, alcohol drinking and diet, appreciated as both confounding and study variables. Endpoints were progression-free survival, overall survival and tumor-specific survival. Prognostic values were estimated using Kaplan-Meier analysis and Cox proportional hazards regression models. Results A good dental care score, summarizing annual dental visits, daily teeth cleaning and use of floss was associated with longer overall survival time (p = .001). The results of the Cox regression models similarly suggested a higher risk of tumor progression and shortened overall survival in patients with poor dental care, but the results lost their statistical significance after other types of health behavior had been controlled for. Frequent use of mouthwash (≥ 2 times/day) significantly increased the risk of tumor-specific death (HR = 2.26; CI = 1.19–4.32). Alcohol consumption and tobacco smoking were dose-dependently associated with tumor progression and shorter overall survival. Conclusion Frequent mouthwash use of ≥ 2 times/day seems to elevate the risk of tumor-specific death in HNSCC patients. Good dental care scores are associated with longer overall survival. Electronic supplementary material The online version of this article (doi:10.1186/s12903-016-0185-0) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- Juliane Friemel
- Leibniz Institute for Prevention Research and Epidemiology - BIPS, Achterstraße 30, D-28359, Bremen, Germany
| | - Ronja Foraita
- Leibniz Institute for Prevention Research and Epidemiology - BIPS, Achterstraße 30, D-28359, Bremen, Germany
| | - Kathrin Günther
- Leibniz Institute for Prevention Research and Epidemiology - BIPS, Achterstraße 30, D-28359, Bremen, Germany
| | - Mathias Heibeck
- Leibniz Institute for Prevention Research and Epidemiology - BIPS, Achterstraße 30, D-28359, Bremen, Germany
| | - Frauke Günther
- Leibniz Institute for Prevention Research and Epidemiology - BIPS, Achterstraße 30, D-28359, Bremen, Germany
| | - Maren Pflueger
- Leibniz Institute for Prevention Research and Epidemiology - BIPS, Achterstraße 30, D-28359, Bremen, Germany
| | - Hermann Pohlabeln
- Leibniz Institute for Prevention Research and Epidemiology - BIPS, Achterstraße 30, D-28359, Bremen, Germany
| | - Thomas Behrens
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurance, Institute of the Ruhr-Universität Bochum (IPA), Bochum, Germany
| | - Jörn Bullerdiek
- Center for Human Genetics, University of Bremen (ZHG), Bremen, Germany
| | - Rolf Nimzyk
- Center for Human Genetics, University of Bremen (ZHG), Bremen, Germany
| | - Wolfgang Ahrens
- Leibniz Institute for Prevention Research and Epidemiology - BIPS, Achterstraße 30, D-28359, Bremen, Germany.
| |
Collapse
|
32
|
Michaud DS, Kelsey KT, Papathanasiou E, Genco CA, Giovannucci E. Periodontal disease and risk of all cancers among male never smokers: an updated analysis of the Health Professionals Follow-up Study. Ann Oncol 2016; 27:941-7. [PMID: 26811350 DOI: 10.1093/annonc/mdw028] [Citation(s) in RCA: 91] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2015] [Accepted: 01/13/2016] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Periodontal disease has a direct impact on the immune response and has been linked to several chronic diseases, including atherosclerosis and stroke. Few studies have examined the association between periodontal disease and cancer. PATIENTS AND METHODS A total of 19 933 men reported being never smokers (of cigarette, pipes or cigars) in the Health Professionals' Follow-up Study. Periodontal disease status and teeth number were self-reported at baseline and during follow-up. All cancers were ascertained during 26 years of follow-up. Cox's proportional hazard models were used to estimate hazard ratios (HRs) and 95% confidence intervals (95% CIs) adjusting for risk factors. RESULTS A 13% increase in total cancer was observed among men reporting periodontitis at baseline, and a 45% increase in risk was observed among men with advanced periodontitis (periodontitis with <17 remaining teeth). Periodontitis was not associated with prostate cancer, colorectal cancer or melanoma, the three most common cancers in this cohort of never smokers, but a 33% increase in risk was observed for smoking-related cancers (lung, bladder, oropharnygeal, esophageal, kidney, stomach and liver cancers; HR = 1.33, 95% CI 1.07-1.65). Men with advanced periodontitis had an HR of 2.57 (95% CI 1.56-4.21; P = 0.0002) for smoking-related cancers, compared with men who did not have periodontitis and had 17 teeth or more. Advanced periodontitis was associated with elevated risks of esophageal and head and neck cancers (HR = 6.29, 95% CI 2.13-18.6; based on five cases with advanced periodontitis) and bladder cancer (HR = 5.06, 95% CI 2.32-11.0; based on nine cases with advanced periodontitis). CONCLUSIONS Advanced periodontitis was associated with a 2.5-fold increase in smoking-related cancers among never smokers. Periodontitis may impact cancer risk through system immune dysregulation. Further studies need to examine the immune impact of advanced periodontitis on cancer, especially for cancers known to be caused by smoking.
Collapse
Affiliation(s)
- D S Michaud
- Department of Public Health and Community Medicine, Tufts University School of Medicine, Boston Department of Epidemiology
| | - K T Kelsey
- Department of Epidemiology Department of Pathology and Laboratory Medicine, Brown University School of Medicine, Providence
| | - E Papathanasiou
- Department of Periodontology, Tufts University School of Dental Medicine, Boston
| | - C A Genco
- Department of Integrative Physiology and Pathobiology, Tufts University School of Medicine, Boston
| | - E Giovannucci
- Department of Nutrition Department of Epidemiology, Harvard School of Public Health, Boston Channing Division of Network Medicine, Department of Medicine, Harvard Medical School and Brigham and Women's Hospital, Boston, USA
| |
Collapse
|
33
|
Bertl K, Loidl S, Kotowski U, Heiduschka G, Thurnher D, Stavropoulos A, Schneider-Stickler B. Oral health status and dental care behaviours of head and neck cancer patients: a cross-sectional study in an Austrian tertiary hospital. Clin Oral Investig 2015; 20:1317-27. [PMID: 26452977 DOI: 10.1007/s00784-015-1618-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2015] [Accepted: 09/21/2015] [Indexed: 12/24/2022]
Abstract
OBJECTIVES This study aimed to assess the oral health status and dental care behaviours of patients treated for head and neck squamous cell carcinoma (HNSCC) in an Austrian tertiary hospital. MATERIALS AND METHODS Dental care behaviours, oral hygiene level, caries, and periodontal parameters were assessed in 48 patients treated for HNSCC >6 months ago. RESULTS Only 52 % requested a dental check-up after HNSCC diagnosis and prior to treatment, and of those, 80 % received some type of dental treatment. At time-point of clinical examination, 69 % of the patients had consulted a dentist within the last year, but 88 % still needed dental treatment; 75 % had at least one tooth with caries and 78 % had moderate to severe periodontitis. CONCLUSION Although it was recommended, only half of the patients did consult a dentist prior to HNSCC treatment and oral health appeared, in general, low prioritized. CLINICAL RELEVANCE About 90 % of the current group of head and neck squamous cell carcinoma cancer patients presented large treatment needs, both in regard with caries and periodontal disease, about 20 months after cancer treatment.
Collapse
Affiliation(s)
- Kristina Bertl
- Department of Periodontology, Faculty of Odontology, University of Malmö, Malmö, Sweden.,Division of Oral Surgery, University Clinic of Dentistry, Medical University of Vienna, Vienna, Austria
| | - Stefanie Loidl
- Division of Phoniatrics-Logopedics, Department of Otorhinolaryngology, Medical University of Vienna, Waehringer Guertel 18-20, A-1090, Vienna, Austria
| | - Ulana Kotowski
- Department of Otorhinolaryngology, Medical University of Vienna, Vienna, Austria
| | - Gregor Heiduschka
- Department of Otorhinolaryngology, Medical University of Vienna, Vienna, Austria
| | - Dietmar Thurnher
- Department of Otorhinolaryngology, Medical University of Vienna, Vienna, Austria
| | - Andreas Stavropoulos
- Department of Periodontology, Faculty of Odontology, University of Malmö, Malmö, Sweden
| | - Berit Schneider-Stickler
- Division of Phoniatrics-Logopedics, Department of Otorhinolaryngology, Medical University of Vienna, Waehringer Guertel 18-20, A-1090, Vienna, Austria.
| |
Collapse
|
34
|
Ahrens W, Pohlabeln H, Foraita R, Nelis M, Lagiou P, Lagiou A, Bouchardy C, Slamova A, Schejbalova M, Merletti F, Richiardi L, Kjaerheim K, Agudo A, Castellsague X, Macfarlane TV, Macfarlane GJ, Lee YCA, Talamini R, Barzan L, Canova C, Simonato L, Thomson P, McKinney PA, McMahon AD, Znaor A, Healy CM, McCartan BE, Metspalu A, Marron M, Hashibe M, Conway DI, Brennan P. Oral health, dental care and mouthwash associated with upper aerodigestive tract cancer risk in Europe: the ARCAGE study. Oral Oncol 2014; 50:616-25. [PMID: 24680035 DOI: 10.1016/j.oraloncology.2014.03.001] [Citation(s) in RCA: 79] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2013] [Revised: 02/05/2014] [Accepted: 03/03/2014] [Indexed: 11/28/2022]
Abstract
OBJECTIVE We aimed to assess the association of oral health (OH), dental care (DC) and mouthwash with upper-aerodigestive tract (UADT) cancer risk, and to examine the extent that enzymes involved in the metabolism of alcohol modify the effect of mouthwash. MATERIALS AND METHODS The study included 1963 patients with incident cancer of the oral cavity, oropharynx, hypopharynx, larynx or esophagus and 1993 controls. Subjects were interviewed about their oral health and dental care behaviors (which were converted to scores of OH and DC respectively), as well as smoking, alcohol drinking, diet, occupations, medical conditions and socio-economic status. Blood samples were taken for genetic analyses. Mouthwash use was analyzed in relation to the presence of polymorphisms of alcohol-metabolizing genes known to be associated with UADT. Adjusted odds ratios (ORs) and 95%-confidence intervals [CI] were estimated with multiple logistic regression models adjusting for multiple confounders. RESULTS Fully adjusted ORs of low versus high scores of DC and OH were 2.36[CI=1.51-3.67] and 2.22[CI=1.45-3.41], respectively, for all UADT sites combined. The OR for frequent use of mouthwash use (3 or more times/day) was 3.23[CI=1.68-6.19]. The OR for the rare variant ADH7 (coding for fast ethanol metabolism) was lower in mouthwash-users (OR=0.53[CI=0.35-0.81]) as compared to never-users (OR=0.97[CI=0.73-1.29]) indicating effect modification (pheterogeneity=0.065) while no relevant differences were observed between users and non-users for the variant alleles of ADH1B, ADH1C or ALDH2. CONCLUSIONS Poor OH and DC seem to be independent risk factors for UADT because corresponding risk estimates remain substantially elevated after detailed adjustment for multiple confounders. Whether mouthwash use may entail some risk through the alcohol content in most formulations on the market remains to be fully clarified.
Collapse
Affiliation(s)
- Wolfgang Ahrens
- Department of Epidemiological Methods and Etiologic Research, Leibniz Institute for Prevention Research and Epidemiology - BIPS, Bremen, Germany; Institute for Statistics, Faculty of Mathematics and Computer Science, University of Bremen, Bremen, Germany.
| | - Hermann Pohlabeln
- Department of Biometry and Data Management, Leibniz Institute for Prevention Research and Epidemiology - BIPS, Bremen, Germany
| | - Ronja Foraita
- Department of Biometry and Data Management, Leibniz Institute for Prevention Research and Epidemiology - BIPS, Bremen, Germany
| | - Mari Nelis
- Estonian Genome Center, University of Tartu, Tartu, Estonia
| | - Pagona Lagiou
- Department of Hygiene, Epidemiology and Medical Statistics, University of Athens Medical School, Athens, Greece
| | - Areti Lagiou
- Faculty of Health Professions, Athens Technological Educational Institute, Athens, Greece
| | - Christine Bouchardy
- Geneva Cancer Registry, Institute of Social and Preventive Medicine, Geneva Cancer Registry, IMSP, University of Geneva, Geneva, Switzerland
| | - Alena Slamova
- Institute of Hygiene and Epidemiology, First Faculty of Medicine, Charles University of Prague, Prague, Czech Republic
| | - Miriam Schejbalova
- Institute of Hygiene and Epidemiology, First Faculty of Medicine, Charles University of Prague, Prague, Czech Republic
| | - Franco Merletti
- Department of Medical Sciences, Cancer Epidemiology Unit, CeRMS and CPO Piemonte University of Turin, Turin, Italy
| | - Lorenzo Richiardi
- Department of Medical Sciences, Cancer Epidemiology Unit, CeRMS and CPO Piemonte University of Turin, Turin, Italy
| | | | - Antonio Agudo
- Catalan Institute of Oncology (ICO), CIBERESP, IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain; Catalan Institute of Oncology (ICO), IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Xavier Castellsague
- Catalan Institute of Oncology (ICO), CIBERESP, IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Tatiana V Macfarlane
- School of Medicine and Dentistry, University of Aberdeen, Aberdeen, United Kingdom
| | - Gary J Macfarlane
- School of Medicine and Dentistry, University of Aberdeen, Aberdeen, United Kingdom
| | - Yuan-Chin Amy Lee
- Department of Family and Preventive Medicine, Division of Public Health, School of Medicine, University of Utah, Utah, USA
| | | | | | - Cristina Canova
- National Heart and Lung Institute, Imperial College London, London, United Kingdom; Laboratory of Public Health and Population Studies, Department of Molecular Medicine, University of Padova, Padova, Italy
| | - Lorenzo Simonato
- Laboratory of Public Health and Population Studies, Department of Molecular Medicine, University of Padova, Padova, Italy
| | - Peter Thomson
- School of Dental Sciences, University of Newcastle, Newcastle, United Kingdom
| | - Patricia A McKinney
- Centre for Epidemiology and Biostatistics, University of Leeds, Leeds, United Kingdom
| | - Alex D McMahon
- Glasgow Dental School, College of Medical, Veterinary and Life Sciences, College of Medicine, University of Glasgow, Glasgow, United Kingdom
| | - Ariana Znaor
- Croatian National Cancer Registry, Zagreb, Croatia
| | - Claire M Healy
- Trinity College School of Dental Science, Dublin, Ireland
| | - Bernad E McCartan
- Trinity College School of Dental Science, Dublin, Ireland; School of Medicine, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Andres Metspalu
- Institute of Molecular and Cell Biology, University of Tartu, Tartu, Estonia; Estonian Genome Center, University of Tartu, Tartu, Estonia; Center of Translational Genomics, University of Tartu, Tartu, Estonia
| | - Manuela Marron
- International Agency for Research on Cancer (IARC), Lyon, France; Institute of Medical Biostatistics, Epidemiology and Informatics (IMBEI), University of Mainz, Mainz, Germany
| | - Mia Hashibe
- Department of Family and Preventive Medicine, Division of Public Health, School of Medicine, University of Utah, Utah, USA; Huntsman Cancer Institute, Salt Lake City, Utah, USA
| | - David I Conway
- Glasgow Dental School, College of Medical, Veterinary and Life Sciences, College of Medicine, University of Glasgow, Glasgow, United Kingdom
| | - Paul Brennan
- International Agency for Research on Cancer (IARC), Lyon, France.
| |
Collapse
|
35
|
Minicucci EM, da Silva GN, Salvadori DMF. Relationship between head and neck cancer therapy and some genetic endpoints. World J Clin Oncol 2014; 5:93-102. [PMID: 24829856 PMCID: PMC4014801 DOI: 10.5306/wjco.v5.i2.93] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2013] [Revised: 02/22/2014] [Accepted: 03/17/2014] [Indexed: 02/06/2023] Open
Abstract
Head and neck cancer (HNC) is the sixth most common human malignancy worldwide. The main forms of treatment for HNC are surgery, radiotherapy (RT) and chemotherapy (CT). However, the choice of therapy depends on the tumor staging and approaches, which are aimed at organ preservation. Because of systemic RT and CT genotoxicity, one of the important side effects is a secondary cancer that can result from the activity of radiation and antineoplastic drugs on healthy cells. Ionizing radiation can affect the DNA, causing single and double-strand breaks, DNA-protein crosslinks and oxidative damage. The severity of radiotoxicity can be directly associated with the radiation dosimetry and the dose-volume differences. Regarding CT, cisplatin is still the standard protocol for the treatment of squamous cell carcinoma, the most common cancer located in the oral cavity. However, simultaneous treatment with cisplatin, bleomycin and 5-fluorouracil or treatment with paclitaxel and cisplatin are also used. These drugs can interact with the DNA, causing DNA crosslinks, double and single-strand breaks and changes in gene expression. Currently, the late effects of therapy have become a recurring problem, mainly due to the increased survival of HNC patients. Herein, we present an update of the systemic activity of RT and CT for HNC, with a focus on their toxicogenetic and toxicogenomic effects.
Collapse
|
36
|
Michaud DS, Langevin SM, Eliot M, Nelson HH, Pawlita M, McClean MD, Kelsey KT. High-risk HPV types and head and neck cancer. Int J Cancer 2014; 135:1653-61. [PMID: 24615247 DOI: 10.1002/ijc.28811] [Citation(s) in RCA: 89] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2013] [Revised: 02/07/2014] [Accepted: 02/11/2014] [Indexed: 12/25/2022]
Abstract
Although HPV16 has been strongly implicated in oropharyngeal carcinogenesis, the role of other high-risk HPV types in the etiology of head and neck cancer remains unclear. To date, few data exist addressing the nature of the association between antibodies to oncogenic proteins of non-HPV16 HPVs in relation to head and neck cancer. We examined the relationship between multiple HPV types (HPV6, 11, 16, 18, 31, 33, 45, 52, 58) and head and neck squamous cell carcinoma (HNSCC) in a large population-based case-control study (1069 cases and 1107 controls). Serological measures for HPV types included antibodies to L1, E6 and/or E7. In a secondary analysis, we excluded HPV16 seropositive subjects to examine independent associations with other high-risk HPVs. All analyses were adjusted for age, race, sex, education, smoking and alcohol consumption. Statistically significant associations were observed for HPV16, 18, 33 and 52 and risk of HNSCC after mutually adjusting for HPV types. Among HPV16 seronegative subjects, elevated risks of HNSCC were observed for HPV18 E6 (OR = 4.19, 95% CI = 1.26-14.0), HPV33 E6 (OR = 7.96, 95% CI = 1.56-40.5) and HPV52 E7 (OR = 3.40, 95% CI = 1.16-9.99). When examined by tumor type, associations with HPV18 and HPV33 remained statistically significant for oropharyngeal cancer, and HPV52 was associated with oral cancer. In addition, magnitude of associations for HNSCC increased markedly with increasing number of seropositive high-risk HPV infections. High-risk HPV types, other than HPV16, are likely to be involved in the etiology of HNSCC.
Collapse
Affiliation(s)
- Dominique S Michaud
- Department of Epidemiology, Brown School of Public Health, Brown University, Providence, RI; Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, United Kingdom
| | | | | | | | | | | | | |
Collapse
|