The association between self-reported poor oral health and gastrointestinal cancer risk in the UK Biobank: A large prospective cohort study

United European Gastroenterol J. 2019 Nov;7(9):1241-1249. doi: 10.1177/2050640619858043. Epub 2019 Jun 8.

Abstract

Background: Controversy remains as to whether poor oral health is independently associated with gastrointestinal cancers, due to potential confounding by smoking, alcohol and poor nutrition. The aim of this study was to investigate the association between oral health conditions and gastrointestinal cancer risk.

Methods: Data from the large, prospective UK Biobank cohort, which includes n = 475,766 participants, were analysed. Cox proportional hazard models were applied to estimate the relationship between gastrointestinal cancer risk and self-reported poor oral health (defined as painful gums, bleeding gums and/or having loose teeth), adjusting for confounders.

Results: During an average six years of follow-up, n = 4069 gastrointestinal cancer cases were detected, of which 13% self-reported poor oral health. Overall, there was no association between self-reported poor oral health and risk of gastrointestinal cancer detected (hazard ratio 0.97, 95% confidence interval 0.88-1.07). In site-specific analysis, an increased risk of hepatobiliary cancers was observed in those with self-reported poor oral health (hazard ratio 1.32, 95% confidence interval 0.95-1.80), which was stronger for hepatocellular carcinoma (hazard ratio 1.75, 95% confidence interval 1.04-2.92).

Conclusion: Overall there was no association between self-reported poor oral health and gastrointestinal cancer risk. However, there was a suggestion of an increased risk of hepatobiliary cancer, specifically hepatocellular carcinoma.

Keywords: Gastrointestinal cancer; epidemiology; liver cancer; poor oral health.

MeSH terms

  • Adenocarcinoma / epidemiology
  • Aged
  • Alcohol Drinking / epidemiology
  • Biliary Tract Neoplasms / epidemiology
  • Biological Specimen Banks
  • Carcinoma, Hepatocellular / epidemiology
  • Carcinoma, Squamous Cell / epidemiology
  • Cholangiocarcinoma / epidemiology
  • Cohort Studies
  • Digestive System Neoplasms / epidemiology*
  • Female
  • Gastrointestinal Neoplasms / epidemiology
  • Humans
  • Liver Neoplasms / epidemiology
  • Male
  • Middle Aged
  • Mouth Diseases / epidemiology*
  • Oral Health / statistics & numerical data*
  • Pancreatic Neoplasms / epidemiology
  • Proportional Hazards Models
  • Prospective Studies
  • Self Report
  • Smoking / epidemiology
  • United Kingdom / epidemiology