Association between periodontal disease and oral cancer screening among US adults: NHANES 2011-2014

Abstract

Objectives: To examine oral cancer screening rates and associated factors among adults with periodontal disease (PD). We hypothesized that adults with severe PD will be less likely to report receipt of any type of oral cancer screening than adults with no PD.

Materials and methods: We used 2011-2014 National Health and Nutrition Examination Survey (NHANES) data on adults ≥30 years. PD status was classified as no PD, mild/moderate PD and severe PD. Survey-adjusted logistic regression analysis was used to examine the model adjusted risk ratio (RR) and 95% confidence intervals (CI) for the outcome of not receiving intraoral, extraoral or both types of oral cancer screenings among adults with PD. Control variables included age, sex, race/ethnicity, health insurance, education, income level, smoking status, alcohol use and last dental visit.

Results: The analytic sample included 6962 adults weighted to the national population of adults who had a periodontal examination during 2011-2014. Overall, 31.5%, 26.8% and 20.9% of adults reported receipt of intraoral, extraoral and both types of oral cancer screening, respectively. Almost 40% of adults had some form of PD (7.6% severe and 32.4% mild/moderate PD). A higher proportion of 45-64-year-olds, males, non-Hispanic Blacks, those with less than high school education, with income level less than 200% federal poverty level, or those with no insurance had severe PD than no PD. In adjusted analyses, adults with severe PD were significantly more likely to report no receipt of intraoral (RR = 1.25, 95% CI = 1.12-1.40), extraoral (RR = 1.17, 95% CI = 1.07-1.27) or both types of oral cancer screenings (RR = 1.18, 95% CI = 1.10-1.27) than those with no PD.

Conclusions: Significantly low proportion of adult's age ≥30 years with severe PD reported receiving any type of oral cancer screening. The association between PD and risk of oral cancers points to the need to improve oral cancer screening rates among adults with PD.

Keywords: adults; health disparities; national surveillance data; oral cancer; oral cancer screening; periodontal disease; risk factors.