Recurrent aphthous stomatitis may be a precursor or risk factor for specific cancers: A case-control frequency-matched study

Cancer Med. 2018 Aug;7(8):4104-4114. doi: 10.1002/cam4.1685. Epub 2018 Jul 15.

Abstract

Background: Recurrent aphthous stomatitis (RAS) is considered a prophase symptom in patients with specific cancers. This study assessed the association between RAS and subsequent onset of cancer based on a nationwide population-based database in Taiwan.

Materials and methods: We selected study participants from the National Health Insurance Research Database from January 2000 to December 2008. Patients in the non-RAS cohort were matched to case study patients at a 1:1 ratio through frequency matching. All participants were followed up for at least 5 years, and those who received cancer diagnoses during follow-up were identified.

Results: Among 52 307 patients with and 52 304 patients without RAS, the combined hazard ratio (HR) of all subsequent cancer cases was 1.3 (95% confidence interval [CI]: 1.25-1.35, P = 0). RAS diagnosis was associated with risk for cancers of the head and neck (aHR = 2, 95% CI: 1.8-2.3), colon (aHR = 1.2, 95% CI: 1.1-1.4), liver (aHR = 1.1, 95% CI: 1-1.3), pancreas (aHR = 1.4, 95% CI: 1.1-1.7), skin (aHR = 1.4, 95% CI: 1.2-1.7), breast (aHR = 1.2, 95% CI: 1.1-1.4), and prostate (aHR = 1.5, 95% CI: 1.3-1.8), as well as hematologic cancers (aHR = 1.6, 95% CI: 1.3-1.9). A higher risk was observed for male patients (aHR = 1.35, 95% CI: 1.28-1.42) than for female patients (aHR = 1.25, 95% CI: 1.18-1.31) with RAS.

Conclusions: RAS was associated with specific cancers. Susceptible RAS patients should be screened for specific cancers.

Keywords: cancer; case-control; gender; recurrent aphthous stomatitis; risk factor.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Case-Control Studies
  • Databases, Factual
  • Female
  • Humans
  • Male
  • Middle Aged
  • Neoplasms / diagnosis
  • Neoplasms / epidemiology*
  • Neoplasms / etiology*
  • Precancerous Conditions / epidemiology*
  • Precancerous Conditions / etiology*
  • Proportional Hazards Models
  • Recurrence
  • Risk Assessment
  • Risk Factors
  • Socioeconomic Factors
  • Stomatitis, Aphthous / complications*
  • Stomatitis, Aphthous / epidemiology*
  • Stomatitis, Aphthous / pathology
  • Young Adult