The association between poor dental health and gastric cancer risk: a nationwide cohort and sibling-controlled study.

IF 7 1区 医学 Q1 MEDICINE, GENERAL & INTERNAL
Zengliang Ruan, Jianfeng Xie, Jingru Yu, Li Yin, Dariush Nasrollahzadeh Nesheli, Weimin Ye
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引用次数: 0

Abstract

Background: Poor dental health has been linked to an increased risk of gastric cancer (GC), but previous studies were limited by their retrospective design and relatively small sample size.

Methods: We followed a nationwide cohort of 5,888,034 Swedish adults over the age of 19 who visited a dentist between 2009 and 2016. Additionally, a nested case-control study was conducted by comparing incident GC cases to their siblings. Cox regression analyses, using attained age as the timescale and adjusting for potential confounders, were performed to evaluate the association between various dental health conditions and the risk of GC. In addition, we stratified our analyses by sex and age and conducted various sensitivity analyses to ensure the robustness of our findings.

Results: Over an average follow-up of 6.4 years, we identified 3993 new GC cases, including 1241 cardia GC and 2752 non-cardia GC. Compared to individuals with healthy teeth, those with periodontitis had an 11% and 25% increased risk of GC and cardia GC, respectively. The positive associations between odontogenic inflammation and the risk of GC were consistent in sibling-controlled analyses. We also observed a dose-response relationship between the number of remaining teeth and the risk of GC, with fewer teeth associated with higher risks. Additionally, we did not find significant interactions between dental inflammatory conditions and the number of remaining teeth in relation to the risk of GC or its subtypes. Our findings were consistent across different sex and age subgroups and in sensitivity analyses.

Conclusions: This study provides the largest prospective cohort study evidence to date, along with the first sibling-controlled comparisons, supporting the association between poor dental health and GC risk. Promoting dental health in the general population could have significant public health implications in preventing this disease.

牙齿健康状况不佳与胃癌风险之间的关系:一项全国队列和兄弟姐妹对照研究。
背景:牙齿健康状况不佳与胃癌(GC)风险增加有关,但以往的研究受限于其回顾性设计和相对较小的样本量。方法:我们对2009年至2016年期间看过牙医的5888034名19岁以上的瑞典成年人进行了全国性队列研究。此外,通过将事件GC病例与其兄弟姐妹进行比较,进行了一项嵌套病例对照研究。采用Cox回归分析,以达到的年龄作为时间尺度,并调整潜在的混杂因素,以评估各种牙齿健康状况与GC风险之间的关系。此外,我们根据性别和年龄对我们的分析进行了分层,并进行了各种敏感性分析,以确保我们发现的稳健性。结果:在平均6.4年的随访中,我们发现3993例新的GC病例,包括1241例贲门GC和2752例非贲门GC。与牙齿健康的人相比,牙周炎患者胃癌和贲门胃癌的风险分别增加了11%和25%。在兄弟姐妹对照分析中,牙源性炎症与胃癌风险之间的正相关是一致的。我们还观察到剩余牙齿数量与GC风险之间的剂量-反应关系,牙齿越少,风险越高。此外,我们没有发现牙齿炎症状况和剩余牙齿数量之间的显著相互作用与胃癌或其亚型的风险有关。我们的发现在不同性别和年龄的亚组和敏感性分析中是一致的。结论:该研究提供了迄今为止最大的前瞻性队列研究证据,以及第一个兄弟姐妹对照比较,支持牙齿健康状况不佳与胃癌风险之间的关联。促进普通人群的牙齿健康可能对预防这种疾病具有重大的公共卫生意义。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
BMC Medicine
BMC Medicine 医学-医学:内科
CiteScore
13.10
自引率
1.10%
发文量
435
审稿时长
4-8 weeks
期刊介绍: BMC Medicine is an open access, transparent peer-reviewed general medical journal. It is the flagship journal of the BMC series and publishes outstanding and influential research in various areas including clinical practice, translational medicine, medical and health advances, public health, global health, policy, and general topics of interest to the biomedical and sociomedical professional communities. In addition to research articles, the journal also publishes stimulating debates, reviews, unique forum articles, and concise tutorials. All articles published in BMC Medicine are included in various databases such as Biological Abstracts, BIOSIS, CAS, Citebase, Current contents, DOAJ, Embase, MEDLINE, PubMed, Science Citation Index Expanded, OAIster, SCImago, Scopus, SOCOLAR, and Zetoc.
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