Association of Oral Health and Periodontal Disease With Oesophageal Cancer: A Nationwide Population-Based Study.

Abstract

Aim: Oral dysbiosis and periodontal inflammation might play a role in oesophageal carcinogenesis via the translocation of periodontal pathogens. We aimed to assess whether poor oral health is associated with oesophageal cancer.

Methods: We conducted a population-based case-control study using the Korean National Health Insurance Service database to evaluate poor oral health as the exposure and oesophageal cancer as the outcome. Two study designs were employed: (1) oral health analysis using screening data, and (2) periodontal disease analysis using claims data. Oesophageal cancer cases were matched to cancer-free controls at a 1:4 ratio using extensive propensity score matching.

Results: After matching, 4238 cases and 16,904 controls were included in the oral health analysis, and 18,905 cases and 75,604 controls were included in the claims-based analysis. In the multivariable analysis, missing teeth (adjusted OR [aOR], 1.16; 95% confidence interval [CI]: 1.08-1.25) and periodontal disease (aOR, 1.05; 95% CI: 1.01-1.09) were both significantly associated with increased odds of oesophageal cancer. Poor oral hygiene practices including infrequent brushing, irregular bedtime brushing, lack of interdental cleaning and dental visits also showed positive associations. Subgroup analyses showed consistent associations across obesity and smoking status, whereas the associations were less consistent in women, the elderly and non-drinkers.

Conclusion: Poor oral health indicators including inadequate oral hygiene behaviours were associated with elevated odds of oesophageal cancer, suggesting the potential utility of oral health status in risk stratification.