Poor oral health influences head and neck cancer patient survival: an International Head and Neck Cancer Epidemiology Consortium pooled analysis.

Journal

Journal of the National Cancer Institute
ISSN: 1460-2105
Titre abrégé: J Natl Cancer Inst
Pays: United States
ID NLM: 7503089

Informations de publication

Date de publication:
19 Sep 2023
Historique:
received: 24 01 2023
revised: 07 06 2023
accepted: 02 08 2023
medline: 19 9 2023
pubmed: 19 9 2023
entrez: 19 9 2023
Statut: aheadofprint

Résumé

Poor oral health has been identified as a prognostic factor potentially affecting the survival of patients with head and neck squamous cell carcinoma. However, evidence to date supporting this association has emanated from studies based on single cohorts with small-to-modest sample sizes. Pooled analysis of 2449 head and neck squamous cell carcinoma participants from 4 studies of the International Head and Neck Cancer Epidemiology Consortium included data on periodontal disease, tooth brushing frequency, mouthwash use, numbers of natural teeth, and dental visits over the 10 years prior to diagnosis. Multivariable generalized linear regression models were used and adjusted for age, sex, race, geographic region, tumor site, tumor-node-metastasis stage, treatment modality, education, and smoking to estimate risk ratios (RR) of associations between measures of oral health and overall survival. Remaining natural teeth (10-19 teeth: RR = 0.81, 95% confidence interval [CI] = 0.69 to 0.95; ≥20 teeth: RR = 0.88, 95% CI = 0.78 to 0.99) and frequent dental visits (>5 visits: RR = 0.77, 95% CI = 0.66 to 0.91) were associated with better overall survival. The inverse association with natural teeth was most pronounced among patients with hypopharyngeal and/or laryngeal, and not otherwise specified head and neck squamous cell carcinoma. The association with dental visits was most pronounced among patients with oropharyngeal head and neck squamous cell carcinoma. Patient-reported gingival bleeding, tooth brushing, and report of ever use of mouthwash were not associated with overall survival. Good oral health as defined by maintenance of the natural dentition and frequent dental visits appears to be associated with improved overall survival among head and neck squamous cell carcinoma patients.

Sections du résumé

BACKGROUND BACKGROUND
Poor oral health has been identified as a prognostic factor potentially affecting the survival of patients with head and neck squamous cell carcinoma. However, evidence to date supporting this association has emanated from studies based on single cohorts with small-to-modest sample sizes.
METHODS METHODS
Pooled analysis of 2449 head and neck squamous cell carcinoma participants from 4 studies of the International Head and Neck Cancer Epidemiology Consortium included data on periodontal disease, tooth brushing frequency, mouthwash use, numbers of natural teeth, and dental visits over the 10 years prior to diagnosis. Multivariable generalized linear regression models were used and adjusted for age, sex, race, geographic region, tumor site, tumor-node-metastasis stage, treatment modality, education, and smoking to estimate risk ratios (RR) of associations between measures of oral health and overall survival.
RESULTS RESULTS
Remaining natural teeth (10-19 teeth: RR = 0.81, 95% confidence interval [CI] = 0.69 to 0.95; ≥20 teeth: RR = 0.88, 95% CI = 0.78 to 0.99) and frequent dental visits (>5 visits: RR = 0.77, 95% CI = 0.66 to 0.91) were associated with better overall survival. The inverse association with natural teeth was most pronounced among patients with hypopharyngeal and/or laryngeal, and not otherwise specified head and neck squamous cell carcinoma. The association with dental visits was most pronounced among patients with oropharyngeal head and neck squamous cell carcinoma. Patient-reported gingival bleeding, tooth brushing, and report of ever use of mouthwash were not associated with overall survival.
CONCLUSIONS CONCLUSIONS
Good oral health as defined by maintenance of the natural dentition and frequent dental visits appears to be associated with improved overall survival among head and neck squamous cell carcinoma patients.

Identifiants

DOI: 10.1093/jnci/djad156 PMID: 37725515
pubmed: 37725515
pii: 7275729
doi: 10.1093/jnci/djad156
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Subventions

Organisme : NIH HHS
ID : NCI R03CA113157
Pays : United States

Informations de copyright

© The Author(s) 2023. Published by Oxford University Press.

Auteurs

Jason Tasoulas (J)

Lineberger Comprehensive Cancer Center, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
Department of Otolaryngology/Head and Neck Surgery, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
Division of Oral and Craniofacial Health Sciences, Adams School of Dentistry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.

Douglas R Farquhar (DR)

Department of Otolaryngology/Head and Neck Surgery, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.

Siddharth Sheth (S)

Division of Hematology/Oncology, Department of Medicine, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.

Trevor Hackman (T)

Department of Otolaryngology/Head and Neck Surgery, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.

Wendell G Yarbrough (WG)

Lineberger Comprehensive Cancer Center, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
Department of Otolaryngology/Head and Neck Surgery, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
Department of Pathology and Laboratory Medicine, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.

Chris B Agala (CB)

Department of Surgery, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.

Alzina Koric (A)

Division of Public Health, Department of Family and Preventive Medicine and Huntsman Cancer Institute, University of Utah School of Medicine, Salt Lake City, UT, USA.

Luca Giraldi (L)

Section of Hygiene, University Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, Rome, Italy.

Eleonora Fabianova (E)

Regional Authority of Public Health, Banska Bystrica, Slovakia.

Jolanta Lissowska (J)

Department of Cancer Epidemiology and Prevention, M. Sklodowska-Curie National Research Institute of Oncology, Warsaw, Poland.

Beata Świątkowska (B)

Department of Environmental Epidemiology, Nofer Institute of Occupational Medicine, Lodz, Poland.

Marta Vilensky (M)

Institute of Oncology Angel H. Roffo, University of Buenos Aires, Buenos Aires, Argentina.

Victor Wünsch-Filho (V)

Epidemiology Department, School of Public Health, University of São Paulo, São Paulo, Brazil.
Oncocentro Foundation of São Paulo, São Paulo, Brazil.

Marcos Brasilino de Carvalho (MB)

Department of Head and Neck, Heliopolis Hospital, São Paulo, Brazil.

Rossana Verónica Mendoza López (RVM)

Cancer Institute of the State of São Paulo (ICESP), São Paulo, Brazil.

Ivana Holcátová (I)

Institute of Hygiene and Epidemiology, Charles University in Prague, Prague, Czech Republic.

Diego Serraino (D)

Unit of Cancer Epidemiology, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Aviano, Italy.

Jerry Polesel (J)

Unit of Cancer Epidemiology, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Aviano, Italy.

Cristina Canova (C)

University of Padua, Padova, Italy.

Lorenzo Richiardi (L)

Department of Medical Sciences, University of Turin, Turin, Italy.

Jose P Zevallos (JP)

Department of Otolaryngology/Head and Neck Surgery, University of Pittsburgh, PA, USA.

Andy Ness (A)

Bristol Dental School, University of Bristol, Bristol, UK.

Miranda Pring (M)

Bristol Dental School, University of Bristol, Bristol, UK.

Steve J Thomas (SJ)

Bristol Dental School, University of Bristol, Bristol, UK.

Tom Dudding (T)

Bristol Dental School, University of Bristol, Bristol, UK.

Yuan-Chin Amy Lee (YA)

Division of Public Health, Department of Family and Preventive Medicine and Huntsman Cancer Institute, University of Utah School of Medicine, Salt Lake City, UT, USA.

Mia Hashibe (M)

Division of Public Health, Department of Family and Preventive Medicine and Huntsman Cancer Institute, University of Utah School of Medicine, Salt Lake City, UT, USA.

Paolo Boffetta (P)

Stony Brook Cancer Center, Department of Family, Population and Preventive Medicine, Stony Brook University, Stony Brook, NY, USA.
Department of Medical and Surgical Sciences, University of Bologna Italy.

Andrew F Olshan (AF)

Department of Otolaryngology/Head and Neck Surgery, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
Department of Epidemiology, Gillings School of Global Public Health, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.

Kimon Divaris (K)

Department of Epidemiology, Gillings School of Global Public Health, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
Division of Pediatric and Public Health, Adams School of Dentistry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
ORCID: 0000-0003-1290-7251

Antonio L Amelio (AL)

Lineberger Comprehensive Cancer Center, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
Department of Otolaryngology/Head and Neck Surgery, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
Division of Oral and Craniofacial Health Sciences, Adams School of Dentistry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
Department of Tumor Biology, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL, USA.
Department of Head and Neck-Endocrine Oncology, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL, USA.
ORCID: 0000-0002-6295-2694

Classifications MeSH