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Oral health and risk for head and neck squamous cell carcinoma: the Carolina Head and Neck Cancer Study

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Abstract

Objective

Recent reports have linked oral health and periodontal disease indicators with increased risk of squamous cell carcinoma of head and neck (SCCHN). Thus far, evidence has been inconclusive; our objective was to study the association between oral health and SCCHN risk in the context of a large population-based study.

Methods

A population-based case–control study of incident SCCHN, the Carolina Head and Neck Cancer Study was carried out in 2002–2006 in 46 counties in North Carolina. Controls (n = 1,361) were frequency matched with cases (n = 1,289) on age, race, and gender. Oral health was assessed using interview data on tooth loss and mobility, mouthwash use, and frequency of dental visits.

Results

Subjects were 26–80 years old (median age = 61). The distribution of tooth loss among controls was 0–5 teeth = 60%; 5–14 = 15%; and 16–28 = 25%. After controlling for covariates, tooth loss did not yield any notable association with SCCHN (16–28 vs. 0–5 lost teeth: OR: 1.21, 95% CI: 0.94, 1.56). Self-reported history of tooth mobility was moderately associated with increased SCCHN risk (OR: 1.33, 95% CI: 1.07, 1.65); however, the association did not persist among never smokers. Routine dental visits were associated with 30% risk reduction (OR: 0.68, 95% CI: 0.53, 0.87).

Conclusions

These data provide support for a possible modest association of periodontal disease, as measured by self-reported tooth loss indicators, but not tooth loss per se, with SCCHN risk.

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Abbreviations

CHANCE:

Carolina Head and Neck Cancer Study

CI:

Confidence interval

HR:

Hazard ratio

ICR:

Interaction contrast ratio

OR:

Odds ratio

OPC:

Oral/oropharyngeal cancer

SCCHN:

Squamous cell carcinoma of the head and neck

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Acknowledgments

This study was supported in part by grants R01-CA90731 from the National Cancer Institute and P30ES10126 from National Institute of Environmental Health Sciences.

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Authors and Affiliations

  1. Department of Epidemiology, CB#7435, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, 27599-7435, USA

    Kimon Divaris, Andrew F. Olshan, Joanna Smith, Mary E. Bell & Patrick T. Bradshaw

  2. Department of Pediatric Dentistry, School of Dentistry, CB#7450, University of North Carolina, Chapel Hill, NC, USA

    Kimon Divaris

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

    Andrew F. Olshan & Mark C. Weissler

  4. Departments of Pathology and Laboratory Medicine, School of Medicine, University of North Carolina, Chapel Hill, NC, USA

    William K. Funkhouser

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  1. Kimon Divaris
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  2. Andrew F. Olshan
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Correspondence to Andrew F. Olshan.

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Divaris, K., Olshan, A.F., Smith, J. et al. Oral health and risk for head and neck squamous cell carcinoma: the Carolina Head and Neck Cancer Study. Cancer Causes Control 21, 567–575 (2010). https://doi.org/10.1007/s10552-009-9486-9

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  • DOI: https://doi.org/10.1007/s10552-009-9486-9

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