The role of oral hygiene in head and neck cancer: Results from International Head and Neck Cancer Epidemiology (INHANCE) Consortium
A partir des données de 13 études incluant 8 925 patients atteints d'un cancer de la tête et du cou et 12 527 témoins, cette étude évalue l'association entre 5 indicateurs de l'hygiène buccale (nombre de visites annuelles chez le dentiste, brossage de dents quotidien, etc) et le risque de cancer de la tête et du cou
Background : Poor oral hygiene has been proposed to contribute to head and neck cancer (HNC) risk although causality and independency of some indicators are uncertain. This study investigates the relationship of five oral hygiene indicators with incident HNCs. Methods : In a pooled analysis of 8,925 HNC cases and 12,527 controls from 13 studies participating in the International Head and Neck Cancer Epidemiology Consortium, comparable data on good oral hygiene indicators were harmonized. These included: no denture wear, no gum disease (or bleeding),<5 missing teeth, tooth brushing at least daily, and visiting a dentist≥once a year. Logistic regression was used to estimate effects of each oral hygiene indicator and cumulative score on HNC risk, adjusting for tobacco smoking and alcohol consumption. Results : Inverse associations with any HNC, in the hypothesized direction, were observed for<5 missing teeth (OR=0.78; 95% CI: 0.74, 0.82), annual dentist visit (OR=0.82; 95% CI: 0.78, 0.87), daily tooth brushing (OR=0.83, 95% CI: 0.79, 0.88), and no gum disease (OR=0.94; 95% CI: 0.89, 0.99), and no association was observed for wearing dentures. These associations were relatively consistent across specific cancer sites, especially for tooth brushing and dentist visits. The population attributable fraction for≤2 out of 5 good oral hygiene indicators was 8.9% (95%CI: 3.3%, 14%) for oral cavity cancer. Conclusion : Good oral hygiene, as characterized by few missing teeth, annual dentist visits, and daily tooth brushing, may modestly reduce the risk of HNC.