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Oral health, dental care and mouthwash associated with upper aerodigestive tract cancer risk in Europe: the ARCAGE study
W. Ahrens, H. Pohlabeln, R. Foraita, M. Nelis, P. Lagiou, A. Lagiou, C. Bouchardy, A. Slamova, M. Schejbalova, F. Merletti, L. Richiardi, K. Kjaerheim, A. Agudo, X. Castellsague, TV. Macfarlane, GJ. Macfarlane, YC. Lee, R. Talamini, L. Barzan, C....
Jazyk angličtina Země Anglie, Velká Británie
Typ dokumentu časopisecké články, práce podpořená grantem
Odkazy
PubMed
24680035
DOI
10.1016/j.oraloncology.2014.03.001
Knihovny.cz E-zdroje
- MeSH
- kouření MeSH
- lidé MeSH
- nádory hlavy a krku etiologie MeSH
- nádory jícnu etiologie MeSH
- orální hygiena * MeSH
- orální zdraví * MeSH
- pití alkoholu MeSH
- rizikové faktory MeSH
- studie případů a kontrol MeSH
- ústní vody * MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
- Geografické názvy
- Evropa MeSH
OBJECTIVE: We aimed to assess the association of oral health (OH), dental care (DC) and mouthwash with upper-aerodigestive tract (UADT) cancer risk, and to examine the extent that enzymes involved in the metabolism of alcohol modify the effect of mouthwash. MATERIALS AND METHODS: The study included 1963 patients with incident cancer of the oral cavity, oropharynx, hypopharynx, larynx or esophagus and 1993 controls. Subjects were interviewed about their oral health and dental care behaviors (which were converted to scores of OH and DC respectively), as well as smoking, alcohol drinking, diet, occupations, medical conditions and socio-economic status. Blood samples were taken for genetic analyses. Mouthwash use was analyzed in relation to the presence of polymorphisms of alcohol-metabolizing genes known to be associated with UADT. Adjusted odds ratios (ORs) and 95%-confidence intervals [CI] were estimated with multiple logistic regression models adjusting for multiple confounders. RESULTS: Fully adjusted ORs of low versus high scores of DC and OH were 2.36[CI=1.51-3.67] and 2.22[CI=1.45-3.41], respectively, for all UADT sites combined. The OR for frequent use of mouthwash use (3 or more times/day) was 3.23[CI=1.68-6.19]. The OR for the rare variant ADH7 (coding for fast ethanol metabolism) was lower in mouthwash-users (OR=0.53[CI=0.35-0.81]) as compared to never-users (OR=0.97[CI=0.73-1.29]) indicating effect modification (pheterogeneity=0.065) while no relevant differences were observed between users and non-users for the variant alleles of ADH1B, ADH1C or ALDH2. CONCLUSIONS: Poor OH and DC seem to be independent risk factors for UADT because corresponding risk estimates remain substantially elevated after detailed adjustment for multiple confounders. Whether mouthwash use may entail some risk through the alcohol content in most formulations on the market remains to be fully clarified.
Aviano Cancer Centre Aviano Italy
Cancer Registry of Norway Oslo Norway
Catalan Institute of Oncology CIBERESP IDIBELL L'Hospitalet de Llobregat Barcelona Spain
Catalan Institute of Oncology IDIBELL L'Hospitalet de Llobregat Barcelona Spain
Center of Translational Genomics University of Tartu Tartu Estonia
Centre for Epidemiology and Biostatistics University of Leeds Leeds United Kingdom
Croatian National Cancer Registry Zagreb Croatia
Estonian Genome Center University of Tartu Tartu Estonia
Faculty of Health Professions Athens Technological Educational Institute Athens Greece
General Hospital of Pordenone Pordenone Italy
Huntsman Cancer Institute Salt Lake City Utah USA
Institute of Medical Biostatistics Epidemiology and Informatics University of Mainz Mainz Germany
Institute of Molecular and Cell Biology University of Tartu Tartu Estonia
International Agency for Research on Cancer Lyon France
National Heart and Lung Institute Imperial College London London United Kingdom
School of Dental Sciences University of Newcastle Newcastle United Kingdom
School of Medicine and Dentistry University of Aberdeen Aberdeen United Kingdom
School of Medicine Royal College of Surgeons in Ireland Dublin Ireland
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- $a Ahrens, Wolfgang $u Department of Epidemiological Methods and Etiologic Research, Leibniz Institute for Prevention Research and Epidemiology - BIPS, Bremen, Germany; Institute for Statistics, Faculty of Mathematics and Computer Science, University of Bremen, Bremen, Germany. Electronic address: ahrens@bips.uni-bremen.de. $7 gn_A_00002543
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- $a OBJECTIVE: We aimed to assess the association of oral health (OH), dental care (DC) and mouthwash with upper-aerodigestive tract (UADT) cancer risk, and to examine the extent that enzymes involved in the metabolism of alcohol modify the effect of mouthwash. MATERIALS AND METHODS: The study included 1963 patients with incident cancer of the oral cavity, oropharynx, hypopharynx, larynx or esophagus and 1993 controls. Subjects were interviewed about their oral health and dental care behaviors (which were converted to scores of OH and DC respectively), as well as smoking, alcohol drinking, diet, occupations, medical conditions and socio-economic status. Blood samples were taken for genetic analyses. Mouthwash use was analyzed in relation to the presence of polymorphisms of alcohol-metabolizing genes known to be associated with UADT. Adjusted odds ratios (ORs) and 95%-confidence intervals [CI] were estimated with multiple logistic regression models adjusting for multiple confounders. RESULTS: Fully adjusted ORs of low versus high scores of DC and OH were 2.36[CI=1.51-3.67] and 2.22[CI=1.45-3.41], respectively, for all UADT sites combined. The OR for frequent use of mouthwash use (3 or more times/day) was 3.23[CI=1.68-6.19]. The OR for the rare variant ADH7 (coding for fast ethanol metabolism) was lower in mouthwash-users (OR=0.53[CI=0.35-0.81]) as compared to never-users (OR=0.97[CI=0.73-1.29]) indicating effect modification (pheterogeneity=0.065) while no relevant differences were observed between users and non-users for the variant alleles of ADH1B, ADH1C or ALDH2. CONCLUSIONS: Poor OH and DC seem to be independent risk factors for UADT because corresponding risk estimates remain substantially elevated after detailed adjustment for multiple confounders. Whether mouthwash use may entail some risk through the alcohol content in most formulations on the market remains to be fully clarified.
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