Increasing evidence supports a positive association between periodontal disease and total cancer risk. We evaluated the association of clinically assessed periodontal disease and a consequence, edentulism with total cancer mortality in participants without a prior cancer diagnosis in a U.S. nationally representative population. Included were 6,034 participants aged ≥40 years without a prior cancer diagnosis who participated in the National Health and Nutrition Examination Survey III. Periodontal health was measured by trained dentists. Cancer deaths (n = 702) were ascertained during a median of 21.3 years of follow‐up. Cox proportional hazards regression was used to estimate the association of periodontal disease and edentulism with total cancer mortality using no periodontal disease/dentate as the reference and adjusting for potential demographic, lifestyle including smoking and social factor confounders. Fifteen percent had periodontitis and 17% were edentulous. Periodontitis was not statistically significantly associated with risk of total cancer death after multivariable adjustment. Edentulism was associated with an increased risk of cancer mortality (hazard ratio = 1.50, 95% confidence interval = 1.12–2.00) after multivariable adjustment, including in men and women and in each racial/ethnic group studied. The positive association was observed in overweight/obese participants but not participants with normal body mass index, more strongly in prediabetic/diabetic participants than in participants without diabetes and in ever cigarette smokers but not in never cigarette smokers. In this U.S. nationally representative population, those with edentulism, but not periodontal disease, had a higher risk of total cancer death, especially in those with shared risk factors for periodontal disease and cancer.

中文翻译：

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临床确定的牙周病和无牙缺失与癌症总死亡率的关联：国家健康和营养检查调查 III。

越来越多的证据支持牙周病与癌症总风险之间存在正相关。我们在美国全国代表性人群中评估了临床评估的牙周病及其后果，即无牙周病与先前没有癌症诊断的参与者的癌症总死亡率之间的关联。包括 6,034 名年龄≥40 岁且无先前癌症诊断的参与者，他们参加了国家健康和营养检查调查 III。牙周健康由训练有素的牙医测量。癌症死亡人数 ( n= 702）是在中位 21.3 年的随访期间确定的。Cox 比例风险回归用于估计牙周病和无牙列缺失与总癌症死亡率的关联，使用无牙周病/牙齿作为参考，并调整潜在的人口统计学、生活方式，包括吸烟和社会因素混杂因素。15% 患有牙周炎，17% 患有缺牙。多变量调整后，牙周炎与癌症总死亡风险无统计学显着相关性。多变量调整后，包括男性和女性以及研究的每个种族/族裔群体，无牙缺失与癌症死亡风险增加有关（风险比 = 1.50，95% 置信区间 = 1.12-2.00）。在超重/肥胖的参与者中观察到了正相关，但在体重指数正常的参与者中没有观察到，在糖尿病前期/糖尿病的参与者中比在没有糖尿病的参与者和曾经吸烟者中更强烈，但在从不吸烟者中没有。在这个美国具有全国代表性的人群中，有牙周病但没有牙周病的人群死于癌症的风险更高，尤其是那些有共同的牙周病和癌症风险因素的人群。