Tooth loss and periodontal disease have been associated with several cancers, and poor oral health may be an important risk factor for upper gastrointestinal (UGI, i.e., esophageal and gastric) cancers. We assessed the relationship between oral health and UGI cancers using a large prospective study of over 50,000 adults living in Golestan Province, Iran, a high-incidence area for these cancers. Hazard ratios (HRs) and 95% confidence intervals (CI) were estimated for the association between three different measures of oral health [frequency of tooth brushing; number of missing teeth; and the sum of decayed, missing, and filled teeth (DMFT)] and UGI cancers. During a median follow-up duration of 13 years, there were 794 incident UGI cancers (396 esophageal and 398 gastric cancers). Daily tooth brushing was associated with a decreased risk of developing both esophageal (HR = 0.670; 95% CI: 0.486–0.924) and gastric (HR = 0.741; 95% CI: 0.544–1.01) cancers (combined UGI cancer HR = 0.697; 95% CI: 0.558–0.871) compared with never brushing. Tooth loss in excess of the loess smoothed, age- and sex-specific median number of teeth lost was significantly associated with esophageal (HR = 1.64; 95% CI: 1.08–2.47) and gastric cancers (HR = 1.58; 95% CI: 1.05–2.38). There were some adverse associations between DMFT and UGI cancers but most were not statistically significant. These results suggest increased risk of developing UGI cancers among individuals with poor oral health, and those who do not perform regular oral hygiene. Prevention Relevance: Poor oral health is associated with the risk of upper gastrointestinal cancers, and oral hygiene practices may help prevent these cancers.

中文翻译：

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来自高风险地区的大型前瞻性研究中的口腔健康和上消化道癌风险：Golestan 队列研究

牙齿脱落和牙周病与几种癌症有关，口腔健康不佳可能是上消化道（UGI，即食道和胃癌）癌症的重要危险因素。我们使用一项大型前瞻性研究评估了口腔健康与 UGI 癌症之间的关系，该研究对居住在伊朗 Golestan 省的 50,000 多名成年人进行了评估，该省是这些癌症的高发区。评估了三种不同口腔健康指标[刷牙频率；缺失牙齿的数量；以及蛀牙、缺失和补牙 (DMFT)] 和 UGI 癌症的总和。在 13 年的中位随访期间，有 794 例发生 UGI 癌（396 例食管癌和 398 例胃癌）。每天刷牙与降低患食道癌（HR = 0.670；95% CI：0.486-0.924）和胃癌（HR = 0.741；95% CI：0.544-1.01）（联合 UGI 癌 HR = 0.697； 95% CI：0.558–0.871）与从不刷牙相比。超过黄土平滑的牙齿脱落、年龄和性别特定的牙齿脱落中位数与食管癌（HR = 1.64；95% CI：1.08-2.47）和胃癌（HR = 1.58；95% CI： 1.05–2.38)。DMFT 和 UGI 癌症之间存在一些不良关联，但大多数没有统计学意义。这些结果表明口腔健康状况不佳和不定期进行口腔卫生的人患上消化道癌的风险增加。预防相关性：口腔健康不佳与上消化道癌的风险有关，