Oral hygiene and risk of nasopharyngeal carcinoma - a population-based case-control study in China.

Publication Type:

Journal Article


Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology (2016)


BACKGROUND: The association between oral health and risk of nasopharyngeal carcinoma (NPC) is largely unknown. Further understanding could shed light on potential pathogenic mechanisms and preventive measures.

METHODS: We conducted a population-based case-control study in southern China between 2010 and 2014. We enrolled 2528 incident NPC cases aged 20-74 years, and 2596 controls, randomly selected from the total population registers, with frequency matching to the 5-year age and sex distribution of the cases by geographic region. We interviewed subjects using a structured questionnaire inquiring about oral health indicators and potential confounding factors. We used unconditional logistic regression to estimate multivariate-adjusted odds ratios (ORs) with 95% confidence intervals (CIs).

RESULTS: A higher number of filled teeth was associated with an elevated risk of NPC. Individuals with 1 to 3 and more than 3 teeth filled versus none had adjusted ORs of 1.25 (95% CI: 1.06, 1.49) and 1.55 (95% CI: 1.13, 2.12), respectively (P trend = 0.002). Conversely, the adjusted OR for those who brushed teeth twice or more per day vs. once or less per day was 0.62 (95% CI: 0.55, 0.70). We detected a borderline significant positive association with earlier age at first adult tooth loss.

CONCLUSIONS: Our study suggested a positive association between some indicators of poor oral health and risk of NPC. Further studies are needed to confirm whether the findings are causal and, if so, to further explain the underlying mechanisms.

IMPACT: Improvement of oral hygiene might contribute to reducing NPC risk.