12 juli9 2012: als aanvulling op onderstaand artikel onderaan het abstract van een groot Zweeds bevolkingsonderzoek dat de oorzaken en risico's voor mond- en keelkanker in kaart heeft gebracht. Daaruit komt naar voren dat het HPV virus, alcohol en roken onafhankelijke voorspellers zijn van kanker in het hoofd- en hals gebied, maar ook een slechte tandverzorging zoals onderstaand artikel suggereert.

10 september 2009: bron: Medscape - WB

Een slecht gebit en vooral parodontitis - chronische ontstekingen aan tandvlees tot op het bot - blijken vaak de oorzaak van het ontstaan van kanker in de mond- en keelholte. Ook strottenhoofdkanker lijkt daardoor te kunnen ontstaan. Dit blijkt uit een vergelijkende studie bij 220 patienten met kanker in het mond- en keelgebied en een controlegroep van 204 mensen zonder kanker..

Onderzoekers ontdekten dat mensen gediagnosticeerd met hoofd-en halskanker veel meer chronische parodontitis hadden/hebben dan personen zonder kanker. Parodontitis is een chronische ontsteking van de tanden en tandvlees tot op het bot toe, die vaak leidt tot botverlies en weke delen dat rond de tanden zit.
In feite werd elke millimeter van botverlies als gevolg van chronische parodontitis geassocieerd met een meer dan vier keer hoger risico op hoofd-en halskanker, rekening houdend en gecorrigeerd met andere bekende risico factoren zoals roken.
Onderzoekers zeggen dat de resultaten kunnen helpen verklaren waarom de gevallen van hoofd-en halskanker blijft stijgen, hoewel roken is afgenomen de laatste 40 jaar.
De studie toont ook aan dat chronische ontstekingen en infecties van invloed blijken te zijn op het risico van ontstaan van kanker, hart-en vaatziekten en andere gezondheidsproblemen.
De studie, gepubliceerd in Cancer Epidemiology, Biomarkers and Prevention, vergeleek de invloed van parodontitis bij 226 mensen met een hoofd en hals kanker met een controlegroep van 207 mensen zonder kanker.
De resultaten toonden aan dat elke millimeter van botverlies als gevolg van chronische parodontitis geassocieerd was met een meer dan vier keer hoger risico op hoofd-en halskanker. Het verband tussen ontstoken tandvlees en vaatziekten en kanker was het sterkst onder mensen met kanker van de mond, gevolgd door kanker van de oropharynx (achterin de mond en keel) en larynx (strottenhoofd).
Toen de onderzoekers keken naar het verband tussen parodontitis en hoofd-halskanker in relatie tot gebruik van tabak waren de onderzoekers verrast om te vinden dat de associatie zwakker was bij de huidige rokers in vergelijking met vroegere rokers en mensen die nooit hadden gerookt.

Advanced Gum Disease May Raise Cancer Risk

Study Shows Link Between Periodontitis and Risk of Head and Neck Cancer

By Jennifer Warner
WebMD Health News

Reviewed by Louise Chang, MD

Sept. 8, 2009 -- Taking care of your teeth and gums may not only save your smile, it could save your life. A new study suggests a common form of gum disease may significantly raise the risk of head and neck cancer.

Researchers found that people diagnosed with head and neck cancers were much more likely to have chronic periodontitis than people without cancer. Periodontitis is advanced gum disease that leads to progressive loss of bone and soft tissue that surround the teeth.

In fact, each millimeter of bone loss due to chronic periodontitis was associated with a more than four times higher risk of head and neck cancer, after taking into account other known risk factors such as smoking.

Researchers say the results may help explain why head and neck cancer rates continue to climb although smoking rates have been declining for the last 40 years.

The study also adds to a growing body of research that shows chronic inflammation and infection can affect the risk of cancer, heart disease, and other health problems.

The study, published in Cancer Epidemiology, Biomarkers and Prevention, compared rates of periodontitis in 226 people with head and neck cancer and a comparison group of 207 people without cancer.

The results showed that each millimeter of bone loss due to chronic periodontitis was associated with a greater than fourfold higher risk of head and neck cancer. The link between gum disease and cancer was strongest among people with cancers of the mouth, followed by cancers of the oropharynx (back of the mouth and throat) and larynx (voice box).

When the researchers looked at the link between periodontitis and head and neck cancers according to tobacco use, researchers say they were surprised to find it was weaker in current smokers compared with former smokers and those who had never smoked.

"Confirmatory studies with more comprehensive assessment of smoking, such as duration, quantity and patterns of use, as well as smokeless tobacco history are needed," says researcher Mine Tezal, DDS, PhD, assistant professor at the school of dental medicine at the University of Buffalo, in a news release.

Risk factors in oral and oropharyngeal squamous cell carcinoma: a population-based case-control study in southern Sweden.

Swed Dent J Suppl. 2005;(179):1-66.

Risk factors in oral and oropharyngeal squamous cell carcinoma: a population-based case-control study in southern Sweden.

Rosenquist K.

Source

Department of Oral Surgery and Oral Medicine, Faculty of Odontology, Malmö University, Sweden.

Abstract

In the year 2002, about 275,000 inhabitants around the world developed oral cancer and over half of them will die of their disease within 5 years. Oral and oropharyngeal squamous cell carcinoma (OOSCC) accounts for about 1% of all cancers in Sweden - which is low compared to the incidence on the Indian subcontinent and in other parts of Asia, where it is one of the most common forms of cancer. The incidence in Sweden is increasing, however. The study comprised 80% (132/165) of all consecutive cases living in the Southern Healthcare Region, born in Sweden and without previous cancer diagnosis (except skin cancer), who were diagnosed with OOSCC during the period September 2000 to January 2004. Using the Swedish Population Register, 396 cancer-free controls were identified and matched by age, gender and county. Of these individuals, 320 (81%) agreed to take part in the study. Cases and controls were subjected to a standardised interview, identical oral examinations including panoramic radiographs, and cell sampling for human papillomavirus (HPV) analysis. In total 128 patients with planned curative treatment were followed for a median time of 22 months (range 0 - 36). The aims were to assess different potential risk factors in OOSCC such as oral hygiene, dental status, oral mucosal lesions, alcohol and tobacco use, virus infection, and some related to lifestyle. A further aim was to assess the influence of these factors on recurrence or occurrence of a new second primary tumour (SPT) of squamous cell carcinoma. In multivariate analysis average oral hygiene (OR 2.0; 95% CI 1.1-3.6) and poor oral hygiene (OR 5.3; 95% CI 2.5-11.3), more than 5 defective teeth (OR 3.1; 95% CI 1.2-8.2) and more than 20 teeth missing (OR 3.4; 95% CI 1.4-8.5), as well as defective or malfunctioning complete dentures (OR 3.8; 95 % CI 1.3-11.4) were identified as significant risk factors for development of OOSCC. Regular dental care reduced the risk of OOSCC (OR 0.4; 95% CI 0.2-0.6). The cases reported a higher consumption of alcohol than the controls. More than 350 g of alcohol per week (OR 2.6; 95% CI 1.3-5.4) and 11-20 cigarettes per day (OR 2.4; 95% CI 1.3-4.1) were dose-dependent risk factors. The results showed a tendency for women to have a greater risk (OR 1.8) than men at any given level of tobacco consumption. There was no increased risk of OOSCC among users of Swedish moist snuff. There was a significant relationship between high-risk human papillomavirus (HPV) infection and OOSCC (OR 63; 95% CI 14-280). Forty-seven of the cases (36%) were high-risk HPV infected and 7 (5.3%) were low-risk HPV infected in the specimens collected from the oral cavity. The corresponding figures for the controls were 3 (0.94%) and 13 (4.1%), respectively. The high-risk HPV types found in the oral cavity were the same types as observed in cervical cancer. Tumour stage was associated with both higher relative rate (RR) of recurrence or second primary tumour (SPT) of squamous cell carcinoma, and death in intercurrent diseases (DICD), defined as death before the occurrence of recurrence or SPT. High-risk HPV infected patients had an almost threefold increased RR of recurrence/SPT, but seemingly a lower RR of DICD compared to high-risk negative cases. Patients with tonsillar carcinoma had a significantly higher cause-specific RR of recurrence/SPT (RR 2.06; CI 0.99 - 4.28) compared to patients with OSCC of other sites. High alcohol consumption was associated with a high RR of recurrence/SPT, but not with DICD. There was no increased RR of recurrence/SPT related to smoking, but an association between smoking and DICD. In conclusion, the results in this study confirm that both smoking tobacco and alcohol consumption are risk factors for OOSCC. The use of Swedish moist snuff had no effect on the risk. Independent risk factors identified are poor oral hygiene, inadequate dental status and malfunctioning complete dentures. Regular dental check-ups are a preventive factor. Among other possible risk factors studied, high-risk HPV infection appears to be the strongest. High-risk HPV infection increases the cause-specific RR of recurrence or SPT. Tumour stage influences the rate of recurrence/SPT.