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The Association Between Oral Health And Gastrointestinal Cancer Risk In The UK Biobank: A Large Prospective Cohort Study


Jordão H, Mc Kenna G, McMenamin Ú, Kunzmann A, Murray L, Coleman H.

Departments / Institutions

Centre for Public Health, Queen’s University Belfast, Belfast, Co. Antrim.

Publication Date

Autumn 2017


Poor oral health, and specifically periodontitis, has been identified in patients with digestive cancers and many systemic diseases. Despite several studies, controversy remains as to whether oral health status is independently associated with these outcomes, due to confounding by smoking, alcohol and poor nutrition, and therefore further research is required.


To investigate the association between oral health status and gastrointestinal cancer risk.


Data from the large, prospective UK Biobank, which includes n=475,766 participants, were analysed. Oral health problems (defined as painful gums, bleeding gums, and/or having loose teeth) were self-reported by questionnaire. Linkage to cancer registries enabled identification of gastrointestinal cancer cases. Cox proportional hazard models were applied to estimate the relationship between gastrointestinal cancer risk and oral health problems, adjusting for confounders.


During an average 6 years of follow-up, n=4,069 gastrointestinal cancer cases were detected, of which 13% reported oral health problems. Overall, there was no association between oral health problems and risk of gastrointestinal cancer (HR 0.97, 95%CI 0.88-1.07). In site-specific analysis, no associations were identified between oral health problems and risk of oesophageal, gastric, pancreatic or colorectal cancers. However, an increased risk of hepatobiliary cancers was observed in those with oral health problems (HR 1.31, 95%CI 0.95-1.80), which became a significant 50% increased risk in analysis restricted to ever smokers, overweight individuals, and those consuming <5 fruit and vegetables portions per day.


Overall there was no association between poor oral health and gastrointestinal cancer risk, however there were suggestions of an increased risk of hepatobiliary cancer.

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