TY - JOUR
T1 - Gastric atrophy and oesophageal squamous cell carcinoma
T2 - Possible interaction with dental health and oral hygiene habit
AU - Nasrollahzadeh, D.
AU - Malekzadeh, R.
AU - Aghcheli, K.
AU - Sotoudeh, M.
AU - Merat, S.
AU - Islami, F.
AU - Kamangar, F.
AU - Abnet, C. C.
AU - Shakeri, R.
AU - Pourshams, A.
AU - Semnani, S.
AU - Boffetta, P.
AU - Dawsey, S. M.
AU - Ye, W.
N1 - Funding Information:
We thank the local health network workers (Behvarz) for their contribution to this study. This work was supported by Digestive Disease Research Centre of Tehran University of Medical Sciences (Grant 82-603), Swedish Research Council (VR-60535801), intramural funds of the National Cancer Institute at the National Institutes of Health, Martin Rinds Foundation (Sweden), and KID grant, Karolinska Institutet faculty funds for postgraduate students (December 2008).
PY - 2012/8/21
Y1 - 2012/8/21
N2 - Background:Gastric fundal atrophy has been hypothesised to increase the risk of oesophageal squamous cell carcinoma (OSCC), but studies have shown inconsistent results.Methods:We measured serum pepsinogen I (PGI) and pepsinogen II (PGII) among 293 incident cases and 524 matched neighbourhood controls in a high-risk area of Northern Iran. Conditional logistic regression model was used to estimate odds ratios (ORs) and their 95% confidence intervals (CIs).Results:After controlling for age, sex, residence area and other potential confounders, gastric atrophy (defined by a validated criterion, PGI <55 μg dl-1) was associated with a two-fold increased risk (OR=2.01, 95% CI: 1.18, 3.45) of OSCC in the absence of nonatrophic pangastritis (defined as PGII <11.8 μg dl-1). Stratification by PGII decreased the misclassification errors due to cancer-induced gastritis. Presence of both poor dental health, indicated by higher than median sum of decayed, missing, and filled teeth (DMFT score), and gastric atrophy further increased the risk of OSCC (OR=4.15, 95% CI: 2.04, 8.42) with relative excess risk due to interaction (RERI) of 1.47 (95% CI: 1.15, 4.1). Coexistence of poor oral hygiene habit with gastric atrophy elevated OSCC risk eight times (OR=8.65, 95% CI: 3.65, 20.46) and the additive interaction index was marginally statistically significant (RERI=4.34, 95% CI: 1.07, 9.76).Conclusion:Gastric atrophy is a risk factor for OSCC, and poor dental health and oral hygiene habit may act synergistically in increasing the risk.
AB - Background:Gastric fundal atrophy has been hypothesised to increase the risk of oesophageal squamous cell carcinoma (OSCC), but studies have shown inconsistent results.Methods:We measured serum pepsinogen I (PGI) and pepsinogen II (PGII) among 293 incident cases and 524 matched neighbourhood controls in a high-risk area of Northern Iran. Conditional logistic regression model was used to estimate odds ratios (ORs) and their 95% confidence intervals (CIs).Results:After controlling for age, sex, residence area and other potential confounders, gastric atrophy (defined by a validated criterion, PGI <55 μg dl-1) was associated with a two-fold increased risk (OR=2.01, 95% CI: 1.18, 3.45) of OSCC in the absence of nonatrophic pangastritis (defined as PGII <11.8 μg dl-1). Stratification by PGII decreased the misclassification errors due to cancer-induced gastritis. Presence of both poor dental health, indicated by higher than median sum of decayed, missing, and filled teeth (DMFT score), and gastric atrophy further increased the risk of OSCC (OR=4.15, 95% CI: 2.04, 8.42) with relative excess risk due to interaction (RERI) of 1.47 (95% CI: 1.15, 4.1). Coexistence of poor oral hygiene habit with gastric atrophy elevated OSCC risk eight times (OR=8.65, 95% CI: 3.65, 20.46) and the additive interaction index was marginally statistically significant (RERI=4.34, 95% CI: 1.07, 9.76).Conclusion:Gastric atrophy is a risk factor for OSCC, and poor dental health and oral hygiene habit may act synergistically in increasing the risk.
KW - atrophic gastritis
KW - dental health
KW - oesophageal neoplasm
KW - oral hygiene
KW - pepsinogen
KW - relative risk
UR - https://www.scopus.com/pages/publications/84865444305
U2 - 10.1038/bjc.2012.332
DO - 10.1038/bjc.2012.332
M3 - Article
C2 - 22814581
AN - SCOPUS:84865444305
SN - 0007-0920
VL - 107
SP - 888
EP - 894
JO - British Journal of Cancer
JF - British Journal of Cancer
IS - 5
ER -