The association between self-reported poor oral health and gastrointestinal cancer risk in the UK Biobank: a large prospective cohort study

Background: Controversy remains as to whether poor oral health is independently associated with gastrointestinal cancers, due to potential confounding by smoking, alcohol and poor nutrition. The aim of this study was to investigate the association between oral health conditions and gastrointestinal cancer risk.

Methods: Data from the large, prospective UK Biobank cohort, which includes n=475,766 participants, were analysed. Cox proportional hazard models were applied to estimate the relationship between gastrointestinal cancer risk and self-reported poor oral health (defined as painful gums, bleeding gums, and/or having loose teeth), adjusting for confounders.

Results: During an average 6 years of follow-up, n=4,069 gastrointestinal cancer cases were detected, of which 13% self-reported poor oral health. Overall, there was no association between self-reported poor oral health and risk of gastrointestinal cancer detected (HR 0.97, 95% CI 0.88-1.07). In site-specific analysis, an increased risk of hepatobiliary cancers was observed in those with self-reported poor oral health (HR 1.32, 95% CI 0.95-1.80), which was stronger for hepatocellular carcinoma (HR 1.75, 95% CI 1.04-2.92).

Conclusion: Overall there was no association between self-reported poor oral health and gastrointestinal cancer risk however, there was a suggestion of an increased risk of hepatobiliary cancer, specifically hepatocellular carcinoma.