Tooth loss is associated with increased risk of total death and death from upper gastrointestinal cancer, heart disease, and stroke in a Chinese population-based cohort

• Published in: International journal of epidemiology Vol. 34; no. 2; pp. 467 - 474
• Main Authors: Abnet, Christian C, Qiao, You-Lin, Dawsey, Sanford M, Dong, Zhi-Wei, Taylor, Philip R, Mark, Steven D
• Format: Journal Article
• Language: English
• Published: Oxford Oxford University Press 01.04.2005; Oxford Publishing Limited (England)
• Subjects: Adult; Aged; Analysis. Health state; Biological and medical sciences; cerebrovascular accident; Cerebrovascular Disorders - complications; Cerebrovascular Disorders - mortality; China; China - epidemiology; cohort studies; Confounding Factors (Epidemiology); Death; Epidemiology; Esophageal Neoplasms - complications; Esophageal Neoplasms - mortality; Female; Gastroenterology. Liver. Pancreas. Abdomen; gastrointestinal neoplasms; General aspects; Health Surveys; heart diseases; Heart Diseases - complications; Heart Diseases - mortality; Humans; Male; Medical sciences; Middle Aged; Proportional Hazards Models; Prospective Studies; Public health. Hygiene; Public health. Hygiene-occupational medicine; Risk Factors; Smoking - mortality; Stomach. Duodenum. Small intestine. Colon. Rectum. Anus; tooth loss; Tooth Loss - complications; Tooth Loss - mortality; Tropical medicine; Tumors; Asia; China; Cardiovascular disease; gastrointestinal neoplasms; Epidemiology; Vascular disease; Cancerology; Heart disease; Cohort study; China; Rural area; Intestinal disease; Adult; Cerebrovascular disease; Public health; Gastric disease; Human; Nervous system diseases; Stroke; Stomatology; Gastrointestinal cancer; Mortality; Dental disease; Loss; Malignant tumor; tooth loss; cerebrovascular accident; Cerebral disorder; Central nervous system disease; Risk factor; heart diseases; cohort studies; Death; Tooth
• ISSN: 0300-5771; 1464-3685
• DOI: 10.1093/ije/dyh375

Background Tooth loss has previously been associated with a higher risk of cancer, heart disease, and stroke, but the role of confounding by smoking remains an issue. Methods We conducted a cohort study including 29 584 healthy, rural Chinese adults who were participants in a chemoprevention trial from 1986 through 1991 and who have been followed-up through 2001. We categorized tooth loss for each subject as less than or equal to or greater than the median number of teeth lost for other subjects of the same age at baseline. Mortality outcomes were categorized as follows: total death (n = 9362), upper gastrointestinal (GI) cancer death (n = 2625), other cancer death (n = 514), heart disease death (n = 1932), and fatal stroke (n = 2866). Results Individuals with greater than the age-specific median number of teeth lost had statistically significant 13% increased risk of total death [95% confidence interval (CI) 9–18%], 35% increased risk of upper GI cancer death (95% CI 14–59%), 28% increased risk of heart disease death (95% CI 17–40%), and 12% increased risk of stroke death (95% CI 2–23%), but no significantly increased risk of death from cancer at other sites. These elevated risks were present in male smokers, male non-smokers, and females, nearly all never-smokers. Conclusions In this Asian population, tooth loss significantly increased the risk of total death and death from upper GI cancer, heart disease, and stroke. These associations were not limited to tobacco smokers.