Oral health and risk of colorectal cancer: results from three cohort studies and a meta-analysis

Ann Oncol. 2016 Jul;27(7):1329-36. doi: 10.1093/annonc/mdw172. Epub 2016 May 23.


Background: While studies have shown that poor oral health status may increase the risk of cancer, evidence of a specific association with the risk of colorectal cancer (CRC) is inconclusive. We evaluated the association between oral health and CRC risk using data from three large cohorts: the Shanghai Men's Health Study (SMHS), the Shanghai Women's Health Study (SWHS), and the Southern Community Cohort Study (SCCS), and carried out a meta-analysis of results from other relevant published studies.

Patients and methods: This study applied a nested case-control study design and included 825 cases/3298 controls from the SMHS/SWHS and 238 cases/2258 controls from the SCCS. The association between oral health status (i.e. tooth loss/tooth decay) and CRC risk was assessed using conditional logistic regression models. A meta-analysis was carried out based on results from the present study and three published studies.

Results: We found that tooth loss was not associated with increased risk of CRC. ORs and respective 95% CIs associated with loss of 1-5, 6-10, and >10 teeth compared with those with full teeth are 0.87 (0.69-1.10), 0.93 (0.70-1.24), and 0.85 (0.66-1.11) among SMHS/SWHS participants; and 1.13 (0.72-1.79), 0.87 (0.52-1.43), and 1.00 (0.63-1.58) for those with loss of 1-4, 5-10, and >10 teeth among SCCS participants. Data regarding tooth decay were available in the SCCS, but were not associated with CRC risk. Meta-analysis confirmed the null association between tooth loss/periodontal disease and CRC risk (OR 1.05, 95% CI 0.86-1.29).

Conclusion: In this analysis of three cohorts and a meta-analysis, we found no evidence supporting an association between oral health and CRC risk.

Keywords: colorectal cancer risk; oral health; periodontal disease; tooth decay; tooth loss.

Publication types

  • Meta-Analysis
  • Research Support, N.I.H., Extramural

MeSH terms

  • China / epidemiology
  • Colorectal Neoplasms / epidemiology*
  • Colorectal Neoplasms / pathology
  • Female
  • Humans
  • Logistic Models
  • Male
  • Oral Health*
  • Oral Hygiene / adverse effects*
  • Risk Factors
  • Tooth Loss / epidemiology*
  • Tooth Loss / pathology