The epithelial cells of the gastric mucosa are the source of gastric cancer (GC), a cancer with a poor overall survival rate. GC can be categorized as either non-cardia gastric cancer or cardia cancer depending on its anatomical location. Although prior research was constrained by its retrospective methodology and small sample size, poor oral health has been associated with an elevated risk of GC.
The impact of tooth count and dental health issues on the long-term risk of GC, which includes its cardia and non-cardia subtypes, in Swedish adults aged 19 and older was investigated in this study using Swedish nationwide registers. Between 2009 and 2016, this study tracked 5,888,034 Swedish people over 19 who went to the dentist as part of a nationwide cohort. Additionally, incident GC patients were compared to their siblings in a nested case-control study.
To assess the relationship between different oral health issues and the risk of GC, Cox regression analyses were conducted, using achieved age as the timeframe and controlling for possible confounders. To make sure that the findings were reliable, they also performed a number of sensitivity analyses and stratified our analyses by age and sex.
This research found 3993 new GC cases, comprising 1,241 cardia GC and 2,752 non-cardia GC, with an average follow-up of 6.4 years. People with periodontitis were 11% and 25% more likely to develop GC and cardia GC, respectively, than people with healthy teeth. Sibling-controlled studies consistently found favourable correlations between odontogenic inflammation and GC risk. Additionally, they found that the risk of GC and the number of remaining teeth had a dose-response connection, with larger risks being linked to fewer teeth.
Furthermore, there are no significant associations between the risk of GC or its subtypes with the number of remaining teeth or dental inflammatory diseases. These findings held up well in sensitivity studies and across all age and sex subgroups. Overall, with sibling-controlled analyses included, this population-based cohort study offers further proof that having fewer teeth is linked to a higher risk of GC. These correlations hold true for both cardia and non-cardia subtypes.
Source:
Ruan, Z., Xie, J., Yu, J., Yin, L., Nesheli, D. N., & Ye, W. (2025). The association between poor dental health and gastric cancer risk: a nationwide cohort and sibling-controlled study. BMC Medicine, 23(1), 434. https://doi.org/10.1186/s12916-025-04273-x
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