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- Title
Congenital Tooth Agenesis and Risk of Early-Onset Cancer.
- Authors
Eiset, Saga Elise; Schraw, Jeremy; Sørensen, Gitte Vrelits; Gregersen, Pernille Axél; Rasmussen, Sonja A.; Ramlau-Hansen, Cecilia H.; Lupo, Philip J.; Hasle, Henrik
- Abstract
Key Points: Question: Is tooth agenesis associated with early-onset cancer? Findings: In this population-based cohort study of 2.5 million live-born singletons with up to 40 years of follow-up, tooth agenesis was positively associated with several cancer types, including neuroblastoma, nephroblastoma, and hepatoblastoma in childhood; osteosarcoma in adolescence; and colorectal carcinomas and carcinomas of the bladder in young adulthood. Meaning: These findings suggest that tooth agenesis is associated with specific cancer types, particularly in early childhood and early adulthood; further evaluation of these associations is needed to assess possible clinical implications. This cohort study of live-born singletons in Denmark examines whether tooth agenesis is associated with early-onset cancer. Importance: There is some evidence that tooth agenesis (congenital absence of 1 or more teeth) is associated with cancer risk, especially carcinomas of the colon and ovaries, but results of previous studies are conflicting, and associations have not yet been evaluated in a population-based setting. Objective: To examine the association between tooth agenesis and specific cancer types before 40 years of age. Design, Setting, and Participants: This population-based cohort study used linking data from nationwide registries in Denmark to assess all Danish live-born singletons born from January 1, 1977, to December 31, 2018, and followed up for up to 40 years. Data were analyzed from January through June 2023. Exposure: Tooth agenesis as documented by the Danish Central Registry of Odontology (Danish municipal pediatric dental care) from January 1, 1988, to December 31, 2018, and from hospital encounters in the Danish National Patient Registry within the entire study period. Main Outcome and Measures: The primary outcome was first cancer diagnosis before 40 years of age obtained from the Danish Cancer Registry. Associations between tooth agenesis and specific cancers were estimated by Cox proportional hazards regression as hazard ratios (HRs) with 95% CIs. Analyses were split into age groups: younger than 1 year, 1 to younger than 3 years, 3 to younger than 10 years, 10 to younger than 20 years, 20 to younger than 30 years, and 30 to younger than 40 years. Associations with nonsyndromic tooth agenesis were evaluated after exclusion of individuals with known syndromes. Results: Among 2 501 715 included individuals (1 284 292 [51.3%] male), 70 288 (2.8%) had a diagnosis of tooth agenesis (mean [SD] age at diagnosis, 13.2 [4.1] years) and 26 308 (1.1%) had a diagnosis of early-onset cancer within the study period; 778 individuals had co-occurrence of tooth agenesis and cancer. Overall, tooth agenesis was positively associated with several cancer types, including neuroblastoma (age 1 to <3 years; HR, 4.20; 95% CI, 2.24-7.88), nephroblastoma (age 1 to <3 years; HR, 4.59; 95% CI, 2.37-8.91), hepatoblastoma (age 1 to <3 years; HR, 7.10; 95% CI, 2.70-18.68), osteosarcoma (age 10 to <20 years; HR, 2.19; 95% CI, 1.11-4.32), colorectal carcinomas (age 30 to <40 years; HR, 2.81; 95% CI, 1.38-5.71), and carcinomas of bladder (age 20 to <30 years; HR, 3.35; 95% CI, 1.35-8.30). Conclusions and Relevance: This cohort study found associations between congenital tooth agenesis and several cancer types, from childhood to early adulthood. Further evaluation of these associations is needed to assess possible clinical implications.
- Subjects
DENMARK; TUMOR risk factors; RISK assessment; TEETH abnormalities; RESEARCH funding; AGE distribution; REPORTING of diseases; DESCRIPTIVE statistics; LONGITUDINAL method; CONFIDENCE intervals; DISEASE complications
- Publication
JAMA Network Open, 2024, Vol 7, Issue 3, pe240365
- ISSN
2574-3805
- Publication type
Article
- DOI
10.1001/jamanetworkopen.2024.0365