Recurrent aphthous stomatitis may be a precursor or risk factor for specific cancers: A case‐control frequency‐matched study

• Published in: Cancer medicine (Malden, MA) MA), 2018-08, Vol.7 (8), p.4104-4114
• Main Authors: Qin, Lei, Kao, Yi‐Wei, Lin, Yueh‐Lung, Peng, Bou‐Yue, Deng, Win‐Ping, Chen, Tsung‐Ming, Lin, Kuan‐Chou, Yuan, Kevin Sheng‐Po, Wu, Alexander T. H., Shia, Ben‐Chang, Wu, Szu‐Yuan
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Aged; Aphthous stomatitis; Breast; Cancer; Cancer Prevention; Case-Control Studies; case‐control; Colon; Databases, Factual; Female; gender; Head and neck; Humans; Male; Middle Aged; Neoplasms - diagnosis; Neoplasms - epidemiology; Neoplasms - etiology; Original Research; Pancreas; Precancerous Conditions - epidemiology; Precancerous Conditions - etiology; Prophase; Proportional Hazards Models; Prostate; Recurrence; recurrent aphthous stomatitis; Risk Assessment; risk factor; Risk Factors; Skin; Socioeconomic Factors; Stomatitis; Stomatitis, Aphthous - complications; Stomatitis, Aphthous - epidemiology; Stomatitis, Aphthous - pathology; Young Adult
• ISSN: 2045-7634; 2045-7634
• DOI: 10.1002/cam4.1685

Background Recurrent aphthous stomatitis (RAS) is considered a prophase symptom in patients with specific cancers. This study assessed the association between RAS and subsequent onset of cancer based on a nationwide population‐based database in Taiwan. Materials and Methods We selected study participants from the National Health Insurance Research Database from January 2000 to December 2008. Patients in the non‐RAS cohort were matched to case study patients at a 1:1 ratio through frequency matching. All participants were followed up for at least 5 years, and those who received cancer diagnoses during follow‐up were identified. Results Among 52 307 patients with and 52 304 patients without RAS, the combined hazard ratio (HR) of all subsequent cancer cases was 1.3 (95% confidence interval [CI]: 1.25‐1.35, P = 0). RAS diagnosis was associated with risk for cancers of the head and neck (aHR = 2, 95% CI: 1.8‐2.3), colon (aHR = 1.2, 95% CI: 1.1‐1.4), liver (aHR = 1.1, 95% CI: 1‐1.3), pancreas (aHR = 1.4, 95% CI: 1.1‐1.7), skin (aHR = 1.4, 95% CI: 1.2‐1.7), breast (aHR = 1.2, 95% CI: 1.1‐1.4), and prostate (aHR = 1.5, 95% CI: 1.3‐1.8), as well as hematologic cancers (aHR = 1.6, 95% CI: 1.3‐1.9). A higher risk was observed for male patients (aHR = 1.35, 95% CI: 1.28‐1.42) than for female patients (aHR = 1.25, 95% CI: 1.18‐1.31) with RAS. Conclusions RAS was associated with specific cancers. Susceptible RAS patients should be screened for specific cancers. Recurrent oral aphthae (ROA) was found to be associated with specific cancers. During treatment, patients with ROA should be cautioned about these associations, especially with respect to head and neck cancers and risks for male patients with ROA. Susceptible patients with ROA should receive screening for specific cancers.