(125) Time-Dependent Risk of Major Dental Treatment Over 10 Years in Cancer Patients Compared to The General Population Using a National Claims Database

Friday, August 26, 2022

8:00 AM – 6:00 PM CEST

Location: Hall C

Publication Number: 456

Presenting Author(s)

Areum Han
– Seoul National University College of Medicine, Jongno-Gu, South Korea

Co-Author(s)

Eun-Gee Park
– Interdisciplinary Program of Medical Informatics, Seoul National University College of Medicine, Seoul, Korea, Republic of Korea
Jeong-Hwa Yoon
– Institute of Health Policy and Management, Medical Research Center, Seoul National University, Korea, Republic of Korea
Ji-Yeob Choi
– Seoul National University College of Medicine, Seoul, South Korea
Hee-Kyung Park
– Department of Oral Medicine and Oral Diagnosis, School of Dentistry and Dental Research Institute, Seoul National University, Korea, Republic of Korea
Seokyung Hahn
– Institute of Health Policy and Management, Medical Research Center, Seoul National University, Korea, Republic of Korea

Background: Dental care for cancer patients is an important issue because diminished masticatory function in cancer patients or survivors can affect their quality of life. However, patients’ interest in oral health during cancer treatment tends to decrease.

Objectives: To evaluate the incidence of major dental treatment event over time after cancer diagnosis in cancer patients compared to a matched sample of the general population

Methods: Time-dependent hazard ratio (HR) and associated 95% confidence interval (CI) of each considered treatment event, stomatitis, tooth loss, dental caries/pulp diseases and gingivitis/periodontal disease, was calculated by applying a subdistribution hazard model with time-varying covariates using the Korean national claims database collected from 2002 to 2015 and mortality treated as a competing event. Subgroup analyses were conducted by type of cancer.

Results: 39,625 cancer patients and a matched control group were selected. The risk of stomatitis treatment was higher in cancer patients than in the control group in all time intervals, with the HR was 2.04 (95% CI = 1.60-2.58) within 30 days after cancer diagnosis and gradually decreased to 1.15 (95% CI = 1.04-1.28) after 5 years. The risk of treatment for tooth loss was lower in cancer patients than in the control group in all time intervals, and the hazard ratio was less than 0.7 within 3 months after cancer diagnosis (0.65; 95% CI = 0.50-0.84 and 0.54; 95% CI = 0.43-0.68 before and after 30 days, respectively) and increased to 0.97 (95% CI = 0.89-1.07) after 5 years. The HRs of a treatment event for dental caries/pulp disease were around 0.8 (0.83; 95% CI = 0.74-0.92 and 0.78; 95% CI = 0.70-0.86 before and after 30 days, respectively) until 3 months after cancer diagnosis, and then increased to 1.09 (95% CI = 1.05-1.13) for 1-3 years. The HRs of a treatment event for gingivitis/periodontal disease were similar until 3 months after cancer diagnosis, and gradually increased thereafter, reaching 1.09 (95% CI = 1.04-1.15) after 5 years. Subgroup analyses by cancer type suggested that risk of all dental treatment events was higher in the head and neck cancer patients, particularly in early phase after cancer diagnosis.

Conclusions: Treatments of dental diseases in cancer patients are delayed or less prioritized, unless they are accompanied or associated with cancer therapy. The national health insurance plan should be extended to dental care for cancer patients/survivors and effective collaboration systems between medical doctors and dentists throughout the course of cancer therapy should be promoted.