Table 3.
Adjusted hazard ratios of lung cancer incidence by three levels of antibodies to 18 oral bacteria in 4263 participants in ARIC a
| Bacterium | Lung cancer cases/Person-Years | Median concentration (ng/mL) | Model 1 HR (95% CI) b | Model 2 HR (95% CI) c | P trend d |
|---|---|---|---|---|---|
|
| |||||
| A. actinomycetemcomitans | |||||
| Group 1 (lowest) | 20/12587 | 9.7 | 1.00 (ref.) | 1.00 (ref.) | 0.13 |
| Group 2 | 41/25534 | 50.6 | 0.94 (0.55–1.60) | 0.94 (0.55–1.58) | |
| Group 3 (highest) | 57/25200 | 212.7 | 1.28 (0.76–2.15) | 1.28 (0.78–2.12) | |
| A. viscosus | |||||
| Group 1 (lowest) | 68/34054 | 2.3 | 1.00 (ref.) | 1.00 (ref.) | 0.89 |
| Group 2 | 25/14492 | 41.9 | 0.89 (0.56–1.40) | 0.80 (0.50–1.28) | |
| Group 3 (highest) | 25/14776 | 211.2 | 0.84 (0.53–1.34) | 0.95 (0.60–1.50) | |
| C. ochracea | |||||
| Group 1 (lowest) | 66/34502 | 5.7 | 1.00 (ref.) | 1.00 (ref.) | 0.87 |
| Group 2 | 24/14609 | 30.9 | 0.81 (0.51–1.30) | 0.95 (0.60–1.51) | |
| Group 3 (highest) | 28/14210 | 80.1 | 0.95 (0.60–1.48) | 0.97 (0.62–1.51) | |
| C. rectus | |||||
| Group 1 (lowest) | 73/39566 | 4.5 | 1.00 (ref.) | 1.00 (ref.) | 0.34 |
| Group 2 | 28/12013 | 30.7 | 1.16 (0.75–1.81) | 1.21 (0.78–1.89) | |
| Group 3 (highest) | 17/11742 | 87.1 | 0.70 (0.41–1.20) | 0.74 (0.43–1.28) | |
| E. corrodens | |||||
| Group 1 (lowest) | 83/47298 | 3.4 | 1.00 (ref.) | 1.00 (ref.) | 0.46 |
| Group 2 | 15/7918 | 26.6 | 1.01 (0.58–1.75) | 1.03 (0.58–1.82) | |
| Group 3 (highest) | 20/8104 | 65.8 | 1.25 (0.76–2.05) | 1.21 (0.74–2.00) | |
| F. nucleatum | |||||
| Group 1 (lowest) | 89/48792 | 3.0 | 1.00 (ref.) | 1.00 (ref.) | 0.83 |
| Group 2 | 13/7287 | 26.9 | 0.92 (0.51–1.65) | 0.99 (0.55–1.80) | |
| Group 3 (highest) | 16/7243 | 65.6 | 1.11 (0.65–1.90) | 1.07 (0.62–1.84) | |
| H. pylori | |||||
| Group 1 (lowest) | 70/39859 | 3.3 | 1.00 (ref.) | 1.00 (ref.) | 0.48 |
| Group 2 | 18/11883 | 32.0 | 0.79 (0.47–1.32) | 0.72 (0.42–1.22) | |
| Group 3 (highest) | 30/11579 | 118.6 | 1.39 (0.90–2.16) | 1.15 (0.74–1.79) | |
| P. gingivalis | |||||
| Group 1 (lowest) | 71/38613 | 5.7 | 1.00 (ref.) | 1.00 (ref.) | 0.50 |
| Group 2 | 31/12447 | 35.6 | 1.29 (0.84–1.98) | 1.05 (0.67–1.64) | |
| Group 3 (highest) | 16/12261 | 193.2 | 0.67 (0.38–1.18) | 0.83 (0.47–1.45) | |
| P. intermedia | |||||
| Group 1 (lowest) | 42/25392 | 6.6 | 1.00 (ref.) | 1.00 (ref.) | 0.48 |
| Group 2 | 37/19038 | 38.3 | 1.11 (0.71–1.74) | 1.25 (0.80–1.95) | |
| Group 3 (highest) | 39/18892 | 156.0 | 1.14 (0.73–1.78) | 1.22 (0.78–1.91) | |
| P. micra | |||||
| Group 1 (lowest) | 30/18551 | 7.5 | 1.00 (ref.) | 1.00 (ref.) | 0.78 |
| Group 2 | 32/22603 | 41.6 | 0.84 (0.51–1.39) | 0.85 (0.52–1.40) | |
| Group 3 (highest) | 56/22167 | 169.6 | 1.44 (0.92–2.25) | 0.99 (0.63–1.57) | |
| P. nigrescens | |||||
| Group 1 (lowest) | 32/15616 | 8.3 | 1.00 (ref.) | 1.00 (ref.) | 0.60 |
| Group 2 | 42/23977 | 45.9 | 0.81 (0.51–1.29) | 0.97 (0.61–1.53) | |
| Group 3 (highest) | 44/23728 | 225.6 | 0.85 (0.54–1.35) | 1.09 (0.69–1.74) | |
| S. intermedius | |||||
| Group 1 (lowest) | 66/35425 | 3.4 | 1.00 (ref.) | 1.00 (ref.) | 0.89 |
| Group 2 | 23/14126 | 37.5 | 0.88 (0.55–1.42) | 0.99 (0.61–1.61) | |
| Group 3 (highest) | 29/13770 | 248.5 | 1.10 (0.71–1.71) | 1.03 (0.66–1.61) | |
| S. noxia | |||||
| Group 1 (lowest) | 83/47910 | 2.0 | 1.00 (ref.) | 1.00 (ref.) | 0.26 |
| Group 2 | 23/7511 | 30.0 | 1.59 (1.00–2.54) | 1.58 (0.98–2.53) | |
| Group 3 (highest) | 12/7901 | 217.8 | 0.89 (0.48–1.64) | 0.67 (0.34–1.32) | |
| S. oralis | |||||
| Group 1 (lowest) | 56/34543 | 4.1 | 1.00 (ref.) | 1.00 (ref.) | 0.21 |
| Group 2 | 28/14642 | 35.9 | 1.18 (0.75–1.86) | 1.00 (0.63–1.58) | |
| Group 3 (highest) | 34/14137 | 149.5 | 1.44 (0.93–2.21) | 1.30 (0.84–2.01) | |
| S. sanguis | |||||
| Group 1 (lowest) | 59/36488 | 2.5 | 1.00 (ref.) | 1.00 (ref.) | 0.62 |
| Group 2 | 30/13288 | 40.7 | 1.41 (0.91–2.20) | 1.28 (0.82–2.01) | |
| Group 3 (highest) | 29/13545 | 226.0 | 1.35 (0.87–2.12) | 1.16 (0.73–1.82) | |
| T. denticola | |||||
| Group 1 (lowest) | 64/30472 | 10.9 | 1.00 (ref.) | 1.00 (ref.) | 0.35 |
| Group 2 | 25/16508 | 27.0 | 0.68 (0.42–1.07) | 0.66 (0.42–1.06) | |
| Group 3 (highest) | 29/16340 | 60.7 | 0.79 (0.50–1.22) | 0.81 (0.52–1.26) | |
| T. forsythensis | |||||
| Group 1 (lowest) | 53/30841 | 8.7 | 1.00 (ref.) | 1.00 (ref.) | 0.68 |
| Group 2 | 39/16253 | 29.4 | 1.33 (0.88–2.02) | 1.35 (0.89–2.06) | |
| Group 3 (highest) | 26/16228 | 87.1 | 0.90 (0.56–1.44) | 1.13 (0.70–1.82) | |
| V. parvula | |||||
| Group 1 (lowest) | 97/52851 | 1.8 | 1.00 (ref.) | 1.00 (ref.) | 0.69 |
| Group 2 (highest) | 21/10470 | 36.2 | 1.01 (0.63–1.63) | 0.91 (0.56–1.47) | |
| Red complex | |||||
| Group 1 (lowest) | 45/21329 | 24.8 | 1.00 (ref.) | 1.00 (ref.) | 0.22 |
| Group 2 | 41/21174 | 71.7 | 0.88 (0.57–1.34) | 1.03 (0.68–1.58) | |
| Group 3 (highest) | 32/20818 | 233.4 | 0.68 (0.43–1.08) | 0.77 (0.48–1.23) | |
| Orange complex | |||||
| Group 1 (lowest) | 32/21572 | 60.7 | 1.00 (ref.) | 1.00 (ref.) | 0.28 |
| Group 2 | 40/21077 | 212.6 | 1.25 (0.78–1.99) | 1.32 (0.83–2.10) | |
| Group 3 (highest) | 46/20673 | 672.5 | 1.39 (0.88–2.20) | 1.36 (0.86–2.14) | |
| P. intermedia + P. nigrescens | |||||
| Group 1 (lowest) | 40/21550 | 21.3 | 1.00 (ref.) | 1.00 (ref.) | 0.81 |
| Group 2 | 40/21072 | 96.5 | 0.98 (0.63–1.53) | 1.18 (0.76–1.83) | |
| Group 3 (highest) | 38/20700 | 397.8 | 0.93 (0.59–1.45) | 1.11 (0.70–1.74) | |
| All bacteria | |||||
| Group 1 (lowest) | 38/21338 | 224.9 | 1.00 (ref.) | 1.00 (ref.) | 0.96 |
| Group 2 | 39/20976 | 733.8 | 1.01 (0.65–1.59) | 1.18 (0.76–1.85) | |
| Group 3 (highest) | 41/21008 | 2143.6 | 1.04 (0.66–1.62) | 1.06 (0.68–1.66) | |
For each bacterium, Group 1 was participants with an antibody concentration at or below the limit of detection (20 ng/mL); Group 2 and Group 3 were participants with an antibody concentration above the limit of detection, divided at the median concentration; if the proportion of at or below the limit of detection was larger than 80% for the antibody, only one group was set for those with an antibody level above the limit of detection; For the sum of bacteria (red complex, orange complex, P. intermedia + P. nigrescens, and all bacteria), participants were divided into tertiles, where Group 1 was the lowest tertile and Group 3 was the highest tertile; All bacteria include 18 bacteria described in the study; Red complex bacteria include P. gingivalis, T. denticola, and T. forsythensis; Orange complex bacteria include C. rectus, F. nucleatum, P. intermedia, P. micra, and P. nigrescens; HR = hazard ratio; CI = confidence interval; HRT = hormone replacement therapy; BMI = body mass index.
Model 1 was adjusted for age, joint terms for field center and race (Black from Jackson; Black from Forsyth; White from Forsyth; White from Washington County [reference is White from Minneapolis]), and joint terms for sex and HRT use (female user, female nonuser [reference is men]).
Model 2 was adjusted for all the variables in model 1, and additionally adjusted for cigarette smoking status, packyears smoked, alcohol drinking status, BMI, diagnosed diabetes status, undiagnosed diabetes status, at risk for diabetes status, family history of cancer; the model was weighted with a propensity score to control the confounding by socioeconomic status and access to and uptake of medical and dental care.
P value for trend for model 2 was from the Wald test of the coefficient for the ordinal variable of the 3 groups in a Cox proportional hazards regression.