br References br Zhang Y
 . Zhang Y, Liu Z, Yu X, Zhang X, Lü S, Chen X, et al. The association between metabolic abnormality and endometrial cancer: a large case-control study in China. Gynecol. Oncol. 2010;117: 41–46.  . McCullough ML, Patel AV, Patel R, Rodriguez C, Feigelson HS, Bandera EV, et al. Body mass and endometrial cancer risk by hormone replacement therapy and can-cer subtype. Cancer Epidemiol. Biomark. Prev. 2008;17: 73–79.
 . Mauland KK, Trovik J, Wik E, Raeder MB, Njølstad TS, Stefansson IM, et al. High BMI is significantly associated with positive progesterone receptor status and clinico-pathological markers for non-aggressive disease in endometrial cancer. Br. J. Cancer. 2011;104: 921–926.
 . Modesitt SC, Tian C, Kryscio R, Thigpen JT, Randall ME, Gallion HH, et al. Impact of body mass index on treatment outcomes in endometrial cancer patients receiving doxorubicin and cisplatin: a gynecologic oncology group study. Gynecol. Oncol. 2007;105: 59–65.
Contents lists available at ScienceDirect
journal homepage: www.elsevier.com/locate/lungcan
Association of oral health with lung cancer risk in a low-income 9(S)-HODE T of African Americans and European Americans in the Southeastern United States
Hyung-Suk Yoon, Wanqing Wen, Jirong Long, Wei Zheng, William J. Blot, Qiuyin Cai
Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center, Vanderbilt-Ingram Cancer Center, Vanderbilt University School of Medicine, Nashville, Tennessee, 37203, USA
Objectives: Previous studies have suggested that poor oral health might increase the risk of lung cancer among European- and Asian- descendants. The association has not been investigated among African Americans or so-cially disadvantaged populations. In this nested case-control study, we investigated whether oral health was associated with lung cancer risk among a low-income population of African Americans and European Americans in the Southeastern United States.
Materials and methods: A total of 403 incident lung cancer cases and 1612 matched controls from the Southern Community Cohort Study were included. Multivariate conditional logistic regression models were fitted to evaluate the risk of lung cancer linked to tooth loss, tooth decay, and history of periodontal disease.
Conclusion: Poor oral health is associated with increased lung cancer risk, and this association appears to vary by race and smoking behavior among a low-income population of African Americans and European Americans in the Southeastern United States.
Lung cancer accounts for approximately 13% of all cancer diagnoses in the United States . The vast majority of lung cancer is attributed to cigarette smoking, but other factors, including radon exposure, air pollution, and dietary habits, are also involved in lung cancer etiology [2,3]. Recently, oral health has been hypothesized as a putative risk indicator in lung cancer. Several studies have suggested that poor oral health is associated with increased risk of lung cancer in European- and Asian- descendants [4–8]. Oral bacterial infections, which induce in-flammation of the gums and tooth loss , can progress to systemic inflammation  and the generation of nitrosamines , an ag-gravation that may be linked to an incremental increased risk of de-veloping various chronic diseases , as well as cancers . Fur-thermore, poor oral health is often the result of smoking  and/or limited access to regular dental care , suggesting that poor oral
health, especially among socioeconomically disadvantaged populations , may predispose them to a greater likelihood of developing lung cancer.
The association of poor oral health with lung cancer risk has not been investigated among African Americans or among socially dis-advantaged populations. African Americans experience a higher in-cidence of lung cancer than other racial groups . In addition, African Americans are at higher risk for poor oral health. Thus, in the present study, we focused on racial disparities in poor oral health and lung cancer risk. We conducted a nested case-control study within the Southern Community Cohort Study (SCCS), which includes a low-in-come population (half of the SCCS participants have annual household incomes of less than the US $15,000) and a large population of African Americans (two-thirds of the SCCS participants) living in the south-eastern United States. Our objective was to evaluate whether oral health status is associated with lung cancer risk, and whether race and