The association between fecal hemoglobin concentration and oral potentially malignant disorders

Objectives: The present study was to investigate the association between fecal hemoglobin (f-Hb) concentration and oral cancer and its precursor, oral potentially malignant disorders (OPMD). Methods: We used a population-based longitudinal cohort study data based on both Taiwanese nationwide oral and colorectal cancer screening programs implemented between 2004 and 2009. The total of 235,234 smokers and/or betel-quid chewers aged 50 to 69 years free of oral cancer and OPMD at entry were followed up over time to quantify the association between baseline f-Hb concentration on newly diagnosed oral cancer and OPMD. Results: The risk of OPMD increased with baseline f-Hb in a dose manner, yielding a statistically significant elevated risk of developing OPMD in parallel with the incremental concentration of f-Hb (adjusted hazard ratios = 0.99, 1,11, 1,07, 1,57, and 1,63 for f-Hb categories of 1–9, 10–19, 20–49, 50–89, and ≥90 µg Hb/g, respectively, as compared with the reference group (low and undetectable f-Hb concentrations)) However, there was lacking of a statistical significance for the corresponding association regarding the risk of oral cancer, which is possibly due to sparse cases given a shorter follow-up time. Conclusion: We discovered that f-Hb concentration was positively related to the risk of OPMD. f-Hb can be used as a biomarker for early detection of OPMD.