Periodontal disease severity and cancer risk in postmenopausal women: the Buffalo OsteoPerio Study

Abstract

Purpose Few prospective studies have reported on relationships between objective periodontal disease (PD) measures and cancer risk. This association was examined in 1,337 postmenopausal women participating in the Buffalo OsteoPerio Study. Methods Oral alveolar crestal bone height (ACH) was measured using oral radiographs. Incident cancers were adjudicated with medical records. Hazard ratios (HR) and 95% confidence intervals (CI) for associations between ACH and incident cancer outcomes were estimated using Cox proportional hazards models. Results There were 203 confirmed total incident cancer cases during follow-up (12.2±4.2 years). After adjusting for age and smoking, there were no statistically significant associations between ACH-defined PD categories and total cancer risk (mild/moderate vs. none: HR=1.33, 95%CI: 0.91–1.94; severe vs. none: HR=1.20, 95%CI: 0.77–1.86). ACH-defined PD categories were not associated with common site-specific cancers. Whole mouth mean and worst site ACH (per 1mm loss) were significantly associated with increased risk of lung (adjusted HR=1.81, 95% CI: 1.30–2.54; adjusted HR=1.34, 95% CI: 1.08–1.66, respectively), but not total or other site-specific cancer. Smoking status modified the associations between continuous ACH variables and total cancer risk; measures of PD were associated with total cancer among smokers but not never-smokers (interaction p=0.02 and p<0.01 for whole mouth mean and worst site ACH, respectively). Conclusions ACH-defined PD was associated with total cancer risk in ever but not never-smoking postmenopausal women. Whole mouth mean and worst site ACH were associated with increased lung cancer risk. However, these results need to be interpreted cautiously given the small number of lung cancer cases (n=18). Further research utilizing a larger sample is warranted to confirm the relationships among oral bone loss, site-specific cancers, and total cancer.

Periodontal disease and risk of non‐Hodgkin lymphoma in the Health Professionals Follow‐Up Study

“…However, analyses of specific hematological cancers, including distinct NHL subtypes, were not possible given that only 24 cases were identified (including 11 exposed cases). 37 No association between periodontitis and hematological cancers was observed in a nationwide study in Taiwan. 38 In a Swedish registry-based case-control study, gingivitis and periodontitis was found to be associated with increased risk of lymphoplasmacytic lymphoma/Waldenstr€ om macroglobulinemia (odds ratio: 1.9; 95% CI: 1.3, 2.7), 39 a rarer subtype of NHL.…”

“…However, analyses of specific hematological cancers, including distinct NHL subtypes, were not possible given that only 24 cases were identified (including 11 exposed cases) [37]. No association between periodontitis and hematological cancers was observed in a nationwide study in Taiwan [38].…”

Relationship between periodontal disease and lung cancer: A systematic review and meta‐analysis

“…15 There is ever-increasing evidence, suggesting that PD appears to be associated with lung cancer. [16][17][18][19][20][21] In the absence of effective therapeutic methods, it is necessary to identify modifiable determinants of lung cancer risk. Zeng et al published the first meta-analysis on this topic in 2016, 22 which included five studies published from 2003 to 2014, followed by Michaud et al with another one in the following year, 23 including five studies published from 2011 to 2016.…”

Subgingival microbial profile of women with breast cancer: a cross-sectional study

“…Nowadays, a great deal of research effort has been dedicated to understanding the impact of the oral microbial burden on systemic health. It is well recognized that periodontal infection increases the level of inflammatory markers in the blood, and several studies [14][15][16][17] have linked this persistent inflammation to the development of different types of cancer, including breast cancer [18,19,25]. Therefore, defining the microbial profile of women with breast cancer and periodontitis is important contributory data to our understanding of the relationship between periodontitis and this systemic condition.…”

“…Indeed, ChP promotes systemic inflammation via translocation of oral bacteria, bacterial toxins, and inflammatory mediators through frequent transient bacteremia that would heighten the systemic burden and could promote cellular differentiation [4,13]. In addition, ChP has also been associated with cancers of the head and neck [14,15], pancreas [16], lung [17], and more recently breast cancer [18,19].…”