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

Abstract

Periodontal disease (PD), as a chronic bacterial infection, might cause cardiovascular and some other systemic diseases, with recent studies reporting that it exhibits some connection with lung cancer. While studies have shown that poor oral health might increase the risk of lung cancer, the veracity of these reports is questionable. Therefore, this meta‐analysis was undertaken to investigate the association between PD and the risk of lung cancer. A search was run in PubMed, EMBASE, MEDLINE, CENTRAL, and ClinicalTrials.gov databases up to January 1, 2020. Cohort and case‐control studies investigating the correlation between PD and lung cancer were included. Eligibility assessment and data extraction were conducted independently, and a meta‐analysis was performed to synthesize the data. The association between PD, edentulism, and lung cancer was measured by the adjusted hazard ratios (HRs) or odds ratios (ORs) and their 95% confidence intervals (CIs) provided in articles. We employed appropriate effect model in terms of I2 (a fixed‐effect model for PD and a random‐effect model for edentulism) to obtain summary effect estimates. Statistical heterogeneity was investigated by chi‐square test and I2 statistics. Newcastle‐Ottawa Scale (NOS) was used to assess the quality of their method. Six cohort studies (eight references) and two case‐control studies, assessed as high‐quality, involving 167 256 participants, were included in the review. The summary estimates based on adjusted data showed an association between PD and a significant risk of lung cancer both in cohort studies (HR = 1.40, 95% CI = 1.25‐1.58; I2 = 8.7%) and case‐control studies (OR = 1.51, 95% CI = 1.16‐1.98; I2 = 36.5%). Similar features were found in the sensitivity analysis and subgroups for six cohort studies, of male only (HR = 1.36, 95% CI = 1.15‐2.60), setting the lung cancer incidence as endpoint (HR = 1.39, 95% CI = 1.24‐1.57; I2 = 23.9%), and adjusting alcohol for multifactorial HR (HR = 1.38, 95% CI = 1.21‐1.57; I2 = 39.9%). The summary HR for edentulism was 1.93 (95% CI = 1.05‐3.57; I2 = 55.3%). No obvious publication bias was detected. This systematic review and meta‐analysis demonstrated a significant association between PD and the incidence of lung cancer. Further observational studies are required by using standardized measurements to assess the periodontal status and by eliminating confounding factors, such as alcohol and diabetes, to verify such a relationship.

Two-sample Mendelian randomization analysis of associations between periodontal disease and risk of colorectal, lung, and pancreatic cancers

“…In contrast to meta-analyses of observational studies suggesting that periodontal disease is associated with the risk of lung and pancreatic cancer, 6–8,41,42 our primary analyses did not indicate that there were significant associations between a genetic predisposition to having chronic or aggressive periodontal disease and the risk of either lung or pancreatic cancer. Given that the effect estimates for colorectal cancer and pancreatic cancer were similar but we had more colorectal cancer cases, it is possible that our pancreatic cancer analyses were underpowered.…”

Association of Edentulism With Various Chronic Diseases in Mexican Elders 60+ Years: Results of a Population-Based Survey

“…In a meta-analysis of cohort studies [25] it was a concluded that design and quality of studies -together with the number of cases and participantssupport the association between tooth loss and both cardiovascular disease and cerebrovascular incidents. Other meta-analyses give creedence to a link between death risk [21], obesity [28], dementia [61], depression [32], Alzheimer's disease [62], asthma [63], different types of cancer [64,65] and metabolic syndrome [66] and oral health indicators. Oral diseases / infections as a risk factor for the development of various systemic conditions is a topic that has been widely investigated and debated.…”

A Etiologia da Lesão Cervical não Cariosa: Um Novo Desafio para o Cirurgião-Dentista do Século XXI The Etiology of Noncarius Cervical Lesions: a New Challenge for the 21ST Century Dentist

“…A doença periodontal (DP) é caracterizada por um processo inflamatório crônico, produzido por uma complexa interação entre o estímulo patogênico (uma comunidade bacteriana) e a resposta do hospedeiro, e afeta os tecidos que circundam e sustentam os dentes (1)(2)(3). Esta patologia inclui a gengivite e a periodontite, além de ser altamente prevalente na população (4).…”