American Association for Cancer Research: 66,000 follow-up for 8 years found that "small" periodontal disease can increase the risk of esophageal cancer by 228%
Release date: 2017-08-08
Don't underestimate periodontal disease!
A study conducted by researchers at the State University of New York at Buffalo involving about 66,000 women (54-86 years) with a mean follow-up of 8.32 years showed that periodontal disease is a big problem!
They found that women with a history of periodontal disease had a 14% increased overall risk of cancer (HR 1.14; 95% CI, 1.08-1.20) and a 73% increase in the risk of gallbladder cancer compared with women without periodontal disease ( HR, 1.73; 95% CI, 1.01–2.95) The risk of esophageal cancer increased by 228% (HR 3.28; 95% CI, 1.64–6.53)! In addition, periodontal disease is also associated with breast cancer, lung cancer and melanoma risk in women [1]!
The author of the study, Professor Jean Wactawski-Wende, Dean of the School of Public Health at Faro School, said: "This is the first study focusing on women, especially older women. Our research is large enough and the research is detailed enough. Not only can you assess the overall risk of cancer in older women with a history of periodontal disease, but also provide useful information about specific areas of cancer!"[2]
The first author of the study, Dr. Ngozi Nwizu, said: "Our study is the first study to report the relationship between periodontal disease and gallbladder cancer risk!"[2]
Related research results were published earlier this month in the Journal of the American Cancer Research Association, Cancer Epidemiology: Biomarkers and Prevention [1].
Professor Jean Wactawski-Wende
It is worth mentioning that the results of this study coincide with the findings published in the Lancet Oncology magazine in 2008: a study involving 48,000 men (40-75 years old) also showed that Compared with men without a history of periodontal disease, the overall risk of cancer in men with a history of periodontal disease increased by 14% (HR 1.14; 95% CI, 1.07-1.22)! Periodontal disease is associated with male lung cancer, kidney cancer, pancreatic cancer, and blood cancer risk [3].
In March of this year, a report published in the medical journal CA also showed that periodontal disease is a risk factor for colorectal cancer and non-Hodgkin's lymphoma! (See God's Medical Journal CA: Small periodontal disease is a high risk factor for colorectal cancer and lymphoma! 丨 Clinical discovery)
Periodontal disease refers to the disease that occurs in periodontal tissues. It is the most common disease in human oral cavity and the first cause of tooth loss in adults [4]. It mainly includes gum disease involving gingival tissues and teeth involving deep periodontal tissues. Zhou Yan.
The left side is normal teeth (healthy gums, cementum), and the right side is periodontal diseased teeth (gingivitis, plaque, periodontal pocket)
Periodontal disease is the most widespread chronic infectious disease in the population, and the prevalence increases with age. According to the third national oral health epidemiological survey, 80%-97% of adults in China currently have different degrees of periodontal disease [4]. In the United States, the prevalence of periodontal disease is as high as 70% in people over 65 years of age [5].
Periodontal disease is a multifactorial disease whose initiating factor is the invasion of plaque microorganisms and their products. Studies have shown that about 30 bacteria in the mouth are associated with the development and progression of periodontal disease [4]. Bacteria in the mouth can enter the esophagus or colon through saliva, or enter the lungs through the plaque, or through the blood vessels of the diseased periodontal tissues to the distal organs.
Many studies have reported that periodontal disease pathogens such as lymph nodes [6], lungs [7], esophagus [8], and colorectal [9] have been isolated from different tissues and organs.
Further studies have shown that P. gingivalis and F. nucleatum, which cause periodontal disease, can stimulate tumorigenesis through proteins on the surface of the oral epithelium (Toll-like receptors); Fusobacterium can also recruit tumor-infiltrating immune cells to produce a pro-inflammatory microenvironment, which is conducive to the formation and development of colorectal cancer [10]!
However, there are few epidemiological studies on the overall risk of periodontal disease and cancer. The 2008 study only focused on the relationship between periodontal disease and male cancer risk [3]. So what is the relationship between periodontal disease and female cancer risk?
Given the higher prevalence of periodontal disease in older people, Professor Wactawski-Wende leads the team from a national forward-looking study, the Women's Health Initiative Observation Study (WHI-OS), which aims to investigate the impact. Risk factors for morbidity and mortality in older women.
According to certain criteria for inclusion, the researchers selected 65,869 women aged 54-86 years to obtain their periodontal history and related information through self-reported questionnaires of these women during 1999-2003; and conducted an average of 8.32. During the year's follow-up, the researchers analyzed the relevant data based on the cancer occurrences determined in September 2013.
Among the women surveyed, there were 7149 cancers, the most important of which was breast cancer (n=2416), followed by lung and bronchial cancer (n=855) and colorectal cancer (n=639). Periodontal disease is associated with an increased overall risk of cancer (HR 1.14; 95% CI, 1.08-1.20). Even after excluding smoking, this interfering factor associated with periodontal disease or cancer, the relationship between periodontal disease and overall risk of cancer remains the same (HR 1.12; 95% CI, 1.04-1.22)!
Among them, women with a history of periodontal disease had the highest risk of esophageal cancer (HR 3.28; 95% CI, 1.64-6.53), followed by gallbladder carcinoma (HR 1.73; 95% CI, 1.01-2.95). Periodontal disease is also associated with breast cancer, lung cancer and melanoma risk.
Dr. Nwizu said: "Esophageal cancer is one of the most deadly cancers, although the cause is still unclear, but chronic inflammation is involved."[2]
In response to this result, Professor Wende believes that "the esophagus is close to the oral cavity, so periodontal pathogens may be more likely to acquire and infect the esophageal mucosa and promote cancer risk in this area."[2]
Seeing such data, the singularity cake could not help but query the cancer data of our country. According to authoritative statistics, in 2015, there were about 4.29 million new cases of cancer in China and about 2.81 million cancer deaths. Among them, esophageal cancer is the third most common cancer in men and the fifth most common cancer in women; and esophageal cancer is the fourth leading cause of death for men and women due to cancer [11]!
Estimated death toll and cancer in China in 2015
(Image from reference 11)
It seems that this study has important reference significance for our people!
Another important significance of this research is that the selected population is elderly women, and the aging of the population has increased the number of elderly people. This study also opened a window for the disease research of the elderly!
Although the researchers have not conducted a causal relationship study between periodontal disease and cancer risk, the researchers indicated that intervention studies for periodontal disease treatment are needed to determine whether this intervention can reduce the overall risk of cancer or the risk of a particular cancer!
Reference material
[1]http://cebp.aacrjournals.org/content/26/8/1255
[2]http://
[3] Michaud DS, Liu Y, Meyer M, et al. Periodontal disease, tooth loss, and cancer risk in male health professionals: a prospective cohort study[J]. The lancet oncology, 2008, 9(6): 550- 558.
[4] Shu Rong. Progress in the etiology and treatment of periodontal disease[J]. Journal of Shanghai Jiaotong University, 2007, 27(6): 625-628
[5] Eke PI, Dye BA, Wei L, et al. Prevalence of periodontitis in adults in the United States: 2009 and 2010 [J]. Journal of dental research, 2012, 91(10): 914-920.
[6] Rajakaruna GA, Umeda M, Uchida K, et al. Possible translocation of periodontal pathogens into the lymph nodes draining the oral cavity[J]. Journal of Microbiology, 2012, 50(5): 827-836.
[7] Bartlett JG, Gorbach SL, Finegold S M. The bacteriology of aspiration pneumonia [J]. The American journal of medicine, 1974, 56(2): 202-207.
[8] Narikiyo M, Tanabe C, Yamada Y, et al. Frequent and preferential infection of Treponema denticola, Streptococcus mitis, and Streptococcus anginosus in esophageal cancers [J]. Cancer science, 2004, 95(7): 569-574.
[9] Kostic AD, Gevers D, Pedamallu CS, et al. Genomic analysis identifies association of Fusobacterium with colorectal carcinoma [J]. Genome research, 2012, 22(2): 292-298.
[10] Gallimidi AB, Fischman S, Revach B, et al. Periodontal pathogens Porphyromonas gingivalis and Fusobacterium nucleatum promote tumor progression in an oral-specific chemical carcinogenesis model [J]. Oncotarget, 2015, 6(26): 22613.
[11] Chen W, Zheng R, Baade PD, et al. Cancer statistics in China, 2015[J]. CA: a cancer journal for clinicians, 2016, 66(2): 115-132.
Source: Singularity Network (micro signal geekheal_com)
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