Periodontal Disease and Cancer Risk: Another Reason to Floss

Summary and Comment from Womens Health September 15, 2017

Anna Wald, MD, MPH  reviewing Nwizu NN et al. Cancer Epidemiol Biomarkers Prev 2017 Aug. 

Postmenopausal women with periodontal disease had excess risk for cancer of the breast, lung, esophagus, and gallbladder and for melanoma.

Periodontal diease has been linked to adverse reproductive outcomes in women, and some studies also suggest an increased risk for cancer. Investigators for the Womens Health Inititave Observational Study examined rates of incident cancer in >65,000 women (mean age, 68:85% white) who were asked about periodontal disease at baseline and followed for a mean of 8 years.

Risk for developing any cancer was 14% higher among women with periodontal disease than among those without gum disease. Statistically exess risks were also noted for cancer of the breast (13%), lung (31%), esophagus (>200%), and gallbladder (73%), and for melanoma (23%). Results were similar regardless of smoking status.

Comment:

Its unclear wether the association between periodontal disease and oncogenesis is casual. However, some studies have shown bacteria associated with periodontitis in tumors or distal tissues such as lymph nodes, and the strikingly high risk for esophageal cancer is consistent with tracing of periodontal pathogens to the gut. Perio dontal disease is also indicative of a systemic proinflammatory state that msy contribute to risk for preterm birth, although treatment of periodontal disease during pregnancy does not abrogate this increased risk (NEJMJW Womens Health Apr 2010 and Am J Obstet Gynecol 2010; 202:147 .e1). Whether treating periodontal disease will lower the increased risk for malignancy is unknown. I find a careful examination of the mouth helpful, as it tells me about the general health of the patient- and it may precipitate referral for dental care. Now, I will also think about the patients risk for cancer.