According to experts, individuals with a history of gum disease tend to be at an increased risk of contracting esophageal and gastric cancer.
People who have periodontal (gum) disease may have a higher risk of developing some forms of cancer, suggests a letter published in the journal Gut detailing a prospective study.Chun-Han Lo, Sohee Kwon, Liang Wang, Georgios Polychronidis, Markus D Knudsen, Rong Zhong, Yin Cao, Kana Wu, Shuji Ogino, Edward L Giovannucci, Andrew T Chan, Mingyang Song. Periodontal disease, tooth loss, and risk of oesophageal and gastric adenocarcinoma: a prospective study. Gut, 2020; gutjnl-2020-321949 DOI: 10.1136/gutjnl-2020-321949
Researchers in the United States discovered that a history of periodontal illness tended to be correlated with an increased incidence of esophageal (gullet) and gastric (stomach) cancer, which was also increased in individuals who had recently lost teeth. The association between periodontal disorder and tooth loss and esophageal and gastric cancer has been inconsistent in the past. As a result, a team of researchers from Harvard T.H. Chan School of Public Health in Boston, USA, conducted a survey of patient records spanning decades.
They investigated the relationship between a history of periodontal disease and tooth loss and the incidence of esophageal and gastric cancer in 98,459 women from the Nurses’ Health Study (1992–2014) and 49,685 men from the Health Professionals Follow-up Study (1988-2016). Follow-up questionnaires were used to determine dental measures, demographics, lifestyle, and nutrition, and self-reported cancer diagnosis was validated by examining medical reports.
The findings indicated that within 22 and 28 years of follow-up, 199 cases of esophageal cancer and 238 cases of gastric cancer occurred. Periodontal disorder was linked to a 43% and 52% elevated incidence of esophageal and gastric cancer, respectively. In comparison to those who had no tooth loss, those who lost two or three teeth had a somewhat increased chance of esophageal and gastric cancer — 42 percent and 33%, respectively.
Additionally, people with a history of periodontal disease were similarly correlated with a 59 percent elevated risk of esophageal cancer if they had no tooth loss or lost one or two teeth, relative to those with no history of periodontal disease and no tooth loss. Similarly, the same number of people faced a 50% and 68% increased chance of developing gastric cancer, respectively.
The authors discuss alternative explanations for the relationship between oral bacteria (oral microbiota) and esophageal and gastric cancer, citing data from other research that tannerella forsythia and porphyromonas gingivalis – representatives of the periodontal pathogen’red complex’ – were correlated with the occurrence or risk of esophageal cancer. Another possibility is that bad oral hygiene and periodontal disease facilitate the development of endogenous nitrosamines, which have been linked to gastric cancer, through nitrate-reducing bacteria. Since this was an empirical analysis, no definitive assumptions regarding cause and effect can be taken, and the researchers cannot rule out the likelihood that any of the reported danger is attributable to unmeasured (confounding) influences.
They conclude, however, as follows: “Taken together, these findings underscore the critical role of the oral microbiota in esophageal and gastric cancer. Additional prospective research assessing the oral microbiota specifically are essential to determine the particular oral bacteria responsible for this interaction. Additionally, the results can serve as readily available, non-invasive biomarkers, assisting in the identification of individuals at high risk for developing these cancers.”