[Lifestyle] Gum disease can increase risk of esophageal and gastric cancer

[G h o s t l y.]

 
 

People who have periodontal disease, called gum disease, may be at increased risk of developing some forms of cancer, suggests a letter published in Gut magazine detailing a prospective study.
 

American researchers found that a history of periodontal disease appeared to be associated with an increased risk of esophageal cancer and gastric cancer, and this risk was also higher among people who had previously lost teeth.
 

Previous findings regarding the relationship of periodontal disease and tooth loss to esophageal and gastric cancer had been inconsistent. Therefore, a team of researchers from the Harvard TH Chan School of Public Health in the United States conducted a study of data on patients over decades of follow-up.
 

They examined the association of a history of periodontal disease and tooth loss with esophageal and gastric cancer risk in 98,459 women from the Nurses' Health Study (1992-2014) and 49,685 men from the Health Professionals Follow-up Study (1988-2016 ).

Dental measures, demographics, lifestyle, and diet were assessed using follow-up questionnaires and the self-reported cancer diagnosis was confirmed after reviewing medical records.
 

The results showed that during 22-28 years of follow-up, there were 199 cases of esophageal cancer and 238 cases of gastric cancer. A history of periodontal disease was associated with a 43% and 52% increased risk of esophageal cancer and gastric cancer, respectively.

Compared to people without tooth loss, the risks of esophageal and gastric cancer for those who lost two or more teeth were also moderately higher: 42% and 33%, respectively.
Furthermore, among individuals with a history of periodontal disease, the absence of tooth loss and the loss of one or more teeth were also associated with a 59% increased risk of esophageal cancer compared to those without a history of periodontal disease. and without loss of teeth. Similarly, the same group of individuals had a 50% and 68% higher risk of gastric cancer, respectively.
 

The authors point to possible reasons for an association between oral bacteria (oral microbiota) and esophageal and gastric cancer, with evidence from other studies suggesting that tannerella forsythia and porphyromonas gingivalis, members of the 'red complex' of periodontal pathogens, were associated with the presence or risk of esophageal cancer.

Another possible reason is that poor oral hygiene and periodontal disease could promote the formation of endogenous nitrosamines that are known to cause gastric cancer through nitrate-reducing bacteria.
 

This was an observational study, so no firm conclusions about cause and effect can be drawn, and the researchers cannot rule out the possibility that some of the observed risk may be due to other unmeasured factors.
However, they conclude that, "together, these data support the importance of the oral microbiome in esophageal and gastric cancer. Additional prospective studies that directly assess the oral microbiome are warranted to identify the specific oral bacteria responsible for this relationship," they suggest. The additional findings can serve as easily accessible non-invasive biomarkers and help identify individuals at high risk for these cancers. "