Periodontitis and Gastrointestinal Cancer: a Nationwide Cohort Study of NHANES 2009-2014

Overview

Journal BMC Public Health

Publisher Biomed Central

Specialty Public Health

Date 2025 Feb 27

PMID 40016703

Authors

Ke Pu

Ting Luo

Juan Li

Qian Tang

Yang Feng

Guodong Yang

Affiliations

Soon will be listed here.

Abstract

Methods: The data utilized in this study were obtained from the National Health and Nutrition Examination Survey (NHANES) database for the years 2009-2014, which included a total of 10,706 participants from the United States. The incidence and mortality rates of GIT cancer were analyzed in relation to periodontitis. To ensure the reliability of the results, additional adjustments for covariates and stratification analyses were conducted.

Results: In the multivariate logistic regression analysis, various variables such as age, sex, race, BMI, income, education, smoking, alcohol consumption, hypertension, hyperlipidemia, and diabetes mellitus were adjusted for. The analysis revealed no positive association between periodontitis and an increased risk of total cancer or GIT cancer including colorectal cancer. However, periodontitis was found to be significantly associated with higher mortality rates among participants for all-cause (HR: 1.58; 95% CI: 1.26-2.00; P < 0.001), GIT cancer (HR: 1.65; 95% CI: 1.24-2.20; P < 0.001), and colorectal cancer (HR: 1.65; 95% CI: 1.24-2.19; P < 0.001) individually.

Conclusions: The study demonstrates that periodontitis is not associated with an increased risk of incidence for total cancer, or GIT cancer including colorectal cancer. However, it is significantly associated with a higher risk of mortality for all-cause, GIT cancer, and colorectal cancer among participants in the NHANES study.

References

. Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III) final report. Circulation. 2002; 106(25):3143-421. View

Ma H, Zheng J, Li X . Potential risk of certain cancers among patients with Periodontitis: a supplementary meta-analysis of a large-scale population. Int J Med Sci. 2020; 17(16):2531-2543. PMC: 7532473. DOI: 10.7150/ijms.46812. View

Michaud D, Kelsey K, Papathanasiou E, Genco C, Giovannucci E . Periodontal disease and risk of all cancers among male never smokers: an updated analysis of the Health Professionals Follow-up Study. Ann Oncol. 2016; 27(5):941-7. PMC: 4843185. DOI: 10.1093/annonc/mdw028. View

Sung H, Ferlay J, Siegel R, Laversanne M, Soerjomataram I, Jemal A . Global Cancer Statistics 2020: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries. CA Cancer J Clin. 2021; 71(3):209-249. DOI: 10.3322/caac.21660. View

Corbella S, Veronesi P, Galimberti V, Weinstein R, Fabbro M, Francetti L . Is periodontitis a risk indicator for cancer? A meta-analysis. PLoS One. 2018; 13(4):e0195683. PMC: 5903629. DOI: 10.1371/journal.pone.0195683. View

Kitamoto S, Nagao-Kitamoto H, Hein R, Schmidt T, Kamada N . The Bacterial Connection between the Oral Cavity and the Gut Diseases. J Dent Res. 2020; 99(9):1021-1029. PMC: 7375741. DOI: 10.1177/0022034520924633. View

Romandini M, Baima G, Antonoglou G, Bueno J, Figuero E, Sanz M . Periodontitis, Edentulism, and Risk of Mortality: A Systematic Review with Meta-analyses. J Dent Res. 2020; 100(1):37-49. DOI: 10.1177/0022034520952401. View

Coussens L, Werb Z . Inflammation and cancer. Nature. 2002; 420(6917):860-7. PMC: 2803035. DOI: 10.1038/nature01322. View

Boutouyrie P, Chowienczyk P, Humphrey J, Mitchell G . Arterial Stiffness and Cardiovascular Risk in Hypertension. Circ Res. 2021; 128(7):864-886. DOI: 10.1161/CIRCRESAHA.121.318061. View

10.

Li C, Ford E, Zhao G, Tsai J, Balluz L . A comparison of depression prevalence estimates measured by the Patient Health Questionnaire with two administration modes: computer-assisted telephone interviewing versus computer-assisted personal interviewing. Int J Public Health. 2011; 57(1):225-33. DOI: 10.1007/s00038-011-0253-9. View

11.

Wen B, Tsai C, Lin C, Chang Y, Lee C, Hsu C . Cancer risk among gingivitis and periodontitis patients: a nationwide cohort study. QJM. 2013; 107(4):283-90. DOI: 10.1093/qjmed/hct248. View

12.

Chung P, Chan T . Association between periodontitis and all-cause and cancer mortality: retrospective elderly community cohort study. BMC Oral Health. 2020; 20(1):168. PMC: 7285774. DOI: 10.1186/s12903-020-01156-w. View

13.

Nwizu N, Wactawski-Wende J, Genco R . Periodontal disease and cancer: Epidemiologic studies and possible mechanisms. Periodontol 2000. 2020; 83(1):213-233. PMC: 7328760. DOI: 10.1111/prd.12329. View

14.

Nwizu N, Marshall J, Moysich K, Genco R, Hovey K, Mai X . Periodontal Disease and Incident Cancer Risk among Postmenopausal Women: Results from the Women's Health Initiative Observational Cohort. Cancer Epidemiol Biomarkers Prev. 2017; 26(8):1255-1265. PMC: 5551444. DOI: 10.1158/1055-9965.EPI-17-0212. View

15.

Eke P, Page R, Wei L, Thornton-Evans G, Genco R . Update of the case definitions for population-based surveillance of periodontitis. J Periodontol. 2012; 83(12):1449-54. PMC: 6005373. DOI: 10.1902/jop.2012.110664. View

16.

Michaud D, Lu J, Peacock-Villada A, Barber J, Joshu C, Prizment A . Periodontal Disease Assessed Using Clinical Dental Measurements and Cancer Risk in the ARIC Study. J Natl Cancer Inst. 2018; 110(8):843-854. PMC: 6093423. DOI: 10.1093/jnci/djx278. View

17.

Wu J, Li Q, Fu X . Fusobacterium nucleatum Contributes to the Carcinogenesis of Colorectal Cancer by Inducing Inflammation and Suppressing Host Immunity. Transl Oncol. 2019; 12(6):846-851. PMC: 6462820. DOI: 10.1016/j.tranon.2019.03.003. View

18.

Yin T, Cheang I, Zhu X, Liao S, Zhang H, Li X . The J-Curve Association Between Blood Pressure and Mortality in Stroke Survivors. Int J Gen Med. 2021; 14:5039-5049. PMC: 8412835. DOI: 10.2147/IJGM.S326301. View

19.

Chung M, Zhao N, Meier R, Koestler D, Wu G, de Castillo E . Comparisons of oral, intestinal, and pancreatic bacterial microbiomes in patients with pancreatic cancer and other gastrointestinal diseases. J Oral Microbiol. 2021; 13(1):1887680. PMC: 7889162. DOI: 10.1080/20002297.2021.1887680. View

20.

Zhang Y, Sun C, Song E, Liang M, Shi T, Min M . Is periodontitis a risk indicator for gastrointestinal cancers? A meta-analysis of cohort studies. J Clin Periodontol. 2019; 47(2):134-147. DOI: 10.1111/jcpe.13217. View