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Gum disease 'increases gastric and oesophageal cancer' risk

Tuesday July 21st 2020

People with periodontal disease may be at increased risk of developing oesophageal and gastric cancer, researchers say today.

Although previous findings on the association between gum disease and tooth loss with those cancers have been inconsistent, a prospective study by researchers at the Harvard T.H. Chan School of Public Health, in Boston, Mass, supports the importance of oral microbiome in oesophageal and gastric cancer.

The team carried out a study of data on patients over decades of follow up, examining the association of history of periodontal disease and tooth loss with the risk of oesophageal 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).

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

The risks of oesophageal and gastric cancer for those who lost two or more teeth were 42% and 33% higher respectively.

In a letter to Gut, the authors suggest tannerella forsythia and porphyromonas gingivalis were associated with the increased cancer risk, supporting evidence from previous studies that pointed to those periodontal pathogens.

They add that poor oral hygiene and periodontal disease could promote the formation of endogenous nitrosamines, which are known to cause gastric cancer through nitrate-reducing bacteria.

Although no firm conclusions can be made from the observational study, the researchers conclude: “Together, these data support the importance of oral microbiome in oesophageal and gastric cancer. Further prospective studies that directly assess oral microbiome are warranted to identify specific oral bacteria responsible for this relationship. The additional findings may serve as readily accessible, non-invasive biomarkers and help identify individuals at high risk for these cancers.”

Lo C-H, Kwon S, Wang l et al. Periodontal disease, tooth loss, and risk of oesophageal and gastric adenocarcinoma: a prospective study. Gut 20 July 2020; doi 10.1136/gutjnl-2020-321949

Tags: Cancer | Gastroenterology | North America

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