• 5/23/2008
  • Ketchum, ID
  • staff
  • CancerConsultants.com

Three recent publications have suggested an association between periodontal disease and/or tooth loss and an increased risk of developing cancer.

There are many factors associated with an increased or decreased risk of developing various types of cancer. Until recently there had been few studies looking at the association between periodontal disease and/or tooth loss and the risk of developing various types of cancer. However, periodontal disease and/or tooth loss has been the subject of several recent studies; three of these studies are summarized here.

Japanese researchers have reported that there is a significant association between tooth loss and risk of cancers of the head and neck, esophagus, and lung. The details of this study were published in the May 1, 2008 issue of Cancer Epidemiology, Biomarkers & Prevention.1 They looked at 5,240 patients with cancer and 10,480 control patients without cancer. They categorized patients into four groups based on the number of remaining teeth. They found that a decreased number of remaining teeth was associated with a 68% increased risk of head and neck cancer and a more than double increase in the risk of esophageal and lung cancer.

Researchers from the Imperial College London and Harvard School of Public Health have reported that periodontal disease was associated with an increase in overall cancer risk in never smokers.2 This study looked at 48,375 male health professionals with a follow-up of over 17 years. There were 5,720 persons with cancer, excluding non-melanoma skin cancer and non-aggressive prostate cancer. Persons with periodontal disease had a 14% increased in cancer risk. This included a 36% increase in lung cancer risk, a 49% increase in kidney cancer risk, a 54% increase in pancreatic cancer risk, and a 30% increase in hematologic cancer risk. Fewer teeth were associated with an increased risk of lung cancer. In never-smokers periodontal disease was associated with a 21% increased risk of total cancers and a 35% increase in hematologic cancers. There was no association between tooth loss and lung cancer in non-smokers.

Researchers from Harvard reviewed the evidence for an association between the risk of cancer and periodontal disease and/or tooth loss.3 They reported that periodontal disease has been associated with increased risk of oral, upper gastrointestinal, lung, and pancreatic cancers in different populations. These associations are still present when corrected for smoking and socioeconomic status.

Comments:
These are important findings, but the underlying cause for these associations is unclear. One hypothesis is that periodontal disease and tooth loss reflects an immune deficiency, which is also associated with an increased risk of cancer. One important issue that is unresolved is whether or not prevention of periodontal disease can lower the risk of developing cancer.

References:
1 Hiraki A, Matsuo K, Takeshi S, et al. Teeth loss and risk of cancer at 14 common sites in Japanese. Cancer Epidemiology, Biomarkers and Prevention. 2008;17:1222-1227.

2 Michaud DS, Liu Y, Meyer M, et al. Periodontal disease, tooth loss, and cancer risk in male health professionals: a prospective cohort study. Lancet Oncology [early online publication]. May 5, 2008.

[3] Meyer, MS, Joshipura K, Giovannucci E, et al. A review of the relationship between tooth loss, periodontal disease and cancer. Cancer Causes Control [early online publication]. May 14, 2008.