Gum
Disease Linked to Cancer Risk
Esophageal, breast and lung cancer,
among others, seen in postmenopausal women in large study
TUESDAY, Aug. 1,
2017 (HealthDay News) -- A new study links gum disease with an
increased risk of several types of cancer in postmenopausal women, even in women who never
smoked.
So-called
periodontal disease was tied to a 14 percent higher risk of developing any type
of cancer, the
investigators found. But the greatest risk was for esophageal cancer, which
was more than three times more likely in older women who had gum disease than
those who didn't.
In addition, gum
disease was associated with a higher risk of lung
cancer, gallbladder cancer, melanoma and breast
cancer, the findings showed.
"These findings
may provide a new target to test an intervention for cancer prevention -- oral
hygiene and periodontal disease treatment and prevention," said lead
researcher Jean Wactawski-Wende. She is dean of the School of Public Health and
Health Professions at the State University of New York at Buffalo.
Breast cancer, lung
cancer and gallbladder cancer were linked with higher risk among women who
smoked and had gum disease.
For those women who
never smoked but had gum disease, other cancers, such as melanoma, were
associated with higher risk, the researchers said.
Although gum disease
has been associated with heart disease, the exact reason it may be tied to an
increased risk of cancer isn't known, Wactawski-Wende said.
She speculated that
gum disease could be a marker for overall health.
"However, there
is real potential for local and systemic inflammation resulting from the
bacteria in the oral cavity reaching other sites through ingestion or
inhalation, as well as bacteria entering the bloodstream through oral
tissues," Wactawski-Wende said.
Because this study
doesn't prove a direct cause-and-effect relationship, a study designed to look
specifically at poor oral hygiene and the association with cancer could help
define what might link the two, experts said.
For the study, the
investigators collected data on nearly 66,000 women, aged 54 to 86, who took
part in the Women's Health Initiative Observational Study.
The women reported
gum disease on questionnaires given between 1999 and 2003. The researchers
monitored the cancer outcomes through September 2013.
Over an average follow-up
of eight years, the researchers identified nearly 7,200 cases of cancer.
One limitation of
the study is that the women self-reported their gum disease, according to
dental and cancer experts.
Dr. Ronald Burakoff,
chair of dental medicine at North Shore University Hospital in Manhasset, N.Y.,
was not involved with the study but was familiar with the findings.
"There may be a
connection between gum disease and cancer, but we really can't tell how strong
it is because the gum disease is self-reported," Burakoff said.
More research is
needed to really define the connection, he added. "If you eliminate
periodontal disease, however, it may reduce your risk of having cancer,"
Burakoff suggested.
People should be on
the lookout for the telltale signs of gum disease, namely bleeding gums when
you brush and loose teeth, he advised.
According to Dr.
Stephanie Bernik, chief of surgical oncology at Lenox Hill Hospital in New York
City, "The findings in this study certainly point to a need to further
investigate the association between periodontal disease and cancer."
The link may not be
direct, but could simply be that those with poor oral hygiene are less likely
to take care of themselves in other ways, she noted.
"Perhaps those
with poor oral hygiene have poor diets, are overweight, lack exercise or drink
in excess, all of which have been shown to increase the risk of cancer,"
Bernik said.
The report was
published Aug. 1 in the journal Cancer
Epidemiology, Biomarkers & Prevention.
Another compelling reason to brush your pearly whites: Bum gums
boosts the risk of cancer for older women, according to a new study.
University of Buffalo researchers concluded that from data on
65,000 postmenopausal subjects between the ages of 54 and 86 enrolled in the
ongoing Women’s
Health Initiative.
Investigators
focused on periodontal health and a question in which women were asked if a
dentist or dental hygienist ever told them they had periodontal or gum disease.
Women
who reported a history of gum disease had a 14% increased risk of overall
cancer. Of the 7,149 cancers that occurred in the study participants, the
majority — or 2,416 — were breast cancer.
Certain other “anatomic sites appear to be vulnerable” as
well, researchers
concluded in the study published Aug. 1 in the journal Cancer
Epidemiology, Biomarkers & Prevention. The risk for esophageal cancer and
gallbladder cancer — which have both been tied to chronic inflammation — were
also significant.
“Our
study was sufficiently large and detailed enough to examine not just overall
risk of cancer among older women with periodontal disease, but also to provide
useful information on a number of cancer-specific sites,” said lead author and
epidemiology professor Jean Wactawski-Wende, Ph.D.
Researchers noted that this is the first study to
report a link between gum health and gallbladder cancer. More study is needed
to fully understand the link between periodontal disease and cancer.
Women with gum disease may need to watch out for cancer
New research has confirmed
that periodontal disease is tied to an elevated risk of several types of
cancer, such as esophageal cancer, breast cancer, and gallbladder cancer,
especially in mature women.
Periodontal
disease, or gum
disease, is also known as "periodontitis"
and it is caused by infection and inflammation of
the gums. It affects many adults and it is particularly common among seniors.
According to the Centers for Disease Control and Prevention (CDC), gum disease
affects over 70 percent of people aged 65 and above in the
United States.
Although
the CDC note that this disease affects more men than women, a significant
proportion (38.4 percent) of the adult female U.S. population live
with periodontitis.
Recent research has shown that women with gum disease
are also more likely to develop breast
cancer. However, until now, no studies had looked at the impact of
periodontitis on cancer risk more generally.
Jean
Wactawski-Wende, Ph.D., from the State University of New York at Buffalo - in
collaboration with colleagues from other U.S. institutions - has, for the first
time, investigated the association between gum disease and several types of
cancer in women.
The
study confirmed previous findings, but it also revealed previously undetected
connections, such as the link between gum disease and gallbladder cancer.
The findings are published in the journal Cancer Epidemiology, Biomarkers &
Prevention.
Periodontitis increases overall cancer risk
To
understand the correlation between periodontal disease and the risk of cancer
in women, the researchers worked with a cohort of 65,869 female participants
from the Women's Health Initiative Observational Study. The
women were aged between 54 and 86, and most of them were white, non-Hispanic.
The
participants reported their gum disease diagnoses through questionnaires
between 1999 and 2003, and they were monitored for cancer detection up until
September 2013.
On
average, the follow-up period for each participant was of 8.32 years. At the
end of this period, 7,149 women had been diagnosed with a form of cancer.
The
researchers found that women who had reported a diagnosis of periodontal
disease had a 14 percent higher risk of developing any type of cancer.
Esophageal
cancer was the type most frequently associated with gum disease, as women with
periodontitis were more than three times likelier to develop it compared with
women without oral health problems.
"The
esophagus is in close proximity to the oral cavity, and so periodontal
pathogens may more easily gain access to and infect the esophageal mucosa and
promote cancer risk at that site," explains Dr. Wactawski-Wende.
Other
types of cancer that exhibited a significant association with gum disease
were lung cancer, gallbladder cancer, melanoma,
or skin cancer, and
breast cancer.
Association with gallbladder cancer reported
The association
between periodontitis and gallbladder cancer was a new discovery, according to
the researchers.
Lead author Dr. Ngozi
Nwizu, from the University of Texas School of Dentistry in Houston, TX,
emphasizes the importance of this finding.
"Chronic inflammation
has also been implicated in gallbladder cancer, but there has been no data on
the association between periodontal disease and gallbladder risk. Ours is the
first study to report on such an association."
Dr. Wactawski-Wende
and her colleagues also found a strong link between gum disease and breast cancer,
lung cancer, and gallbladder cancer in the case of women who smoked. Especially
significant, according to Dr. Nwizu, were the verdicts on gallbladder cancer
and cancer of the esophagus.
Esophageal cancer
still has no known causes, so the researchers hope that this will be the first
step in gaining a better understanding of its formation.
"Esophageal
cancer ranks among the most deadly cancers and its etiology is not well known,
but chronic inflammation has been implicated," says Dr. Nwizu. The next
step, she suggests, will be to determine whether bacteria linked to gum disease
also play a role in inflammation related to esophageal cancer:
"Certain
periodontal bacteria have been shown to promote inflammation [...], and these
bacteria have been isolated from many organ systems and some cancers including
esophageal cancers. It is important to establish if periodontal disease is an
important risk of esophageal cancer, so that appropriate preventive measures
can be promoted."
Underlying mechanisms remain mysterious
What exactly causes
the link between periodontitis and various types of cancer is yet to be
understood. One explanation offered by the researchers is that bacteria and
other pathogens from the mouth might make their way into the bloodstream
through saliva or diseased gum tissue.
In this way,
pathogens could reach various parts of the body and be involved in the process
of cancer formation. However, more research needs to be carried out in this
direction to establish the actual mechanism at play.
The researchers
acknowledge that their study faced some limitations - mainly the fact that the
data used for the analysis were self-reported by the participants, so they may
not have been entirely accurate.
Nevertheless, Dr.
Wactawski-Wende and her colleagues place their confidence in the extensive size
of the population sample, emphasizing the comprehensiveness of their study and
the impact of their novel findings.
"Our study was
sufficiently large and detailed enough to examine not just overall risk of
cancer among older women with periodontal disease, but also to provide useful
information on a number of cancer-specific sites," conclude the
researchers.
.
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