Periodontal disease, tooth loss and colorectal cancer risk: Results from the Nurses' Health Study
Fatemeh Momen-Heravi, Ana Babic, Shelley S Tworoger, Libin Zhang, Kana Wu, Stephanie A Smith-Warner, Shuji Ogino, Andrew T Chan, Jeffrey Meyerhardt, Edward Giovannucci, Charles Fuchs, Eunyoung Cho, Dominique S Michaud, Meir J Stampfer, Yau-Hua Yu, David Kim, Xuehong Zhang, Fatemeh Momen-Heravi, Ana Babic, Shelley S Tworoger, Libin Zhang, Kana Wu, Stephanie A Smith-Warner, Shuji Ogino, Andrew T Chan, Jeffrey Meyerhardt, Edward Giovannucci, Charles Fuchs, Eunyoung Cho, Dominique S Michaud, Meir J Stampfer, Yau-Hua Yu, David Kim, Xuehong Zhang
Abstract
Periodontal diseases including tooth loss might increase systemic inflammation, lead to immune dysregulation and alter gut microbiota, thereby possibly influencing colorectal carcinogenesis. Few epidemiological studies have examined the association between periodontal diseases and colorectal cancer (CRC) risk. We collected information on the periodontal disease (defined as history of periodontal bone loss) and number of natural teeth in the Nurses' Health Study. A total of 77,443 women were followed since 1992. We used Cox proportional hazard models to calculate multivariable hazard ratios (HRs) and 95% confidence intervals (95% CIs) after adjustment for smoking and other known risk factors for CRC. We documented 1,165 incident CRC through 2010. Compared to women with 25-32 teeth, the multivariable HR (95% CI) for CRC for women with <17 teeth was 1.20 (1.04-1.39). With regard to tumor site, the HRs (95% CIs) for the same comparison were 1.23 (1.01-1.51) for proximal colon cancer, 1.03 (0.76-1.38) for distal colon cancer and 1.48 (1.07-2.05) for rectal cancer. In addition, compared to those without periodontal disease, HRs for CRC were 0.91 (95% CI 0.74-1.12) for periodontal disease, and 1.22 (95% CI 0.91-1.63) when limited to moderate to severe periodontal disease. The results were not modified by smoking status, body mass index or alcohol consumption. Women with fewer teeth, possibly moderate or severe periodontal disease, might be at a modest increased risk of developing CRC, suggesting a potential role of oral health in colorectal carcinogenesis.
Keywords: colorectal cancer; microbiota; oral health; periodontal disease; tooth loss.
Conflict of interest statement
The authors declare that they have no conflicts of interest.
© 2016 UICC.
Source: PubMed