Gum Disease Increases Risk of Cancer in Postmenopausal Women

History of periodontal disease was associated with a 14 percent higher risk of developing any cancer in postmenopausal women, finds a new study

Highlights:

Postmenopausal women with gum disease are at higher risk of developing several types of cancer
The risk of developing cancer was higher even in women who had never smoked
The risk of gallbladder and esophageal cancers were higher among postmenopausal women with a history of gum disease

Gum disease was associated with increased risk of cancer in postmenopausal women, finds a study that involved more than 65,000 women. A research team at the State University of New York at Buffalo conducted a study to find an association between gum or periodontal disease and gallbladder cancer risk in women.

"This study is the first national study focused on women, particularly older women. 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 Jean Wactawski-Wende, the study's senior author.

Risk of Cancer in Postmenopausal Women with Gum Disease

The research team conducted a study that included 65,869 postmenopausal women to investigate the risk of cancer. The participants had enrolled in the Women’s Health Initiative, an ongoing national prospective study designed to investigate factors that affect disease and death risk in older American women. Most of the participants were non-Hispanic white women, and their average age was 68.

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University of Buffalo researchers found that among all women, the risk of breast cancer was 14 percent higher in women who had periodontal disease.

‘Gum disease was associated with a 14 percent higher risk of developing any cancer in postmenopausal women. The association was higher for esophageal cancer’

The participants answered a follow-up health questionnaire, of which one question was: “Has a dentist or dental hygienist ever told you that you had periodontal or gum disease.

The findings showed that women who reported a history of gum disease had a 14 percent increased risk of overall cancer. A total of 7,149 cancers were reported among the study participants. Of the 7,149 cancers, the majority (2,416) were breast cancer. Periodontal disease was associated with total cancer risk among former and current smokers.

"There is increasing evidence that periodontal disease may be linked to an increased cancer risk and this association warrants further investigation," said, Ngozi Nwizu, the paper’s first author and assistant professor of oral and maxillofacial pathology at the University of Texas Health Science Center at Houston.

Esophageal and Gallbladder Cancer Risk

Periodontal disease increased the risk of esophageal cancer. The esophagus is in proximity to the oral cavity, and periodontal pathogens may easily infect the esophageal mucosa and promote cancer risk at that site, said, Wactawski-Wende, dean of UB's School of Public Health and Health Professions and a professor of epidemiology and environmental health.

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The risk of gallbladder cancer was also high in women with periodontal disease. “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," said Nwizu.

The findings of the study are significant because esophageal cancer ranks among the most deadly cancers. The etiology of esophageal cancer is not well known, but the chronic inflammation has been implicated.

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Certain gum disease pathogens have been shown to promote inflammation even in tiny amounts. These bacteria have been isolated from many organs and some cancers including esophageal cancers. It is important to establish gum disease as a risk factor for esophageal cancer so that appropriate preventive measures can be taken.

The findings of the study are important because they offer a window into the disease in a population of Americans that continue to increase as people live longer lives.

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The research team also found significantly higher risk of lung cancer, gallbladder cancer, melanoma, and breast cancer. Cancers of the lung, breast, and gallbladder were higher among postmenopausal women who smoked and had gum disease. However, the risk of melanoma was higher among women who never smoked, but had gum disease.

Gum disease pathogens could be carried in saliva and dental plaque into the blood circulation to reach other organs and contribute to the development of cancer.

Older adults are more disproportionately affected by gum disease than other age groups. For most types of cancers, the process of cancer development usually occurs over many years. The adverse effects of gum disease are more likely to be seen among postmenopausal women because of their old age.

The findings of the study were published in the journal Cancer Epidemiology, Biomarkers & Prevention.

Gum Disease

Periodontitis is untreated gingivitis that can lead to tooth loss and other health complications. Heart disease, diabetes, pulmonary disease, low-birth weight complications in pregnancy have been linked to periodontal disease. Scientists have found a link between periodontal disease and cancer.

Chronic inflammation has been the reason behind the association between certain types of cancers and periodontitis. Previously conducted studies have shown a link between oral cancer, gastric cancer, pancreatic cancer, and esophageal cancer.

Reference:

Jo L. Freudenheim, Robert J. Genco, Michael J. LaMonte, Amy E. Millen, Kathleen M. Hovey, Xiaodan Mai, Ngozi Nwizu, Christopher A. Andrews, Jean Wactawski-Wende. Periodontal Disease and Breast Cancer: Prospective Cohort Study of Postmenopausal Women. Cancer Epidemiology, Biomarkers & Prevention. (2017) DOI:10.1158/1055-9965.EPI-17-0212

Source-Medindia