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Cancer Epidemiol Biomarkers Prev. 2016 Jan;25(1):43-50. doi: 10.1158/1055-9965.EPI-15-0750. Epub 2015 Dec 21.

Periodontal Disease and Breast Cancer: Prospective Cohort Study of Postmenopausal Women.

Author information

1
Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, University at Buffalo, State University of New York, Buffalo, New York. jfreuden@buffalo.edu.
2
Department of Oral Biology, School of Dental Medicine, University at Buffalo, State University of New York, Buffalo, New York.
3
Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, University at Buffalo, State University of New York, Buffalo, New York.
4
Department of Diagnostic and Biomedical Sciences, School of Dentistry, The University of Texas Health Science Center at Houston School of Dentistry, Houston, Texas.
5
Department of Ophthalmology and Visual Sciences, University of Michigan, Ann Arbor, Michigan.

Abstract

BACKGROUND:

Periodontal disease has been consistently associated with chronic disease; there are no large studies of breast cancer, although oral-associated microbes are present in breast tumors.

METHODS:

In the Women's Health Initiative Observational Study, a prospective cohort of postmenopausal women, 73,737 women without previous breast cancer were followed. Incident, primary, invasive breast tumors were verified by physician adjudication. Periodontal disease was by self-report. HRs and 95% confidence intervals (CI) were estimated by Cox proportional hazards, adjusted for breast cancer risk factors. Because the oral microbiome of those with periodontal disease differs with smoking status, we examined associations stratified by smoking.

RESULTS:

2,124 incident, invasive breast cancer cases were identified after mean follow-up of 6.7 years. Periodontal disease, reported by 26.1% of women, was associated with increased breast cancer risk (HR 1.14; 95% CI, 1.03-1.26), particularly among former smokers who quit within 20 years (HR 1.36; 95% CI, 1.05-1.77). Among current smokers, the trend was similar (HR 1.32; 95% CI, 0.83-2.11); there were few cases (n = 74) and the CI included the null. The population attributable fraction was 12.06% (95% CI, 1.12-21.79) and 10.90% (95% CI, 10.31-28.94) for periodontal disease among former smokers quitting within 20 years and current smokers, respectively.

CONCLUSION:

Periodontal disease, a common chronic inflammatory disorder, was associated with increased risk of postmenopausal breast cancer, particularly among former smokers who quit in the past 20 years.

IMPACT:

Understanding a possible role of the oral microbiome in breast carcinogenesis could impact prevention.

Comment in

PMID:
26689418
PMCID:
PMC4713270
DOI:
10.1158/1055-9965.EPI-15-0750
[Indexed for MEDLINE]
Free PMC Article

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