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Cancer Epidemiol Biomarkers Prev. 2017 Aug;26(8):1255-1265. doi: 10.1158/1055-9965.EPI-17-0212.

Periodontal Disease and Incident Cancer Risk among Postmenopausal Women: Results from the Women's Health Initiative Observational Cohort.

Author information

1
Department of Diagnostic and Biomedical Sciences, School of Dentistry, The University of Texas Health Science Center at Houston, Houston, Texas.
2
Department of Cancer Prevention and Control, Roswell Park Cancer Institute, Buffalo, New York.
3
Department of Epidemiology and Environmental Health, University at Buffalo, State University of New York, Buffalo, New York.
4
Department of Oral Biology, University at Buffalo, State University of New York, Buffalo, New York.
5
Department of Epidemiology and Environmental Health, University at Buffalo, State University of New York, Buffalo, New York. jww@buffalo.edu.
6
Department of Gynecology-Obstetrics, University at Buffalo, State University of New York at Buffalo, Buffalo, New York.

Abstract

Background: Periodontal pathogens have been isolated from precancerous and cancerous lesions and also shown to promote a procarcinogenic microenvironment. Few studies have examined periodontal disease as a risk factor for total cancer, and none have focused on older women. We examined whether periodontal disease is associated with incident cancer among postmenopausal women in the Women's Health Initiative Observational Study.Methods: Our prospective cohort study comprised 65,869 women, ages 54 to 86 years. Periodontal disease information was obtained via self-report questionnaires administered between 1999 and 2003, whereas ascertainment of cancer outcomes occurred through September 2013, with a maximum follow-up period of 15 years. Physician-adjudicated incident total cancers were the main outcomes and site-specific cancers were secondary outcomes. HRs and 95% confidence intervals (CI) were calculated using Cox proportional hazards regression. All analyses were conducted two-sided.Results: During a mean follow-up of 8.32 years, 7,149 cancers were identified. Periodontal disease history was associated with increased total cancer risk (multivariable-adjusted HR, 1.14; 95% CI, 1.08-1.20); findings were similar in analyses limited to 34,097 never-smokers (HR, 1.12; 95% CI, 1.04-1.22). Associations were observed for breast (HR, 1.13; 95% CI, 1.03-1.23), lung (HR, 1.31; 95% CI, 1.14-1.51), esophagus (HR, 3.28; 95% CI, 1.64-6.53), gallbladder (HR, 1.73; 95% CI, 1.01-2.95), and melanoma skin (HR, 1.23; 95% CI, 1.02-1.48) cancers. Stomach cancer was borderline (HR, 1.58; 95% CI, 0.94-2.67).Conclusions: Periodontal disease increases risk of total cancer among older women, irrespective of smoking, and certain anatomic sites appear to be vulnerable. Impact: Our findings support the need for further understanding of the effect of periodontal disease on cancer outcomes. Cancer Epidemiol Biomarkers Prev; 26(8); 1255-65. ©2017 AACR.

PMID:
28765338
PMCID:
PMC5551444
DOI:
10.1158/1055-9965.EPI-17-0212
[Indexed for MEDLINE]
Free PMC Article

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