Abstract CN16
Background
Although emerging evidence suggests periodontal disease might increase the risk of cancers, comorbidity and lifestyle behaviors, such as smoking or body mass index (BMI), may have confounded the reported association. This study aimed to investigate whether chronic periodontitis is associated with cancer risk.
Methods
We conducted a population-based retrospective cohort study using the Korean National Health Insurance Cohort Database obtained from January 2003 to December 2015. Among a total of 713,201 participants, 53,075 patients who had a history of periodontitis without a cancer history were selected and followed up for ten years from this cohort. Confounding factors included demographic factors (age, sex. Income, residential area), lifestyle behaviors (smoking history, BMI), comorbidities, defined by Charlson Comorbidity Index (CCI), such as hypertension, diabetes, heart failure, pulmonary disease. Multivariable cox regression analysis was applied to estimate the adjusted hazard ratio (aHR).
Results
Among a total of 713,201 participants, 53,075 patients with periodontitis and 660,126 controls were included in this study. During a 10-year follow-up, overall cancer incidence rates were 6,600 and 2,996 per 100,000 person-years in the periodontitis and control groups, respectively. An increased risk of total cancer was observed for participants with periodontitis, compared to participants without periodontitis, adjusting for age, sex, comorbidities using CCI, BMI, and smoking history (aHR, 1.129; 95% confidence interval [CI], 1.089 to 1.171; P < 0.0001). Organ-specifically, significant associations were found in stomach cancer (aHR, 1.136; 95% CI, 1.042-1.239), colorectal cancer (aHR, 1.129; 95% CI, 1.029-1.239), lung cancer (aHR, 1.127; 95% CI, 1.008-1.260), bladder cancer (aHR, 1.307; 95% CI, 1.071-1.595), thyroid cancer (aHR, 1.191; 95% CI, 1.085-1.308), and leukemia (aHR, 1.394; 95% CI, 1.039-1.872), respectively.
Conclusions
Periodontitis disease was associated with a modest but significantly increased risk of cancer, which persisted after controlling confounding factors. The increased risks suggest that systemic effect of oral inflammation might evade host immune system participating cancer immune surveillance.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
This work was supported in part by the National Research Foundation of Korea (NRF) grant funded by the Korea government (MSIT) (2019R1C1C1006709, 2018R1A5A2025079, and 2020M3F7A1094093), a grant of the Korea Health Technology R&D Project through the Korea Health Industry Development Institute (KHIDI), funded by the Ministry of Health & Welfare, Korea (KHIDIHI19C1015010020), \"The Alchemist Project\" through the Ministry of Trade, Industry and Energy (MOTIE, Korea) (20012443), and Severance Hospital Research fund for Clinical excellence (SHRC) (C-2020-0032 and C-2020-0025) (H.S.K.)
Disclosure
All authors have declared no conflicts of interest.