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Study links gum disease, cancer
Newsday Staff Writer
January 18, 2007
Harvard researchers say they have found strong evidence that gum disease may increase the risk of pancreatic cancer, which is the fourth-leading cause of cancer deaths in the United States.
Gum disease can more than double a person's risk of pancreatic cancer. There are previous researches that suggest people with infected gums may be more prone to some serious illnesses, such as heart disease.
Researchers, using data from the 51,529 participants of the Health Professionals Follow-Up Study, reported on 216 cases of pancreatic cancer during a 16-year period starting in 1986, according to the study published this week in the Journal of the National Cancer Institute.
In a key study finding, researchers reported 67 of those with pancreatic cancer also had periodontal disease, and there was a 63 percent higher risk of developing pancreatic cancer when compared to those reporting no gum disease after adjusting for age, smoking, diabetes, body mass index and a number of other factors, according to the study.
"Most convincing was our finding that never-smokers [with gum disease] had a two-fold increase in risk of pancreatic cancer," the lead study author, Dominique Michaud, said in a statement. Previous studies have identified smoking as a high risk factor for developing pancreatic cancer. Michaud, assistant professor of epidemiology at the Harvard School of Public Health, said in a statement that the findings "may provide some new insights into the mechanism of this highly fatal disease."
But Dr. John W. Birk, assistant professor of clinical medicine at Stony Brook University Medical Center, said the findings might not have a practical application.
"Epidemiological risk factors are not always that helpful in diagnosing the disease because the incidents are low and the cancer occurs sporadically," said Birk, who routinely treats and diagnoses pancreatic cancer.
Study researchers speculated that explanations may include systemic inflammation caused by gum disease, which is believed to contribute to increased levels of carcinogenic compounds generated by bacteria in the mouth.
Dr. Eugene Antenucci, a dentist with an office in Huntington, was surprised by the findings. "This is the first I have heard that there is a correlation between gum disease and body cancer," said Antenucci, who did not participate in the study. "It is just another reason ... for people to keep their mouth healthy and clean."
Losing a tooth during the past four years from gum disease was associated with a 2.7-fold increase in cancer of the pancreas.
It isn't clear yet how gum disease leads to pancreatic cancer. The researchers themselves have stressed the need for further studies. Michaud and colleagues suggest that longstanding gum infections trigger a bodywide immune response: inflammation. Inflamed tissues give off chemical signals that promote tumor growth.
The pancreas produces enzymes that contribute to the digestion of food and it also secretes hormones which maintain and regulate body sugar levels, among other things.
The most common periodontal diseases are gingivitis and periodontitis. Gingivitis is a milder and reversible form of gum disease that only affects the gums. Gingivitis may lead to more serious, destructive forms of gum disease called periodontitis.
Factors that increase the risk of gum disease are smoking or chewing tobacco, bridges that no longer fit properly, crooked teeth, fillings that need changing. Bleeding gums, or red, swollen gums are warning signs, as well as persistent bad breath or taste, permanent teeth that are loose or falling, changes in the way your teeth fit together when you bite etc.
Doctors recommend regular dental checkups, because sometimes there are no warning signs to a gum disease.
The authors noted that their study was limited by the fact that periodontal disease was self-reported, and the incidence may have been subject to measurement error.
Poor Oral Health Poses Increased Risk of Developing Pancreatic Cancer
According to an article recently published in the Journal of the National Cancer Institute, men with poor oral health have a significantly increased risk of developing pancreatic cancer over those with good oral health.
The pancreas is an organ that is surrounded by the stomach, small intestine, bile ducts (tubes that connect the liver to the small intestine), gallbladder, liver, and spleen. The pancreas helps the body to break down food and produces hormones, such as insulin, to regulate the body's storage and use of food.
There are approximately 33,730 new cases of pancreatic cancer diagnosed in the United States every year, with 32,200 deaths attributed to this disease annually. Pancreatic cancer is the fourth leading cause of cancer deaths in the United States.
The majority of patients are diagnosed with pancreatic cancer once it has spread from the pancreas to distant sites in the body, a stage referred to as metastatic pancreatic cancer. The reason that the majority of pancreatic cancers are diagnosed at such a late stage is that the disease usually causes no symptoms until it has spread. As well, there are no universal screening methods for the disease.
Due to the lethal nature of pancreatic cancer, understanding risk factors that contribute to its development is critical. Greater understanding of these risk factors may help identify patients who are at a high risk so that they may undergo regular screening for the disease and thus be diagnosed and treated early. This understanding may also allow individuals at high risk to reduce their risk by altering certain behaviors.
Researchers from Massachusetts and Puerto Rico recently conducted a clinical study to evaluate the potential association between oral health and the development of pancreatic cancer. This study included 51, 529 male health professionals between the ages of 40-75 years who were followed for 16 years. Data on periodontal (gum) disease were obtained at the beginning of the trial and every year thereafter. Data involving several other factors, including smoking (a known risk factor for pancreatic disease), were also collected. Overall, 216 patients were diagnosed with pancreatic cancer during the study.
- A history of periodontal disease increased the risk of developing pancreatic cancer by 64%.
- Among individuals who had never smoked, the risk of developing pancreatic cancer more than doubled for those with a history of periodontal disease compared to those with no history of periodontal disease.
- The greater the severity of periodontal disease, the greater the risk for developing pancreatic cancer.
The researchers concluded that periodontal disease significantly increases the risk of developing pancreatic cancer among men. These results provide more data to support a relationship between good oral health and overall health.
Reference: Michaud D, Joshipura K, Giovannucci E, Fuchs C, et al. A prospective study of periodontal disease and pancreatic cancer in U.S. male health professionals. Journal of the National Cancer Institute. 2007; 99:171-175.
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