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Wang Q, Gu WJ, Ning FL, Sun M, Zhao ZMG, Abe MU, Li ZN, Zhang CD. Association between Periodontal Diseases and the Risk of Site-Specific Gastrointestinal Cancers: A Systematic Review and Meta-Analysis. J Dent Res 2024:220345241263768. [PMID: 39185624 DOI: 10.1177/00220345241263768] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/27/2024] Open
Abstract
The association between periodontal diseases and the risk of gastrointestinal cancers, especially site-specific gastrointestinal cancers, remains unclear. Here, we comprehensively searched PubMed, EMBASE, Web of Science, and Google Scholar from inception to April 2024 to identify relevant studies. The pooled hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated with a random-effects model. Subgroup analyses and sensitivity analyses were conducted to confirm the robustness of the main findings in different populations. This study was reported according to PRISMA 2020 guidelines. In total, we identified 19 studies, including 16.6 million participants. Individuals with periodontal diseases had an increased risk of overall gastrointestinal cancers compared with those without periodontal diseases (HR 1.31, 95% CI 1.16-1.49). Periodontal diseases significantly increased the risk of esophageal cancer by 39% (HR 1.39, 95% CI 1.15-1.68), gastric cancer by 13% (HR 1.13, 95% CI 1.01-1.26), colorectal cancer by 21% (HR 1.21, 95% CI 1.05-1.39), pancreatic cancer by 35% (HR 1.35, 95% CI 1.00-1.82), and liver cancer by 9% (HR 1.09, 95% CI 1.04-1.13). The risk of gastrointestinal cancers was significantly increased by periodontitis (HR 1.45, 95% CI 1.14-1.85), gingivitis (HR 1.03, 95% CI 1.01-1.04), and periodontitis/gingivitis (HR 1.27, 95% CI 1.07-1.51). Furthermore, severe periodontal diseases showed a significantly increased risk of gastrointestinal cancer (HR 1.79, 95% CI 1.07-2.99). Results of sensitivity analyses for site-specific gastrointestinal cancers were robust with the main findings. In summary, periodontal diseases, especially severe periodontitis, increase the risk of overall and site-specific gastrointestinal cancers. Interventions to prevent and manage periodontal diseases may reduce the risk of developing gastrointestinal cancers.
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Affiliation(s)
- Q Wang
- Department of Thoracic and Esophagus Surgery, The Fourth Affiliated Hospital of China Medical University, Shenyang, China
| | - W-J Gu
- Department of Intensive Care Unit, The First Affiliated Hospital of Jinan University, Guangzhou, China
| | - F-L Ning
- Department of General Surgery, The Affiliated Xuzhou Hospital of Nanjing University of Chinese Medicine, Xuzhou Hospital of Traditional Chinese Medicine, Xuzhou, China
| | - M Sun
- Department of General Surgery, Taihe Hospital, Hubei University of Medicine, Shiyan, China
| | - Z-M G Zhao
- Department of Surgical Oncology, The Fourth Affiliated Hospital of China Medical University, Shenyang, China
| | - M U Abe
- Department of Oral & Maxillofacial Surgery, The University of Tokyo Hospital, Tokyo, Japan
- Division for Health Service Promotion, The University of Tokyo, Tokyo 1138655, Japan
| | - Z-N Li
- Department of Oromaxillofacial-Head and Neck Surgery, School and Hospital of Stomatology, China Medical University, Liaoning Province Key Laboratory of Oral Disease, Shenyang, China
| | - C-D Zhang
- Department of Surgical Oncology, The Fourth Affiliated Hospital of China Medical University, Shenyang, China
- Central Laboratory, The Fourth Affiliated Hospital of China Medical University, Shenyang, China
- Lead contact
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Zhao N, Teles F, Lu J, Koestler DC, Beck J, Boerwinkle E, Bressler J, Kelsey KT, Platz EA, Michaud DS. Epigenome-wide association study using peripheral blood leukocytes identifies genomic regions associated with periodontal disease and edentulism in the Atherosclerosis Risk in Communities study. J Clin Periodontol 2023; 50:1140-1153. [PMID: 37464577 PMCID: PMC10528731 DOI: 10.1111/jcpe.13852] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Revised: 06/28/2023] [Accepted: 06/30/2023] [Indexed: 07/20/2023]
Abstract
AIM To investigate individual susceptibility to periodontitis by conducting an epigenome-wide association study using peripheral blood. MATERIALS AND METHODS We included 1077 African American and 457 European American participants of the Atherosclerosis Risk in Communities (ARIC) study who had completed a dental examination or reported being edentulous at Visit 4 and had available data on DNA methylation from Visit 2 or 3. DNA methylation levels were compared by periodontal disease severity and edentulism through discovery analyses and subsequent testing of individual CpGs. RESULTS Our discovery analysis replicated findings from a previous study reporting a region in gene ZFP57 (6p22.1) that was significantly hypomethylated in severe periodontal disease compared with no/mild periodontal disease in European American participants. Higher methylation levels in a separate region in an unknown gene (located in Chr10: 743,992-744,958) was associated with significantly higher odds of edentulism compared with no/mild periodontal disease in African American participants. In subsequent CpG testing, four CpGs in a region previously associated with periodontitis located within HOXA4 were significantly hypermethylated in severe periodontal disease compared with no/mild periodontal disease in African American participants (odds ratio per 1 SD increase in methylation level: cg11015251: 1.28 (1.02, 1.61); cg14359292: 1.24 (1.01, 1.54); cg07317062: 1.30 (1.05, 1.61); cg08657492: 1.25 (1.01, 1.55)). CONCLUSIONS Our study highlights epigenetic variations in ZPF57 and HOXA4 that are significantly and reproducibly associated with periodontitis. Future studies should evaluate gene regulatory mechanisms in the candidate regions of these loci.
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Affiliation(s)
- Naisi Zhao
- Department of Public Health & Community Medicine, Tufts University School of Medicine, Tufts University, Boston, MA
| | - Flavia Teles
- Department of Basic & Translational Sciences, University of Pennsylvania, Philadelphia, PA
| | - Jiayun Lu
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | - Devin C. Koestler
- Department of Biostatistics & Data Science, University of Kansas Medical Center, Kansas City, KS
- University of Kansas Cancer Center, Kansas City, KS
| | - James Beck
- Division of Comprehensive Oral Health/Periodontology, Adams School of Dentistry, University of North Carolina, Chapel Hill, NC
| | - Eric Boerwinkle
- Human Genetics Center, School of Public Health, University of Texas Health Science Center at Houston, Houston, TX
- Human Genome Sequencing Center, Baylor College of Medicine, Houston, TX
| | - Jan Bressler
- Human Genetics Center, School of Public Health, University of Texas Health Science Center at Houston, Houston, TX
| | - Karl T. Kelsey
- Department of Epidemiology, Brown University, Providence, RI
- Department of Pathology and Laboratory Medicine, Brown University, Providence, RI
| | - Elizabeth A. Platz
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
- The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, MD
| | - Dominique S. Michaud
- Department of Public Health & Community Medicine, Tufts University School of Medicine, Tufts University, Boston, MA
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Li X, Man J, Chen H, Yang X. Spatiotemporal trends of disease burden of edentulism from 1990 to 2019: A global, regional, and national analysis. Front Public Health 2022; 10:940355. [PMID: 36518579 PMCID: PMC9742533 DOI: 10.3389/fpubh.2022.940355] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Accepted: 11/10/2022] [Indexed: 11/29/2022] Open
Abstract
Background Understanding the spatiotemporal trends in disease burden of edentulism is critical to reducing disease burden of edentulism and deploying medical resources. We assessed the changing patterns of disease burden of edentulism at global, regional, and national levels from 1990 to 2019. Methods Data on incident cases, prevalent cases, disability-adjusted life years (DALYs), and age-standardized rates (ASRs) of edentulism were extracted from the Global Burden of Disease 2019 Study. We calculated the estimated annual percentage change (EAPC) to quantify spatiotemporal trends in the ASRs of edentulism. Results In 2019, the number of prevalent cases and DALYs of edentulism were 35.2 and 9.6 million, and the ASPR and ASDR were 43.12/1,000 and 1.18/1,000, with EAPCs of -0.18 [95% confidence interval (CI): -0.28, -0.09] and -0.16[95% CI: -0.26, -0.07] from 1990 to 2019, respectively. Females and the elderly had a higher burden of edentulism. Although the ASPR, ASDR, and ASIR in the high SDI, high-middle SDI, and middle SDI regions showed a decreasing or stable trend, the absolute disease burdens of edentulism in these regions were still high. Although the absolute disease burdens of low SDI and low-middle SDI were low, their ASPR and ASDR showed an upward trend. In countries with high initial disease burden or high SDI, ASPR, ASDR, and ASIR showed stable or declining trends. Conclusion The absolute disease burden due to edentulism was increasing in many countries and regions. Countries should reduce the disease burden caused by edentulism by adopting measures including the prevention and treatment of dental caries and periodontal disease.
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Affiliation(s)
- Xiao Li
- Department of Special Treatment, Jinan Stomatological Hospital, Jinan, China
| | - Jinyu Man
- Department of Epidemiology and Health Statistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Hui Chen
- Clinical Epidemiology Unit, Qilu Hospital of Shandong University, Jinan, China,Clinical Research Center of Shandong University, Jinan, China
| | - Xiaorong Yang
- Clinical Epidemiology Unit, Qilu Hospital of Shandong University, Jinan, China,Clinical Research Center of Shandong University, Jinan, China,*Correspondence: Xiaorong Yang
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Wang K, Zhang Z, Wang Z. Assessment of the association between periodontal disease and total cancer incidence and mortality: a meta-analysis. PeerJ 2022; 10:e14320. [PMID: 36389427 PMCID: PMC9648345 DOI: 10.7717/peerj.14320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Accepted: 10/09/2022] [Indexed: 11/09/2022] Open
Abstract
Background Periodontal disease (PD) is a chronic inflammatory disease that leads to alveolar bone resorption and tooth loss. Many studies have reported the association between periodontal disease and various cancers including oral cancer, lung cancer, breast cancer and so on. However, there is still no specialized meta-analysis that assesses the association between periodontal disease and cancer incidence and mortality in-deepth. Thus, we conducted this meta-analysis. Methods This meta-analysis was registered with PROSPERO: CRD42020183497. We searched five online databases for observational studies about the association between periodontal disease and breast, prostate, lung and bronchial, colorectal, and total cancers by July 2020. Then we evaluated quality of the included studies by the Newcastle-Ottawa scale. Risk ratios (HRs) and their 95% confidence intervals (CIs) were pooled to evaluate the strength of the association between periodontal disease and four cancers, total cancer incidence and mortality. In addition, we analyzed heterogeneity by subgroup analysis and sensitivity analysis. Finally, we inspected publication bias by Begg's and Egger's tests. Results None of the studies included in this meta-analysis were of poor quality. PD is not only related to breast cancer incidence (HR = 1.26,95%CI [1.11-1.43], I 2 = 75.8%, P = 0.000), but also connected with total cancer mortality (HR = 1.40,95%CI [1.24-1.58], I 2 = 0.0%, P = 0.718). Subgroup analyses showed that study population, study design, dental status, follow-up period, adjustment for smoking partially explained the heterogeneity between studies. The results of Begg's test and Egger's test were consistent and indicated that there is no publication bias in this study. Conclusion In conclusion, this meta-analysis revealed a positive relationship between periodontal disease and breast cancer incidence and total cancer mortality. Further well-designed studies with specific inclusion and exclusion criteria are required to strengthen the conclusion of this meta-analysis. However, longer follow-up period, multi-center trials and even multinational studies are required to corroborate the results.
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Affiliation(s)
- Kaili Wang
- Department of Stomatology, Beijing You ’an Hospital, Capital Medical University, Beijing, China
| | - Zheng Zhang
- Tianjin Stomatological Hospital, School of Medicine, Nankai University, Tianjin, China,Tianjin Key Laboratory of Oral and Maxillofacial Function Reconstruction, Tianjin, China
| | - Zuomin Wang
- Department of Stomatology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China
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Association between smoking habits and dental care utilization and cost using administrative claims database and specific medical check-up data. BMC Oral Health 2022; 22:372. [PMID: 36056338 PMCID: PMC9440590 DOI: 10.1186/s12903-022-02397-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Accepted: 08/16/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND This study aims to evaluate the association between smoking habits and dental care utilization and cost in individuals registered with the Japan Health Insurance Association, Osaka branch. METHODS We used the administrative claims database and specific medical check-up data and included 226,359 participants, who visited dental institutions, underwent dental examinations, and underwent specific medical checkups, with smoking data from April 2016 to March 2017. We calculated propensity scores with age, gender, exercise, eating habits, alcohol intake, and sleep. We also compared dental care utilization with the total cost of each procedure. RESULTS According to propensity score matching, 62,692 participants were selected for each group. Compared to non-smokers, smokers were younger, and a higher proportion were men. Smokers tended to skip breakfast, have dinner just before bed, and drink alcohol. After adjusting for potential confounding factors with propensity score matching, the mean annual dental cost among smokers was significantly higher than non-smokers. The prevalence of pulpitis, missing teeth, and apical periodontitis were higher among smokers than non-smokers, while inlay detachment, caries, and dentine hypersensitivity were higher among non-smokers. CONCLUSION This study suggests that smokers have higher dental cost consisted of progressive dental caries, missing teeth, and uncontrolled acute inflammation that necessitated the use of medications. It is suggested that smokers tend to visit the dentist after their symptoms become severe.
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