Gum disease raises risk of pancreatic cancer: study
What goes on in your mouth affects entire body, doctor warns
Sharon Kirkey
CanWest News Service
Harvard researchers have linked common gum disease wit a 63-percent-increased risk of pancreatic cancer, one of the most rapidly lethal cancers.
The more severe the periodontal disease, the greater the risk. Losing a tooth during the past four years from gum disease was associated with a 2.7-fold increase in cancer of the pancreas, a banana-shaped gland located deep within the abdomen close to the stomach and spine.
In a study involving more than 50,000 male health professionals - most of them dentists - researchers from the Harvard School of Public Health and Dana-Farber Cancer Institute in Boston found men with periodontal disease were significantly more likely to develop pancreatic cancer than those with healthy gums and teeth, even after taking age, smoking and other risk factors into account.
"Pancreatic cancer is the fourth-leading cause of cancer deaths in the United States," said Dr. Charles Fuchs, an associate professor of medicine at Dana-Farber. "We really know very little about it and its risk factors."
Smoking is the only widely accepted risk factor, but at most accounts for 20 to 25 percent of cases, Fuchs said. "Clearly something else is going on."
The study doesn't prove gum disease causes cancer. But the Boston team hypothesizes that is causes chronic inflammation throughout the body "that ultimately predisposes people to cancer of the pancreas," said Fuchs.
Another possibility is that the higher levels of bacteria in the mouth of people with gum disease, as well as nitrosamines - potent cancer-causing compounds also found in tobacco - could be leading to cancer.
The new report is the latest to warn what's going on in the mouth may affect the entire body. Periodontal disease has been linked with increased risk of heart disease, heart attacks, stroke, diabetes and pre-term and low birth-weight babies.
"Something like periodontal disease is bacterial in nature," said Dr. Charles Alleyn, a periodontist and member of the Canadian Dental Association's committee on specialty affairs. "Why would we think that bacteria would stay in your mouth and not disperse to other areas or your body?"
About 3.000 people are diagnosed each year in Canada with cancer of the pancreas. The five-year survival rate is four per cent.
The study involved 51,529 dentists, veterinarians, pharmacists, optometrists, doctors and other health professionals followed since 1986. The men filled out questionnaires about their health every two years. Between 1986 and 2002, there were 216 confirmed cases of pancreatic cancer. Of those, 67 reported periodontal disease.
According to background information released with the study, 25 cases of pancreatic cancer would be expected per 100,000 men. Having periodontal disease bumped that rate to 61 per 100,000 men.
Surprisingly, non-smokers in the study fared worse - they had a two-fold increase in risk.
Blood levels of C-reactive protein, a sign of inflammation throughout the body, are higher in people with periodontal disease.
"The message from a public health standpoint is it's important to take care of your teeth and gums. See your dentist," Fuchs said.
Periodontal disease affects the tissues that hold the teeth in place. The two most common are gingivitis, inflammation caused by plaque affecting about 80 percent of the population, and periodontitus, affecting10 to 20 percent of the population, which results in loss of bone and is the number one cause of tooth loss in adults.
Dr. Molly Rodgers, General Dentist - Providing services in Dentistry to the area of Edmonton Alberta, Canada.
