. 2022 Oct 1;56(3):155–171.

Table 4.

Study findings for inflammatory cancers associated with periodontitis

Reference

Study type(s)

Outcome

Strength of evidence

Corbella et al. 2018⁶³

SR & MA:

8 prospective studies (6 in MA)

Explored whether humans with periodontal disease were at higher risk than those without; explored various cancers (esophageal, liver, pancreatic, gastric, colorectal, prostate, hemopoietic)

Low statistically significant associations for all included cancers but used HRs not ORs *Interpret with caution

Weak

Chen et al. 2019⁶⁵

SR:

17 case–control studies

Reported on potential association between oral microbes and various GI cancers (colorectal, pancreatic, gastric, esophageal, liver)

Associations found with P. gingivalis, T. forsythia & P. intermedia but with differences in microbes for upper and lower GI cancers

No MA

Not assessed

Xiao et al. 2020⁶⁶

SR & MA:

18 articles (including 39 studies)

Effects of periodontal bacteria on incidence & prognosis of a variety of cancers

Bacterial infection increased overall incidence of cancer (OR 1.25) & was associated with poor overall survival (HR 1.75)

Subgroup analysis revealed associations with P. gingivalis (OR 2.16; 95% CI, 1.34–3.47) & P. intermedia (OR 1.28; 95% CI, 1.01–1.63)

Strong

(P. gingivalis)

Weak (P. intermedia)

Reitano et al. 2021⁶⁷

SR:

28 studies

(26 case–control; 2 cohort)

Variety of digestive cancers

Findings in contrast with Xiao et al.⁶⁶ P. gingivalis and F. nucleatum appeared to be associated with colorectal cancer

No quantitative analysis

Weak

(due to study types and high levels of heterogeneity in studies)

Maisonneuve et al. 2017⁶⁸

SR & MA:

8 studies (7 were cohort studies)

Explored relationship between periodontal disease, edentulism & pancreatic cancer

Results support a relationship between periodontal disease & pancreatic cancer (RR 1.74; 95% CI, 1.41–2.15)

For edentulism & pancreatic cancer (RR 1.54; 95% CI, 1.16–2.05)

Moderate

Weak

Sun et al. 2021⁶⁹

SR & MA:

14 studies (incidence)

3 (mortality)

Focused on incidence & mortality of colorectal cancer being associated with periodontal disease

Incidence RR 1.179 (95% CI, 1.036–1.342), p < 0.013

Weak

Wei al. 2021⁷⁴

SR & MA:

7 studies

(4 prospective cohort studies; 3 retrospective cohort studies)

Explored association between periodontal disease & prostate cancer

Revealed a significant association (RR 1.17; 95% CI, 1.07–1.27; p < 0.000)

Weak

Wu et al. 2020⁷⁵

SR & MA:

6 studies

(4 cohort, 1 case–control, 1 retrospective cohort)

Investigated relationship between periodontal disease & hematopoietic & lymphatic cancers

Significant association between both types of cancers but stronger for lymphatic (RR 1.17; 95% CI, 1.07–1.27; p < 0.001)

Weak