Poor oral health is associated with an increased risk of pancreatic cancer in African-American women, according to a large, long-term study.
Researchers used data from a study that began in 1995 that included almost 60,000 African-American women. Women who had periodontal disease but no tooth loss were 77% more likely to have been diagnosed with pancreatic cancer than those with neither periodontal disease nor tooth loss, they reported in the journal Cancer Epidemiology, Biomarkers & Prevention (March 28, 2019).
"These findings, taken together with what we know about patterns of oral health in the United States, suggest that the existing racial disparities in pancreatic cancer and mortality could be reduced by improving oral care for African-Americans," noted study author Julie Palmer, ScD, MPH, in a statement by the American Association for Cancer Research (AACR) , publisher of the journal. Dr. Palmer is a professor and the associate director of the Slone Epidemiology Center at Boston University.
Higher incidence
Pancreatic cancer is a rare but highly fatal type of cancer, with less than 10% of patients surviving more than five years after their diagnosis. Its incidence is higher in U.S. African-American women than in those identifying as white. The reasons for the disparity are not known, according to the study authors.
The researchers of the current study wanted to see if association exists between poor oral health and pancreatic cancer in African-American women, according to Dr. Palmer. Previous studies had shown a higher incidence in white women, she noted.
The researchers used data from the Black Women's Health Study, which enrolled 59,000 African-American women ages 21 to 69 in 1995. Participant information was updated every other year, adding data on cancers, other health conditions, smoking, alcohol use, weight, and other variables. The new study focused on the years 2007 to 2016, in which 78 cases of pancreatic cancer were reported.
During the follow-up period, participants were asked if they were experiencing periodontal disease, tooth loss, or both. Questions varied slightly each time but generally included asking if participants had gingivitis, bleeding gums, or tooth loss. Researchers determined the number of cancer cases through cancer registries and the National Death Index.
African-American women who reported periodontal disease but no tooth loss were 77% more likely to have been diagnosed with pancreatic cancer than those who reported neither periodontal disease nor tooth loss, the researchers found. Also, those who reported both periodontal disease and tooth loss were 58% more likely to have been diagnosed with pancreatic cancer.
In addition, African-American women who reported tooth loss without periodontal disease were more than twice as likely to have been diagnosed with pancreatic cancer. The association was strongest among women who had lost at least five teeth.
Rare disease
Pancreatic cancer is a rare disease, and even in a large study population, only 78 cases were diagnosed, Dr. Palmer noted in the AACR statement.
Oral health may be a factor in this diagnosis, but that further research is necessary to understand the mechanisms behind this increased risk, the researchers concluded.
"Results from this study suggest that poor oral health may play a role in racial disparities in pancreatic cancer incidence," Dr. Palmer stated.
