Gum disease, periodontitis, which, if left untreated, can lead to tooth loss even at a young age, could promote the onset of colon tumors. This was revealed by a study just published in the journal Cancer Prevention Research, which involved 42,486 individuals of both sexes. The sample was monitored for several decades and periodically provided information about their health and nutrition, including information on dental problems such as gingivitis and tooth loss.
The study was led by Mingyang Song, an epidemiologist from the prestigious Harvard TH Chan School of Public Health Clinical and Translational Epidemiology Unit at Mass General Hospital and Harvard Medical School in Boston. The researchers studied the reports of colonoscopy performed on the sample, documenting the incidence of two types of intestinal lesions that are precursors of colon cancer: serrated polyps and conventional adenomas.
75% of colon cancers come from conventional adenomas, resulting from glandular cells found in the colon. On the other hand, 25% of tumors derive from serrated polyps. Removing these polyps substantially reduces the risk of cancer. In all, epidemiologists recorded 2,336 cases of serrated polyps and 4,102 cases of conventional adenomas.
Well, it emerged that, compared to individuals who do not have and have never suffered in the past from gum disease, those who suffer from periodontitis have a 17% greater risk of serrated polyps and an 11% greater risk of conventional adenomas. . Scientists also found that the loss of 4 or more teeth is associated with a 20% greater risk of serrated polyps.
The study, the authors point out, adds to a vast body of data linking periodontitis to cancers. “Our results – they write – increase the understanding of the link between oral health, gut microbiota and colorectal carcinogenesis”. “This prospective study on a truly extensive case study – underlines Nicola Marco Sforza, president-elect of the Italian Society of Implantology and Periodontology – follows other recent epidemiological studies that highlight a possible correlation between chronic inflammation of the oral cavity typical of periodontitis, dysbiosis of the microbiome oral and intestinal carcinogenic activity. As always, given the delicacy of the subject, it is necessary to be cautious in evaluating the results. In this work, a slight increase in the risk of subjects suffering from periodontitis is actually shown to develop forms precancerous of the intestine, such as polyps and adenomas and this risk becomes more significant (20% more) if, in addition to periodontitis, the subject has lost more than 4 teeth due to gum disease ”.
Reading the work carefully – underlines Sforza – however, one can note some methodological limitations that could partly reduce the impact of the results, such as the fact that the diagnosis of periodontitis is derived from the use of a questionnaire filled in by the individual patient and not certified by a periodontal examination or that polyps of small size and therefore difficult to diagnose may have escaped the analysis, reducing the statistical power of the periodontitis-intestinal precancerous association ”.
Nonetheless – he concludes – the fact remains that the results of Harvard epidemiologists suggest the potential role of the oral microbiome in the development of intestinal tumors, even if further prospective long-term clinical studies are certainly desirable, carried out with a shared protocol between periodontologists and gastroenterologists. to define the real impact of this correlation “.
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