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Cancer Prevention Research
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Research Article

Periodontal Disease, Tooth Loss, and Risk of Serrated Polyps and Conventional Adenomas

Chun-Han Lo, Long H. Nguyen, Kana Wu, Shuji Ogino, Andrew T. Chan, Edward L. Giovannucci and Mingyang Song
Chun-Han Lo
1Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts.
2Division of Gastroenterology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts.
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  • ORCID record for Chun-Han Lo
Long H. Nguyen
2Division of Gastroenterology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts.
3Clinical and Translational Epidemiology Unit, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts.
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Kana Wu
4Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts.
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Shuji Ogino
1Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts.
5Program in MPE Molecular Pathological Epidemiology, Department of Pathology, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts.
6Broad Institute of MIT and Harvard, Cambridge, Massachusetts.
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Andrew T. Chan
2Division of Gastroenterology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts.
3Clinical and Translational Epidemiology Unit, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts.
6Broad Institute of MIT and Harvard, Cambridge, Massachusetts.
7Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts.
8Department of Immunology and Infectious Disease, Harvard T.H. Chan School of Public Health, Boston, Massachusetts.
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Edward L. Giovannucci
1Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts.
4Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts.
7Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts.
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Mingyang Song
1Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts.
2Division of Gastroenterology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts.
3Clinical and Translational Epidemiology Unit, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts.
4Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts.
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  • For correspondence: msong@hsph.harvard.edu
DOI: 10.1158/1940-6207.CAPR-20-0090 Published August 2020
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Abstract

Growing data indicate an association between periodontal disease and the development of cancer. However, the evidence for colorectal cancer has been inconsistent and longitudinal study examining its precursor lesions is lacking. We prospectively collected information on periodontal disease and number of tooth loss in the Nurses' Health Study (1992–2002) and the Health Professionals Follow-up Study (1992–2010). Polyp diagnosis was acquired via self-reported questionnaires and confirmed through review of medical records. We used logistic regression to calculate the multivariate-adjusted ORs and 95% confidence intervals (CI) with adjustment for smoking and other known risk factors for periodontal disease and colorectal cancer. In this study, we included 17,904 women and 24,582 men. We documented 2,336 cases of serrated polyps and 4,102 cases of conventional adenomas among 84,714 person-endoscopies throughout follow-up. The ORs of serrated polyps and conventional adenomas comparing individuals with and without periodontal disease were 1.17 (95% CI, 1.06–1.29) and 1.11 (95% CI, 1.02–1.19), respectively. Compared with participants without tooth loss, those who lost ≥4 teeth had 20% (OR, 1.20; 95% CI, 1.03–1.39) greater risk of serrated polyps (Ptrend 0.01). Among never smokers, similar associations with periodontal disease were observed for both serrated polyps (OR, 1.20; 95% CI, 1.02–1.41) and conventional adenomas (OR, 1.12; 95% CI, 1.00–1.26). History of periodontal disease and possibly higher number of tooth loss may modestly increase the risk of developing colorectal precursor lesions. Our findings advance our understanding of the interplay between oral health, microbiome, and early colorectal carcinogenesis.

Footnotes

  • Note: Supplementary data for this article are available at Cancer Prevention Research Online (http://cancerprevres.aacrjournals.org/).

  • Cancer Prev Res 2020;13:699–706

  • Received February 25, 2020.
  • Revision received April 7, 2020.
  • Accepted May 28, 2020.
  • Published first July 29, 2020.
  • ©2020 American Association for Cancer Research.
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Cancer Prevention Research: 13 (8)
August 2020
Volume 13, Issue 8
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Periodontal Disease, Tooth Loss, and Risk of Serrated Polyps and Conventional Adenomas
Chun-Han Lo, Long H. Nguyen, Kana Wu, Shuji Ogino, Andrew T. Chan, Edward L. Giovannucci and Mingyang Song
Cancer Prev Res August 1 2020 (13) (8) 699-706; DOI: 10.1158/1940-6207.CAPR-20-0090

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Periodontal Disease, Tooth Loss, and Risk of Serrated Polyps and Conventional Adenomas
Chun-Han Lo, Long H. Nguyen, Kana Wu, Shuji Ogino, Andrew T. Chan, Edward L. Giovannucci and Mingyang Song
Cancer Prev Res August 1 2020 (13) (8) 699-706; DOI: 10.1158/1940-6207.CAPR-20-0090
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