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. 2022 Dec;127(12):2133-2140.
doi: 10.1038/s41416-022-02018-8. Epub 2022 Oct 22.

Poor dental health and risk of pancreatic cancer: a nationwide registry-based cohort study in Sweden, 2009-2016

Jingru Yu  1 , Alexander Ploner  2 , Margaret Sällberg Chen  3   4 , Ji Zhang  2 , Gunilla Sandborgh-Englund  3   5 , Weimin Ye  6   7
Affiliations

Poor dental health and risk of pancreatic cancer: a nationwide registry-based cohort study in Sweden, 2009-2016

Jingru Yu et al. Br J Cancer. 2022 Dec.

Abstract

Background: Previous studies have reported inconsistent results regarding the association between poor dental health and pancreatic cancer risk. This study aimed to assess this association using a well-functioning nationwide dental health registry in Sweden.

Methods: Information of exposures (dental caries, root canal infection, mild inflammation, and periodontitis; the number of teeth) was ascertained from the Swedish Dental Health Register, and occurrence of pancreatic cancer was identified from both cancer and cause of death registries. Hazard ratios (HRs) were estimated using Cox models.

Results: During a median of 7.2 years of follow-up, 10,081 pancreatic cancers were identified among 5,889,441 individuals. Compared with the healthy status, a higher risk of pancreatic cancer was observed in individuals with root canal infection, mild inflammation, and periodontitis in the <50 age group (P for trend <0.001). In the 50-70 age group, only the subgroup with periodontitis had an excess risk (multivariable-adjusted HR = 1.20, 95% confidence interval [CI] 1.11-1.29). No positive association with statistical significance was observed in the 70+ age group. Individuals with fewer teeth tended to have a higher risk in all age groups.

Conclusions: Our results confirmed the association between poor dental health and pancreatic cancer risk, which warrants further studies on underlying mechanisms.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1. Flow chart for recruitment of the study population.
*Records of the number of teeth were matched with dental care records by date of dental visit. If they were not matched by the same date, the number of teeth with the date that is closest to dental care date up to 6 months before or 5 years after was used.
Fig. 2
Fig. 2. Multivariable-adjusted hazard ratios (HRs) for pancreatic cancer in relation to a combination of dental inflammatory conditions and number of teeth by age group.
Time scale is attained age. The Cox models were adjusted for sex, calendar year, family income, education, family history of pancreatic cancer, smoking-related diseases, and alcohol-related disorders and diseases. Dental inflammation includes mild inflammation and periodontitis; no inflammation includes healthy, caries, and root canal infection; no inflammation and ≥28 teeth was the reference group; in the <50 age group, the subgroups having 15–20 and 1–14 teeth were combined into 1–20 teeth due to the small numbers of cancer cases, with the label of “(No) inflammation & 15–20 teeth”. X-axis is logged. P value for interaction was 0.469 in the <50 age group, 0.477 in the 50–70 age group, and 0.772 in the 70+ age group.
See this image and copyright information in PMC

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