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Meta-Analysis
. 2024 Jan 31:79:100321.
doi: 10.1016/j.clinsp.2023.100321. eCollection 2024.

Gastric adenocarcinoma and periodontal disease: A systematic review and meta-analysis

Francisco José Nunes Aguiar  1 , Fabrício Dos Santos Menezes  2 , Marcela de Araújo Fagundes  1 , Gisele Aparecida Fernandes  3 , Fabio de Abreu Alves  4 , João Goncalves Filho  5 , Maria Paula Curado  6
Affiliations
Meta-Analysis

Gastric adenocarcinoma and periodontal disease: A systematic review and meta-analysis

Francisco José Nunes Aguiar et al. Clinics (Sao Paulo). .

Abstract

Background: The oral cavity is a link between of external environment with gastrointestinal tract. Studies are controversial on the presence of Periodontal Disease (PD) and its association with Gastric Adenocarcinoma (GAC).

Methods: The authors performed a systematic review and meta-analysis to verify the association between PD and GAC. Six electronic databases were evaluated between 1961 and 2022. Titles and abstracts were reviewed independently according to the eligibility criteria, assessing full texts of selected studies. The quality of the included research was verified using the Newcastle-Ottawa Scale for case-control and cohort studies. Statistical analyses were performed based on fixed and/or random effects models to calculate the summarized Relative Risk (RR) and its 95 % Confidence Interval (95 % CI).

Results: There were 639 studies, of which nine articles were included (3 case-controls and 6 cohorts). Overall, the authors identified 1,253 cases of GAC 2,501 controls in case-control studies, and 1,631 patients with GAC enrolled in cohort studies. Patients presenting PD increased the risk of developing GAC by 17 % (RR=1.17; 95 % CI 1.03‒1.32), which remained regardless of the diagnostic method for PD, i.e., clinical examination (RR = 1.19; 95 % CI 1.14‒1.24) and self-report (RR = 1.34; 95 % CI 1.06‒1.69). Moreover, Asian patients (RR=1.17; 95 % CI 1.00‒1.36) with PD had a higher risk of having GAC than American and European patients (RR = 1.18; 95 % CI 0.84‒1.66).

Conclusions: The presence of PD the risk of GAC suggesting that its infectious-inflammatory process of PD may be related to GAC development. Further investigations on the oral-gastric microbiota and its role in the carcinogenesis of gastric cancer should be carried out, and the screening of patients with potential risk for GAC should be considered in the clinical practice of dentists.

Keywords: Epidemiology; Gastric neoplasia; Periodontal disease; Periodontitis.

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Conflict of interest statement

Conflicts of Interest The authors declare no conflicts of interest.

Figures

Fig. 1
Fig. 1
Prisma Selection of eligible studies for the systematic review.
Fig. 2
Fig. 2
Evaluation of the methodological quality of case-control and cohort studies according to the Newcastle ‒ Ottawa Scale (Wells et al., 2014).
Fig. 3
Fig. 3
Forest plot of cohort and case-control studies between periodontal disease and gastric adenocarcinoma (Random model).
Fig. 4
Fig. 4
Forest plot of cohort (A) and case-control (B) studies between periodontal diseases and gastric adenocarcinoma (Random model).
Fig. 5
Fig. 5
Forest plot of Asian (A) and American and European (B) studies between periodontal diseases and gastric adenocarcinoma (Random model).
Fig. 6
Fig. 6
Forest plot of periodontal diagnostic, clinical examination (A) self-report (B) between periodontal diseases and gastric adenocarcinoma.
Fig. 7
Fig. 7
Funnel plot of all studies included in the meta-analysis.
See this image and copyright information in PMC

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