The association between concurrent oral cancer and periodontal disease: a systematic review and meta-analysis

Abstract

Background: Since emerging studies have reported a positive association on oral cancer and periodontal disease, this study aims to evaluate the odds ratio of having concurrent oral cancer in patients with periodontal disease.

Methods: A systematic review following the PRISMA guidelines was conducted with three electronic databases. The inclusion criteria were structured according to the PECOS framework: (P) Human subjects aged over 18; (E) Patients with periodontal disease; (C) Individuals without periodontal disease; (O) The odds of patients developing oral and/or head and neck cancers; (S) Case-control studies. After screening, 18 clinical studies from 13 different regions, comprising a total of 31,504 participants, were included.

Results: A meta-analysis was performed and revealed that the odds ratio (OR) for developing oral cancer in patients with periodontal disease, compared to those without, was 3.35 (95% CI: 2.63-4.26; P < .001). After adjusting for potential confounding factors, the adjusted OR was found to be 2.32 (95% CI: 1.71-3.15; P < .001). Case definition also has an impact, with OR of 2.02 if using missing teeth compared to OR of 2.68 by using AAP clinical periodontal parameters.

Conclusion: Clinical considerations for this specific group of patients should draw new attention for a strategic interdisciplinary care.

Keywords: case-control studies; odds ratio; oral cancer; periodontal disease; periodontitis.