Individuals with higher numbers of oral pathogens associated with periodontal disease may be at risk for precancerous gastric lesions, according to new research published in the Journal of Periodontology.
Investigators found that patients with precancerous gastric lesions more often showed increased periodontal pathogen colonization and lower oral bacterial diversity, which led them to conclude that controlling periodontal disease could be important for gastric cancer prevention.
“Our study reinforces earlier findings that poor oral health is associated with an increased risk of precancerous lesions of stomach cancer,” Yihong Li, DDS, MPH, DrPH, professor of basic science and craniofacial biology at NYU Dentistry, said in a press release.
Prompted by the hypothesis that a specific group of pathogens may cause periodontal disease and the chronic systemic inflammation that could contribute to the development of gastric cancer, Li and colleagues aimed to evaluate the association between periodontal pathogen colonization and risk for precancerous gastric lesions, including chronic atrophic gastritis, intestinal metaplasia, and dysplasia.
They performed full mouth examinations on 105 patients (68.6% women) who underwent upper endoscopy, and took saliva and dental plaque samples to assess pathogen colonization and characterize oral microbial diversity. Thirty-five patients were newly diagnosed with precancerous lesions of gastric cancer. The 70 patients without precancerous lesions were matched by age and served as controls.
Patients with precancerous lesions showed a higher prevalence of bleeding when probed (31.5% vs. 22.4%; P < .05), higher levels of two pathogens (T. denticola and A. actinomycetemcomitans; P < .01 for both), and less bacterial diversity in their saliva (P < .01) compared with controls.
Multivariate analysis accounting for sociodemographic factors, oral health behavior and periodontal health showed that higher colonization with the periodontal pathogens T. forsythia, T. denticola and A. actinomycetemcomitans, lower bacterial diversity in dental plaque, and not flossing regularly all significantly predicted an increased risk for precancerous lesions of gastric cancer (P = .022).
Li and colleagues acknowledged that their study is limited by its small sample size.
“Based on our findings, treatment for chronic periodontal disease and control of periodontal pathogen infections should be included in future strategies for preventing stomach cancer,” Li said in the press release. – by Adam Leitenberger
Disclosures: The authors report no relevant financial disclosures.