Chronic Periodontitis and the Risk of Tongue Cancer | Head and Neck Cancer | JAMA Otolaryngology–Head & Neck Surgery | JAMA Network
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 Cancer Facts & Figures, 2006.  American Cancer Society. Atlanta, Ga: American Cancer Society; 2006:4. Accessed June 2006
Schwartz  LHOzsahin  MZhang  GN Synchronous and metachronous head and neck carcinomas.  Cancer 1994;741933- 1938PubMedGoogle ScholarCrossref
Canto  MTDevesa  SS Oral cavity and pharynx cancer incidence rates in the United States 1975-1998.  Oral Oncol 2002;38610- 617PubMedGoogle ScholarCrossref
Karin  MLawrence  TNizet  V Innate immunity gone awry: linking microbial infections to chronic inflammation and cancer.  Cell 2006;124823- 835PubMedGoogle ScholarCrossref
Lax  AJThomas  W How bacteria could cause cancer: one step at a time.  Trends Microbiol 2002;10293- 299PubMedGoogle ScholarCrossref
Helicobacter and Cancer Collaborative Group, Gastric cancer and Helicobacter pylori: a combined analysis of 12 case control studies nested within prospective cohorts.  Gut 2001;49347- 353PubMedGoogle ScholarCrossref
Littman  AJWhite  EJackson  LAThornquist  MD Chlamydia pneumoniae infection and risk of lung cancer.  Cancer Epidemiol Biomarkers Prev 2004;131624- 1630Google Scholar
Ekbom  AHelmnick  CZack  M Ulcerative colitis and colorectal cancer, a population based study.  N Engl J Med 1990;3231228- 1233PubMedGoogle ScholarCrossref
Lazcano-Ponce  ECMiquel  JFMunoz  N Epidemiology and molecular pathology of gallbladder cancer.  CA Cancer J Clin 2001;51349- 364PubMedGoogle ScholarCrossref
Caygill  CPHill  MJBraddick  M Cancer mortality in chronic typhoid and paratyphoid carriers.  Lancet 1994;34383- 84PubMedGoogle ScholarCrossref
Loesche  WJGrossman  NS Periodontal disease as a specific, albeit chronic, infection: diagnosis and treatment.  Clin Microbiol Rev 2001;14727- 752PubMedGoogle ScholarCrossref
Cappuyns  IGugerli  PMombelli  A Viruses in periodontal disease—a review.  Oral Dis 2005;11219- 229PubMedGoogle ScholarCrossref
Hormia  MWillberg  JRuokonen  H Marginal periodontium as a potential reservoir of human papillomavirus in oral mucosa.  J Periodontol 2005;76358- 363PubMedGoogle ScholarCrossref
Saygun  IKubar  AOzdemir  A Periodontitis lesions are a source of salivary cytomegalovirus and Epstein-Barr virus.  J Periodontal Res 2005;40187- 191PubMedGoogle ScholarCrossref
Hausmann  EAllen  KDunford  R A reliable computerized method to determine the level of the radiographic alveolar crest.  J Periodontal Res 1989;24368- 369PubMedGoogle ScholarCrossref
Papapanou  PNTonetti  MS Diagnosis and epidemiology of periodontal osseous lesions.  Periodontol 2000 2000;228- 21PubMedGoogle ScholarCrossref
Original Article
May 2007

Chronic Periodontitis and the Risk of Tongue Cancer

Author Affiliations

Author Affiliations: Departments of Periodontics and Endodontics (Dr Tezal), Restorative Dentistry (Dr Sullivan), Social and Preventive Medicine (Drs Reid, Marshall, Hyland, and Wactawski-Wende), Surgery (Dr Loree), and Oral Biology (Dr Scannapieco), State University of New York at Buffalo; and Departments of Dentistry and Maxillofacial Prosthetics (Drs Tezal and Sullivan), Cancer Prevention and Control (Drs Reid and Marshall), Cancer Prevention and Population Sciences (Dr Hyland), Head and Neck Surgery (Dr Loree), and Tumor Registry (Mss Lillis and Hauck), Roswell Park Cancer Institute, Buffalo.

Arch Otolaryngol Head Neck Surg. 2007;133(5):450-454. doi:10.1001/archotol.133.5.450

Objective  To assess the association between the history of chronic periodontitis and the risk of tongue cancer.

Design  Case-control study using preexisting data from patients admitted between June 15, 1999, and November 17, 2005.

Setting  Department of Dentistry and Maxillofacial Prosthetics at Roswell Park Cancer Institute (RPCI), Buffalo, NY.

Patients  The cases comprised 51 non-Hispanic white men newly diagnosed as having primary squamous cell carcinoma of the tongue, and the controls, 54 non-Hispanic white men evaluated during the same period but with negative results for malignancy. Children (aged <21 years), edentulous or immunocompromised patients, and those with history of any cancer were excluded. History of periodontitis was assessed by alveolar bone loss measured from panoramic radiographs by 1 examiner blind to cancer status.

Main Outcome Measure  Incidence of tongue cancer obtained from the RPCI Tumor Registry.

Results  After adjusting for the effects of age at diagnosis, smoking status, and number of teeth, each millimeter of alveolar bone loss was associated with a 5.23-fold increase in the risk of tongue cancer (odds ratio, 5.23; 95% confidence interval, 2.64-10.35).

Conclusions  This study suggests an association between chronic periodontitis and the risk of tongue cancer in men, independent of smoking status, age, race, ethnicity, and number of teeth. This association needs to be confirmed by larger studies using quantitative assessment of lifetime tobacco exposure. If this association is confirmed, it has a potential impact on understanding the etiology of oral cancer as well as on its prevention and control.