Severity of chronic periodontitis and risk of gastrointestinal cancers: A population-based follow-up study from Taiwan

The present study aimed to assess the association between the severity of chronic periodontitis and the risk of gastrointestinal (GI) cancers by investigating whether severe chronic periodontitis (CP), rather than mild CP, correlates with an increased risk of total or individual GI cancers. Adults (≥18 years) with mild and severe CP were identified from a random sample of 2 million insured patients in the National Health Insurance Research Database (2001–2010). After propensity score matching, 25,485 individuals, each with mild or severe CP, were included for comparison. The primary endpoint was the incidence of total or individual GI cancers, including cancers of the esophagus, stomach, small intestine, colon/rectum, and pancreas. Cox proportional hazard models with the robust aggregated sandwich estimator were used to calculate hazard ratios (HRs) and 95% confidence intervals (95% CIs) after adjusting for known risk factors. GI cancers occurred in 275 individuals with mild CP and 324 individuals with severe CP. After adjusting for known risk factors, severe CP was not associated with an increased risk of total GI cancer relative to mild CP (HR: 0.99, 95% CI: 0.84–1.16) or individual GI cancers, including esophageal (HR: 1.15, 95% CI: 0.62–2.15), gastric (HR: 1.01, 95% CI: 0.68–1.49), small intestinal (HR: 0.70, 95% CI: 0.22–2.22), colorectal (HR: 0.95, 95% CI: 0.78–1.16), and pancreatic cancers (HR: 0.90, 95% CI: 0.47–1.75). Severe CP was not associated with an increased risk of total or individual GI cancers when compared with mild CP.