title: Periodontal Pathogens and Risk of Incident Cancer in Postmenopausal Females: The Buffalo OsteoPerio Study.
abstract: BACKGROUND
  Extraoral translocation of oral bacteria may contribute to associations between periodontal disease and cancer. The associations among the presence of three orange-complex periodontal pathogens (Fusobacterium nucleatum, Prevotella intermedia, and Campylobacter rectus), two red-complex periodontal pathogens (Porphyromonas gingivalis and Tannerella forsythia), and cancer risk were investigated.
  
  
  METHODS
  A total of 1,252 postmenopausal females enrolled in the Buffalo Osteoporosis and Periodontal Disease Study were followed prospectively. Baseline subgingival plaque samples were assessed for the presence of periodontal pathogens using indirect immunofluorescence. Incident cancer cases were adjudicated by staff physicians via review of medical records. Cox proportional hazards regression was used to calculate hazard ratios (HRs) and 95% confidence intervals (CIs) for the associations of periodontal pathogens with total cancer and site-specific cancer risk in unadjusted and multivariable-adjusted models.
  
  
  RESULTS
  Neither the presence of individual pathogens nor the presence of any red-complex pathogens was associated with total cancer or site-specific cancers. Borderline associations were seen among the presence of any orange-complex pathogens (F. nucleatum, P. intermedia, and C. rectus), total cancer risk (HR = 1.35, 95% CI = 1.00 to 1.84), and lung cancer risk (HR = 3.02, 95% CI = 0.98 to 9.29).
  
  
  CONCLUSIONS
  No associations were found between the presence of individual subgingival pathogens and cancer risk. However, there were suggestions of borderline positive associations of the presence of any orange-complex pathogens with total cancer and lung cancer risk. The study is limited by the small number of cancer cases and the assessment of only five oral bacteria. Additional research is needed to understand the possible role of periodontal disease in carcinogenesis.
authors.affiliation: Department of Epidemiology and Environmental Health, University at Buffalo, State University of New York, Buffalo, NY.
authors.forename: Xiaodan
authors.initials: X
authors.lastname: Mai
authors.affiliation: Department of Oral Biology, University at Buffalo, State University of New York.
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Genco
authors.affiliation: Department of Epidemiology and Environmental Health, University at Buffalo, State University of New York, Buffalo, NY.
authors.forename: Michael J
authors.initials: MJ
authors.lastname: LaMonte
authors.affiliation: Department of Epidemiology and Environmental Health, University at Buffalo, State University of New York, Buffalo, NY.
authors.forename: Kathleen M
authors.initials: KM
authors.lastname: Hovey
authors.affiliation: Department of Epidemiology and Environmental Health, University at Buffalo, State University of New York, Buffalo, NY.
authors.forename: Jo L
authors.initials: JL
authors.lastname: Freudenheim
authors.affiliation: Department of Ophthalmology and Visual Sciences, University of Michigan, Ann Arbor, MI.
authors.forename: Christopher A
authors.initials: CA
authors.lastname: Andrews
authors.affiliation: Department of Epidemiology and Environmental Health, University at Buffalo, State University of New York, Buffalo, NY.
authors.forename: Jean
authors.initials: J
authors.lastname: Wactawski-Wende
mesh_terms: D016976:Aggregatibacter actinomycetemcomitans; D001439:Bacteroides; D003773:Dental Plaque; D005260:Female; D016967:Fusobacterium nucleatum; D006801:Humans; D009369:Neoplasms / Q000453:epidemiology*; D010510:Periodontal Diseases / Q000453:epidemiology*; D016966:Porphyromonas gingivalis; D017698:Postmenopause; D018713:Prevotella intermedia
keywords: Bacterial infections; dental plaque; epidemiology; neoplasms; periodontal diseases; postmenopause