Cancer Causes & Control

, Volume 26, Issue 6, pp 941–947 | Cite as

Periodontal bone loss and risk of epithelial ovarian cancer

  • Ana Babic
  • Elizabeth M. Poole
  • Kathryn L. Terry
  • Daniel W. Cramer
  • Ricardo P. Teles
  • Shelley S. Tworoger
Brief report
First Online:
Received:
Accepted:

Abstract

Purpose

Periodontitis, a chronic inflammatory response to pathogenic bacteria in the oral microbiome, is common among adults. It is associated with several medical conditions, including cardiovascular diseases, and potentially with esophageal, lung, oral, and pancreatic cancer. One of the proposed mechanisms behind these associations is systemic inflammation, which has also been implicated in ovarian cancer etiology. The aim of this study was to evaluate association between ovarian cancer and periodontal bone loss.

Methods

The association between periodontal bone loss, a marker of periodontitis, and risk of epithelial ovarian cancer was estimated among 60,560 participants of the prospective Nurses’ Health Study using Cox proportional hazards analysis. Competing risks analysis was used to estimate association by histologic subtype.

Results

We did not observe an increased risk of ovarian cancer among participants with periodontal bone loss (HR 0.86, 95 % CI 0.64–1.15). Among women younger than 69 years, periodontal bone loss was associated with a 40 % (HR 0.60, 95 % CI 0.36–0.98) decreased ovarian cancer risk, while there was no association in women older than 69 (HR 1.09, 95 % CI 0.75–1.58), although this difference did not reach statistical significance (p-heterogeneity = 0.06). We observed a suggestive decreased risk for serous tumors (HR 0.76, 95 % CI 0.53–1.09). The number of natural teeth and root canals, other metrics of oral health, were not associated with ovarian cancer risk.

Conclusion

Our results do not support an increased ovarian cancer risk in women with periodontal bone loss; however, there was a significant decrease in risk in women younger than 69. Given the unexpected association between periodontal bone loss and ovarian cancer risk in younger women, further research is warranted.

Keywords

Ovarian cancer Periodontitis Oral microbiome Cohort study 
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Notes

Acknowledgments

This work was supported by the National Cancer Institute at the National Institutes of Health (UM1 CA186107, P01 CA87969, 5T32CA009001-38) and the Department of Defense (W81XWH-10-1-0280). We would like to thank the participants and staff of the Nurses’ Health Study for their valuable contributions as well as the following state cancer registries for their help: AL, AZ, AR, CA, CO, CT, DE, FL, GA, ID, IL, IN, IA, KY, LA, ME, MD, MA, MI, NE, NH, NJ, NY, NC, ND, OH, OK, OR, PA, RI, SC, TN, TX, VA, WA, WY.

Conflict of interest

The authors declare that they have no conflict of interest.

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Copyright information

© Springer International Publishing Switzerland 2015

Authors and Affiliations

  • Ana Babic
    • 1
    • 2
  • Elizabeth M. Poole
    • 2
  • Kathryn L. Terry
    • 1
    • 3
  • Daniel W. Cramer
    • 1
    • 3
  • Ricardo P. Teles
    • 4
  • Shelley S. Tworoger
    • 1
    • 2
  1. 1.Department of EpidemiologyHarvard T.H. Chan School of Public HealthBostonUSA
  2. 2.Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s HospitalHarvard Medical SchoolBostonUSA
  3. 3.Department of Obstetrics and Gynecology, Obstetrics and Gynecology Epidemiology Center, Brigham and Women’s HospitalHarvard Medical SchoolBostonUSA
  4. 4.Department of PeriodontologyUniversity of North Carolina School of DentistryChapel HillUSA

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