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Tooth loss, pancreatic cancer, and Helicobacter pylori^1,2,3

¹ From the Nutritional Epidemiology Branch, Division of Cancer Epidemiology and Genetics (RZS-S and DA), the Statistical Research and Applications Branch, Division of Cancer Control and Population Sciences (KWD), and the Cancer Prevention Studies Branch, Center for Cancer Research (PRT), National Cancer Institute, Bethesda, MD; the Departments of Medicine and Microbiology, New York University School of Medicine and the Department of Veterans Affairs Medical Center, New York (MJB); and the National Public Health Institute, Helsinki (JV).

Background: Poor dental health has been associated with increased risks of oral, esophageal, and gastric cancer and may also be associated with pancreatic cancer. In addition, Helicobacter pylori has been found in dental plaque and has been associated with periodontal disease and pancreatic cancer.

Objective: The objective was to investigate prospectively the relation between dentition history and pancreatic cancer in the Alpha-Tocopherol, Beta-Carotene Cancer Prevention Study cohort in Finland and the association between dentition history and H. pylori seropositivity in a cross-sectional sample of subjects without cancer (n = 475) from the same cohort.

Design: Of the 29 104 male smokers aged 50–69 y in the cohort for whom there were complete data, 174 developed pancreatic cancer from 1985 to 1997. Cox proportional hazard models were used to estimate age-, smoking-, education-, urban living–, and height-adjusted hazard ratios and 95% CIs for pancreatic cancer, and logistic regression models were used to estimate age- and education-adjusted odds ratios for H. pylori carriage.

Results: Tooth loss was positively associated with pancreatic cancer (edentulous compared with missing 0–10 teeth: hazard ratio = 1.63; 95% CI: 1.09, 2.46; P for trend = 0.02) but was not significantly associated with H. pylori seropositivity (edentulous compared with missing 0–10 teeth: odds ratio = 1.30; 95% CI: 0.73, 2.32; P for trend = 0.37).

Conclusion: Additional studies are needed to evaluate the association between tooth loss and pancreatic cancer, as well as cancers at other gastrointestinal sites, particularly with respect to possible biological mechanisms.

Key Words: Pancreatic cancer • Helicobacter pylori • tooth loss • male smokers • Finland

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