Oral Health in Relation to Pancreatic Cancer Risk in African American Women

Background: Incidence of pancreatic cancer is higher in African Americans than in U.S. whites. We hypothesized that poor oral health, disproportionately common in African Americans and associated with increased risk of pancreatic cancer in several studies of predominantly white populations, may play a role in this disparity.

Methods: We examined the relation of self-reported measures of oral health (periodontal disease and adult tooth loss) in relation to pancreatic cancer incidence in the prospective Black Women's Health Study (BWHS). Cox proportional hazard analyses were used to calculate HRs of pancreatic cancer for women with periodontal disease, tooth loss, or both, relative to women who reported neither. Multivariable models adjusted for age, cigarette smoking, body mass index (BMI), type 2 diabetes, and alcohol consumption.

Results: Participants aged 33 to 81 were followed for an average of 9.85 years from 2007 through 2016, with occurrence of 78 incidence cases of pancreatic cancer. Multivariable HRs for pancreatic cancer incidence were 1.77 [95% confidence interval (CI) 0.57–5.49] for periodontal disease with no tooth loss, 2.05 (95% CI, 1.08–3.88) for tooth loss without report of periodontal disease, and 1.58 (95% CI, 0.70–3.57) for both tooth loss and periodontal disease. The HR for loss of at least five teeth, regardless of whether periodontal disease was reported, was 2.20 (95% CI, 1.11–4.33).

Conclusions: The poor oral health experienced by many African Americans may contribute to their higher incidence of pancreatic cancer.

Impact: Future research will assess associations between the oral microbiome and pancreatic cancer risk in this population.