Non-Cochrane · aetiology · PM41889038
Periodontal Disease and Incidence of Cancers: A Systematic Review and Meta-analysis of Cohort Studies.
Duan Chengwei, Wan Weiping, Tureke Muhetaer, et al. · International dental journal · 2026 · PubMed · doi:10.1016/j.identj.2026.109527
Findings
Population Participants in cohort studies with and without periodontal disease, followed for cancer incidence
67 findings
| Periodontal disease (exposure) | No periodontal disease | Incidence of prostate cancer Long follow-up (above the median follow-up of included studies) · Cohort studies from America, Asia and Europe · Long follow-up | RR 1.26 [1.02, 1.56] GRADE not reported 2 studies |
| Periodontal disease (exposure) | No periodontal disease | Incidence of colorectal cancer Short follow-up (below the median follow-up of included studies) · Cohort studies from America, Asia and Europe · Short follow-up | RR 1.47 [0.82, 2.65] GRADE not reported 4 studies |
| Periodontal disease (exposure) | No periodontal disease | Incidence of bladder cancer Cohort studies from America, Asia and Europe · Asian studies | RR 1.22 [1.04, 1.44] GRADE not reported 2 studies |
| Periodontal disease (exposure) | No periodontal disease | Incidence of head and neck cancer Short follow-up (below the median follow-up of included studies) · Cohort studies from America, Asia and Europe · Short follow-up | RR 1.20 [1.09, 1.32] GRADE not reported 2 studies |
| Periodontal disease (exposure) | No periodontal disease | Incidence of gastric cancer Short follow-up (below the median follow-up of included studies) · Cohort studies from America, Asia and Europe · Short follow-up | RR 1.22 [0.94, 1.58] GRADE not reported 3 studies |
| Periodontal disease (exposure) | No periodontal disease | Incidence of bladder cancer Short follow-up (below the median follow-up of included studies) · Cohort studies from America, Asia and Europe · Short follow-up | RR 1.26 [1.12, 1.43] GRADE not reported 3 studies |
| Periodontal disease (exposure) | No periodontal disease | Incidence of bladder cancer Cohort studies from America, Asia and Europe · Clinically examined PD | RR 1.16 [0.93, 1.46] GRADE not reported 2 studies |
| Periodontal disease (exposure) | No periodontal disease | Incidence of esophageal cancer Short follow-up (below the median follow-up of included studies) · Cohort studies from America, Asia and Europe · Short follow-up | RR 1.10 [1.05, 1.17] GRADE not reported 3 studies |
| Periodontal disease (exposure) | No periodontal disease | Incidence of colorectal cancer Cohort studies from America, Asia and Europe · Self-reported PD | RR 1.28 [1.01, 1.62] GRADE not reported 7 studies |
| Periodontal disease (exposure) | No periodontal disease | Incidence of pancreatic cancer Long follow-up (above the median follow-up of included studies) · Cohort studies from America, Asia and Europe · Long follow-up | RR 1.45 [1.11, 1.89] GRADE not reported 5 studies |
| Periodontal disease (exposure) | No periodontal disease | Incidence of gastric cancer Cohort studies from America, Asia and Europe · Clinically examined PD | RR 1.11 [1.04, 1.16] GRADE not reported 3 studies |
| Periodontal disease (exposure) | No periodontal disease | Incidence of pancreatic cancer Short follow-up (below the median follow-up of included studies) · Cohort studies from America, Asia and Europe · Short follow-up | RR 1.03 [0.88, 1.20] GRADE not reported 4 studies |
| Periodontal disease (exposure) | No periodontal disease | Incidence of colorectal cancer Cohort studies from America, Asia and Europe · American studies | RR 1.17 [0.93, 1.48] GRADE not reported 4 studies |
| Periodontal disease (exposure) | No periodontal disease | Incidence of prostate cancer Short follow-up (below the median follow-up of included studies) · Cohort studies from America, Asia and Europe · Short follow-up | RR 1.15 [1.03, 1.28] GRADE not reported 2 studies |
| Periodontal disease (exposure) | No periodontal disease | Incidence of esophageal cancer Long follow-up (above the median follow-up of included studies) · Cohort studies from America, Asia and Europe · Long follow-up | RR 1.35 [1.11, 1.64] GRADE not reported 4 studies |
| Periodontal disease (exposure) | No periodontal disease | Incidence of esophageal cancer Cohort studies from America, Asia and Europe · American studies | RR 1.24 [0.98, 1.57] GRADE not reported 3 studies |
| Periodontal disease (exposure) | No periodontal disease | Incidence of kidney cancer Short follow-up (below the median follow-up of included studies) · Cohort studies from America, Asia and Europe · Short follow-up | RR 1.20 [0.98, 1.46] GRADE not reported 2 studies |
| Periodontal disease (exposure) | No periodontal disease | Incidence of lung cancer Cohort studies from America, Asia and Europe · Asian studies | RR 1.30 [0.75, 2.28] GRADE not reported 3 studies |
| Periodontal disease (exposure) | No periodontal disease | Incidence of hematologic cancer Cohort studies from America, Asia and Europe · Asian studies | RR 1.50 [0.65, 3.46] GRADE not reported 2 studies |
| Periodontal disease (exposure) | No periodontal disease | Incidence of colorectal cancer Long follow-up (above the median follow-up of included studies) · Cohort studies from America, Asia and Europe · Long follow-up | RR 1.23 [1.00, 1.50] GRADE not reported 7 studies |
| Periodontal disease (exposure) | No periodontal disease | Incidence of esophageal cancer Cohort studies from America, Asia and Europe · Asian studies | RR 0.98 [0.98, 1.19] GRADE not reported 3 studies |
| Periodontal disease (exposure) | No periodontal disease | Incidence of lung cancer Cohort studies from America, Asia and Europe · American studies | RR 1.31 [1.12, 1.53] GRADE not reported 3 studies |
| Periodontal disease (exposure) | No periodontal disease | Incidence of lung cancer Short follow-up (below the median follow-up of included studies) · Cohort studies from America, Asia and Europe · Short follow-up | RR 1.40 [0.85, 2.31] GRADE not reported 3 studies |
| Periodontal disease (exposure) | No periodontal disease | Incidence of bladder cancer Geometric mean follow-up 13.89 years · Cohort studies from America, Asia and Europe | RR 1.21 [1.11, 1.32] GRADE not reported 6 studies · 1092434 participants |
| Periodontal disease (exposure) | No periodontal disease | Incidence of melanoma cancer Geometric mean follow-up 14.69 years · Cohort studies from America, Asia and Europe | RR 1.06 [0.86, 1.30] GRADE not reported 2 studies · 49712 participants |
| Periodontal disease (exposure) | No periodontal disease | Incidence of breast cancer Short follow-up (below the median follow-up of included studies) · Cohort studies from America, Asia and Europe · Short follow-up | RR 1.16 [1.10, 1.23] GRADE not reported 3 studies |
| Periodontal disease (exposure) | No periodontal disease | Incidence of kidney cancer Long follow-up (above the median follow-up of included studies) · Cohort studies from America, Asia and Europe · Long follow-up | RR 1.16 [0.72, 1.86] GRADE not reported 2 studies |
| Periodontal disease (exposure) | No periodontal disease | Incidence of hematologic cancer Geometric mean follow-up 11.03 years · Cohort studies from America, Asia and Europe | RR 1.32 [0.84, 2.09] GRADE not reported 4 studies · 295274 participants |
| Periodontal disease (exposure) | No periodontal disease | Incidence of gastric cancer Cohort studies from America, Asia and Europe · American studies | RR 1.42 [1.15, 1.74] GRADE not reported 3 studies |
| Periodontal disease (exposure) | No periodontal disease | Incidence of pancreatic cancer Cohort studies from America, Asia and Europe · Clinically examined PD | RR 1.11 [0.96, 1.26] GRADE not reported 4 studies |
| Periodontal disease (exposure) | No periodontal disease | Incidence of hematologic cancer Long follow-up (above the median follow-up of included studies) · Cohort studies from America, Asia and Europe · Long follow-up | RR 0.98 [0.87, 1.10] GRADE not reported 2 studies |
| Periodontal disease (exposure) | No periodontal disease | Incidence of hematologic cancer Cohort studies from America, Asia and Europe · Self-reported PD | RR 1.72 [0.98, 3.02] GRADE not reported 2 studies |
| Periodontal disease (exposure) | No periodontal disease | Incidence of gastric cancer Long follow-up (above the median follow-up of included studies) · Cohort studies from America, Asia and Europe · Long follow-up | RR 1.17 [0.92, 1.48] GRADE not reported 4 studies |
| Periodontal disease (exposure) | No periodontal disease | Incidence of colorectal cancer Cohort studies from America, Asia and Europe · Asian studies | RR 1.35 [0.92, 1.99] GRADE not reported 6 studies |
| Periodontal disease (exposure) | No periodontal disease | Incidence of bladder cancer Long follow-up (above the median follow-up of included studies) · Cohort studies from America, Asia and Europe · Long follow-up | RR 1.16 [0.93, 1.46] GRADE not reported 3 studies |
| Periodontal disease (exposure) | No periodontal disease | Incidence of hematologic cancer Cohort studies from America, Asia and Europe · American studies | RR 1.31 [1.13, 1.53] GRADE not reported 2 studies |
| Periodontal disease (exposure) | No periodontal disease | Incidence of colorectal cancer Cohort studies from America, Asia and Europe · Clinically examined PD | RR 1.04 [0.96, 1.12] GRADE not reported 4 studies |
| Periodontal disease (exposure) | No periodontal disease | Incidence of breast cancer Geometric mean follow-up 10.73 years · Cohort studies from America, Asia and Europe | RR 1.11 [1.03, 1.17] GRADE not reported 7 studies · 374483 participants |
| Periodontal disease (exposure) | No periodontal disease | Incidence of gastric cancer Cohort studies from America, Asia and Europe · Asian studies | RR 1.10 [1.05, 1.17] GRADE not reported 3 studies |
| Periodontal disease (exposure) | No periodontal disease | Incidence of lung cancer Geometric mean follow-up 11.48 years · Cohort studies from America, Asia and Europe | RR 1.29 [0.97, 1.72] GRADE not reported 7 studies · 1132860 participants |
| Periodontal disease (exposure) | No periodontal disease | Incidence of kidney cancer Geometric mean follow-up 11.70 years · Cohort studies from America, Asia and Europe | RR 1.16 [0.93, 1.44] GRADE not reported 4 studies · 1027615 participants |
| Periodontal disease (exposure) | No periodontal disease | Incidence of lung cancer Cohort studies from America, Asia and Europe · Self-reported PD | RR 1.19 [1.09, 1.31] GRADE not reported 4 studies |
| Periodontal disease (exposure) | No periodontal disease | Incidence of head and neck cancer Geometric mean follow-up 10.03 years · Cohort studies from America, Asia and Europe | RR 1.11 [1.03, 1.21] GRADE not reported 5 studies · 1069853 participants |
| Periodontal disease (exposure) | No periodontal disease | Incidence of lung cancer Cohort studies from America, Asia and Europe · Clinically examined PD | RR 1.49 [0.67, 3.31] GRADE not reported 3 studies |
| Periodontal disease (exposure) | No periodontal disease | Incidence of hematologic cancer Cohort studies from America, Asia and Europe · Clinically examined PD | RR 0.97 [0.86, 1.09] GRADE not reported 2 studies |
| Periodontal disease (exposure) | No periodontal disease | Incidence of kidney cancer Cohort studies from America, Asia and Europe · Asian studies | RR 1.06 [0.79, 1.44] GRADE not reported 2 studies |
| Periodontal disease (exposure) | No periodontal disease | Incidence of pancreatic cancer Geometric mean follow-up 12.36 years · Cohort studies from America, Asia and Europe | RR 1.26 [1.03, 1.52] GRADE not reported 9 studies · 1391853 participants |
| Periodontal disease (exposure) | No periodontal disease | Incidence of esophageal cancer Cohort studies from America, Asia and Europe · Clinically examined PD | RR 1.13 [0.88, 1.46] GRADE not reported 4 studies |
| Periodontal disease (exposure) | No periodontal disease | Incidence of bladder cancer Cohort studies from America, Asia and Europe · Self-reported PD | RR 1.26 [1.12, 1.43] GRADE not reported 4 studies |
| Periodontal disease (exposure) | No periodontal disease | Incidence of breast cancer Long follow-up (above the median follow-up of included studies) · Cohort studies from America, Asia and Europe · Long follow-up | RR 1.02 [0.97, 1.08] GRADE not reported 4 studies |
| Periodontal disease (exposure) | No periodontal disease | Incidence of gastric cancer Geometric mean follow-up 16.69 years · Cohort studies from America, Asia and Europe | RR 1.16 [1.08, 1.25] GRADE not reported 7 studies · 1220129 participants |
| Periodontal disease (exposure) | No periodontal disease | Incidence of prostate cancer Geometric mean follow-up 26.55 years · Cohort studies from America, Asia and Europe | RR 1.17 [1.07, 1.29] GRADE not reported 4 studies · 275876 participants |
| Periodontal disease (exposure) | No periodontal disease | Incidence of kidney cancer Cohort studies from America, Asia and Europe · American studies | RR 1.32 [1.06, 1.65] GRADE not reported 2 studies |
| Periodontal disease (exposure) | No periodontal disease | Incidence of hematologic cancer Short follow-up (below the median follow-up of included studies) · Cohort studies from America, Asia and Europe · Short follow-up | RR 1.73 [0.99, 3.03] GRADE not reported 2 studies |
| Periodontal disease (exposure) | No periodontal disease | Incidence of lung cancer Long follow-up (above the median follow-up of included studies) · Cohort studies from America, Asia and Europe · Long follow-up | RR 1.16 [0.83, 1.62] GRADE not reported 4 studies |
| Periodontal disease (exposure) | No periodontal disease | Incidence of head and neck cancer Long follow-up (above the median follow-up of included studies) · Cohort studies from America, Asia and Europe · Long follow-up | RR 0.97 [0.86, 1.11] GRADE not reported 3 studies |
| Periodontal disease (exposure) | No periodontal disease | Incidence of pancreatic cancer Cohort studies from America, Asia and Europe · American studies | RR 1.07 [0.95, 1.89] GRADE not reported 4 studies |
| Periodontal disease (exposure) | No periodontal disease | Incidence of head and neck cancer Cohort studies from America, Asia and Europe · Asian studies | RR 1.05 [0.89, 1.25] GRADE not reported 3 studies |
| Periodontal disease (exposure) | No periodontal disease | Incidence of pancreatic cancer Cohort studies from America, Asia and Europe · Asian studies | RR 1.07 [0.93, 1.22] GRADE not reported 4 studies |
| Periodontal disease (exposure) | No periodontal disease | Incidence of bladder cancer Cohort studies from America, Asia and Europe · American studies | RR 1.27 [1.12, 1.44] GRADE not reported 3 studies |
| Periodontal disease (exposure) | No periodontal disease | Incidence of esophageal cancer Cohort studies from America, Asia and Europe · Self-reported PD | RR 1.24 [0.98, 1.57] GRADE not reported 3 studies |
| Periodontal disease (exposure) | No periodontal disease | Incidence of gastric cancer Cohort studies from America, Asia and Europe · Self-reported PD | RR 1.34 [1.11, 1.63] GRADE not reported 4 studies |
| Periodontal disease (exposure) | No periodontal disease | Incidence of pancreatic cancer Cohort studies from America, Asia and Europe · Self-reported PD | RR 1.42 [1.03, 1.96] GRADE not reported 5 studies |
| Periodontal disease (exposure) | No periodontal disease | Incidence of colorectal cancer Geometric mean follow-up 15.01 years · Cohort studies from America, Asia and Europe | RR 1.16 [1.01, 1.34] GRADE not reported 11 studies · 1283990 participants |
| Periodontal disease (exposure) | No periodontal disease | Incidence of liver cancer Geometric mean follow-up 10.26 years · Cohort studies from America, Asia and Europe | RR 1.12 [1.04, 1.21] GRADE not reported 3 studies · 979240 participants |
| Periodontal disease (exposure) | No periodontal disease | Incidence of esophageal cancer Geometric mean follow-up 11.05 years · Cohort studies from America, Asia and Europe | RR 1.34 [1.04, 1.71] GRADE not reported 7 studies · 6243547 participants |
| Periodontal disease (exposure) | No periodontal disease | Incidence of head and neck cancer Cohort studies from America, Asia and Europe · American studies | RR 1.13 [0.80, 1.60] GRADE not reported 2 studies |
Included primary studies 27
Open in Studies| Study | Year | Also included by | Outcomes it informs here | Trial data |
|---|---|---|---|---|
| Arora M 2010 An Exploration of Shared Genetic Risk Factors Between Periodontal Disease and Cancers: A Prospective Co-Twin Study DOI:10.1093/aje/kwp340 | 2009 | this review only | not stated | not extracted yet |
| Bertrand KA 2017 Periodontal disease and risk of non‐Hodgkin lymphoma in the Health Professionals Follow‐Up Study DOI:10.1002/ijc.30518 | 2016 | this review only | not stated | not extracted yet |
| Boylan MR 2014 A Prospective Study of Periodontal Disease and Risk of Gastric and Duodenal Ulcer in Male Health Professionals DOI:10.1038/ctg.2013.14 | 2014 | this review only | not stated | not extracted yet |
| Chang JS 2016 Investigating the Association Between Periodontal Disease and Risk of Pancreatic Cancer DOI:10.1097/mpa.0000000000000419 | 2016 | this review only | not stated | not extracted yet |
| Chou SH 2018 Severity of chronic periodontitis and risk of gastrointestinal cancers DOI:10.1097/md.0000000000011386 | 2018 | this review only | not stated | not extracted yet |
| Chung SD 2016 A population-based study on the associations between chronic periodontitis and the risk of cancer DOI:10.1007/s10147-015-0884-6 | 2015 | this review only | not stated | not extracted yet |
| Farhat 2021 Periodontal Disease and Breast Cancer Risk: Results from the Nurses' Health Study DOI:10.1158/1055-9965.epi-21-0257 | 2021 | this review only | not stated | not extracted yet |
| Farhat Z 2021 matched by author and year (probable) | NR | this review only | not stated | not extracted yet |
| Freudenheim JL 2016 Periodontal Disease and Breast Cancer: Prospective Cohort Study of Postmenopausal Women DOI:10.1158/1055-9965.epi-15-0750 | 2016 | this review only | not stated | not extracted yet |
| Gerlovin H 2020 Oral Health in Relation to Pancreatic Cancer Risk in African American Women DOI:10.1158/1055-9965.epi-18-1053 | 2019 | this review only | not stated | not extracted yet |
| Hu JM 2018 Risk of colorectal cancer in patients with periodontal disease severity: a nationwide, population-based cohort study DOI:10.1007/s00384-018-2965-2 | 2018 | this review only | not stated | not extracted yet |
| Jia M 2020 The Association Between Periodontal Disease and Breast Cancer in a Prospective Cohort Study DOI:10.1158/1940-6207.capr-20-0018 | 2020 | this review only | not stated | not extracted yet |
| Kang EJ 2023 Associations between missing teeth and the risk of cancer in Korea: a nationwide cohort study DOI:10.1186/s12903-023-02997-x | 2023 | this review only | not stated | not extracted yet |
| Kim BG 2024 Chronic periodontitis and risk of lung cancer: a nationwide cohort study DOI:10.3389/fonc.2024.1413590 | 2024 | this review only | not stated | not extracted yet |
| Kim EH 2022 Periodontal disease and cancer risk: A nationwide population-based cohort study DOI:10.3389/fonc.2022.901098 | 2022 | this review only | not stated | not extracted yet |
| Lee JH 2017 Association between Periodontal disease and Prostate cancer: Results of a 12-year Longitudinal Cohort Study in South Korea. PMID:28928887 | 2017 | this review only | not stated | not extracted yet |
| Lo CH 2020 Periodontal disease, tooth loss, and risk of oesophageal and gastric adenocarcinoma: a prospective study DOI:10.1136/gutjnl-2020-321949 | 2020 | this review only | not stated | not extracted yet |
| Mai X 2014 History of periodontal disease diagnosis and lung cancer incidence in the Women’s Health Initiative Observational Study DOI:10.1007/s10552-014-0405-3 | 2014 | this review only | not stated | not extracted yet |
| Mai X 2016 Periodontal disease severity and cancer risk in postmenopausal women: the Buffalo OsteoPerio Study DOI:10.1007/s10552-015-0699-9 | 2015 | this review only | not stated | not extracted yet |
| Michaud DS 2007 A Prospective Study of Periodontal Disease and Pancreatic Cancer in US Male Health Professionals DOI:10.1093/jnci/djk021 | 2007 | this review only | not stated | not extracted yet |
| Michaud DS 2009 Periodontal disease, tooth loss, and cancer risk in male health professionals: a prospective cohort study DOI:10.1016/s1470-2045(08)70106-2 | 2008 | this review only | not stated | not extracted yet |
| Michaud DS 2016 Periodontal disease and risk of all cancers among male never smokers: an updated analysis of the Health Professionals Follow-up Study DOI:10.1093/annonc/mdw028 | 2016 | this review only | not stated | not extracted yet |
| Michaud DS 2018 Periodontal Disease Assessed Using Clinical Dental Measurements and Cancer Risk in the ARIC Study DOI:10.1093/jnci/djx278 | 2018 | this review only | not stated | not extracted yet |
| Momen-Heravi F 2017 Periodontal disease, tooth loss and colorectal cancer risk: Results from the Nurses' Health Study DOI:10.1002/ijc.30486 | 2016 | this review only | not stated | not extracted yet |
| Nwizu NN 2017 Periodontal Disease and Incident Cancer Risk among Postmenopausal Women: Results from the Women's Health Initiative Observational Cohort DOI:10.1158/1055-9965.epi-17-0212 | 2017 | this review only | not stated | not extracted yet |
| Oh H 2020 Gastric and duodenal ulcers, periodontal disease, and risk of bladder cancer in the Health Professionals Follow-up Study DOI:10.1007/s10552-020-01274-4 | 2020 | this review only | not stated | not extracted yet |
| Zhang J 2022 Poor Oral Health and Esophageal Cancer Risk: A Nationwide Cohort Study DOI:10.1158/1055-9965.epi-22-0151 | 2022 | this review only | not stated | not extracted yet |
Review question
| Element | Planned (methods) | Found (results) |
|---|---|---|
| Population | Humans in cohort or longitudinal studies | 16,257,141 participants and 53,884 cancer cases across 26 cohort studies (US, Korea, China, Sweden) |
| Intervention | Periodontal disease (self-reported or clinically examined) | Periodontal disease, self-reported or clinically examined |
| Comparison | Participants without periodontal disease | No periodontal disease |
| Outcomes | Incident cancer (HR, RR or OR); at least two studies per cancer type | Incident cancers: colorectal (n=11), pancreatic (9), breast (7), gastric (7), lung (7), esophageal (7), bladder (6), head and neck (5), prostate (4), hematologic (4), kidney (4), liver (3), melanoma (2) |
| Study designs | Prospective and retrospective cohort studies | 26 cohort studies (NOS scores 7 to 9) |
| Timing | Follow-up duration (short vs long) | Geometric mean follow-up 10.03 to 26.55 years by cancer type |