Periodontal Disease and Systemic Cancer Risk: A Community-Based Cross-Sectional Study in Guntur, South India
DOI:
https://doi.org/10.64149/J.Carcinog.24.2s.367-373Abstract
Background: Periodontal disease (PD), a chronic inflammatory condition affecting 20–50% of adults worldwide, is linked to systemic carcinogenesis, particularly in high-tobacco-use regions like South India, where tobacco synergistically amplifies oncogenic pathways. This study assesses severe PD's association with cancer risk, tobacco modification, and role in initiation versus metastasis in an underserved South Indian cohort.
Methods: This cross-sectional study (May 2025–July 2025) enrolled 200 participants (40–75 years) at a Guntur, India, cancer screening camp: 100 with confirmed systemic malignancies (52 non-metastatic [M0], 48 metastatic [M1]) and 100 matched controls. Blinded examiners assessed periodontal parameters (e.g., CAL, PPD, BoP, PDI). Adjusted multivariate logistic regression estimated ORs (95% CIs); interaction/subgroup analyses were performed (Hosmer-Lemeshow p=0.72; R²=0.42).
Results: Cancer patients had worse periodontal health (e.g., CAL: 5.6 ± 1.5 mm vs. 2.3 ± 0.9 mm, p < 0.001; d=2.6). Severe PD increased risk (OR=5.12 [2.78–9.43] for CAL >4 mm; OR=5.89 [3.12–11.09] for PDI >3; p < 0.001), amplified by tobacco (interaction OR=2.34 [1.15–4.76]; p=0.02). Higher risks for oral cancer (OR=6.8) and smokers (OR=7.2) vs. non-oral (OR=4.7) and non-smokers (OR=3.8). No metastasis link (p > 0.39). ARI for severe CAL: 38% (NNH=3).
Conclusion: Severe PD elevates cancer risk in South Indian high-risk groups via initiation, modulated by tobacco. Community PD screening (~$50/patient) could prevent 10–15% of cases; longitudinal studies are needed.
