(Vienna, June 18, 2019) Poor oral health is associated with a 75% increased risk of hepatocellular carcinoma (HCC), the most common form of liver cancer, new research published in UEG Journal has found.
The study, by researchers at Queen’s University Belfast, analysed a large cohort of over 469,000 people in the UK, investigated the association between oral health conditions and the risk of a number of gastrointestinal cancers, including liver, colon, rectum and pancreatic cancer. Models were applied to estimate the relationship between cancer risk and self-reported oral health conditions, such as painful or bleeding gums, mouth ulcers and loose teeth.
Whilst no significant associations were observed on the risk of the majority gastrointestinal cancers and poor oral health, a substantial link was found for hepatobiliary cancer.
“Poor oral health has been associated with the risk of several chronic diseases, such as heart disease, stroke and diabetes”, explained Dr Haydée WT Jordão, from the Centre of Public Health at Queen’s University Belfast and lead author of the study. “However, there is inconsistent evidence on the association between poor oral health and specific types of gastrointestinal cancers, which is what our research aimed to examine.”
Of the 469,628 participants, 4,069 developed gastrointestinal cancer during the (average) six-year follow up. In 13% of these cases, patients reported poor oral health. Participants with poor oral health were more likely to be younger, female, living in deprived socioeconomic areas and consumed less than two portions of fruit and vegetables per day.
The biological mechanisms by which poor oral health may be more strongly associated with liver cancer, rather than other digestive cancers, is currently uncertain. One explanation is the potential role of the oral and gut microbiome in disease development. “The liver contributes to the elimination of bacteria from the human body”, stated Dr Jordão. “When the liver is affected by diseases, such as hepatitis, cirrhosis or cancer, its function will decline and bacteria will survive for longer and therefore have the potential to cause more harm. One bacteria, Fusobacterium nucleatum, originates in the oral cavity but its role in liver cancer is unclear. Further studies investigating the microbiome and liver cancer are therefore warranted.”
Another theory in explaining the higher cancer risk due to poor oral health suggests that participants with a high number of missing teeth may alter their diet, consuming softer and potentially less nutritious foods, which in turn influence the risk of liver cancer.
Liver cancer is the sixth bigger cancer killer in the EU, claiming the lives of almost 60,000 people per year. The five-year survival rate for the disease across Europe is just 11%4 and approximately 9 in 10 cases are in individuals over the age of 55 ref media pack3. It is believed that up to half of cases of liver cancer are preventable, with risk factors often relating to lifestyle, such as overweight or obesity, smoking and alcohol consumption.
Notes to Editors
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UEG, or United European Gastroenterology, is a professional non-profit organisation combining all the leading European medical specialist and national societies focusing on digestive health. Together, its member societies represent over 30,000 specialists, working across medicine, surgery, paediatrics, gastrointestinal oncology and endoscopy. This makes UEG the most comprehensive organisation of its kind in the world, and a unique platform for collaboration and the exchange of knowledge.
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About Queens University Belfast
Queen’s University Belfast is a member of the Russell Group of the UK’s leading research-intensive universities. Queen’s is a global top 200 university and is a UK top ten research-intensive university. Founded by Queen Victoria in 1845, as one of three Queen’s Colleges in Ireland, it became an independent university in its own right in 1908 and, today, combines its international academic reputation with its standing as a leader in innovation and education. The University has won six Queen’s Anniversary Prizes for Further and Higher Education, five Times Higher Education Awards, and is currently the leading institution in the UK for the commercialisation of its intellectual property and for knowledge transfer partnerships. Four Global Research Institutes are the University’s flagships for interdisciplinary research in areas of major societal challenge, including inclusive secure and enriched societies, technology futures and a healthy global population.
Find out more about UEG’s work by visiting www.ueg.eu or contact:
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- UEG Journal. 2019. The association between self-reported poor oral health and gastrointestinal cancer risk in the UK Biobank: A large prospective cohort study. Available at: https://journals.sagepub.com/doi/full/10.1177/2050640619858043
- World Cancer Research Fund report on Diet, Nutrition and Liver cancer risk: https://www.wcrf-uk.org/uk/preventing-cancer/cancer-types/liver-cancer
- ECIS - European Cancer Information System: https://ecis.jrc.ec.europa.eu/
- Cancer Research UK, Liver Cancer Survival Statistics: https://www.cancerresearchuk.org/health-professional/cancer-statistics/statistics-by-cancer-type/liver-cancer/survival#heading-One
- International Liver Congress 2019 Media Pack: https://ilc-congress.eu/wp-content/uploads/2019/04/EASL-ILC-2019-Media-Kit-Final.pdf
- Cancer Research UK, Liver Cancer Statistics: https://www.cancerresearchuk.org/health-professional/cancer-statistics/statistics-by-cancer-type/liver-cancer#heading-Three