Risk of Colorectal Cancer in Patients With Periodontal Disease Severity: A Nationwide, Population-Based Cohort Study

Int J Colorectal Dis. 2018 Mar;33(3):349-352. doi: 10.1007/s00384-018-2965-2. Epub 2018 Feb 3.


Background: Periodontal disease (PD) and colorectal cancer (CRC) were associated with chronic inflammation. This retrospective cohort study examined the association between PD severity and CRC in a large-scale, population-based Chinese cohort.

Methods: A total of approximately 106,487 individuals with newly diagnosed PD and 106,487 age-matched and sex-matched patients without PD from 2000 to 2002 were identified from Taiwan's National Health Insurance Research Database (NHIRD).

Results: The Kaplan-Meier analysis revealed that the cumulative incidence of CRC was significantly higher in patients with PD than in those without PD (log-rank test, P < 0.001). After adjustment for age, sex, and comorbidities, patients with PD were associated with a significantly higher risk of CRC compared with those without PD (adjusted HR = 1.64, 95% CI = 1.50-1.80). Further, the risk of CRC appeared to increase with increasing frequency of PD medical visits [adjusted HR (95% CI) was 1.78 (1.58-2.02) and 1.53 (1.35-1.74) for annual visits > 10 and < 4, respectively].

Conclusion: Based on our study, PD severity was associated with an increase in the risk of CRC. Further mechanistic research is needed.

Keywords: Colorectal cancer (CRC); National Health Insurance Research Database (NHIRD); Periodontal disease (PD); Retrospective cohort study.

MeSH terms

  • Adult
  • Cohort Studies
  • Colorectal Neoplasms / epidemiology*
  • Colorectal Neoplasms / etiology*
  • Female
  • Humans
  • Kaplan-Meier Estimate
  • Male
  • Periodontal Diseases / complications*
  • Periodontal Diseases / pathology*
  • Risk Factors
  • Severity of Illness Index*