Background: Chronic periodontitis, an inflammation-related disorder affecting global populations, has been revealed to be linked to diverse cancers. Numerous epidemiological studies have not shown a link between chronic periodontitis and blood cancers in Taiwan. Methods: This study included 601,628 patients, diagnosed with newly chronic periodontitis by the ICD-9-CM classification, who were enrolled from 2001 to 2021 in the National Health Insurance Research Database (NHIRD) in Taiwan. In this study, we employed comprehensive statistical analyses to investigate the association between chronic periodontitis and hematologic cancers. Initially, we calculated incidence density and used a Poisson regression to analyze relative risk. Subsequently, we compared the cumulative incidence of hematological cancer in both chronic and non-chronic periodontitis groups using the Kaplan–Meier method. Results: The results revealed a significantly lower cumulative incidence of hematologic cancer in individuals with non-chronic periodontitis over a 12-year follow-up period. To further explore the risk factors, a Cox proportional hazard regression analysis was conducted. Being male (adjusted hazard ratio [aHR] = 1.21, 95% CI: 1.04 to 1.42;p= 0.014) and having hypertension (aHR = 1.34, 95% CI: 1.06 to 1.69;p= 0.015) were demonstrated to be associated with an increased risk of hematologic cancers, respectively. In addition, in a subtype multivariate analysis for categorizing hematologic cancers into lymphoma and leukemia, the aHR for leukemia was 1.48 (95% CI: 1.13 to 1.93;p= 0.004) and aHR for lymphoma was 1.15 (95% CI: 0.96 to 1.37;p= 0.140). Conclusions: This study found that being male and having hypertension were the significant risk factors for hematological malignancies. Moreover, the association between chronic periodontitis and specific subtypes of hematologic cancers was confirmed.
背景：慢性牙周炎作为一种影响全球人口的炎症相关疾病，已被揭示与多种癌症存在关联。然而，台湾地区多项流行病学研究尚未证实慢性牙周炎与血液癌症之间的明确联系。方法：本研究纳入2001年至2021年间台湾全民健康保险研究数据库中601,628名根据ICD-9-CM分类新诊断为慢性牙周炎的患者。通过系统性的统计分析方法，我们深入探讨了慢性牙周炎与血液系统恶性肿瘤之间的潜在关联。首先计算发病率密度并采用泊松回归分析相对风险，随后运用Kaplan-Meier法比较慢性牙周炎组与非慢性牙周炎组的血液癌症累积发病率。结果：在12年随访期间，非慢性牙周炎人群的血液癌症累积发病率显著较低。通过Cox比例风险回归模型进一步分析风险因素发现，男性（调整后风险比[aHR] = 1.21，95% CI：1.04-1.42；p=0.014）与高血压病史（aHR = 1.34，95% CI：1.06-1.69；p=0.015）均为血液系统恶性肿瘤的独立危险因素。在将血液癌症细分为淋巴瘤与白血病的亚型多变量分析中，白血病aHR为1.48（95% CI：1.13-1.93；p=0.004），淋巴瘤aHR为1.15（95% CI：0.96-1.37；p=0.140）。结论：本研究表明男性性别与高血压病史是血液系统恶性肿瘤的重要风险因素，同时证实了慢性牙周炎与特定血液癌症亚型之间的关联性。
Association between Periodontitis and Hematologic Cancer: An NHIRD Cohort Study in Taiwan
肿瘤(癌症)患者之家