The interrelationship between periodontitis and pancreatic cancer: a retrospective cohort study.

[BACKGROUND] Periodontitis and pancreatic cancer are major public health concerns with increasing prevalence worldwide, including in Taiwan. Although previous studies have suggested a potential association between periodontitis and pancreatic cancer, findings remain inconclusive, particularly in Taiwanese populations. This study aimed to investigate the relationship between periodontitis and pancreatic cancer.

[METHODS] The study conducted a retrospective cohort study using data from Taiwan's National Health Insurance Research Database (NHIRD) between 2000 and 2019. Patients diagnosed with periodontitis were compared with matched controls without periodontitis. All statistical analyses were conducted using SAS software. Beyond descriptive statistics, the study conducted bivariate analyses to examine differences between patients with and without pancreatic cancer, followed by Cox regression to further evaluate the the risk of pancreatic cancer, adjusting for demographic, clinical, and socioeconomic factors.

[RESULTS] A total of 428,814 patients with periodontitis and matched controls were included. Overall, no significant increase in pancreatic cancer risk was observed among periodontitis patients compared with controls (aHR = 1.08, 95% CI: 0.96-1.22). However, subgroup analyses indicated higher risks in specific populations, including males (aHR = 1.16, 95% CI: 1.01-1.34), individuals aged 45-64 years (aHR = 4.43, 95% CI: 3.68-5.33), and those aged ≥ 65 years (aHR = 9.18, 95% CI: 7.43-11.30). Additionally, low annual expenditures for periodontitis care (≤ USD 11) and higher outpatient visit frequencies (> 0.7 per year) were associated with increased pancreatic cancer risk.

[CONCLUSION] The study findings underscore the potential role of periodontitis as a risk factor for pancreatic cancer in specific subgroups. Effective management of periodontitis, particularly among high-risk populations, may help mitigate systemic inflammatory effects linked to pancreatic cancer. Further studies are warranted to clarify the underlying mechanisms and inform targeted prevention strategies.