Growing data indicate an association between periodontal disease and the development of cancer. However, the evidence for colorectal cancer has been inconsistent and longitudinal study examining its precursor lesions is lacking. We prospectively collected information on periodontal disease and number of tooth loss in the Nurses' Health Study (1992–2002) and the Health Professionals Follow-up Study (1992–2010). Polyp diagnosis was acquired via self-reported questionnaires and confirmed through review of medical records. We used logistic regression to calculate the multivariate-adjusted ORs and 95% confidence intervals (CI) with adjustment for smoking and other known risk factors for periodontal disease and colorectal cancer. In this study, we included 17,904 women and 24,582 men. We documented 2,336 cases of serrated polyps and 4,102 cases of conventional adenomas among 84,714 person-endoscopies throughout follow-up. The ORs of serrated polyps and conventional adenomas comparing individuals with and without periodontal disease were 1.17 (95% CI, 1.06–1.29) and 1.11 (95% CI, 1.02–1.19), respectively. Compared with participants without tooth loss, those who lost ≥4 teeth had 20% (OR, 1.20; 95% CI, 1.03–1.39) greater risk of serrated polyps (Ptrend 0.01). Among never smokers, similar associations with periodontal disease were observed for both serrated polyps (OR, 1.20; 95% CI, 1.02–1.41) and conventional adenomas (OR, 1.12; 95% CI, 1.00–1.26). History of periodontal disease and possibly higher number of tooth loss may modestly increase the risk of developing colorectal precursor lesions. Our findings advance our understanding of the interplay between oral health, microbiome, and early colorectal carcinogenesis.

中文翻译：

---

牙周病、牙齿脱落以及锯齿状息肉和传统腺瘤的风险

越来越多的数据表明牙周病与癌症的发展之间存在关联。然而，结直肠癌的证据并不一致，并且缺乏检查其前体病变的纵向研究。我们在护士健康研究（1992-2002）和卫生专业人员随访研究（1992-2010）中前瞻性地收集了有关牙周病和牙齿脱落数量的信息。息肉诊断是通过自我报告的问卷获得的，并通过查看病历来确认。我们使用逻辑回归来计算多变量调整后的 OR 和 95% 置信区间 (CI)，并调整吸烟和牙周病和结直肠癌的其他已知危险因素。在这项研究中，我们包括 17,904 名女性和 24,582 名男性。我们记录了 2,336 例锯齿状息肉和 4, 在整个随访期间，84,714 人的内窥镜检查中有 102 例常规腺瘤。锯齿状息肉和传统腺瘤的 OR 分别为 1.17（95% CI，1.06-1.29）和 1.11（95% CI，1.02-1.19）。与没有牙齿脱落的参与者相比，失去 4 颗牙齿的参与者患锯齿状息肉的风险高 20%（OR，1.20；95% CI，1.03-1.39）（Ptrend 0.01）。在从不吸烟者中，锯齿状息肉 (OR, 1.20; 95% CI, 1.02–1.41) 和传统腺瘤 (OR, 1.12; 95% CI, 1.00–1.26) 与牙周病的相关性相似。牙周病史和可能更多的牙齿脱落可能会适度增加患结直肠前体病变的风险。我们的发现促进了我们对口腔健康、微生物组、