Poor oral health is associated with a 75 per cent increased risk of hepatocellular carcinoma (HCC), the most common form of liver cancer, new research has found.
The study, by researchers at Queen’s University Belfast, analysed a large cohort of over 469,000 people in the United Kingdom (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 per cent 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 Haydée WT 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 biggest 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 per cent and approximately nine in 10 cases are in individuals over the age of 55 ref media pack. 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.
Meanwhile, new report on inequalities in access to water, sanitation and hygiene also reveals more than half of the world does not have access to safe sanitation services.
According to a new report by the United Nations Children Fund (UNICEF) and the World Health Organisation (WHO), billions of people around the world are continuing to suffer from poor access to water, sanitation and hygiene. Some 2.2 billion people around the world do not have safely managed drinking water services, 4.2 billion people do not have safely managed sanitation services, and 3 billion lack basic handwashing facilities.
The Joint Monitoring Programme Report, progress on drinking water, sanitation and hygiene: 2000-2017: Special focus on inequalities finds that, while significant progress has been made toward achieving universal access to basic water, sanitation and hygiene, there are huge gaps in the quality of services provided.
“Mere access is not enough. If the water isn’t clean, is not safe to drink or is far away, and if toilet access is unsafe or limited, then we’re not delivering for the world’s children,” said Kelly Ann Naylor, Associate Director of Water, Sanitation and Hygiene, UNICEF.
“Countries must double their efforts on sanitation or we will not reach universal access by 2030,” said Dr. Maria Neira, WHO Director, Department of Public Health, Environmental and Social Determinants of Health.