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Certain oral bacteria linked to esophageal cancer
Tannerella forsythia — bacteria commonly linked to gum disease — appeared associated with a 21% increased risk for esophageal cancer, according to study results.
Strands of Streptococcus and Neisseria bacteria appeared associated with an approximate 24% decrease in risk, the research showed.
“Our study brings us much closer to identifying the underlying causes of these cancers, because we now know that at least in some cases, disease appears consistently linked to the presence of specific bacteria in the upper digestive tract,” Jiyoung Ahn, PhD, associate professor of population health and associate director of population sciences at the Laura and Isaac Perlmutter Cancer Center at NYU Langone Medical Center, said in a press release. “Conversely, we have more evidence that the absence or loss of other bacteria in the mouth may lead to these cancers, or to gut diseases that trigger these cancers.”
Previous research showed an association between periodontal disease from various oral microbiota and several cancers, including oral and head and neck cancers. No studies have prospectively reviewed whether upper digestive tract microbiota influences risk for subsequent esophageal cancer.
Ahn and colleagues evaluated data from 122,000 patients from the NCI Prostate, Lung, Colorectal and Ovarian Cancer Screening Trial cohort and American Cancer Society Cancer Prevention Study II Nutrition cohort.
Both cohorts collected oral wash samples, comprehensive demographics and prospective follow-up for cancer incidence.
Researchers assessed oral bacteria using 16S rRNA gene sequencing in prediagnostic mouthwash samples from 81 patients with esophageal cancer — matched with 160 controls — and 25 patients with esophageal squamous cell carcinoma cases, matched with 50 controls.
Alcohol appeared to be the only risk factor associated with esophageal squamous cell carcinoma (P = .004) among the groups when researchers evaluated patient characteristics.
Doubling of the abundance of T. forsythia — a periodontal pathogen — appeared associated with a 1.21 (95% CI, 1.01-1.46) times higher likelihood for esophageal adenocarcinoma.
Increased abundance of species Actinomyces cardiffensis, Selenomonas oral taxon 134, and
Veillonella oral taxon 917 also increased risk for esophageal adenocarcinoma (P < .05 for all).
However, increased abundance of Corynebacterium durum, Prevotella nanceiensis, Streptococcus pneumoniae, Lachnoanaerobaculum umeaense, Oribacterium parvum, Solobacterium moorei, Neisseria sicca, Neisseria flavescens and Haemophilus oral taxon 908 each decreased risk (P < .05 for all).
Increased abundance of Porphyromonas gingivalis, another periodontal pathogen, showed a marginally increased risk for esophageal squamous cell carcinoma (OR = 1.3; 95% CI, 0.96-1.77), but not esophageal adenocarcinoma.
Increased abundance of Prevotella nanceiensis, Bergeyella oral taxon 322, Neisseria weaveri and Treponema vincentii appeared linked to higher esophageal squamous cell carcinoma risk, whereas increased abundance of Prevotella oral taxon 306 and Aggregatibacter paraphrophilus decreased risk (P < .05 for all).
“Our study indicates that learning more about the role of oral microbiota may potentially lead to strategies to prevent esophageal cancer, or at least to identify it at earlier stages,” Ahn said in a press release. “The next step is to verify whether these bacteria could be used as predictive biomarkers.”
Because researchers did not have complete information on oral health, they could not determine whether oral pathogens alone affected esophageal cancer risk, or if periodontal disease was the risk factor.
Still, the findings may be useful for assessing disease risk and for the early detection of esophageal cancers.
“Esophageal cancer is a highly fatal cancer, and there is an urgent need for new avenues of prevention, risk stratification and early detection,” Ahn said in a press release. “Early diagnosis could really help because esophageal cancers are often diagnosed in the later stages when the disease is harder to treat.” – by Melinda Stevens
Disclosures: The authors report no relevant financial disclosures.