Correlation Between Chronic Periodontitis and Lung Cancer: A Systematic Review With Meta-Analysis

Periodontal disease is associated with many systemic diseases, such as cardiovascular diseases, atherosclerosis, diabetes mellitus, stroke, and pulmonary diseases. Interestingly, recent literature suggests that periodontal disease might be a risk factor for various cancers such as lung, colon, oesophageal, head, and neck cancers. However, the precise mechanistic link is lacking. Hence, in this meta-analysis, we aimed to investigate the correlation between periodontal disease and lung cancer in periodontally diseased patients. Data were searched for relevant studies from 2010 to 2022. We correlated periodontal disease and lung cancer based on adjusted ORs/HRs and associated CIs. I2 statistic was used to assess statistical heterogeneity. Publication bias was analyzed by visually inspecting the symmetry of the funnel plot and Egger's test. The study is registered in the International Prospective Register of Systematic Reviews (PROSPERO; registration no: CRD42023390819). A total of 194,850 participants from observational studies (two case-control studies and five cohort studies) were incorporated for the current analysis. The meta-analysis of included studies showed an overall effect size (risk ratio) of the periodontal disease group with respect to the non-periodontal disease group for lung neoplasm to be 1.41 (95% CI: 1.32-1.52). The value was more than 1, indicating that the periodontal disease group had a relatively higher lung cancer prevalence than the non-periodontal disease group. Further, the overall risk ratio was found to be statistically significant (p<0.00001). Moreover, the funnel plot suggested some degree of publication bias. Evidence in our study implicated that there is an increased risk of occurrence of lung cancer in chronic periodontitis patients.