Preventing pancreatic cancer through good oral health?

Certain types of bacteria and fungi found in the mouth may increase the risk of pancreatic cancer, according to a major study published in JAMA Oncology, paving the way for oral swabs as a potential method of prevention.Risk factors for pancreatic cancer—smoking, obesity, a history of pancreatitis and genetics—account for only 30% of cases. Other causes remain to be clarified, including the role of poor oral health in the development of the disease. Experts have long observed that those with poor oral health are more vulnerable to pancreatic cancer than those with healthier mouths, but precisely which species may contribute to the condition had until now remained unclear.122,000 participantsThe American research team analyzed the oral microbiome sequencing of 122,000 participants who had provided a buccal sample to identify groups of bacteria involved in the carcinogenesis of pancreatic tumours. In this cohort, 445 patients developed pancreatic cancer during the 13-year followup period. These patients were matched with 445 healthy patients who formed the control group.The researchers identified about 20 bacteria and fungi that were more prevalent in the mouths of patients even before they were diagnosed. Periodontal bacteria from the red complex (Porphyromonas gingivalis) and orange complex (Eubacterium nodatum and Parvimonas micra) were particularly associated with a higher risk of pancreatic cancer.Ingesting oral pathogens“When ingested, oral pathogens can reach pancreatic tissue and cause significant changes in the pancreatic microbiome,” researchers wrote. “This leads to dysbiosis and the release of microbial metabolites and toxins, thereby promoting the formation of pancreatic tumours.” Thirteen other bacteria were more prevalent in individuals with pancreatic cancer, including three species of the genus Bacteroidetes, six species of the genus Actinobacteria, one Fusobacterium and Firmicutes.Based on the species identified, the researchers constructed a bacterial profile grouping together the microbes that appeared to be the most threatening. They targeted a combination of 27 microbial agents, including three periodontal pathogens, 20 other bacterial species, and four fungi. Individuals whose analysis included all these agents were three times more likely to develop pancreatic cancer (OR = 3.44; 95% CI, 2.63-4.51).According to the researchers, a simple oral swab could be an accessible and non-invasive way to identify individuals at highest risk and implement personalized prevention approaches.Fungi to watch out forThe oral mycobiome has also revealed fungal species that appear to be harmful. In particular, an abundance of Candida in the mouth has been associated with a higher risk of pancreatic cancer. Candida has also been detected in the tumours of cancer patients.“Although research has mainly focused on the bacterial microbiome, the relationship between oral fungi and the risk of pancreatic cancer remains largely unexplored. Yet fungi interact with bacterial communities and influence the overall microbial balance,” the study authors pointed out.This article has been translated from its original French and first appeared on our sister site Profession Santé.

Preventing pancreatic cancer through good oral health?

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