Relationship between Community Periodontal Index and Fecal Hemoglobin Concentration,an Indicator for Colorectal Neoplasm

Abstract

Periodontal disease and colorectal cancer have inflammatory processes in common. It is therefore worthwhile to investigate whether there is an association between periodontal probing depth and fecal hemoglobin concentration (FHbC), an indicator of colorectal neoplasms, in 40- to 44-year-old Taiwanese. We enrolled a total of 6,214 attendees aged 40 to 44 yr who were participating in a community-based integrated screening program and who received both periodontal and FHbC examinations between 2003 and 2008. A proportional odds logistic regression model was used to estimate the odds ratios of different FHbC levels in treating an increased level of community periodontal index (CPI) measuring periodontal probing depth as ordinary data from 0 to 4. Periodontal probing depth with the order of CPI was in parallel with an increase in the mean values of FHbC: 21.3 ± 156.3, 26.0 ± 167.7, 27.2 ± 151.1, and 39.5 ± 255.7 ng/mL for CPI 0, CPI 1, CPI 2, and CPI 3/4, respectively. The log-FHbC varied across the categories of CPI (p = .0078). After adjusting for age, sex, education level, smoking, alcohol intake, exercise, body mass index, and intake of meat and vegetables, subjects with positive fecal immunochemical test results (FHbC ≥ 100 ng/mL) had a 33% higher risk of deteriorating to severe CPI than did those within the normal range of fecal immunochemical test (FHbC < 100 ng/mL) (adjusted odds ratio = 1.33, 95% confidence interval: 1.03-1.73). A positive association was demonstrated between FHbC and periodontal probing depth assessed by CPI among 6,214 Taiwanese aged 40 to 44 yr who participated in a community-based integrated health screening program. These results could have significant implications for early identification of high-risk individuals, as those with deep periodontal pockets should be advised to undergo screening for colorectal cancer at a younger age than commonly recommended.