Periodontitis as a field of cancerization: association with carcinoembryonic antigen in colorectal cancer patients

Abstract

OBJECTIVES: This study aimed to, first, determine the prevalence of periodontitis in patients diagnosed with colorectal cancer (CRC) through a comprehensive clinical periodontal evaluation, and second, to analyze the relationship between periodontitis and different tumor severity variables. MATERIALS AND METHODS: In a cross-sectional and analytical study in patients with CRC, we divided the patients into two groups, periodontitis and non-periodontitis, based on a complete periodontal assessment (clinical attachment loss, probing pocket depth, bleeding on probing, plaque index, number of present teeth, and a periodontal severity index). In both groups, in addition to sociodemographic variables, 12 histopathological tumor severity variables were compared. RESULTS: Out of 59 patients diagnosed with CRC, 41 (69.5%, 95% CI: 56.1-80.8) were diagnosed with periodontitis. The mean values in ng/mL of baseline and peak carcinoembryonic antigen (CEA) in the periodontitis patient group, mean ± SD (0.44 ± 0.39, 0.69 ± 0.49), were much higher compared to the non-periodontitis group (0.11 ± 0.29, 0.35 ± 0.45), 95% CI: 0.12-0.54, p < 0.001 and 95% CI: 0.06-0.62, p = 0.005, respectively. The rest of the comparisons between the different characteristics and histopathological variables of the tumor showed very similar results between both groups. CONCLUSIONS: The 69.5% prevalence of periodontitis in patients with colorectal cancer highlights the relationship between both diseases. Furthermore, the association between periodontitis and elevated CEA levels suggests a possible role of chronic inflammation in tumor susceptibility. However, the absence of an association with other histopathological variables suggests that periodontitis is not related to cancer severity. CLINICAL RELEVANCE: Recognizing periodontitis as a potential field cancerization highlights the importance of periodontal management as a possible strategy to reduce CRC susceptibility. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s00784-025-06399-x.