Abstract 4350: Human oral microbiome and prospective risk for pancreatic cancer: a population based, nested case control study

Abstract

Abstract Background: A history of periodontal disease and the presence of circulating antibodies to selected oral pathogens have been associated with increased risk of pancreatic cancer in prospective studies; however, relationships of oral microbes with pancreatic cancer have not been directly evaluated. We conducted a prospective study to examine the relationship of oral microbiota with subsequent risk of pancreatic cancer. Methods: We selected 361 incident pancreatic cancer cases and 371 matched controls from two prospective cohort studies, the ACS Cancer Prevention Study (CPS) II and the NCI Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial (PLCO). From pre-diagnostic oral wash samples, we characterized the composition of the oral microbiota using bacterial 16S rRNA gene amplification and sequencing. Logistic regression analysis was used to examine the association between oral microbiota and risk of pancreatic cancer, controlling for the random effect of cohorts and other covariates, age, race, sex, smoking status, alcohol consumption, body mass index, and history of diabetes. Findings: Carriage of oral pathogens, Porphyromonas gingivalis and Aggregatibacter actinomycetemcomitans, were associated with higher risk of pancreatic cancer (adjusted Odds Ratio [OR]p.g = 1·59 and 95% confidence interval [CI] = 1·15-2·20; ORa.a = 2·19 and 95%CI = 1·15-4·15, respectively). Greater relative abundance of phylum Fusobacteria was associated with decreased pancreatic cancer risk (OR per percent increase of abundance = 0·92, 95%CI = 0·87-0·98). Risks related to these phylotypes remained after exclusion of cases that developed within two years of sample collection, reducing the likelihood of reverse causation in this prospective study. Interpretation: The study provides evidence that the oral mcirobiota plays a role in the etiology of pancreatic cancer and may point to accessible means for prevention of this disease. Citation Format: Xiaozhou Fan, Alexander V. Alekseyenko, Jing Wu, Eric J. Jacobs, Susan M. Gapstur, Mark P. Purdue, Christian C. Abnet, Rachael Stolzenberg-Solomon, George Miller, Jacque Ravel, Richard B. Hayes, Jiyoung Ahn. Human oral microbiome and prospective risk for pancreatic cancer: a population based, nested case control study. [abstract]. In: Proceedings of the 107th Annual Meeting of the American Association for Cancer Research; 2016 Apr 16-20; New Orleans, LA. Philadelphia (PA): AACR; Cancer Res 2016;76(14 Suppl):Abstract nr 4350.