Evidence map›Paper›PMID 26689418›Full record

Observational studyCancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology2016

Periodontal Disease and Breast Cancer: Prospective Cohort Study of Postmenopausal Women.

Jo L Freudenheim, Robert J Genco, Michael J LaMonte, Amy E Millen, Kathleen M Hovey, Xiaodan Mai, Ngozi Nwizu, Christopher A Andrews, Jean Wactawski-Wende

Open access · bronzeAbstract readObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 55 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
55citing papers in PubMed, 4 pooled it
7.7field-weighted citation impact, top 2% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

55 citing papers in PubMed, 4 syntheses or guidelines pooled it, 94 citations in OpenAlex.

  1. Pooled it
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  8. Observational
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  13. A retrospective cohort study of the oral healthcare needs of cancer patients.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2025
    Article
  14. The Oral Microbiome and Cancer.Advances in experimental medicine and biology · 2025
    Review
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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

9 authors at 2 institutions in 1 country.

Jo L FreudenheimDepartment of Epidemiology and Environmental Health, School of Public Health and Health Professions, University at Buffalo, State University of New York, Buffalo, New York. jfreuden@buffalo.edu.
Robert J GencoDepartment of Oral Biology, School of Dental Medicine, University at Buffalo, State University of New York, Buffalo, New York.
Michael J LaMonteDepartment of Epidemiology and Environmental Health, School of Public Health and Health Professions, University at Buffalo, State University of New York, Buffalo, New York.
Amy E MillenDepartment of Epidemiology and Environmental Health, School of Public Health and Health Professions, University at Buffalo, State University of New York, Buffalo, New York.
Kathleen M HoveyDepartment of Epidemiology and Environmental Health, School of Public Health and Health Professions, University at Buffalo, State University of New York, Buffalo, New York.
Xiaodan MaiDepartment of Epidemiology and Environmental Health, School of Public Health and Health Professions, University at Buffalo, State University of New York, Buffalo, New York.
Ngozi NwizuDepartment of Diagnostic and Biomedical Sciences, School of Dentistry, The University of Texas Health Science Center at Houston School of Dentistry, Houston, Texas.
Christopher A AndrewsDepartment of Ophthalmology and Visual Sciences, University of Michigan, Ann Arbor, Michigan.
Jean Wactawski-WendeDepartment of Epidemiology and Environmental Health, School of Public Health and Health Professions, University at Buffalo, State University of New York, Buffalo, New York.
University at Buffalo, State University of New York · USThe University of Texas Health Science Center at Houston · US

Funding

Interdisciplinary Training in Cancer Epidemiology at UBR25CA113951 · NCI · STATE UNIVERSITY OF NEW YORK AT BUFFALO · PI FREUDENHEIM, JO L., MOYSICH, KIRSTEN B. · 2007 to 2016
$2.5M
NCI NIH HHS R25 CA113951NCI NIH HHS R25CA113951NHLBI NIH HHS HHSN268201100001INHLBI NIH HHS HHSN268201100002INHLBI NIH HHS HHSN268201100003INHLBI NIH HHS HHSN268201100004INHLBI NIH HHS HHSN268201100046CNIA NIH HHS HHSN271201100004CWHI NIH HHS HHSN268201100001CWHI NIH HHS HHSN268201100002CWHI NIH HHS HHSN268201100003CWHI NIH HHS HHSN268201100004C
6 · The paper itself

Abstract

backgroundPeriodontal disease has been consistently associated with chronic disease; there are no large studies of breast cancer, although oral-associated microbes are present in breast tumors.

methodsIn the Women's Health Initiative Observational Study, a prospective cohort of postmenopausal women, 73,737 women without previous breast cancer were followed. Incident, primary, invasive breast tumors were verified by physician adjudication. Periodontal disease was by self-report. HRs and 95% confidence intervals (CI) were estimated by Cox proportional hazards, adjusted for breast cancer risk factors. Because the oral microbiome of those with periodontal disease differs with smoking status, we examined associations stratified by smoking.

results2,124 incident, invasive breast cancer cases were identified after mean follow-up of 6.7 years. Periodontal disease, reported by 26.1% of women, was associated with increased breast cancer risk (HR 1.14; 95% CI, 1.03-1.26), particularly among former smokers who quit within 20 years (HR 1.36; 95% CI, 1.05-1.77). Among current smokers, the trend was similar (HR 1.32; 95% CI, 0.83-2.11); there were few cases (n = 74) and the CI included the null. The population attributable fraction was 12.06% (95% CI, 1.12-21.79) and 10.90% (95% CI, 10.31-28.94) for periodontal disease among former smokers quitting within 20 years and current smokers, respectively.

conclusionPeriodontal disease, a common chronic inflammatory disorder, was associated with increased risk of postmenopausal breast cancer, particularly among former smokers who quit in the past 20 years. IMPACT: Understanding a possible role of the oral microbiome in breast carcinogenesis could impact prevention.

Indexed as

AgedBreast NeoplasmsFemaleFollow-Up StudiesHumansMiddle AgedNeoplasm InvasivenessNeoplasm StagingPeriodontal DiseasesPostmenopausePrognosisProspective StudiesWomen's Health

Identifiers

PMID26689418
PMCPMC4713270
OpenAlexW2210320168

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.