Some studies suggest, for example, that the oral microbiome may play a role in periodontal disease and cancer incidence.2,3

Dysbiosis of the microbiome is defined as a definitive change in the microbiome at a given site within the host that results in reduction of host-microbial mutualism. This event was implicated in inflammatory and systemically-driven disease, including periodontal disease.

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This mechanism is highly complex, as multiple species belonging to multiple phyla were identified that promote periodontal disease. The balance of these potentially pathogenic organisms and so-called health-promoting organisms also appears to be an important factor.

Multiple studies linked microbiome dysbiosis with various cancers, including gastric and esophageal cancers, hepatobiliary cancers, pancreatic cancer, lung cancer, and colorectal cancer. Many of these are also associated with periodontal disease.

Some studies linked NHL subtypes with seropositivity to Borrelia burgdorferi, which causes Lyme disease, and presence of Chlamydophila psittaci. In leukemia, investigators found greater variety of organisms in the microbiome of the supragingival plaque among healthy children vs those with acute lymphoblastic leukemia.4

Dr Bertrand acknowledged that some oral pathogens, such as Porphyromonas gingivalis, may have a direct or indirect role in the development of NHL. “Some specific viral and bacterial infections have been linked to certain subtypes of NHL. It is plausible, therefore, that certain oral bacteria could increase NHL risk,” she said.

There are, however, no definitive studies of the oral microbiome composition and NHL risk, or similarities in the oral microbiome of individuals with periodontal disease and/or NHL.

“Further research is needed to determine whether the association we observed is causal and to identify the causal mechanism. It is also possible that an individual’s unique microbiome or microbiota could affect his or her susceptibility to both periodontal disease and NHL,” Dr Bertrand told Cancer Therapy Advisor.

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She noted that the immediate clinical implications of the findings from the study include the importance of good oral health. Additional studies are needed, however, to further evaluate the association between periodontal disease and NHL risk, as well as to determine common mechanisms.


  1. Bertrand KA, Shingala J, Evens A, Birmann BM, Giovannucci E, Michaud DS. Periodontal disease and risk of non-Hodgkin lymphoma in the Health Professionals Follow-Up Study. Intl J Cancer. 2017;140:1020-6. doi: 10.1002/ijc.30518
  2. Mira A, Simon-Soro A, Curtis MA. Role of microbial communities in the pathogenesis of periodontal diseases and caries. J Clin Periodontal. 2017;44(Suppl 18): S23-S38. doi: 10.1111/jcpe.12671
  3. Vogtmann E, Goedert JJ. Epidemiologic studies of the human microbiome and cancer. Br J Cancer. 2016;114:237-42. doi: 10.1038/bjc.2015.465
  4. Wang Y, Xue J, Zhou X, et al. Oral microbiota distinguishes acute lymphoblastic leukemia pediatric hosts from healthy populations. PLoS ONE. 2014;9:e102116. doi: 10.1371/journal.pone.0102116