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stronger associations in those who never smoke (up to a 3-fold increase in risk). The possible mechanisms include those
already mentioned for oral cancer.
Conclusion
To date, a limited number of investigations can be used to analyze the relationship between periodontal disease and
various cancers. At this point, the data suggest some potential concerns with links between periodontal disease and oral,
upper gastrointestinal, gastric and pancreatic cancer, but there is no reliable data to support any link to lung cancer. Further
research is needed to confirm the present findings and to help explain the underlying biological mechanisms. These studies
will have to rigorously control for confounding factors such as smoking, diet and socioeconomic status. In fact, the studies
should probably be restricted to subjects who never smoke, include dietary monitoring (fruit, vegetable and vitamin C intake)
and examine individuals with documented healthy immune systems. In this way, we can be sure that periodontitis is not simply
a marker for compromised immune systems that are not able to clear infection and perform effective surveillance for tumour
growth. a
References
1. Pihlstrom BL, Michalowicz BS, Johnson NW. Periodontal diseases. Lancet 2005; 366(9499):1809–20.
2. Meyer MS, Joshipura K, Giovannucci E, Michaud DS. A review of the relationship between tooth loss, periodontal disease, and cancer. Cancer
Causes Control 2008 May 14. [Epub ahead of print]
3. Saygun I, Kubar A, Ozdemir A, Slots J. Periodontitis lesions are a source of salivary cytomegalovirus and Epstein-Barr virus. J Periodontal Res
2005; 40(2):187–91.
4. Hansson BG, Rosenquist K, Antonsson A, Wennerberg J, Schildt EB, Bladström A, and other. Strong association between infection with
human papillomavirus and oral and oropharyngeal squamous cell carcinoma: a population-based case-control study in southern Sweden. Acta
Otolaryngol 2005; 125(12):1337–44.
5. Karin M, Lawrence T, Nizet V. Innate immunity gone awry: linking microbial infections to chronic inflammation and cancer. Cell 2006;
124(4):823–35.
Dr. Anthony M. Iacopino is dean, professor of restorative dentistry and director of the International Centre for Oral–Systemic Health at the
faculty of dentistry, University of Manitoba, Winnipeg, Manitoba. Email: iacopino@cc.umanitoba.ca.
Alberta Honours Dr. George Zarb
Dr. George Zarb of Toronto was presented with Honourary Membership in the
Alberta Dental Association and College (ADA&C) at a ceremony held in Jasper
in May. Honourary Membership is the highest award given by the ADA&C, recognizing
individuals from outside Alberta who have made outstanding contributions
to the art or science of dentistry or to the dental profession over a sustained period
of time.
Dr. Zarb was professor and head of prosthodontics at the faculty of dentistry
at the University of Toronto until his retirement from academia. His clinical
research was in implant prosthodontics and the clinical management of temporomandibular
disorders.
He has written more than 150 papers on different aspects of prosthodontics and
is co-author of 13 textbooks. Dr. Zarb continues to practise his specialty in Toronto
and is editor-in-chief of the International Journal of Prosthodontics.
Dr. Zarb has received numerous awards throughout his career, including
honorary doctorates from the University of Gothenburg, Dalhousie University, the University of Malta,
the University of Montreal and the University of Turin. Dr. Zarb was recently named as a member of the
Order of Canada. a
590 JCDA • www.cda-adc.ca/jcda • September 2008, Vol. 74, No. 7 •
Dr. George Zarb (right), ADA&C 2008 Honourary
Membership recipient, with Dr. Gordon
Thompson, ADA&C executive director and
registrar.