A Prospective Investigation of the Oral Microbiome and Pancreatic Cancer

The emergence of new microbial gene sequencing and bioinformatics methods provides an opportunity to study how oral microbial communities may contribute to pancreatic cancer risk and disparities. Leveraging the existing resources of two prospective, epidemiologic studies, the Black Women’s Health Study (BWHS) and the Southern Community Cohort Study, we propose to substantially advance this emerging line of enquiry by conducting a comprehensive investigation of the oral microbiome and pancreatic cancer. In a nested case-control study of 125 incident pancreatic cancer cases and 450 controls, using pre-diagnostic oral rinse samples, we will employ high-output genomic shotgun sequencing to characterize and compare the oral microbiome of cases and controls, hypothesizing that microbial abundance, diversity, and/or function will differ between these groups. Among the controls, we will also evaluate racial differences in the oral microbiome and identify any differences that may explain the increased incidence of pancreatic cancer among African Americans. We will further determine the association between recognized, modifiable risk factors for pancreatic cancer (cigarette smoking, obesity, red meat and processed meat consumption, alcohol consumption, type 2 diabetes) and oral microbiome attributes, and evaluate whether these exposures are associated with high-risk oral microbiome profiles. This study could have both immediate and long-term major impact by opening the doors for new mechanistic research as well as translational activities including manipulating the microbiome for cancer prevention, developing therapies related to the microbiome, and ultimately reducing the incidence of, and disparities in, pancreatic cancer.