牙周病与胃肠道癌症（尤其是特定部位胃肠道癌）风险之间的关联仍不清楚。在这里，我们全面检索了 PubMed、EMBASE、Web of Science 和 Google Scholar 从成立到 2024 年 4 月的相关研究。使用随机效应模型计算汇总风险比 (HR) 和 95% 置信区间 (CI)。进行了亚组分析和敏感性分析，以确认主要研究结果在不同人群中的稳健性。本研究根据 PRISMA 2020 指南进行报告。我们总共确定了 19 项研究，包括 1660 万名参与者。与没有牙周病的人相比，患有牙周病的人患胃肠道癌症的风险更高（HR 1.31，95% CI 1.16-1.49）。牙周病使食管癌的风险显着增加39%（HR 1.39，95% CI 1.15-1.68），胃癌的风险显着增加13%（HR 1.13，95% CI 1.01-1.26），结直肠癌的风险显着增加21%（HR 1.21，95% CI 1.15-1.68）。 95% CI 1.05-1.39），胰腺癌降低 35%（HR 1.35，95% CI 1.00-1.82），肝癌降低 9%（HR 1.09，95% CI 1.04-1.13）。牙周炎（HR 1.45，95% CI 1.14-1.85）、牙龈炎（HR 1.03，95% CI 1.01-1.04）和牙周炎/牙龈炎（HR 1.27，95% CI 1.07-1.51）显着增加胃肠道癌症的风险。此外，严重的牙周病显示胃肠癌的风险显着增加（HR 1.79，95% CI 1.07-2.99）。针对特定部位胃肠道癌症的敏感性分析结果与主要发现一致。总之，牙周疾病，尤其是严重牙周炎，会增加整体和特定部位胃肠癌的风险。预防和管理牙周病的干预措施可以降低患胃肠道癌症的风险。

The association between periodontal diseases and the risk of gastrointestinal cancers, especially site-specific gastrointestinal cancers, remains unclear. Here, we comprehensively searched PubMed, EMBASE, Web of Science, and Google Scholar from inception to April 2024 to identify relevant studies. The pooled hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated with a random-effects model. Subgroup analyses and sensitivity analyses were conducted to confirm the robustness of the main findings in different populations. This study was reported according to PRISMA 2020 guidelines. In total, we identified 19 studies, including 16.6 million participants. Individuals with periodontal diseases had an increased risk of overall gastrointestinal cancers compared with those without periodontal diseases (HR 1.31, 95% CI 1.16-1.49). Periodontal diseases significantly increased the risk of esophageal cancer by 39% (HR 1.39, 95% CI 1.15-1.68), gastric cancer by 13% (HR 1.13, 95% CI 1.01-1.26), colorectal cancer by 21% (HR 1.21, 95% CI 1.05-1.39), pancreatic cancer by 35% (HR 1.35, 95% CI 1.00-1.82), and liver cancer by 9% (HR 1.09, 95% CI 1.04-1.13). The risk of gastrointestinal cancers was significantly increased by periodontitis (HR 1.45, 95% CI 1.14-1.85), gingivitis (HR 1.03, 95% CI 1.01-1.04), and periodontitis/gingivitis (HR 1.27, 95% CI 1.07-1.51). Furthermore, severe periodontal diseases showed a significantly increased risk of gastrointestinal cancer (HR 1.79, 95% CI 1.07-2.99). Results of sensitivity analyses for site-specific gastrointestinal cancers were robust with the main findings. In summary, periodontal diseases, especially severe periodontitis, increase the risk of overall and site-specific gastrointestinal cancers. Interventions to prevent and manage periodontal diseases may reduce the risk of developing gastrointestinal cancers.