Adverse Health Effects of Betel Quid and the Risk of Oral and Pharyngeal Cancers

Abstract

Global reports estimate 600 million betel quid (BQ) chewers. BQ chewing has been demonstrated not only to be a risk factor for cancers of the oral cavity and pharynx and oral potentially malignant disorders (OPMD) but also to cause other cancers and adverse health effects. Herein, we summarized the international comparison data to aid in the understanding of the close relationship between the prevalence of BQ chewing, the occurrence of oral and pharyngeal cancers, and adverse health effects. Potential biomarkers of BQ carcinogens, such as areca nut, alkaloids, and 3-methylnitrosaminopropionitrile (MNPN), are closely associated with human health toxicology. Molecular mechanisms or pathways involving autophagy, hypoxia, COX-2, NF-κB activity, and stemness are known to be induced by BQ ingredients and are very closely related to the carcinogenesis of cancers of oral and pharynx. BQ abuse-related monoamine oxidase (MAO) gene was associated with the occurrence and progress of oral and pharyngeal cancers. In summary, our review article provides important insights into the potential roles of environmental BQ (specific alkaloid biomarkers and nitrosamine products MNPN) and genetic factors (MAO) and offers a basis for studies aiming to reduce or eliminate BQ-related OPMD and oral/pharyngeal cancer incidences in the future.

Effects of income and residential area on survival of patients with head and neck cancers following radiotherapy: working age individuals in Taiwan

“…Approximately 10% of Taiwan’s population habitually chews betel nut (∼2 million people) ( Ko et al, 1992 ). This percentage is higher in Southern and Eastern Taiwan, particularly among men (men: 16.5%; women: 2.9%), those of lower SES, habitual smokers, alcoholics, and aborigines ( Chen et al, 2017 ; Chi-Pang et al, 2009 ).…”

Head and neck cancer prevention: from primary prevention to impact of clinicians on reducing burden

“…In endemic countries, betel quid chewing dates back thousands of years and is integrated into both ceremonial situations and daily life [63]. Betel quid users chew recreationally and during working hours for pharmacological effects: euphoria, heightened alertness, focused attention, appetite suppression, and improved digestion [64]. Approximately 600 million people worldwide chew betel quid [61], and it is the fourth most commonly consumed psychoactive substance behind alcohol, nicotine, and caffeine [65].…”

Long non‑coding RNA expression profiles and related regulatory networks in areca nut chewing‑induced tongue squamous cell carcinoma

“…Areca nut has been identified as a group 1 carcinogen that is closely associated with the development of OSCC and its precancerous lesions (11). Epidemiological evidence has demonstrated that in the Indian mainland, Southeast Asia countries and Hunan province of China, extensive areca nut chewing has caused a high incidence of OSCC, including TSCC (10,24,54).…”

“…Although surgery, radiotherapy and chemotherapy have demonstrated great progress in cancer treatment in recent decades, the 5-year survival rate (40-50%) remains low, and the prognosis of most patients is poor (6)(7)(8)(9)(10). Among the pathogenic factors of several TSCCs, reports have demonstrated an association between areca nut chewing and TSCC (11,12).…”