The precancer risk of betel quid chewing, tobacco use and alcohol consumption in oral leukoplakia and oral submucous fibrosis in southern Taiwan

Ch, Lee; Yc, Ko; Hl, Huang; Chao, Yu-Ying; Tsai, Chang‐Youh; Ty, Shieh; Lm, Lin

doi:10.1038/sj.bjc.6600727

Cited by 239 publications

(208 citation statements)

References 20 publications

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“…In our study, a 2.9-and 2.2-fold elevated risk of contracting esophageal cancer was found to relate to areca nut chewing with a piece of Piper Betel Linn inflorescence and with betel leaf/stem and inflorescence mixed, respectively; both types of products do not use tobacco as an ingredient in Taiwan. 4,9 Comparable results were reported by studies conducted in 2 areas of India, 15,23 in those studies a 1.6 -2.2-fold increase risk for esophageal cancer was observed among chewers without tobacco. These findings suggest that chewing products without tobacco was an independent risk factor for squamous cell carcinoma of the esophagus.…”

Section: Discussionmentioning

confidence: 70%

“…As reported in our previous studies, smoking not only explains about 62.0% of lung cancer in men in Taiwan, 33 but combining with betel quid chewing, the 2 factors account for 86.5% of oral precancer (oral leukoplakia or submucous fibrosis). 9 Avoidance or cessation of use of these substances would greatly benefit the health of the residents in Taiwan. Although approximately 36% of cancer cases in our study were excluded from the final data analyses, similar patterns for selected demographic factors, such as age and gender between recruited and non-recruited patients were detected in each geographic area. Education in the present study was found to strongly relate to risk of esophageal caner.…”

Section: Discussionmentioning

confidence: 99%

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Independent and combined effects of alcohol intake, tobacco smoking and betel quid chewing on the risk of esophageal cancer in Taiwan

Lee

et al. 2004

Intl Journal of Cancer

208

175

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A multicenter case-control study was conducted in northern and southern Taiwan to clarify the independent and combined effects of alcohol intake, tobacco smoking and betel quid chewing on the risk of esophageal cancer. A total of 513 patients with newly diagnosed and histopathologically confirmed squamous cell carcinoma of the esophagus and 818 gender, age and study hospitalmatched controls were included. We found a significant doseresponse relationship between the duration and intensity of consumption of the 3 substances and the development of this neoplasm in this site. Although the amount of alcohol consumed had a stronger effect on the risk of esophageal cancer than the number of years it was consumed, however, the number of years one smoked had a stronger effect on the risk than the amount of cigarettes consumed. The strongest risk factor of esophageal cancer was alcohol intake, with highest risk (OR ‫؍‬ 13.9) being for those who consumed more than 900 g/day-year. Combined exposure to any 2 of 3 substances brought the risks up to 8.8 -19.7 fold and, to all 3 substances, to 41.2-fold. A multiplicative interaction effect for alcohol drinkers who smoked on cancer risk was detected, whereas an additive interaction effect was found among drinkers who chewed. The combined effect of all 3 substances accounted for 83.7% of the attributable fraction of contracting esophageal cancer in this population. In conclusion, these results suggest that the intensity and the length of time alcohol and tobacco are used play different roles in the etiology of esophageal cancer. Alcohol separately interacts with tobacco and betel quid in a differently synergistic way in determining the development of this site of cancer.

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Section: Discussionmentioning

confidence: 70%

Section: Discussionmentioning

confidence: 99%

Independent and combined effects of alcohol intake, tobacco smoking and betel quid chewing on the risk of esophageal cancer in Taiwan

Lee

et al. 2004

Intl Journal of Cancer

208

175

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“…Tobacco and alcohol have been established as risk factors for the development of such potentially malignant and malignant disorders of the oral mucosa (Jaber et al, 1999;Moreno-Lopez et al, 2000;Lee et al, 2003;Znaor et al, 2003;Saraswathi et al, 2006;Yen et al, 2007;Cebeci et al, 2009;Javed et al, 2010). In South India chewing betel quid/ paan (betel leaf enclosing sliced areca nut, catechu, lime and various other spices which may or may not contain tobacco) (Warnakulasuriya et al, 2002;Rani et al, 2003;Aruna et al, 2011) is a common habit but the evidence for cancer occurrence due to this habit without tobacco is limited (Znaor et al, 2003;Lee et al, 2005).…”

Section: Introductionmentioning

confidence: 99%

Prevalence and Correlation of Oral Lesions among Tobacco Smokers, Tobacco Chewers, Areca Nut and Alcohol Users

Sujatha¹,

Hebbar²,

Pai³

2012

Asian Pacific Journal of Cancer Prevention

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Introduction: The incidence of oral premalignant and malignant lesions is on the rise due to an increased number of people taking in tobacco and alcohol related habits. Material and Methods: 1028 patients with tobacco, alcohol and areca nut habits attending our Department of Oral Medicine and Radiology formed the study sample. An interviewer based questionnaire was used to record the habit details. All the patients were then examined clinically for the presence of lesions. Chi square and Fisher exact tests were used to assess the statistical significance of the study parameters. Results: Males had a higher prevalence and comprised 87.9% of the sample. The commonest habit in this study sample was smoking (39.2%) followed by smokeless tobacco use (28.1%). Out of the 1028 patients with habits 40% had no clinically detectable changes in their mucosa. Of the mucosal changes leukoplakia (14%) was the commonest. Conclusions: This study provided information about the habit trends in the patients visiting this institution. The study may serve as a useful tool in educating the patients about the deleterious effects of oral tobacco, alcohol and betel exposure.

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“…2,[4][5][6][7] Betel nut contains unique alkaloid, and its major constituents -arecoline and arecaidine -are capable of inhibiting g-aminobutyric acid (GABA) receptor. 8 The previous researches suggest that betel nut chewing can increase body mass index (BMI) 9 or contribute to central obesity.…”

Section: Introductionmentioning

confidence: 99%

Betel nut chewing and other risk factors associated with obesity among Taiwanese male adults

et al. 2005

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Objective: The research aimed at examining betel nut chewing and other risk factors associated with obesity among Taiwanese male adults. Design: The research analyzed the data obtained by the 2001 National Health Interview Survey in Taiwan that covered all the administrative divisions in Taiwan. Multistage stratified systematic sampling design was adopted for survey. All members of a sampled household received the interview. Subjects: The research analyzed questionnaires answered by nonaboriginal male respondents aged between 20 and 59 years old, and the total number of samples analyzed read 6126. Since very few female subjects chewed betel nut, they were excluded from the analysis. Measurements: Criteria of obesity was defined as body mass indexX27 kg/m 2 . The variables incorporated for analysis included the respondents' status of betel nut chewing, age, educational background, presence of hypertension and diabetes mellitus, drinking and smoking status, exercise status, and demand for physical strength at job. Generalized estimating equations model was employed to estimate the odd ratios (with 95% CI) of obesity of each independent variable. Results: Approximately 16.2% of respondents were obese. The distribution of betel nut chewing was current chewers 15.9%, ex-chewers 4.3%, and nonchewers 79.8%. After controlling above-mentioned independent variables, hypertension, diabetes mellitus, betel nut chewing, never exercising, and sedentary jobs were closely associated with obesity. Conclusion: The research found that betel nut chewing closely associated with obesity. The increased appetite of betel nut chewers is speculated as the underlying cause. The prospective study is needed to clarify this issue. In addition to increasing the risk of developing oral cancer, betel nut chewing seemed to be related with another health hazard: obesity.

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The precancer risk of betel quid chewing, tobacco use and alcohol consumption in oral leukoplakia and oral submucous fibrosis in southern Taiwan

Cited by 239 publications

References 20 publications

Independent and combined effects of alcohol intake, tobacco smoking and betel quid chewing on the risk of esophageal cancer in Taiwan

Independent and combined effects of alcohol intake, tobacco smoking and betel quid chewing on the risk of esophageal cancer in Taiwan

Prevalence and Correlation of Oral Lesions among Tobacco Smokers, Tobacco Chewers, Areca Nut and Alcohol Users

Betel nut chewing and other risk factors associated with obesity among Taiwanese male adults

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