- Volume 14 Issue 7
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Betel Quid Chewing and Upper Aerodigestive Tract Cancers: A Prospective Cohort Study in Khon Kaen, Thailand
- Kampangsri, Wilas (Nongkungsri Public Health Office) ;
- Vatanasapt, Patravoot (Department of Otorhinolaryngology, Faculty of Medicine, Khon Kaen University) ;
- Kamsa-ard, Siriporn (Department of Biostatistics and Demography, Faculty of Public Health, Khon Kaen University) ;
- Suwanrungruang, Krittika (Cancer Unit, Faculty of Medicine, Khon Kaen University) ;
- Promthet, Supannee (Department of Epidemiology, Faculty of Public Health, Khon Kaen University)
- Published : 2013.07.30
Background: This study aimed to determine the association between betel quid chewing and the occurrence of upper aerodigestive tract (UADT) cancers. Methods: A cohort of 17,388 subjects, recruited and interviewed over the 1990-2001 period, in Khon Kaen, Thailand, was followed up until 2011. The data were linked to the Khon Kaen Population-Based Cancer Registry. Results: The prevalence of betel quid chewing was 15.9%, with a female predominance (97.7%); the mean age of chewers was 57.7 years (SD 6.6). The overall incidence of UADT cancers from the cohort was 14.7 per 100,000 person-years, whereas the incidence among the chewers was 45.7. Betel nut chewing was the only major risk factor for UADT cancers in this population (HR=5.26, 95%CI=2.51-11.0), while weak associations were found for tobacco smoking and alcohol (HR=1.16, 95%CI=0.45-3.01 and 1.47, 95%CI=0.72-3.03 respectively). Conclusions: We found betel quid chewing to be a main risk factor for UADT cancers, resulting in a higher incidence in females. However, further study is required to explore the potential risk factors among non-chewers, non-smokers, and non-drinkers.
Betel nut chewing;upper aerodigestive tract cancers;cohort study;Thailand
- Akhtar S, Sheikh A, Qureshi H (2012). Chewing areca nut, betel quid, oral snuff, cigarette smoking and the risk of oesophageal squamous-cell carcinoma in South Asians: a multicentre case-control Study. Eur J Cancer, 48, 655-61. https://doi.org/10.1016/j.ejca.2011.06.008
- Amarasinghe H, Usgodaarachchi U, Johnson N, et al (2010). Betel-quid chewing with or without tobacco is a major risk factor for oral potentially malignant disorders in Sri Lanka: a case-control Study. Oral Oncol, 46, 297-301. https://doi.org/10.1016/j.oraloncology.2010.01.017
- Boonyaphiphat P, Thongsuksai P, Sriplung H, et al (2002). Life style habits and genetic susceptibility and the risk of esophageal cancer in the Thai population. Cancer Letters, 186, 193-9. https://doi.org/10.1016/S0304-3835(02)00354-3
- Ferlay J, Shin HR, Bray F, et al (2010). Globocan 2008 v1.2, Cancer Incidence and Mortality Worldwide: IARC Cancer Base No. 10 [Internet]. Lyon, France: International Agency for Research on Cancer, 2010. Available from: http:// globocan.iarc.fr.
- Gupta PC, Warnakulasuriya S (2002). Global epidemiology of areca nut usage. Addict Biol, 7, 77-83. https://doi.org/10.1080/13556210020091437
- Herrero R, Castellsague X, Pawlita M, et al (2003). Human papilloma virus and oral cancer: the international agency for research on cancer multicenter study. J Natl Cancer I, 95, 1772-83. https://doi.org/10.1093/jnci/djg107
- IARC (2004). Working group on the evaluation of carcinogenic risks to humans. Betel-quid and areca-nut chewing and some areca-nut derived nitrosamines. IARC Monographs on the Evaluation of Carcinogenic Risks to Humans/World Health Organization, International Agency for Research on Cancer, 85, 1-334.
- Khuhaprema T, Attasara P, Sriplung H, et al (2012). Cancer in Thailand, Vol.VI, 2004-2006. Bangkok: Ministry of Public Health.
- Kreimer A, Clifford G, Boyle P, et al (2005). Human papilloma virus types in head and neck squamous cell carcinomas worldwide: a systematic review. Cancer Epidem Biomar, 14, 467-75. https://doi.org/10.1158/1055-9965.EPI-04-0551
- Lee KW, Kuo WR, Tsai SM, et al (2005). Different impact from betel quid, alcohol and cigarette: Risk factors for pharyngeal and laryngeal cancer. Int J Cancer, 117, 831-6. https://doi.org/10.1002/ijc.21237
- Lin WJ, Jiang RS, Wu SH, et al (2011). Smoking, alcohol, and betel quid and oral cancer: a prospective cohort study. J Oncol, 2011, 1-5.
- Loyha K, Vatanasapt P, Promthet S, et al (2012). Risk factors for oral cancer in Northeast Thailand. Asian Pac J Cancer Prev, 13, 5087-90. https://doi.org/10.7314/APJCP.2012.13.10.5087
- Prateepko S (1998). A case-control study on risk factors for oral cancer in Southern Thailand. Master of Science Thesis in Epidemiology, Songkla, Thailand: Prince of Songkla University.
- Qiu W, Chavarro J, Lazarus R, et al (2012). Power and sample size calculation for survival analysis of epidemiological studies. CRAN, 1-52.
- Reichart PA, Supanchart C, Khongkhunthian P (2007). Traditional chewing and smoking habits from the point of view of Northern Thai betel quid vendors. Oral Health Prev Dent, 5, 245-9.
- Simarak S, de Jong UW, Breslow N, et al (1977). Cancer of the oral cavity, pharynx/larynx and lung in North Thailand: case-control study and analysis of cigar smoke. Bri J Cancer, 36, 130-40. https://doi.org/10.1038/bjc.1977.163
- Sriamporn S, Parkin DM, Pisani P, et al (2005). A prospective study of diet, lifestyle, and genetic factors and the risk of cancer in Khon Kaen province, Northeast Thailand: Description of the cohort. Asian Pac J Cancer Prev, 6, 295-303.
- Thomas SJ, Bain CJ, Battistutta D, et al (2007). Betel quid not containing tobacco and oral cancer: a report on a case-control study in Papua New Guinea and a meta-analysis of current evidence. Int J Cancer, 120 ,1318-23. https://doi.org/10.1002/ijc.22304
- Vatanasapt P, Suwanrungruang K, Kamsa-Ard S, et al (2011). Epidemiology of oral and pharyngeal cancers in Khon Kaen, Thailand: a high incidence in females. Asian Pac J Cancer Prev, 12, 2505-8.
- Vatanasapt V, Martin N, Sriplung H, et al (1995). Cancer incidence in Thailand, 1988-1991. Cancer Epidemiol, Biomarkers and Prev, 4, 475-83.
- Yen TT, Lin WD, Wang CP, et al (2008). The association of smoking, alcoholic consumption, betel quid chewing and oral cavity cancer: a cohort study. Eur Arch Oto-Rhino-L, 265, 1403-7. https://doi.org/10.1007/s00405-008-0659-z