A comprehensive analysis on the association between tobacco-free betel quid and risk of head and neck cancer in Taiwanese men

Yuan Hua Wu, Chia Jui Yen, Jenn Ren Hsiao, Chun Yen Ou, Jehn Shyun Huang, Tung Yiu Wong, Sen Tien Tsai, Cheng Chih Huang, Wei Ting Lee, Ken Chung Chen, Sheen Yie Fang, Jiunn Liang Wu, Wei Ting Hsueh, Forn Chia Lin, Ming Wei Yang, Jang Yang Chang, Hsiao Chen Liao, Shang Yin Wu, Chen Lin Lin, Yi Hui WangYa Ling Weng, Han Chien Yang, Yu Shan Chen, Jeffrey S. Chang

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Abstract

Objectives: Although betel quid (BQ) is an established risk factor of head and neck cancer (HNC), insufficiencies exist in the literature regarding the dose-response, BQ types, HNC sites, and BQ cessation. The current study was conducted to fill these insufficiencies. Materials and Methods: A hospital-based case-control study was conducted to evaluate the association between BQ and HNC. In-person interview was conducted to collect data on BQ chewing. The current analysis included 487 men newly diagnosed with HNC and 617 male controls who were frequency-matched to the cases by age. The association between BQ and HNC was assessed using multivariable unconditional logistic regression. Results: Ever BQ chewing was associated with an increased HNC risk regardless of the BQ types. A non-linear positive association between BQ and HNC was observed, with a steep rise in HNC risk for the first 5 pack-years or 200,000 minutes of BQ consumption. Every year of BQ cessation was associated with a 2.9% reduction in HNC risk; however, the risk did not reduce to the level of non-BQ chewers even after 20 years of BQ cessation. Eliminating BQ chewing may prevent 51.6% of HNCs, 62.6% of oral cancers, and 41.3% of pharyngeal cancers in Taiwan. Conclusion: Our results supported the positive association between BQ and HNC. BQ cessation is effective in reducing HNC risk and should be encouraged. Because BQ cessation may not reduce the HNC risk to the level of non-BQ chewers, it is important to prevent the initiation of BQ chewing.

Original languageEnglish
Article number0164937
JournalPloS one
Volume11
Issue number10
DOIs
Publication statusPublished - 2016 Oct

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All Science Journal Classification (ASJC) codes

  • Biochemistry, Genetics and Molecular Biology(all)
  • Agricultural and Biological Sciences(all)
  • General

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