Abstract
ObjectivesAlthough 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 MethodsA 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.ResultsEver 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.ConclusionOur 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.
Highlights
Head and neck cancer (HNC), including cancers of the oral cavity, oropharynx, hypopharynx, and larynx, is one of the leading cancers in the world, with approximately 600,000 new cases each year [1]
Ever betel quid (BQ) chewing was associated with an increased head and neck cancer (HNC) risk regardless of the BQ types
Our results supported the positive association between BQ and HNC
Summary
Head and neck cancer (HNC), including cancers of the oral cavity, oropharynx, hypopharynx, and larynx, is one of the leading cancers in the world, with approximately 600,000 new cases each year [1]. HNC was the fourth most common cancer among Taiwanese men in 2011 with the incidence rising from 5 per 100,000 in 1979 to 41 per 100,000 in 2011 [2, 3]. In South and South-East Asia, including Taiwan, where betel quid (BQ) chewing is common, BQ contributes to a large proportion of HNC cases [4]. “Stem quid” is rare and is consumed mostly by the aboriginal Taiwanese [5, 6]. BQ use remains a serious problem in Taiwan
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