Abstract
This study aimed to determine the association between betel quid chewing and the occurrence of upper aerodigestive tract (UADT) cancers. 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. 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). 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.
Highlights
Materials and MethodsCancers of the upper aerodigestive tract (UADT), including mouth, pharynx and esophagus, is one of the major disease burdens in public health with more than 880,000 cases annually diagnosed world-wide (Ferlay et al, 2010)
Betel nut chewing was the only major risk factor for UADT cancers in this population (HR=5.26, 95%CI=2.5111.0), 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)
Our study showed the incidence of UADT cancers from the cohort was 14.7 per 100,000 person-years
Summary
Cancers of the upper aerodigestive tract (UADT), including mouth, pharynx and esophagus, is one of the major disease burdens in public health with more than 880,000 cases annually diagnosed world-wide (Ferlay et al, 2010). A significantly increasing trend in incidence was found only in females (Vatanasapt et al, 2011) This begs the question: could this unique pattern of cancer incidence be explained by known risk factors?. This study, was primarily aimed to determine the association between betel quid chewing and UADT cancers in the Khon Kaen population. The data on determinants was obtained by questionnaire interview during the cohort recruitment phase, including demographic data, tobacco smoking, alcohol drinking, and betel-quid chewing. The 13-digit ID number was used to link the cohort to the Khon Kaen population-based cancer registry, and doublechecked with the subjects name, birth date, and address in questionable cases. The association between betel quid Risk Factors; Crude Analysis chewing, including other potential relevant factors, and UADT cancers was analysed by cox-proportional hazard regression (Qiu et al, 2012) using STATA version 10.0 software. According to the recruited subjects in the cohort, the power of study was calculated to be greater than 99%
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