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From the Bangkok Post, August 8, 2003. Download as a PDF.
Study says betel chewing conducive to oral cancer
Asia suffers far more than other regions
Betel chewing products, used from time immemorial in India and elsewhere in Asia as a mild stimulant and consumed even by children, are a major cancer hazard, according to a new study released yesterday.
Countries where betel chewing is prevalent have higher rates of cancer of the mouth, pharynx and oesophagus, and Asian immigrant communities also suffer more from these diseases than the surrounding population, according to the report by the International Agency for Research on Cancer (IARC).
“There are hundreds of millions of users worldwide, and there is great concern that the habit will spread to populations in North America and Europe not previously exposed to the habit,” the agency said. Britain is the world’s leading importer of betel products outside Asia, it added.
A common product known as betel quid is a kind of candy made from areca tropical palm nuts, slaked lime and spices, and wrapped in a leaf from the betel vine. Tobacco is often added to the mix.
The quid is held between the teeth and the cheek, where it slowly releases a stimulant called arecoline. People who use betel frequently over a long period of time usually have red teeth. They are also likely, the new study finds, to suffer from a hardening of tissue called oral submucous fibrosis, which can turn into cancer.
A previous IARC study in 1985 showed that chewing betel mixed with tobacco was a cause of cancer and the original assumption was that cancer was caused by the tobacco. But recent investigations have shown that chewing betel on its own was dangerous as well. The latest study reveals just how dangerous.
Of the 390,000 cases of cancers of the mouth and related systems estimated to occur in the world each year, 228,000 cases or 58% occur in the Indian subcontinent and Southeast Asia.
A steep increase in chewing of betel products without tobacco in Taiwan in the 1970s led to an equally steep rise in the incidence of oral cancer a few years later.
The IARC, which is part of the World Health Organisation, said it was concerned about the easy availability of mass-produced, pre-packaged betel products in many countries around the world.
“Aggressive advertising, targeted at the middle class and at children, has enhanced the sales and use of these products,” the study said. “In some parts of India, almost one out of three children and teenagers regularly or occasionally chew these products.”