Areca nut use and cancer in India

Prakash C. Gupta, C. Ray
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引用次数: 12

Abstract

Areca nut is widely used in India and the consumption has increased over the past two decades, with availability in new dry packaged forms (pan masala, gutka, mawa). Recent reports of increasing mouth cancer incidence have suggested an association with areca nut consumption. Here we have reviewed the evidence for carcinogenicity of areca nut, including epidemiological studies, several animal studies and mechanistic evidence. Studies primarily from India, providing odds ratios (ORs) or relative risks for precancers or cancer with use of areca nut without inclusion of tobacco is the focus of the review. Six case-control studies on oral submucous fibrosis (OSF) had significantly elevated ORs for use of areca nut in various forms. Six case-control studies on head and neck cancers, primarily oral cancer reported elevated ORs for chewing of betel quid without tobacco. Eight case control studies on oral cancer have reported elevated and significant ORs for betel quid with tobacco. A significant risk in oral cancer was noted in gutka users. Animal studies confirmed correlation between development of precancers or cancers and exposure to areca nut or pan masala without tobacco. Mechanistic evidence shows a role for areca nut alkaloids, polyphenols and copper in promoting carcinogenesis. Our review emphasizes control policies on areca nut products and appropriate mass communication programs for awareness of hazards of areca nut with emphasis on areca nut per se.
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在印度槟榔的食用和癌症
槟榔果在印度被广泛使用,在过去二十年中消费量有所增加,有了新的干包装形式(pan masala, gutka, mawa)。最近的报告表明,口腔癌发病率的增加与槟榔果的食用有关。本文综述了槟榔致癌性的证据,包括流行病学研究、一些动物实验和机理证据。主要来自印度的研究提供了使用槟榔果而不包括烟草的癌症前期或癌症的优势比(ORs)或相对风险,这是综述的重点。六项关于口腔粘膜下纤维化(OSF)的病例对照研究表明,使用各种形式的槟榔可显著提高口服口服盐的风险。六项关于头颈部癌症(主要是口腔癌)的病例对照研究报告,咀嚼不含烟草的槟榔液会导致ORs升高。8例口腔癌病例对照研究报告了含烟草的槟榔液的ORs升高和显著升高。gutka使用者患口腔癌的风险显著。动物研究证实了癌症前期或癌症的发展与接触槟榔或无烟草的pan masala之间的相关性。机制证据表明槟榔生物碱、多酚和铜在促进癌变中的作用。我们的综述强调槟榔产品的控制政策和适当的大众传播计划,以提高人们对槟榔危害的认识,重点是槟榔本身。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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