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Interaction between cigarette, alcohol and betel nut use on esophageal cancer risk in Taiwan.
Eur J Clin Invest. 2006 Apr; 36(4):236-41.EJ

Abstract

OBJECTIVE

In 2003 esophageal cancer was the sixth leading cause of death among men in Taiwan, but it is the fastest increasing (70%) alimentary tract cancer. The aim of this study was to investigate the impact of different habits of betel nut chewing on esophageal squamous cell carcinoma (SCC) and its interaction with cigarette use and alcohol consumption.

MATERIALS AND METHODS

All 165 cases were pathologically proven esophageal SCC patients (all male, mean age = 56.0, range = 35-92 years) diagnosed by biopsy during gastroendoscopic examinations. The control group comprised 255 subjects (all male, mean age = 54.8, range = 40-92 years) selected from patients who had visited the Otolaryngology Outpatient or Inpatient Department of KMUH owing to a benign lesion over this field. All were interviewed to collect demographic and substance use information by a trained interviewer using a standardized questionnaire.

RESULTS

Smoking (aOR = 5.4, 95% CI = 2.4-12.9, PAR = 72%), alcoholic beverage drinking (aOR = 17.6, 95% CI = 9.3-35.2, PAR = 76%) and low education level are independent risk factors for esophageal cancer. Although betel nut chewers only had a borderline significant higher risk than nonchewers (aOR = 1.7; 95% CI = 0.8-3.1), those who chewed with a piece of betel inflorescence (aOR = 4.2, 95% CI = 1.4-16.0) and swallow betel-quid juice (aOR = 3.3, 95% CI = 1.3-9.3) had a significant higher risk. Significant dose-response effects were found in daily quantity of drinking and smoking. There is a synergistic effect of these three substances on the development of esophageal cancer.

CONCLUSION

Betel nut chewing plays a relevant role in the development of esophageal SCC but adds to the carcinogenetic effect of smoking and alcohol drinking. Direct mucosal contact of betel juice may contribute to its carcinogenesis.

Authors+Show Affiliations

Department of Internal Medicine, Kaohsiung Medical University Hospital, Taiwan.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

16620285

Citation

Wu, I C., et al. "Interaction Between Cigarette, Alcohol and Betel Nut Use On Esophageal Cancer Risk in Taiwan." European Journal of Clinical Investigation, vol. 36, no. 4, 2006, pp. 236-41.
Wu IC, Lu CY, Kuo FC, et al. Interaction between cigarette, alcohol and betel nut use on esophageal cancer risk in Taiwan. Eur J Clin Invest. 2006;36(4):236-41.
Wu, I. C., Lu, C. Y., Kuo, F. C., Tsai, S. M., Lee, K. W., Kuo, W. R., Cheng, Y. J., Kao, E. L., Yang, M. S., & Ko, Y. C. (2006). Interaction between cigarette, alcohol and betel nut use on esophageal cancer risk in Taiwan. European Journal of Clinical Investigation, 36(4), 236-41.
Wu IC, et al. Interaction Between Cigarette, Alcohol and Betel Nut Use On Esophageal Cancer Risk in Taiwan. Eur J Clin Invest. 2006;36(4):236-41. PubMed PMID: 16620285.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Interaction between cigarette, alcohol and betel nut use on esophageal cancer risk in Taiwan. AU - Wu,I C, AU - Lu,C Y, AU - Kuo,F C, AU - Tsai,S M, AU - Lee,K W, AU - Kuo,W R, AU - Cheng,Y J, AU - Kao,E L, AU - Yang,M S, AU - Ko,Y C, PY - 2006/4/20/pubmed PY - 2006/9/14/medline PY - 2006/4/20/entrez SP - 236 EP - 41 JF - European journal of clinical investigation JO - Eur J Clin Invest VL - 36 IS - 4 N2 - OBJECTIVE: In 2003 esophageal cancer was the sixth leading cause of death among men in Taiwan, but it is the fastest increasing (70%) alimentary tract cancer. The aim of this study was to investigate the impact of different habits of betel nut chewing on esophageal squamous cell carcinoma (SCC) and its interaction with cigarette use and alcohol consumption. MATERIALS AND METHODS: All 165 cases were pathologically proven esophageal SCC patients (all male, mean age = 56.0, range = 35-92 years) diagnosed by biopsy during gastroendoscopic examinations. The control group comprised 255 subjects (all male, mean age = 54.8, range = 40-92 years) selected from patients who had visited the Otolaryngology Outpatient or Inpatient Department of KMUH owing to a benign lesion over this field. All were interviewed to collect demographic and substance use information by a trained interviewer using a standardized questionnaire. RESULTS: Smoking (aOR = 5.4, 95% CI = 2.4-12.9, PAR = 72%), alcoholic beverage drinking (aOR = 17.6, 95% CI = 9.3-35.2, PAR = 76%) and low education level are independent risk factors for esophageal cancer. Although betel nut chewers only had a borderline significant higher risk than nonchewers (aOR = 1.7; 95% CI = 0.8-3.1), those who chewed with a piece of betel inflorescence (aOR = 4.2, 95% CI = 1.4-16.0) and swallow betel-quid juice (aOR = 3.3, 95% CI = 1.3-9.3) had a significant higher risk. Significant dose-response effects were found in daily quantity of drinking and smoking. There is a synergistic effect of these three substances on the development of esophageal cancer. CONCLUSION: Betel nut chewing plays a relevant role in the development of esophageal SCC but adds to the carcinogenetic effect of smoking and alcohol drinking. Direct mucosal contact of betel juice may contribute to its carcinogenesis. SN - 0014-2972 UR - https://www.unboundmedicine.com/medline/citation/16620285/Interaction_between_cigarette_alcohol_and_betel_nut_use_on_esophageal_cancer_risk_in_Taiwan_ L2 - https://doi.org/10.1111/j.1365-2362.2006.01621.x DB - PRIME DP - Unbound Medicine ER -