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Chewing areca nut, betel quid, oral snuff, cigarette smoking and the risk of oesophageal squamous-cell carcinoma in South Asians: a multicentre case-control study.
Eur J Cancer. 2012 Mar; 48(5):655-61.EJ

Abstract

Oesophageal cancer remains an important public health problem worldwide. This multicentre matched case-control study examined the chewing areca nut alone, betel quid with tobacco, oral snuff (snuff dipping) and cigarette smoking as the risk factors for oesophageal squamous-cell carcinoma. We enrolled 91 cases of oesophageal squamous-cell carcinoma and 364 matched controls from three tertiary-care hospitals in Karachi, Pakistan. A structured questionnaire was used to collect the data through face-to-face interview of the participants. Multivariable conditional logistic regression model showed that after adjusting for the effect of ethnicity, ever chewed areca nut alone (adjusted matched odds ratio (mOR(adj))=3.7; 95% confidence interval (CI): 1.6-8.5), ever chewed betel quid with tobacco (mOR(adj)=12.8; 95% CI: 6.3-26.2), ever practiced snuff dipping (mOR(adj)=4.3; 95% CI: 1.6-11.7) and ever smoked cigarettes (mOR(adj)=2.9; 95% CI: 1.4-5.9) were significantly and independently associated with oesophageal squamous-cell carcinoma status. The adjusted summary population attributable risk (PAR) percent for all four substances together was 67.0. Furthermore, despite incomplete synergy, there was manifold increase in the risk of oesophageal squamous-cell carcinoma, if the respondents ever smoked cigarettes and ever chewed betel quid with tobacco (mOR(adj)=21.4; 95% CI: 6.3-72.4) or if they ever smoked cigarettes and ever practiced snuff dipping (mOR(adj)=14.4; 95% CI: 2.3-91.1). The adjusted PAR (%) was higher for the dual practice of smoking cigarettes and chewing betel quid with tobacco (64.3) than the dual practice of smoking cigarettes and snuff dipping (32.2). Public awareness to curtail the addiction to these substances may result in a substantial reduction in the incidence of oesophageal squamous-cell carcinoma and related mortality in this and similar settings.

Authors+Show Affiliations

Faculty of Medicine, Kuwait University, Jabriya, Kuwait. saeed.akhtar@hsc.edu.kwNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Multicenter Study

Language

eng

PubMed ID

21733677

Citation

Akhtar, Saeed, et al. "Chewing Areca Nut, Betel Quid, Oral Snuff, Cigarette Smoking and the Risk of Oesophageal Squamous-cell Carcinoma in South Asians: a Multicentre Case-control Study." European Journal of Cancer (Oxford, England : 1990), vol. 48, no. 5, 2012, pp. 655-61.
Akhtar S, Sheikh AA, Qureshi HU. Chewing areca nut, betel quid, oral snuff, cigarette smoking and the risk of oesophageal squamous-cell carcinoma in South Asians: a multicentre case-control study. Eur J Cancer. 2012;48(5):655-61.
Akhtar, S., Sheikh, A. A., & Qureshi, H. U. (2012). Chewing areca nut, betel quid, oral snuff, cigarette smoking and the risk of oesophageal squamous-cell carcinoma in South Asians: a multicentre case-control study. European Journal of Cancer (Oxford, England : 1990), 48(5), 655-61. https://doi.org/10.1016/j.ejca.2011.06.008
Akhtar S, Sheikh AA, Qureshi HU. Chewing Areca Nut, Betel Quid, Oral Snuff, Cigarette Smoking and the Risk of Oesophageal Squamous-cell Carcinoma in South Asians: a Multicentre Case-control Study. Eur J Cancer. 2012;48(5):655-61. PubMed PMID: 21733677.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Chewing areca nut, betel quid, oral snuff, cigarette smoking and the risk of oesophageal squamous-cell carcinoma in South Asians: a multicentre case-control study. AU - Akhtar,Saeed, AU - Sheikh,Adnan A, AU - Qureshi,Hammad U, Y1 - 2011/07/04/ PY - 2011/04/01/received PY - 2011/05/25/revised PY - 2011/06/03/accepted PY - 2011/7/8/entrez PY - 2011/7/8/pubmed PY - 2012/6/27/medline SP - 655 EP - 61 JF - European journal of cancer (Oxford, England : 1990) JO - Eur. J. Cancer VL - 48 IS - 5 N2 - Oesophageal cancer remains an important public health problem worldwide. This multicentre matched case-control study examined the chewing areca nut alone, betel quid with tobacco, oral snuff (snuff dipping) and cigarette smoking as the risk factors for oesophageal squamous-cell carcinoma. We enrolled 91 cases of oesophageal squamous-cell carcinoma and 364 matched controls from three tertiary-care hospitals in Karachi, Pakistan. A structured questionnaire was used to collect the data through face-to-face interview of the participants. Multivariable conditional logistic regression model showed that after adjusting for the effect of ethnicity, ever chewed areca nut alone (adjusted matched odds ratio (mOR(adj))=3.7; 95% confidence interval (CI): 1.6-8.5), ever chewed betel quid with tobacco (mOR(adj)=12.8; 95% CI: 6.3-26.2), ever practiced snuff dipping (mOR(adj)=4.3; 95% CI: 1.6-11.7) and ever smoked cigarettes (mOR(adj)=2.9; 95% CI: 1.4-5.9) were significantly and independently associated with oesophageal squamous-cell carcinoma status. The adjusted summary population attributable risk (PAR) percent for all four substances together was 67.0. Furthermore, despite incomplete synergy, there was manifold increase in the risk of oesophageal squamous-cell carcinoma, if the respondents ever smoked cigarettes and ever chewed betel quid with tobacco (mOR(adj)=21.4; 95% CI: 6.3-72.4) or if they ever smoked cigarettes and ever practiced snuff dipping (mOR(adj)=14.4; 95% CI: 2.3-91.1). The adjusted PAR (%) was higher for the dual practice of smoking cigarettes and chewing betel quid with tobacco (64.3) than the dual practice of smoking cigarettes and snuff dipping (32.2). Public awareness to curtail the addiction to these substances may result in a substantial reduction in the incidence of oesophageal squamous-cell carcinoma and related mortality in this and similar settings. SN - 1879-0852 UR - https://www.unboundmedicine.com/medline/citation/21733677/Chewing_areca_nut_betel_quid_oral_snuff_cigarette_smoking_and_the_risk_of_oesophageal_squamous_cell_carcinoma_in_South_Asians:_a_multicentre_case_control_study_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0959-8049(11)00402-3 DB - PRIME DP - Unbound Medicine ER -