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Chewing betel quid without tobacco can lead to oral cancer, says expert

Staff Reporter

THIRUVANANTHAPURAM: Chewing betel quid without tobacco can also lead to oral cancer because arecanut, a common component in all chewing mixtures, is carcinogenic to humans, according to cancer researchers.

Epidemiological studies conducted by WHO's International Agency for Research on Cancer among populations where betel quid chewing without tobacco is popular had reported that habitual chewing of arecanut can cause oral sub-mucous fibrosis, a precancerous condition that leads to oral cancer, says Saman Warnakulasuriya, Head of the Department of Oral Medicine, King's College London, who is also the director of the WHO Collaborating Centre on oral cancer. Talking to The Hindu on the sidelines of an international conference on oral cancer, organised here recently by the Regional Cancer Centre (RCC), he said pre-packaged chewing products widely available in the market today could not be considered safe just because these do not contain tobacco.

It was a cause for concern that youth, especially teenagers, had picked up the addictive habit of chewing.

In the past 10 years, oral cancer was seen more commonly among those under the age of 45. About six per cent of those with oral cancer in the Thames Cancer Registry were below 40 years, he said.

The tobacco habit normally takes 20 to 30 years before it manifests as oral cancer. However, in recent times, even people with a tobacco habit of 10 to 15 years were being diagnosed as having oral cancer.

It requires to be studied whether genetic factors or viruses like the Human Papilloma Virus could be contributing to the high incidence of oral cancer in the young, Dr. Warnakulasuriya said.

"The message that should go across to the public is that there is no safe form of tobacco use. Not just smoking, all forms of smoke-less tobacco such as snuff, can also cause cancer," he said.

Like tobacco, alcohol is also a major risk factor for oral cancer. A potential carcinogen in alcohol is acetaldehyde, which is produced in the mouth when alcohol is consumed.

The attributable risk of oral cancer due to tobacco and alcohol combined is estimated to be more than 80 per cent. Heavy drinkers and smokers have 38 times the risk of getting oral cancer than those who do not smoke or consume alcohol excessively (recommended limit being 30 gm/day), the researcher said.

It is never too late to give up the tobacco habit; even if one were to kick the tobacco habit over a period of five years, it substantially reduces the risk of cancer. Research on oral cancer should be now focussed on those who have fallen prey to oral cancer even though they did not have the common risk factors, Dr. Warnakulasuriya said.

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