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Paan without tobacco: An independent risk factor for oral cancer
Author(s) -
Merchant Anwar,
Husain Syed S. M.,
Hosain Mervyn,
Fikree Fariyal F.,
Pitiphat Waranuch,
Siddiqui Amna Rehana,
Hayder Syed J.,
Haider Syed M.,
Ikram Mubashir,
Chuang SungKiang,
Saeed Shaikh A.
Publication year - 2000
Publication title -
international journal of cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.475
H-Index - 234
eISSN - 1097-0215
pISSN - 0020-7136
DOI - 10.1002/(sici)1097-0215(20000401)86:1<128::aid-ijc20>3.0.co;2-m
Subject(s) - areca , medicine , betel , oral submucous fibrosis , cancer , chewing tobacco , risk factor , malignancy , smokeless tobacco , basal cell , traditional medicine , epidemiology , dermatology , demography , tobacco use , environmental health , population , structural engineering , nut , engineering , sociology
Oral cancer is the second most common cancer in women and the third most common in men in Pakistan. Tobacco is smoked and chewed extensively in Pakistan. Paan is a quid of piper betel leaf that contains areca nut, lime, condiment, sweeteners, and sometimes tobacco, which is also used extensively. We did this study to clarify the independent association of paan and oral cancer. Between July 1996 and March 1998, we recruited biopsy‐proven, primary cases of oral squamous‐cell carcinoma, from 3 tertiary teaching centers in Karachi, Pakistan, and controls pair‐matched for age, gender, hospital and time of occurrence, excluding persons with a past or present history of any malignancy. There were 79 cases and 149 controls. Approximately 68% of the cases were men, 49 years old on average, the youngest being 22 years old and the eldest 80. People with oral submucous fibrosis were 19.1 times more likely to develop oral cancer than those without it, after adjusting for other risk factors. People using paan without tobacco were 9.9 times, those using paan with tobacco 8.4 times, more likely to develop oral cancer as compared with non‐users, after adjustment for other co‐variates. This study identifies an independent effect of paan without tobacco in the causation of oral cancer. Its findings may be of significance in South Asian communities where paan is used, and among health‐care providers who treat persons from South Asia. Int. J. Cancer 86:128–131, 2000. © 2000 Wiley‐Liss, Inc.