Open AccessA Comprehensive Analysis on the Association between Tobacco-Free Betel Quid and Risk of Head and Neck Cancer in Taiwanese Men
Author(s) -
Yuan Wu,
Chia Jui Yen,
Jenn Ren Hsiao,
Chien-Hui Ou,
Jow-Lay Huang,
Tung Yiu Wong,
Sen Tien Tsai,
Cheng Huang,
Wei Ting Lee,
Ken Chung Chen,
Sheen Yie Fang,
Jiunn-Lin Wu,
Wei Hsueh,
Fengyi Lin,
Ming Yang,
Jang Yang Chang,
Hsiao Chen Liao,
Shang Yin Wu,
Chen Lin Lin,
Yi Hui Wang,
Ya Ling Weng,
Han Yang,
Yu Shan Chen,
Jeffrey S. Chang
Publication year - 2016
Publication title -
plos one
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.99
H-Index - 332
ISSN - 1932-6203
DOI - 10.1371/journal.pone.0164937
Subject(s) - medicine , head and neck cancer , logistic regression , chewing tobacco , head and neck , risk factor , smoking cessation , cancer , oncology , surgery , pathology
Objectives Although betel quid (BQ) is an established risk factor of head and neck cancer (HNC), insufficiencies exist in the literature regarding the dose-response, BQ types, HNC sites, and BQ cessation. The current study was conducted to fill these insufficiencies. Materials and Methods A hospital-based case-control study was conducted to evaluate the association between BQ and HNC. In-person interview was conducted to collect data on BQ chewing. The current analysis included 487 men newly diagnosed with HNC and 617 male controls who were frequency-matched to the cases by age. The association between BQ and HNC was assessed using multivariable unconditional logistic regression. Results Ever BQ chewing was associated with an increased HNC risk regardless of the BQ types. A non-linear positive association between BQ and HNC was observed, with a steep rise in HNC risk for the first 5 pack-years or 200,000 minutes of BQ consumption. Every year of BQ cessation was associated with a 2.9% reduction in HNC risk; however, the risk did not reduce to the level of non-BQ chewers even after 20 years of BQ cessation. Eliminating BQ chewing may prevent 51.6% of HNCs, 62.6% of oral cancers, and 41.3% of pharyngeal cancers in Taiwan. Conclusion Our results supported the positive association between BQ and HNC. BQ cessation is effective in reducing HNC risk and should be encouraged. Because BQ cessation may not reduce the HNC risk to the level of non-BQ chewers, it is important to prevent the initiation of BQ chewing.