Betel quid chewing and oral cancer: Experimental studies on hamsters

Abstract

Betel quid ingredients--betel nut, betel leaf, lime, catechu and tobacco--were tested separately and in various combinations for carcinogenicity, using hamster cheek pouch as the experimental site. The four modes of administration used were (1) tri-weekly painting of the cheek pouch with aqueous extracts of test materials, (2) deposition of replaceable wax pellets containing the test material, (3) gelatin capsules containing the powdered material and (4) insertion of natural material into the pouch for trauma and direct exposure. Untreated controls and standard carcinogen DMBA-treated controls were also maintained. A total of 317 young adult golden Syrian hamsters (Mesocricetus auratus) used for the experiments were killed in two age groups: 6-12 months and 13-24 months, only when signs of general debility were observed. In the untreated controls, animals were free of any malignancy. In the experimental series, various betel quid ingredient combinations under test induced both oral and gastric lesions ranging from massive atypia and precancerous lesions to frank carcinomas. Maximum lesions were observed in the groups receiving betel nut, lime and tobacco combinations and in the polyphenol fraction of betel nut containing major tannins. The mode of administration of test material resulted in distinct differences; tri-weekly paintings giving oral lesions in the range of 22-23% and gastric lesions 39-48%; the same material given either through the replaceable gelatin capsule or in natural form induced 69% oral lesions and 63 to 82% gastric lesions. Overall evaluation of the data of all the four series confirms the potent carcinogenicity of betel nut, particularly its tannin-containing polyphenolic fraction and its combination with lime and tobacco. Maximum oral lesions induced in the hamsters by continuous exposure to capsules and natural material, highlight the direct relationship of frequency of chewing in habitual chewers with oral carcinogenesis. The high incidence of gastric (forestomach) lesions invites special attention.

Evaluation of carcinogenic/co-carcinogenic activity of a common chewing product, pan masala, in mouse skin, stomach and esophagus

“…Ahmed et al, 1993). Betel-quid ingredients, when administered separately or in various combinations to Syrian hamsters, have been shown to induce gastric and buccal-pouch tumors (Ranadive et al, 1979). In the present study, administration of EPME to DEN-initiated ICRC mice significantly enhanced, in a concentrationdependent manner, the development of papillomas in the forestomach and esophagus for up to 25 mg EPME.…”

Pathological Features of Betel Quid-Related Oral Epithelial Lesions in Taiwan with Special Emphasis on the Tumor Progression and Human Papillomavirus Association

“…In this study, OELs associated with BQ chewing tended to develop in the buccal mucosa It is a typical site for BQ chewers [23], but different from the retromolar region for smoking and the floor of the mouth for drinking [24, 25]. The microtrauma by the thick fibers of the areca nut may result in the development of oral lesions in combination with the effect of the BQ ingredient [26, 27]. The practice of changing chewing sites may contribute to the higher rate of multiple lesions, especially in bilateral buccal mucosa.…”

Characterization and Quantification of Compounds in the Hydroalcoholic Extract of the Leaves from Terminalia catappa Linn. (Combretaceae) and Their Mutagenic Activity

“…Incidences of certain cancers, such as esophageal cancer, have been reported to be related to consumption of tannin-rich foods such as betel nuts and herbal teas, suggesting that tannins might be carcinogenic [22]. However, other reports have indicated that the carcinogenic activity of tannins might be related to components that are associated with tannins, rather than the tannins themselves [23, 24]. Tannins have also been reported to exert other physiological effects, such as the acceleration of blood clotting, a reduction in blood pressure, a decrease in serum lipid levels, liver necrosis, and modulation of the immune response [21, 25].…”