Buccal Mucosa Cancer in South India

Factors related to betel chewing among junior high school students in Taiwan

“…It has been estimated that at least 200 million people worldwide have practiced betel chewing, but the extent of the habit varies markedly from one region to another. Betel chewing is found to be related to the occurrence of oral cancer (2)(3)(4)(5)(6), oral leukoplakia and submucosal fibrosis (7,8). In Taiwan, the increase in the mortality rates of oral cancer is thought to be closely related to betel chewing.…”

Betel Quid Carcinogenesis in the Baboon

“…Tobacco has been considered by many investigators to be the in gredient of the betel quid most likely to cause oral mucosal changes that eventuate in the development of oral cancer [2,4,6,24,25,26], Fig. 3.…”

“…India leads the world with its high rate of oral cancer, particularly buccal mucosal carcinoma [1,2], Paymaster found a 34.9% incidence of oral/pharyngeal cancer in an urban Indian hospital cancer popula tion in contrast to a 3.4 percentage of oral cancer in a similar United States population [I], Many investigators have postulated a definite relationship between the high rate of oral cancer in India with the prevalent habit of chewing betel [2,3,4,5,6], Calcium hydroxide ('lime') is one of the 4 principal ingredients found in the standard betel chew, which is known in India as 'pan'. The other major constituents are: betel pepper leaf, areca palm nut, and catechu [3,7], Tobacco is also often added to the betel quid.…”

“…Accord ing to individual taste, custom, or financial ability to purchase them, spicy substances such as nutmeg, amber, camphor, musk cardamon, and cloves are mixed with the standard chew to enhance its flavor [7], Each of the 4 principal ingredients of the basic betel quid may play some role in cancer formation, either directly, as a carcinogenic sub stance, or indirectly, as a co-carcinogen. Previous clinical investigations indicate that buccal carcinoma is much more prevalent among Indians who do incorporate tobacco in their betel chew [2,3,4,5,6], Lime, a weak alkali and known tissue irritant, has also been suggested as a possible carcinogen [4,8,9], Wahi discovered an incidence of 31.9% for oral and pharyngeal cancer in Uttar Pradesh after reviewing a total of 6,010 malignant specimens from a hospital tumor population [10], After examining 10,000 randomly selected Indians in Lucknow, Uttar Pradesh, Pindborg found 24 persons (0.24%) who demonstrated buccal carcinoma. All of them had one or several smoking and/or chewing habits [11], South Indians exhibit a similar propensity for oral cancer [6], Oral cancer in the Kanyakumari District of Madras ranked exceptionally high in its cancer registry for 1965-1967, comprising 542 out of 899 new cancer cases reported (60%) [12].…”

“…Previous clinical investigations indicate that buccal carcinoma is much more prevalent among Indians who do incorporate tobacco in their betel chew [2,3,4,5,6], Lime, a weak alkali and known tissue irritant, has also been suggested as a possible carcinogen [4,8,9], Wahi discovered an incidence of 31.9% for oral and pharyngeal cancer in Uttar Pradesh after reviewing a total of 6,010 malignant specimens from a hospital tumor population [10], After examining 10,000 randomly selected Indians in Lucknow, Uttar Pradesh, Pindborg found 24 persons (0.24%) who demonstrated buccal carcinoma. All of them had one or several smoking and/or chewing habits [11], South Indians exhibit a similar propensity for oral cancer [6], Oral cancer in the Kanyakumari District of Madras ranked exceptionally high in its cancer registry for 1965-1967, comprising 542 out of 899 new cancer cases reported (60%) [12]. In a survey of railway hospital records on one million employees and one million dependent family members in 1967, Maihorta found 470 cancer cases; of these 183 (39%) were related to the oral cavity [13], Experimentally, Muir and Kirk were able to induce squamous cell carcinoma in the ear skin of Swiss mice after 2 years of painting with the Singapore betel quid, including tobacco [14].…”