Do betel quid and areca nut chewing deteriorate prognosis of oral cancer? A systematic review, meta‐analysis, and research agenda

Abstract

Objective To explore the correlations between the habit of betel quid and areca nut (BQ‐AN) chewing and the prognosis of oral cancer (OC). Methods We performed a systematic review and meta‐analysis to clarify this issue. Data searches were performed using PubMed, Web of Science, Epistemonikos, and Embase databases through November 2019. The primary outcome was the difference in the prognosis of OC between BQ‐AN chewers and non‐chewers, measured in terms of 5‐year overall survival (OS) and 5‐year disease‐specific survival (DSS) log (HR) reported in articles. The pooled HR with 95% CI of 5‐year OS and 5‐year DSS was calculated using a fixed‐effects model. Results Ten articles with eleven OS or DSS survival studies (one of the articles contained two studies), which were published between 2003 and 2017, were eligible for inclusion in the present study. All the 11 studies were observational studies, among which 10 were retrospective and 1 was prospective. One study measured both OS and DSS. Eight studies, with a total of 2,761 patients, used 5‐year OS as the primary endpoint and four studies, with a total of 2,551 patients, used 5‐year DSS. Overall, the pooled HR evaluating BQ‐AN chewers was 1.26 (95% CI: 1.09–1.46) for 5‐year OS and 1.40 (95% CI: 1.15–1.70) for 5‐year DSS, compared with non‐chewers. There was a significant association between BQ‐AN chewing and OC survival. Conclusions Betel quid and areca nut chewing is significantly associated with poor prognosis in patients with OC.

Combined Impacts of Genetic Variants of Long Non-Coding RNA MALAT1 and the Environmental Carcinogen on the Susceptibility to and Progression of Oral Squamous Cell Carcinoma

“…Actually, chewing betel quid was reported to be the strongest risk factors for causing OSCC in East Asian population ( 24 ). Taiwan is also an endemic betel quid-chewing area, and betel quid chewing was reported to be correlated with a poor prognosis in OSCC ( 25 ). In this study, we further divided our recruited OSCC patients into betel quid-chewing and non-betel quid-chewing groups, and further investigated the difference between MALAT1 SNPs and the OSCC clinicopathological status in these two subgroups.…”

Chemical Composition, Pharmacological, and Toxicological Effects of Betel Nut

“…It is vital to prevent OSF and stop chewing betel nut for reducing the morbidity of OC. A recent meta-analysis of Yang et al [ 52 ] found that the prognosis of patients with betel nut chewing habits was poorer than those not. Therefore, long-term betel nut users should be aware of the potential risk of cancer.…”

The circEPSTI1/mir-942-5p/LTBP2 axis regulates the progression of OSCC in the background of OSF via EMT and the PI3K/Akt/mTOR pathway

“…Many reports from India indicate that better tumor differentiation, slower growth, a lower probability of cervical metastasis, a lower probability of postoperative recurrence, more favorable prognosis and higher survival rates are distinctive features of OSCC with OSF 7,8 . However, Guo et al and Jun et al found that OSCC patients with OSF in China have less favorable clinicopathological features and prognoses than OSCC patients without OSF 9,10 . These completely opposite results, on the one hand, could be explained by the possibility that differences in the betel quid and areca nut processing methods between the South/Southeast Asian countries and China could result in different immune responses in the oral mucosa.…”