Betel quid chewing and the risk of oral and oropharyngeal cancers: a meta-analysis with implications for cancer control.

摘要: We conducted a random-effects meta-analysis of 50 publications assessing the relationship between oral/oropharyngeal cancer and chewing betel quid, with (BQ+T) or without added tobacco (BQ-T), common practice in many parts Asia globally among Asian immigrants. Exposure-response, by daily amount years BQ chewed, was assessed using spline models. Attributable fractions (PAF%) were calculated to estimate public health impact if no longer chewed. The meta-relative risk (mRR) for Indian subcontinent 2.56 (95%CI, 2.00-3.28; 15 studies) BQ-T 7.74 5.38-11.13; 31 BQ+T; Taiwan, China, mRR 10.98 4.86-24.84; 13 studies). Restricting studies that adjusted alcohol use had only small effect on estimates. For BQ+T subcontinent, much higher women (mRR, 14.56; 95%CI, 7.63-27.76) than men. Exposure-response analyses showed increased increasing duration (years) India China. Roughly half oral cancers these countries could be prevented chewed (PAF%=53.7% China; PAF%=49.5% India). demonstrate quid chewing, tobacco, increases an exposure-dependent manner, independently use. Further work is needed explain risks associated