International Journal of Head and Neck Surgery

Register      Login

VOLUME 1 , ISSUE 1 ( January-April, 2010 ) > List of Articles


Areca Nut or Betel Nut Control is Mandatory if India Wants to Reduce the Burden of Cancer Especially Cancer of the Oral Cavity

Chaturvedi Pankaj

Citation Information : Pankaj C. Areca Nut or Betel Nut Control is Mandatory if India Wants to Reduce the Burden of Cancer Especially Cancer of the Oral Cavity. Int J Head Neck Surg 2010; 1 (1):17-20.

DOI: 10.5005/jp-journals-10001-1003

Published Online: 01-08-2011

Copyright Statement:  Copyright © 2010; The Author(s).


A lesser known reason of epidemic proportion of oral cancer in India is the rampant use of Areca nut chewing. Just like tobacco, areca nut or betel nut is a psychostimulant, an addictive substance and a carcinogen. The cancer causing properties of areca nut have been well-reported in animal, human and epidemiologic studies. The World Health Organization and International Agency for Research on cancer classified areca nut as a Group 1 human carcinogens with sufficient evidence of increased risk of submucus fibrosis (precancerous oral lesion) and cancers of the oral cavity, pharynx, and esophagus. This was based upon several studies from India, Bangladesh, Pakistan and Taiwan. Cancers caused by betel nut chewing also shows a strong dose–response relationship for frequency and duration of chewing. It is postulated that areca nut-specific N-nitroso compounds converted from alkaloids are responsible for oral and pharyngeal cancer. There are several other reports that have linked areca nut chewing (with or without tobacco) with hepatocellular carcinoma, cholangiocarcinoma, cancers of the larynx, stomach, lung and cervix in humans.

PDF Share
  1. Prevalence of head and neck cancers in the north east an institutional study. Indian Journal of Otolaryngology and Head and Neck Surgery January-March 2006;58(1):15-19.
  2. A dependency syndrome related to Areca nut use: Some medical and psychological aspects among Areca nut users in the Gujarat community in the UK. Addict Biol 2000;5:173-79.
  3. Role of Areca nut in betel quid-associated chemical carcinogenesis: Current awareness and future perspectives. Oral Oncol 2001;37:477-92.
  4. IARC monographs on the evaluation of carcinogenic risks to humans. (International Agency for Research on Cancer, Lyon, France) 2004;85.
  5. Association of betel nut with carcinogenesis. The Cancer Journal 1996;9:13-19.
  6. Alert for an epidemic of oral cancer due to use of the betel quid substitutes gutkha and paan masala: A review of agents and causative mechanisms. Mutagenesis 2004;19:251-62.
  7. Global epidemiology of Areca nut use. Areca nut symposium, Addict Biol 2002;7:77-83.
  9. Areca Nut Chewing and Mortality in an Elderly Cohort Study Am J of Epidemiol.
  10. Acute toxicities of betel nut: Rare by probably overlooked events. Clinical Toxicology 2001;39(4):355-60.
  11. Cardiac arrhythmia and betel nut chewing–Is there a causal effect? Vet-Hum-Toxicol 1998;40(5):287-89.
  12. Transgenerational effects of betel-quid chewing on the development of the metabolic syndrome in the Keelung community-based integrated screening program. Am J Clin Nutr 2006;83:688-92.
  13. Community screening for diabetes in the National Capital District, Papua New Guinea: Is betel nut chewing a risk factor for diabetes? Papua New Guinea Medical J 2001;44:101-07.
  14. A population-based study of the association between Areca-nut chewing and Type 2 diabetes mellitus in men. Diabetologia 2004;47:17776-81.
  15. Betel-nut chewing and asthma. Lancet 1992;9;339(8802): 1134-36.
  16. Betel quid chewing and risk of adverse birth outcomes among aborigines in eastern Taiwan. J. Toxicol. Environ. Health A 2001;64:465-72.
  17. Areca-nut abuse and neonatal withdrawal syndrome. Pediatrics 2006;117: e129–e31.
  18. Pan and Gutkha use in the United States: A pilot study in Bangladeshi and Indian-Gujrati immigrants in New York city. J Immigr Refug Stud 2006;4(1):99-110.
  19. “Betelmania”. Betel quid chewing by Cambodian women in the United Sates and its potential health effects. West J Med 1994;160(4): 326-30.
  20. Gutkha or areca nut Chewer's syndrome. Indian J Cancer 2009;46:170-72.
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.