| Title: |
Lifetime Prevalence of Betel Nut Chewing in India and Taiwan: Raising Awareness of Oral Cancer Risks and the Urgent Call for Regulation |
| Authors: |
Umar Rehman; Helen Hudson; Chung-Yu Hao; Yuju Ahn; Sanket Kachole; Jacklyn Liu; Shruti Patel; Mary Jue Xu; Maral J. Rouhani; Paul O’Flynn; Vaijayanti Pethe; Sheng-Po Hao; Dhananjay Kelkar; Matt Lechner |
| Source: |
Cancers ; Volume 18 ; Issue 7 ; Pages: 1074 |
| Publisher Information: |
Multidisciplinary Digital Publishing Institute |
| Publication Year: |
2026 |
| Collection: |
MDPI Open Access Publishing |
| Subject Terms: |
betel nut; oral cancer; health education |
| Description: |
Introduction: Globally, 600 million people chew areca nut, also known as betel nut, with habitual use being a major risk factor for oral cancer. Taiwan and India have some of the highest age-standardized incidence and mortality rates of oral cancer, underscoring the significant health burden in these countries. Aims: This observational cross-sectional study aims to investigate the betel nut consumption habits in the Taiwanese and Indian populations and assess their awareness of its association with oral cancer. Methodology: An interview was conducted and completed by 516 adults across Taiwan and 989 in India to assess betel nut habits and awareness of oral cancer risks. Results: In Taiwan, 95.2% (n = 491) were aware that betel nut can cause oral cancer versus 51.3% (n = 507) in India. Lifetime prevalence of betel nut use in Taiwan was 19.2% (n = 99) versus 42.6% (n = 421) in India. Only in India was betel nut chewing (OR: 0.6, 95% CI: 0.4–0.8, p < 0.001) associated with decreased awareness of the oral cancer risk linked to betel nut use. Using the population attributable fraction (PAF), an estimated 70.5% (95% CI: 46.0–85.5%) of oral cancer cases in India and 53.7% (95% CI: 42.2–64.1%) in Taiwan are potentially attributable to betel nut use. Conclusions: Betel nut use remains prevalent in India and Taiwan, with lack of awareness posing a greater challenge in India and betel nut use being associated with higher risks of self-reported oral cancer symptoms. Effective intervention requires country-specific strategies to curb usage, improve awareness of associated risks and government strategies to reduce betel nut cultivation and availability. |
| Document Type: |
text |
| File Description: |
application/pdf |
| Language: |
English |
| Relation: |
Cancer Survivorship and Quality of Life; https://dx.doi.org/10.3390/cancers18071074 |
| DOI: |
10.3390/cancers18071074 |
| Availability: |
https://doi.org/10.3390/cancers18071074 |
| Rights: |
https://creativecommons.org/licenses/by/4.0/ |
| Accession Number: |
edsbas.15407BD0 |
| Database: |
BASE |