Warnakulasuriya W, Chen T H H. Areca Nut and Oral Cancer: Evidence from Studies Conducted in Humans. J Dent Res 2022; DOI: 10.1177/00220345221092751. Online ahead of print.

Oral leukoplakia and oral submucous fibrosis are the main potentially malignant disorders caused by areca nut chewing that can progress to oral cancer.

Areca nut chewing is one of the major risk factors for oral cancer, with large-magnitude risks reported in studies comparing betel quid chewers and never-users, and it has been evaluated as a group 1 carcinogen by the International Agency for Research on Cancer. Data from a high-quality meta-analysis examining risk estimates are presented in summary form with additional information from more recent studies. The risk of oral cancer increases in a dose-response manner with the daily number of quids consumed and the number of years chewing. In the Indian subcontinent and in Taiwan, approximately half of oral cancers reported are attributed to betel quid chewing. Oral leukoplakia and oral submucous fibrosis are two main oral potentially malignant disorders caused by areca nut chewing that can progress to oral cancer with continued use. Ex-chewers seem to demonstrate lower risks than current chewers, but the impact of areca nut cessation on oral cancer risk has not been evaluated through randomised controlled studies.