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Smokeless tobacco (paan and gutkha) consumption, prevalence, and contribution to oral cancer

Haji Bahadar|Kamal Niaz|Faheem Maqbool|Fazlullah Khan|Fatima Ismail Hassan|Mohammad Abdollahi
한국역학회 (Korean Society of Epidemiology)|2017.01|Epidemiology and Health|제39권 |pp. 1-11|DOI DOI: https://doi.org/10.4178/epih.e2017009

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참고문헌

키워드

PrevalenceFibrosisOral cancerArecaSmokeless tobacco

초록

inSmokeless tobacco consumption, which is widespread throughout the world, leads to oral submucous fibrosis (OSMF), which is a long-lasting and devastating condition of the oral cavity with the potential for malignancy. In this review, we mainly focus on the consumption of smokeless tobacco, such as paan and gutkha, and the role of these substances in the induction of OSMF and ultimately oral cancer. The list of articles to be examined was established using citation discovery tools provided by PubMed, Scopus, and Google Scholar. The continuous chewing of paan and swallowing of gutkha trigger progressive fibrosis in submucosal tissue. Generally, OSMF occurs due to multiple risk factors, especially smokeless tobacco and its components, such as betel quid, areca nuts, and slaked lime, which are used in paan and gutkha. The incidence of oral cancer is higher in women than in men in South Asian countries. Human oral epithelium cells experience carcinogenic and genotoxic effects from the slaked lime present in the betel quid, with or without areca nut. Products such as 3-(methylnitrosamino)-proprionitrile, nitrosamines, and nicotine initiate the production of reactive oxygen species in smokeless tobacco, eventually leading to fibroblast, DNA, and RNA damage with carcinogenic effects in the mouth of tobacco consumers. The metabolic activation of nitrosamine in tobacco by cytochrome P450 enzymes may lead to the formation of N-nitrosonornicotine, a major carcinogen, and micronuclei, which are an indicator of genotoxicity. These effects lead to further DNA damage and, eventually, oral cancer.

Abstract

inSmokeless tobacco consumption, which is widespread throughout the world, leads to oral submucous fibrosis (OSMF), which is a long-lasting and devastating condition of the oral cavity with the potential for malignancy. In this review, we mainly focus on the consumption of smokeless tobacco, such as paan and gutkha, and the role of these substances in the induction of OSMF and ultimately oral cancer. The list of articles to be examined was established using citation discovery tools provided by PubMed, Scopus, and Google Scholar. The continuous chewing of paan and swallowing of gutkha trigger progressive fibrosis in submucosal tissue. Generally, OSMF occurs due to multiple risk factors, especially smokeless tobacco and its components, such as betel quid, areca nuts, and slaked lime, which are used in paan and gutkha. The incidence of oral cancer is higher in women than in men in South Asian countries. Human oral epithelium cells experience carcinogenic and genotoxic effects from the slaked lime present in the betel quid, with or without areca nut. Products such as 3-(methylnitrosamino)-proprionitrile, nitrosamines, and nicotine initiate the production of reactive oxygen species in smokeless tobacco, eventually leading to fibroblast, DNA, and RNA damage with carcinogenic effects in the mouth of tobacco consumers. The metabolic activation of nitrosamine in tobacco by cytochrome P450 enzymes may lead to the formation of N-nitrosonornicotine, a major carcinogen, and micronuclei, which are an indicator of genotoxicity. These effects lead to further DNA damage and, eventually, oral cancer.

참고문헌 (100)

  1. Banerjee SC, "Gutka and Tambaku Paan use among South Asian immigrants: a focus group study", J Immigr Minor Health, 16, pp.531~539 (2014)
  2. Shah G, "Arecanut as an emerging etiology of oral cancers in India", Indian J Med Paediatr Oncol, 33, pp.71~79 (2012)
  3. Gupta PC, "Global epidemiology of areca nut usage", Addict Biol, 7, pp.77~83 (2002)
  4. Pillai R, "Pathogenesis of oral submucous fibrosis. Relationship to risk factors associated with oral cancer", Cancer, 69, pp.2011~2020 (1992)
  5. Johnson N, "Tobacco use and oral cancer: a global perspective", J Dent Educ, 65, pp.328~339 (2001)
  6. Changrani J, "Paan and Gutka in the United States: an emerging threat", J Immigr Health, 7, pp.103~108 (2005)
  7. Thomas G, "Risk factors for multiple oral premalignant lesions", Int J Cancer, 107, pp.285~291 (2003)
  8. Pindborg, JJ, "Jan 15-19; Bombay", Control of tobacco-related cancers and other disease. Proceedings of an International Symposium, pp.13~23 (1992), Oxford University Press
  9. Awang M, "Areca catechu (betel) nut and oral submucous fibrosis", pp.1983
  10. Lu CT, "Prevalence and characteristics of areca nut chewers among junior high school students in Changhua county, Taiwan", Community Dent Oral Epidemiol, 21, pp.370~373 (1993)
  11. Chen JW, "A study on betel quid chewing behavior among Kaohsiung residents aged 15 years and above", J Oral Pathol Med, 25, pp.140~143 (1996)
  12. Yang MS, "Prevalence and related risk factors of betel quid chewing by adolescent students in southern Taiwan", J Oral Pathol Med, 25, pp.69~71 (1996)
  13. Ho CS, "The prevalence of betel chewing among the students of the different senior high schools in southern Taiwan", Kaohsiung J Med Sci, 16, pp.32~38 (2000)
  14. in zarda tobacco, "Cancer Lett", 1988, 113~118
  15. Ali SM, "Prevalence of oral submucous fibrosis and use of tobacco and related products amongst school going males", Pak Oral Dent J, 31, pp.384~387 (2011)
  16. Mehrotra R, "Trends of prevalence and pathological spectrum of head and neck cancers in North India", Indian J Cancer, 42, pp.89~93 (2005)
  17. Ali NS, "Smokeless tobacco use among adult patients who visited family practice clinics in Karachi, Pakistan", J Oral Pathol Med, 38, pp.416~421 (2009)
  18. Dongre A, "Tobacco consumption among adolescents in rural Wardha: where and how tobacco control should focus its attention?", Indian J Cancer, 45, pp.100~106 (2008)
  19. Mazahir S, "Socio-demographic correlates of betel, areca and smokeless tobacco use as a high risk behavior for head and neck cancers in a squatter settlement of Karachi, Pakistan", Subst Abuse Treat Prev Policy, 1, pp.10~ (2006)
  20. Changrani J, "Paan and gutka use in the United States: a pilot study in Bangladeshi and Indian-Gujarati immigrants in New York City", J Immigr Refug Stud, 4, pp.99~110 (2006)
  21. Krishna Rao SV, "Epidemiology of oral cancer in Asia in the past decade--an update (2000-2012)", Asian Pac J Cancer Prev, 14, pp.5567~5577 (2013)
  22. Muwonge R, "Role of tobacco smoking, chewing and alcohol drinking in the risk of oral cancer in Trivandrum, India: a nested case-control design using incident cancer cases", Oral Oncol, 44, pp.446~454 (2008)
  23. Ferlay J, "Estimates of worldwide burden of cancer in 2008: GLOBOCAN 2008", Int J Cancer, 127, pp.2893~2917 (2010)
  24. Curado MP, "World Health Organization. Cancer incidence in five continents. Vol. IX", IARC, 258~ (2007)
  25. Bhurgri Y, "Cancer incidence in Karachi, Pakistan: first results from Karachi Cancer Registry", Int J Cancer, 85, pp.325~329 (2000)
  26. Bhurgri Y., "Cancer of the oral cavity - trends in Karachi South (1995-2002)", Asian Pac J Cancer Prev, 6, pp.22~26 (2005)
  27. Gupta PC, "Epidemiology of betel quid usage", Ann Acad Med Singapore, 33, pp.31~36 (2004)
  28. Qidwai W, "Are our people health conscious? Results of a patients survey in Karachi, Pakistan", J Ayub Med Coll Abbottabad, 15, pp.10~13 (2003)
  29. Mahmood Z, "Smoking and chewing habits of people of Karachi-- 1981", J Pak Med Assoc, 32, pp.34~37 (1982)
  30. Khawaja MR, "Knowledge, attitude and practices of a Karachi slum population regarding the role of products of betel, areca and smokeless tobacco in the etiology of head & neck cancers", J Pak Med Assoc, 55, pp.S41~ (2005)
  31. Shah SM, "Addicted schoolchildren: prevalence and characteristics of areca nut chewers among primary school children in Karachi, Pakistan", J Paediatr Child Health, 38, pp.507~510 (2002)
  32. Javed F, "Periodontal conditions and oral symptoms in gutka-chewers with and without type 2 diabetes", Acta Odontol Scand, 66, pp.268~273 (2008)
  33. Reichart PA, "Betel quid chewing, oral cancer and other oral mucosal diseases in Vietnam: a review", J Oral Pathol Med, 37, pp.511~514 (2008)
  34. Amarasinghe HK, "Betel-quid chewing with or without tobacco is a major risk factor for oral potentially malignant disorders in Sri Lanka: a case-control study", Oral Oncol, 46, pp.297~301 (2010)
  35. Sawair FA, "High relative frequency of oral squamous cell carcinoma in Yemen: qat and tobacco chewing as its aetiological background", Int J Environ Health Res, 17, pp.185~195 (2007)
  36. Ngelangel CA, "Epidemiological risk factors for cancers of the lung, breast, colon-rectum & oral cavity: a case-control study in the Philippines", Acta Med Philipp, 43, pp.29~34 (2009)
  37. Loyha K, "Risk factors for oral cancer in northeast Thailand", Asian Pac J Cancer Prev, 13, pp.5087~5090 (2012)
  38. Saini R, "Significant association of high-risk human papillomavirus (HPV) but not of p53 polymorphisms with oral squamous cell carcinomas in Malaysia", J Cancer Res Clin Oncol, 137, pp.311~320 (2011)
  39. "A study on the economics of tobacco in Nepal" (2003)[URL]
  40. Güneri P, "Primary oral cancer in a Turkish population sample: association with sociodemographic features, smoking, alcohol, diet and dentition", Oral Oncol, 41, pp.1005~1012 (2005)
  41. Kaduri P, "Smokeless tobacco use among adolescents in Ilala Municipality, Tanzania", Tanzan J Health Res, 10, pp.28~33 (2008)
  42. Nair J, "Tobacco-specific and betel nut-specific N-nitroso compounds: occurrence in saliva and urine of betel quid chewers and formation in vitro by nitrosation of betel quid", Carcinogenesis, 6, pp.295~303 (1985)
  43. Nair UJ, "Formation of reactive oxygen species and of 8-hydroxydeoxyguanosine in DNA in vitro with betel quid ingredients", Chem Biol Interact, 63, pp.157~169 (1987)
  44. Reichart PA, "Betel chewer’s mucosa in elderly Cambodian women", J Oral Pathol Med, 25, pp.367~370 (1996)
  45. Ikeda N, "Prevalence study of oral mucosal lesions in a selected Cambodian population", Community Dent Oral Epidemiol, 23, pp.49~54 (1995)
  46. Ysaol J, "A survey of betel nut chewing in Palau", Isla, 4, pp.244~255 (1996)
  47. Warnakulasuriya S, "Areca nut use following migration and its consequences", Addict Biol, 7, pp.127~132 (2002)
  48. Bedi R, "The prevalence of betel-quid and tobacco chewing among the Bangladeshi community resident in a United Kingdom area of multiple deprivation", Prim Dent Care, 2, pp.39~42 (1995)
  49. Ahmed S, "Use of betel quid and cigarettes among Bangladeshi patients in an inner-city practice: prevalence and knowledge of health effects", Br J Gen Pract, 47, pp.431~434 (1997)
  50. Babu S, "Oral fibrosis among teenagers chewing tobacco, areca nut, and pan masala", Lancet, 348, pp.692~ (1996)
  51. Jyoti S, "Evaluation of micronucleus frequency by acridine orange fluorescent staining in bucccal epithelial cells of oral submucosus fibrosis (OSMF) patients", Egypt J Med Human Genet, 14, pp.189~193 (2013)
  52. Morton JF, "Further associations of plant tannins and human cancer", Q J Crude Drug Res, 12, pp.1829~1841 (1972)
  53. Stich HF, "Chromosome-damaging activity of saliva of betel nut and tobacco chewers", Cancer Lett, 15, pp.193~202 (1982)
  54. Giri AK, "Induction of sister chromatid exchange and dominant lethal mutation by ‘Katha’ (catechu) in male mice", Cancer Lett, 38, pp.357~364 (1988)
  55. Dunham LJ, "Proliferative lesions in cheek pouch and esophagus of hamsters treated with plants from Curacao, Netherland Antilles", J Natl Cancer Inst, 53, pp.1259~1269 (1974)
  56. Bhide SV, "Arecoline tumorigenicity in Swiss strain mice on normal and vitamin B deficient diet", J Cancer Res Clin Oncol, 107, pp.169~171 (1984)
  57. Rojas E, "DNA damage in exfoliated buccal cells of smokers assessed by the single cell gel electrophoresis assay", Mutat Res, 370, pp.115~120 (1996)
  58. Speit G, "Investigations on the effect of cigarette smoking in the comet assay", Mutat Res, 542, pp.33~42 (2003)
  59. Katyal S, "DNA strand breaks, neurodegeneration and aging in the brain", Mech Ageing Dev, 129, pp.483~491 (2008)
  60. Jyoti S, "Micronucleus investigation in human buccal epithelial cells of gutkha users", Adv Biomed Res, 1, pp.35~ (2012)
  61. Jeng JH, "Role of areca nut in betel quid-associated chemical carcinogenesis: current awareness and future perspectives", Oral Oncol, 37, pp.477~492 (2001)
  62. Chiu CJ, "Interaction of collagen-related genes and susceptibility to betel quid-induced oral submucous fibrosis", Cancer Epidemiol Biomarkers Prev, 11, pp.646~653 (2002)
  63. Kandasamy M, "Etiopathogenesis of oral submucous fibrosis: review of literature", J Adv Med Dent Sci Res, 3, pp.53~58 (2015)
  64. Nair J, "Endogenous nitrosation in the oral cavity of chewers while chewing betel quid with or without tobacco", IARC Sci Publ, pp.465~469 (1987)
  65. Nair U, "Alert for an epidemic of oral cancer due to use of the betel quid substitutes gutkha and pan masala: a review of agents and causative mechanisms", Mutagenesis, 19, pp.251~262 (2004)
  66. Jyoti S, "Genotoxic effects of pan masala and gutkha: a review", World J Zool, 6, pp.301~306 (2011)
  67. Fareed M, "Micronucleus investigation in buccal mucosal cells among pan masala", gutkha chewers and its relevance for oral cancer, 2011, pp.3, 8~15
  68. Jadhav K, "Micronuclei: an essential biomarker in oral exfoliated cells for grading of oral squamous cell carcinoma", J Cytol, 28, pp.7~12 (2011)
  69. Sudha S, "Mixture of betel leaf, areca nut and tobacco chewing is a risk factor for cytogenetic damage in construction workers from south India", Braz J Oral Sci, 8, pp.145~148 (2009)
  70. Patel BP, "Micronuclei and chromosomal aberrations in healthy tobacco chewers and controls: a study from Gujarat, India", Arch Oncol, 17, pp.7~10 (2009)
  71. Jaju RJ, "Chromosome damaging effects of pan masala", Cancer Lett, 65, pp.221~226 (1992)
  72. Gandhi G, "Chewing pan masala and", or betel quid-fashionable attributes and, J Hum Ecol, pp.2005, 17[DOI]
  73. Nair UJ, "Role of lime in the generation of reactive oxygen species from betel-quid ingredients", Environ Health Perspect, 98, pp.203~205 (1992)
  74. Sirsat SM, "Histological changes in the oral mucosa of the wistar rat treated with commercial lime (calcium hydroxide)--an optical and submicroscopic study", Br J Cancer, 22, pp.303~315 (1968)
  75. Shirname LP, "Correlation of mutagenicity and tumorigenicity of betel quid and its ingredients", Nutr Cancer, 5, pp.87~91 (1983)
  76. Sundqvist K, "Cytotoxic and genotoxic effects of areca nut-related compounds in cultured human buccal epithelial cells", Cancer Res, 49, pp.5294~5298 (1989)
  77. Adhvaryu SG, "An in vitro assessment of the genotoxic potential of pan masalas", Indian J Med Res, 90, pp.131~134 (1989)
  78. Niphadkar MP, "Mutagenic potential of Indian tobacco products", Mutagenesis, 11, pp.151~154 (1996)
  79. Nagabhushan M, "Catechin as an antimutagen: its mode of action", J Cancer Res Clin Oncol, 114, pp.177~182 (1988)
  80. Panigrahi GB, "Study of the genotoxicity of the total aqueous extract of betel nut and its tannin", Carcinogenesis, 7, pp.37~39 (1986)
  81. Mukherjee A, "Effect of ‘pan masala’ on the germ cells of male mice", Cancer Lett, 58, pp.161~165 (1991)
  82. Dave BJ, "Cytogenetic studies reveal increased genomic damage among ‘pan masala’ consumers", Mutagenesis, 6, pp.159~163 (1991)
  83. Bagchi M, "Role of reactive oxygen species in the development of cytotoxicity with various forms of chewing tobacco and pan masala", Toxicology, 179, pp.247~255 (2002)
  84. Yadav JS, "Genotoxic studies in pan masala chewers: a high cancer risk group", Int J Hum Genet, 2, pp.107~112 (2002)
  85. Chadda R, "Tobacco use by Indian adolescents", Tob Induc Dis, 1, pp.111~119 (2002)
  86. Kumar S, "Effect of pan masala on sperm morphology of a mouse", Bull Environ Contam Toxicol, 70, pp.1184~1188 (2003)
  87. Singh R, "Global youth tobacco survey: a report from Jammu and Kashmir", JK Sci J Med Educ Res, 10, pp.65~69 (2008)
  88. Siddique YH, "Micronucleus investigation in oral mucosal cells of gutkha", pan masala chewers, 2008, pp.40, 1~5
  89. Sarma AB, "Evaluation of pan masala for toxic effects on liver and other organs", Food Chem Toxicol, 30, pp.161~163 (1992)
  90. Wu IC, "Quantification of blood betel quid alkaloids and urinary 8-hydroxydeoxyguanosine in humans and their association with betel chewing habits", J Anal Toxicol, 34, pp.325~331 (2010)
  91. Lin CY, "Cytochrome p450 metabolism of betel quid-derived compounds: implications for the development of prevention strategies for oral and pharyngeal cancers", Scientific World Journal, 2013, pp.618032~ (2013)
  92. Ramchandani AG, "Evaluation of carcinogenic", co-carcinogenic activity of a common chewing product, pan masala, in mouse skin, stomach and esophagus, 1998, pp.75, 225~232
  93. Nigam SK, "Toxicological evaluation of pan masala in pure inbred Swiss mice: a preliminary report on long-term exposure study", Curr Sci, 80, pp.1306~1309 (2001)
  94. Stich HF, "The involvement of reactive oxygen species in oral cancers of betel quid", tobacco chewers, 1989, pp.214, 47~61
  95. Javed F, "Comparison of periodontal and socioeconomic status between subjects with type 2 diabetes mellitus and non-diabetic controls", J Periodontol, 78, pp.2112~2119 (2007)
  96. Mavropoulos A, "The acute effects of smokeless tobacco (snuff) on gingival blood flow in man", J Periodontal Res, 36, pp.221~226 (2001)
  97. Avasn Maruthit Y, "Impact of gutkha chewing & smoking on microbial environment of oral cavity: a case study on slum dwellers of selected areas in Visakhapatnam", J Environ Sci Eng, 46, pp.268~273 (2004)
  98. Tseng YH, "Areca nut extract represses migration and differentiation while activating matrix metalloproteinase-9 of normal gingival epithelial cells", J Periodontal Res, 43, pp.490~499 (2008)
  99. Hazare VK, "Oral submucous fibrosis, areca nut and pan masala use: a case-control study", Natl Med J India, 11, pp.299~ (1998)
  100. Gupta PC, "Incidence rates of oral cancer and natural history of oral precancerous lesions in a 10-year follow-up study of Indian villagers", Community Dent Oral Epidemiol, 8, pp.283~333 (1980)

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