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Cancer Causes & Control
Erschienen in: Cancer Causes & Control 2/2013

01.02.2013 | Review article

Areca nut chewing and esophageal squamous-cell carcinoma risk in Asians: A meta-analysis of case–control studies

verfasst von: Saeed Akhtar

Erschienen in: Cancer Causes & Control | Ausgabe 2/2013

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Abstract

Purpose

This meta-anlaysis quantitatively assessed an overall independent association between areca nut chewing and esophageal squamous-cell carcinoma in Asians.

Methods

Studies (case–control and/or cohort) were identified by searching the PubMed, Medline, and Embase databases through 30 September, 2012, using the keywords o/esophageal squamous-cell carcinoma, o/esophageal cancer, chewing areca nut, betel quid without tobacco, Asia, and the reference lists of retrieved articles. Random-effects model was used to compute adjusted summary ORRE for the main effect of areca nut chewing and additive (biological) interaction between areca nut chewing and tobacco smoking along with their corresponding 95 % confidence intervals (CI). To quantify the impact of between-study heterogeneity on adjusted main-effect summary ORRE, Higgins’ H and I 2 statistics along with their 95 % uncertainty intervals were used. Funnel plot and Egger’s test were used to evaluate publication bias.

Results

Meta-analysis of 12 case–control studies (2,836 cases; 9,553 controls) showed that areca nut chewing was significantly and independently associated with an increased risk of esophageal squamous-cell carcinoma (adjusted main-effect summary ORRE = 3.05; 95 % CI 2.41, 3.87). Furthermore, pooled analysis of additive interaction between areca nut chewing and tobacco smoking reported by six of the included studies revealed manifold increased risk of esophageal squamous-cell carcinoma among those who indulged in both the practices compared with those who practiced none (adjusted additive interaction-effect summary ORRE = 6.79; 95 % CI 4.71, 9.79). There was no significant publication bias (p = 0.289).

Conclusions

Areca nut chewing was significantly and independently associated with an increased risk of esophageal squamous-cell carcinoma in Asians. Additionally, individuals who indulged in both areca nut chewing and tobacco smoking had manifold increased risk of esophageal squamous-cell carcinoma. The efforts aimed at curtailing the addiction to areca nut chewing may contribute to lower the incidence of esophageal squamous-cell carcinoma and related mortality in Asians.
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Metadaten
Titel
Areca nut chewing and esophageal squamous-cell carcinoma risk in Asians: A meta-analysis of case–control studies
verfasst von
Saeed Akhtar
Publikationsdatum
01.02.2013
Verlag
Springer Netherlands
Erschienen in
Cancer Causes & Control / Ausgabe 2/2013
Print ISSN: 0957-5243
Elektronische ISSN: 1573-7225
DOI
https://doi.org/10.1007/s10552-012-0113-9

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