The International Agency for Research on Cancer
(IARC) has been classified areca nut (AN) and betel quid (BQ) (with or
without slaked lime) as a Group 1 carcinogen. Chewing betel nuts are associated
with oral cancer. Oral cancer is the most common cancer among young adult male in
Taiwan, moreover, it ranked the fourth in male cancer incidence and death rate.
More than 8,000 persons annually were diagnosed as oral cancer, among which 90%
were male (2019 Taiwan Cancer Registry Report, HPA). About 3,000 deaths from
oral cancer each year (2021 Cause of Death Statistics, MOHW). A research found oral
cancer patients with BQ chewing had 28 times cancer risk than people with no BQ
chewing. If patients used tobacco, alcohol, and BQ further increased oral
cancer risks by 123 times.
The 2021 Taiwan Global
Youth Tobacco Survey (GYTS) conducted by HPA shown adolescents’ BQ chewing rate
decreased in 2021 compared with year 2017. The junior high school students’ BQ
chewing rate was 0.4%, a 0.43% reduction; senior high school students’ BQ
chewing rate was 1.66%, a 0.48% reduction. Furthermore, almost 58% junior high
school and 47% senior high school students knew that chewing BQ itself can cause
cancer. The Ministry of Education (MOE) has included the prevention and control
of betel quid hazards issue and resistance skills in the general guidelines of curricula.
The HPA works with MOE and various departments to campaign the prevention and
control BQ hazards through multiple channels of communication to establish
supportive betel-quid-free environments on campus, communities and workplaces.
December 3rd
is the “Betel Quid Prevention Day.” The HPA Director General Chao-Chun Wu
reiterates that AN and BQ are carcinogenic to human. Do not try or chew them.
Please stop to chew BQ. We provided oral cancer screening services to all
smokers and BQ chewers over 30 years of age and offered betel nut cessation
class. Regular oral visual inspection (OVI) could early detection, diagnosis,
and treatment of oral cancer.
OVI only take three
minutes reduces death risks
Evidence shown that smokers and BQ chewers do not take regular OVI
increased 35% death risk. Among screeners with oral lesions, more than 75% of lesions
are precancerous lesions and early-stage cancer; with smoking and BQ chewing cessation
and continued treatment and follow-ups, this could lower chance of precancerous
lesions to become oral cancers. Regular oral cancer screening could lower 26%
mortality, with over 80% survival rate. It should be caution that even cessation of use tobacco and BQ products
would still have chance to find mouth lesions. We strongly suggested to uptake
regular screening.
Oral cancer is the most easily spotted cancer.
With your mouth open wide, you can see the symptoms. The HPA subsidizes oral
cancer screening program biennial for people over 30 years old (aborigines aged
18) with BQ chewing (or quitted chewing) and smoking habits. The HPA said that OVI
is easy and only takes 3 minutes. Doctors will see and touch your mouth to
check for precancerous lesions or cancer. Qualified residents can take their NHI
cards to see a doctor in nearby contracted dentistry and ENT clinics.
Mouth Self Examination to detect suspicious symptoms and
seek medical advice if necessary
The HPA
reminds that when we wear facial masks to prevent Covid-19, it is easy for us
to neglect our oral and facial change. We can check our mouth every day when we
brush our teeth. If any of the following symptoms are spotted, we should seek
immediate medical help. For example, if the same oral ulcer did not heal for
more than two weeks, you should go to see the doctor and take biopsy when
necessary for early diagnosis and treatment to lower the incidence and death
rate of oral cancer. Symptoms to look out for:
(1) Ulcers: oral ulcers that do
not heal for more than two weeks
(2) Patches: unexpected red or
white patches on the lining of your mouth
(3) Hard mucosa: hard and tight
mouth mucosa leading inability to open the mouth
(4) Lumps: irregular lumps on
mouth mucosa (papillae or verrucae)
(5) Swelling: swelling in the
faces or necks cause asymmetry