THE ARECA NUT CHEWING HABIT AND ORAL SQUAMOUS-CELL CARCINOMA IN SOUTH-AFRICAN INDIANS - A RETROSPECTIVE STUDY

A retrospective study (1983 - 1989) of oral squamous carcinomas and co ncomitant oral habits was undertaken in South African Indians from Nat al. Information came from hospital records and interviews with patient s, families and friends. There were 143 oral squamous carcinomas; thes e occurred in a ratio of 1:1,6 for men and women respectively. Squamou s carcinomas of the cheek (buccal mucosa, alveolar sulcus and gingiva) occurred most frequently, especially in women (57/89 - 64%), while in men tongue cancer predominated (22/54 - 41-%). Ninety-three per cent of women (83/87) and 17% of men (9/54) habitually chewed the areca nut . Thirty-nine of 57 women (68%) with cheek cancer and 21/25 (84%) with tongue cancer only chewed the nut (no tobacco, snuff or smoking). Ana lyses confirmed an association between nut chewing and cheek cancer. T he odds ratio (OR) for oral cancer in women 25 years and older who onl y chewed the nut was 43,9 and the attributable risk (AR) 0,89 (89%). W ith tobacco the OR increases to 47,42 and the AR to 0,91 (91%). The da ta showed that the areca nut habit with or without tobacco use is impo rtant in the development of oral squamous carcinoma. Elimination of th is habit can reduce the risk in these women substantially (89 - 91%) i f all other factors remain the same.