Betel quid chewing as a risk factor for hepatocellular carcinoma: a case-control study

The role of betel quid chewing in the aetiology of hepatocellular carcinoma (HCC) was evaluated in a case-control study including 263 pairs of age- an d sex-matched HCC patients and healthy controls. Serum hepatitis B surface antigen (HBsAg), and antibodies to hepatitis C virus (anti-HCV) were determ ined, and standardized personal interview conducted using a structured ques tionnaire. Multivariate analysis indicated that betel quid chewing (odds ra tio (OR), 3.49; 95% confidence interval (CI), 1.74-6.96), HBsAg (OR, 16.69; 95% CI, 9.92-28.07), anti-HCV (OR, 38.57; 95% CI, 18.15-81.96), and educat ional duration of less than 10 years (OR, 1.71; 95% CI, 1.05-2.78) are inde pendent risk factors of HCC. In addition, there was an additive interaction between betel quid chewing and chronic infection with either hepatitis B v irus (synergy index, 5.37) or hepatitis C virus (synergy index, 1.66). More over, risk on HCC increased as duration of betel quid chewing increased, or amount of betel quid consumed (each P for trend < 0.0001). (C) 2001 Cancer Research Campaign.