2017 -- Conference report inside the country
魏玉亭、吳晉祥、李幸容、楊宜青、陳全裕、張智仁、盧豐華：嚼食檳榔與大腸息肉增加之風險相關 台灣家庭醫學醫學會106年度學術研討會會刊 P202-203.
Yu-Ting Wei, Jin-Shang Wu, Hsing-Jung Lee, Yi-Ching Yang, Chuan-Yu Chen, Chih-Jen Chang, Feng-Hwa Lu: Betel Nut Chewing Associated with an Increased Risk of Neoplastic Colon Polyps
Colorectal cancer is one of the leading cancers worldwide and the incidence of colorectal cancer is increasing in Taiwan. Colon polyps can become malignant through the adenoma–carcinoma sequence; thus, early screening of colorectal cancer is recommended. Betel nut (areca, or betel quid) is one of the most popular psychoactive substances especially in South and Southeast Asia and the Asia Pacific region. To date, only one study was conducted to investigate the association of betel nut use with colon polyps and it showed an insignificant relationship between them. However, the above study had a relatively small sample size and did not primarily focus on the relationship between betel nut use and colon polyp. The aim of this study was thus to determine the association of betel nuts with colon polyps in a Taiwanese population.
This work was a cross-sectional design on the adults (age ≥ 18 years) who received health examination with colonoscopies in National Cheng Kung University Hospital between June 2001 and August 2009. According to the habits of betel nut use, the participants were categorized into non-chewers, ex-chewers, and current chewers. The exclusion criteria were patients who had past history of colon cancer (n=13), familial adenomatous polyposis (n=1), Peutz–Jeghers syndrome (n=1), and previous colorectomy not due to colorectal cancer (n=7), missing data (n=34), and diagnosis of colorectal cancer in the current colonoscopy (n=39). Based on the types of colon polyps, they were divided into three groups, including polyp-free (n=7334), non-neoplastic polyps (n=899), and neoplastic polyps (n=1247). Finally, 9,480 participants were recruited to the analysis.
Among the subjects with different kinds of colon polyps, there were significant differences in age, gender, body mass index (BMI), systolic and diastolic blood pressures, fasting plasma glucose, total cholesterol, triglyceride, high density lipoprotein (HDL-C), and the habits of smoking, alcohol drinking, and betel nut use. In multivariate analysis, current betel nut use was independently associated with an increased risk of neoplastic polyps (OR: 1.62, 95% CI: 1.02-2.57); while previous betel nut chewing showed no significance (OR: 1.08, 95% CI:0.77-1.53). In addition, the associated factors of neoplastic polyps were age groups of 40-64 (OR: 3.31, 95%CI:2.58-4.25) and ≥65 years (OR: 5.38, 95% CI: 4.03-7.17), male gender (OR:1.71, 95% CI: 1.48-1.98), BMI ≥ 27 (OR:1.19, 95% CI:1.01-1.41), hypertension (OR: 1.23, 95% CI:1.06-1.43), and diabetes mellitus (OR:1.36, 95% CI:1.16-1.58). As for non-neoplastic polyps, their independently associated factors were age groups of 40-64 (OR: 1.73, 95%CI:1.39-2.16) and ≥65 years (OR:2.04, 95% CI: 1.52-2.73), male gender (OR: 1.38, 95% CI:1.17-1.63), BMI ≥ 27 (OR:1.22, 95% CI:1.01-1.48), and current smoking (OR: 1.58, 95% CI: 1.26-1.99). Neither current chewers nor ex-chewers exhibited a higher risk of non-neoplastic polyps.
Current betel nut chewers were associated with a higher risk of neoplastic polyps of colon but ex-chewers were not significant. Stopping betel nut chewing may thus potentially be beneficial to reduce the risk of neoplastic colon polyps.