Effects of Betel Quid, Smoking and Alcohol on Oral Cancer Risk: A Case–Control Study in Hunan Province, China

Background: The high prevalence of betel quid chewing is associated with a serious burden of oral diseases. However, there is limitertd research on the effects of betel quid, smoking, and alcohol on oral cancer in the Hunan province, China. Objectives: We investigated the relationship between oral cancer and betel quid chewing, smoking, and alcohol consumption in the betel quid endemic area of Hunan province. Methods: A paired case-control study from January 2014 to September 2015 was conducted in the Hunan province, China. We recruited 304 oral cancer patients and 304 controls as subjects, and both groups were treated in the same provincial cancer hospital. Control subjects and cancer patients were matched by sex, age (3-year groups), education level, and residential district. Conditional logistic regression analyses were used to examine the associations between oral cancer and betel quid, smoking, and alcohol consumption. Results: A significantly increased risk of oral cancer was associated with smoking, alcohol consumption, and betel quid chewing (odds ratio [OR] of 1.49, 1.56, and 5.80, respectively; p < .05). The risk of cancer was significantly elevated at high levels of intake and prolonged duration of consumption of betel quid, smoking, and alcohol. After adjusting for confounders, betel quid chewers were found to have almost 5 times increased risk for oral cancer (OR = 5.41, 95% confidence interval: 3.32–8.80, p < .001). Conclusions: There was a positive correlation between betel quid chewing and risk of oral cancer in the Hunan Province.