Source: www.saipantribune.com
Author: Moneth Deposa

A betel nut and oral cancer pilot study will be conducted on Saipan and Guam beginning this year. The study hopes to gather baseline date to develop protocols for studying oral precancerous lesions and other health risks among betel nut users in Micronesia.

University of Guam epidemiologist Dr. Yvette Paulino, co-leader in the pilot study, will work with Dr. Suzanne Murphy from the Cancer Research Center of Hawaii in the pilot study.

In a presentation to members of the Commonwealth Cancer Association last week, Dr. Paulino disclosed that oral cancer is the sixth leading cancer worldwide, but ranks in the Top 3 cancers in countries where there are betel nut/areca nut chewers.

Betel nut, she said, is apparently a misnomer. The nut itself is more accurately called “areca nut” and “betel” refers to the leaf that is sometimes used with the nut. “Betel quid” refers to the mixture of nut and leaf.

The three-year pilot study aims to collect information on betel nut/areca nut use among 300 study participants in Guam and on Saipan and members of their families.

In the course of the study, oral examinations and biopsies will be performed as needed, health risks will be measured, and associations of duration, frequency, and type of betel nut/areca nut use with oral pre-cancers and health risks will be studied.

Dr. Paulino said that betel nut/areca nut is considered a human carcinogen. She revealed that betel nut chewing has been shown to be associated with asthma, cardiovascular disease, diabetes, metabolic syndrome, and obesity. In Guam, Paulino said betel nut chewing has shown to be associated with these diseases.

Activities for the pilot study this year include logistics, oral screening workshop, recruitment and data collection.

In 2011, the investigators are slated to continue the recruitment and data collection and analysis.

Reporting for the findings of the study is scheduled in 2012.

Saipan Tribune learned that CCA’s board president, Alex Sablan, submitted a letter of support for this pilot study sometime last year, and received notice in March this year that the project had been fully funded. The primary role of the cancer association in this project will be to assist the researchers in the areas of community outreach and awareness on Saipan.

Incidence rates in Micronesia:
In the same presentation, Dr. Paulino disclosed that the incidence rate of oral cancer is higher in men than women.

In Micronesia, incidence rates vary: Five for every 100,000 Chuukese; 10 per 100,000 for Guam Chamorros and Pohnpei; 10 per 100,000 in Guam Micronesia, Palau, and Republic of the Marshall Islands; and 20 per 100,000 people in Yap.

Dr. Paulino also emphasized the following determinants of oral cancer: tobacco, smoking, heavy alcohol use, infection, history of oral cancer, diet and betel nut use.

Data from Dr. Paulino’s study indicated that up to 600 million people worldwide chew betel nut and that it is commonly chewed in African, Asian, and Pacific countries. Its usage may vary by gender.