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- and sex-matched HCC patients and healthy controls. Serum hepatitis B surface antigen (HBsAg), and antibodies to hepatitis C virus (anti-HCV) were determined, and standardized personal interview conducted using a structured questionnaire. Multivariate analysis indicated that betel quid chewing (odds ratio (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 educational duration of less than 10 years (OR, 1.71; 95% CI, 1.05-2.78) are independent risk factors of HCC. In addition, there was an additive interaction between betel quid chewing and chronic infection with either hepatitis B virus (synergy index, 5.37) or hepatitis C virus (synergy index, 1.66). Moreover, risk on HCC increased as duration of betel quid chewing increased, or amount of betel quid consumed (each P for trend < 0.0001).
Department of Internal Medicine, Kaohsiung Medical University College of Medicine, Taiwan, Republic of China.
J F
JF
Tsai
L Y
LY
Chuang
J E
JE
Jeng
M S
MS
Ho
M Y
MY
Hsieh
Z Y
ZY
Lin
L Y
LY
Wang
D000328:Adult; D000368:Aged; D001114:Areca / Q000009:adverse effects*; D006528:Carcinoma, Hepatocellular / Q000453:epidemiology / Q000209:etiology*; D016022:Case-Control Studies; D004522:Educational Status; D005260:Female; D006509:Hepatitis B / Q000175:diagnosis; D006526:Hepatitis C / Q000175:diagnosis; D006801:Humans; D008113:Liver Neoplasms / Q000453:epidemiology / Q000209:etiology*; D008297:Male; D008409:Mastication; D008875:Middle Aged; D010946:Plants, Medicinal; D012307:Risk Factors