Affiliation:
1. Department and Graduate Institute of Biomedical Sciences Chang Gung University Taoyuan Taiwan
2. Healthy Aging Research Center Chang Gung University Taoyuan Taiwan
3. Cardiovascular Department Chang Gung Memorial Hospital Taoyuan Taiwan
4. Department of Public Health College of Health Sciences, Kaohsiung Medical University Kaohsiung Taiwan
5. Social, Behavioral, and Population Sciences, School of Public Health and Tropical Medicine Tulane University New Orleans Louisiana USA
6. Research Center for Precision Environmental Medicine Kaohsiung Medical University Kaohsiung Taiwan
7. Department of Medical Research Kaohsiung Medical University Hospital, Kaohsiung Medical University Kaohsiung Taiwan
8. College of Professional Studies National Pingtung University of Science and Technology Pingtung Taiwan
Abstract
AbstractObjectiveThis study aimed to provide a comprehensive assessment of the measurement and prevalence of betel‐quid (BQ) abuse, dependence, and BQ use disorder (BUD), as well as to evaluate the impact of BQ addiction on oral malignant diseases.MethodsWe used the PRISMA guidelines to perform a systematic review and meta‐analysis. We searched for relevant publications up to April 2024 in PubMed, Web of Science, and Embase. The articles were evaluated for BQ addiction and its relationship with oral potentially malignant disorders (OPMD) and oral cancer.ResultsThe prevalence of BQ abuse, dependence, and BUD in South, Southeast, and East Asia varied between 0.8%–46.3%, 0.4%–43.5%, and 4.7%–39.2%, respectively. Among BQ chewers, the corresponding proportions of these disorders ranged from 40.5%–99.6%, 20.9%–99.6%, and 55.2%–99.3%. The pooled risks of OPMD associated with BQ abuse, dependence, and BUD were 16.3, 18.7, and 9.6–35.5, respectively. The risk of oral cancer for mild, moderate, and severe BUD was 8.5, 8.2, and 42.3, respectively.ConclusionsBUD mediates the link between BQ use and an increased risk of oral malignant disorders. Addressing and treating BQ addiction is an important component of comprehensive OPMD and oral cancer preventive and intervention programs that go beyond simple cessation efforts.