SynthesisAnnals of global health2022
Risk Reversal of Oral, Pharyngeal and Oesophageal Cancers after Cessation of Betel Quid Users: A Systematic Review and Meta-Analysis.
Synthesis in Annals of global health, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers, 1 of them a synthesis that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
12 citing papers in PubMed, 1 synthesis or guideline pooled it, 16 citations in OpenAlex.
- Smoking and oral and pharyngeal cancer: a meta-analysis.Oncology reviews · 2025Pooled it
- Cessation of Betel Quid Chewing, Smoking, and Alcohol Drinking and Risk of Oral Precancer and Oral Cancer.JCO global oncology · 2026Article
- Molecular and microenvironmental drivers of malignant transformation from oral potentially malignant disorders to oral squamous cell carcinoma.Frontiers in oncology · 2026Review
- Research progress on carcinogenic factors and personalized treatment of oral cancer.Discover oncology · 2025Review
- Periodontitis presenting among betel quid users: A case series.Clinical advances in periodontics · 2025Article
- Current status and perspectives of esophageal cancer: a comprehensive review.Cancer communications (London, England) · 2025Review
- The Relationship Between Smokeless Tobacco and the Incidence of Oral Cancer: A Systematic Review Study.Addiction & health · 2025Review
- Review
- Traditional Chinese medicine use in patients with oral cancer: A retrospective longitudinal cohort study in Taiwan.Medicine · 2022Article
- p-S6 as a Prognostic Biomarker in Canine Oral Squamous Cell Carcinoma.Biomolecules · 2022Article
- Stress, inflammation, and resilience among patients with oral squamous cell carcinoma undergoing multimodal therapy: Current knowledge and future directions.Tzu chi medical journalReview
- Status and Determinants of Early Detection of Oral Premalignant and Malignant Lesions in India.Cancer control : journal of the Moffitt Cancer CenterReview
Corrections and comments
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Authors and funding
11 authors at 5 institutions in 6 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundAreca nut (AN), the principal ingredient of betel quid (BQ) has been categorized as a human carcinogen associated with various cancers of upper aerodigestive tract. However, there has been no attempt at summarizing the risk reversal of oral and other cancers after cessation of BQ with or without tobacco (BQ+T/BQ-T).
objectiveTo analyze the effect of cessation of betel quid without tobacco (BQ-T) and with tobacco (BQ+T) on reversal of the risk of oral, pharyngeal and oesophageal cancers.
methodsA systematic literature search was conducted for publications evaluating risk of these three cancers among current and former users of BQ-T or BQ+T. The overall as well as subgroup meta-relative risks (meta-RR) were estimated using random-effect models.
resultsA total of 14 studies, seven each providing estimates for BQ-T and BQ+T, were identified. For BQ-T and oral cancer, a 28.9% risk reversal was observed among former users (meta-RR 5.61, 95% CI 2.24-14.04) compared to current users (meta-RR 7.89, 95% CI 3.90-15.98). A risk reversal of 48% was noted for pharyngeal cancer - former users (meta-RR 2.50, 95% CI 1.43-4.38), current users (meta-RR 4.81, 95% CI 2.05-11.30). For oesophageal cancer, no appreciable difference in risk was observed between current and former users.For BQ+T and oral cancer the overall meta-RR indicated a higher risk in former than in current users. However, sensitivity analysis including only better-quality studies showed a modestly lower cancer risk in former than in current users. Compared to current users, the risk in former users who quit less than 10 years ago (meta-RR 1.21, 95% CI 0.90-1.63) was increased, but decreased in former users who quit more than 10 years ago (meta-RR 0.72, 95% CI 0.48-1.07).
conclusionOur analysis highlights for the first time the potential of risk reversal for oral and pharyngeal cancers following cessation of BQ-T and for oral cancer in long-term quitters (greater than 10 years) of BQ+T. The suggestive evidence from this systematic review further supports the imperative need of a strong policy to reduce the initiation of BQ use and inclusion of interventions for BQ cessation in cancer control efforts especially in geographic regions where BQ chewing is prevalent.
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