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Hernández-Morales A, González-López BS, Scougall-Vilchis RJ, Bermeo-Escalona JR, Velázquez-Enríquez U, Islas-Zarazúa R, Márquez-Rodríguez S, Sosa-Velasco TA, Medina-Solís CE, Maupomé G. Lip and Oral Cavity Cancer Incidence and Mortality Rates Associated with Smoking and Chewing Tobacco Use and the Human Development Index in 172 Countries Worldwide: An Ecological Study 2019-2020. Healthcare (Basel) 2023; 11:healthcare11081063. [PMID: 37107897 PMCID: PMC10137392 DOI: 10.3390/healthcare11081063] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Revised: 04/04/2023] [Accepted: 04/06/2023] [Indexed: 04/29/2023] Open
Abstract
Tobacco use is associated with diseases worldwide, including cancer. This is one of the major public health problems globally, causing more than 19 million new cases in 2020. Lip and oral cavity cancer (LOCC) is neoplastic growth in the tongue, gums, and lips. The objective of this ecological study was to quantify the strength of the association between incidence and mortality of LOCC, with tobacco use and with the Human Development Index (HDI). Incidence and mortality data on LOCC were obtained for 172 countries in 2020, from the Global Cancer Observatory (GLOBOCAN). The prevalence of tobacco smoking and chewing was obtained from reports conducted in 2019. The inequality in human development was estimated using the HDI from the United Nations Development Program, Human Development Report (2019). Statistically significant correlations were observed between the incidence of LOCC and tobacco smoking and chewing prevalence, except for negative correlations between the prevalence of tobacco smoking LOCC mortality in women, just as in the case of the HDI. No statistically significant differences were found between the prevalence of tobacco chewing only and the incidence of LOCC overall and by sex. A higher LOCC incidence overall and by sex was associated with higher HDI. In conclusion, the present study found positive correlations for various HDI socioeconomic indicators and tobacco use with the incidence and mortality of LOCC, but also a few inverse correlations.
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Affiliation(s)
- Antonio Hernández-Morales
- Doctoral Program in Health Sciences, School of Behavioral Sciences, Autonomous University of the State of Mexico, Toluca 50130, Mexico
- Faculty of Dentistry, Autonomous University of the State of Mexico, Toluca 50130, Mexico
| | - Blanca Silvia González-López
- Advanced Studies and Research Center in Dentistry "Dr. Keisaburo Miyata" of Faculty of Dentistry, Autonomous University of the State of Mexico, Toluca 50130, Mexico
| | - Rogelio José Scougall-Vilchis
- Advanced Studies and Research Center in Dentistry "Dr. Keisaburo Miyata" of Faculty of Dentistry, Autonomous University of the State of Mexico, Toluca 50130, Mexico
| | | | - Ulises Velázquez-Enríquez
- Advanced Studies and Research Center in Dentistry "Dr. Keisaburo Miyata" of Faculty of Dentistry, Autonomous University of the State of Mexico, Toluca 50130, Mexico
| | - Rosalina Islas-Zarazúa
- Academic Area of Dentistry of Health Sciences Institute, Autonomous University of Hidalgo State, Pachuca 42160, Mexico
| | - Sonia Márquez-Rodríguez
- Academic Area of Dentistry of Health Sciences Institute, Autonomous University of Hidalgo State, Pachuca 42160, Mexico
| | | | - Carlo Eduardo Medina-Solís
- Advanced Studies and Research Center in Dentistry "Dr. Keisaburo Miyata" of Faculty of Dentistry, Autonomous University of the State of Mexico, Toluca 50130, Mexico
- Academic Area of Dentistry of Health Sciences Institute, Autonomous University of Hidalgo State, Pachuca 42160, Mexico
| | - Gerardo Maupomé
- Richard M. Fairbanks School of Public Health, Indiana University-Purdue University, Indianapolis, IN 46202, USA
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Genetic and epigenetic instability induced by betel quid associated chemicals. Toxicol Rep 2023; 10:223-234. [PMID: 36845258 PMCID: PMC9945799 DOI: 10.1016/j.toxrep.2023.02.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Accepted: 02/03/2023] [Indexed: 02/06/2023] Open
Abstract
Over the years, betel quid chewing and tobacco use have attracted considerable interest as they are implicated as the most likely causative risk factors of oral and esophageal cancers. Although areca nut use and betel quid chewing may lead to apoptosis, chronic exposure to areca nut and slaked lime may promote pre-malignant and malignant transformation of oral cells. The putative mutagenic and carcinogenic mechanisms may involve endogenous nitrosation of areca and tobacco alkaloids as well as the presence of direct alkylating agents in betel quid and smokeless tobacco. Metabolic activation of carcinogenic N-nitrosamines by phase-I enzymes is required not only to elicit the genotoxicity via the reactive intermediates but also to potentiate the mutagenicity with the sporadic alkylations of nucleotide bases, resulting in the formation of diverse DNA adducts. Persistent DNA adducts provides the impetus for genetic and epigenetic lesions. The genetic and epigenetic factors cumulatively influence the development and progression of disorders such as cancer. Accumulation of numerous genetic and epigenetic aberrations due to long-term betel quid (with or without tobacco) chewing and tobacco use culminates into the development of head and neck cancers. We review recent evidence that supports putative mechanisms for mutagenicity and carcinogenicity of betel quid chewing along with tobacco (smoking and smokeless) use. The detailed molecular mechanisms of the extent of accumulation and patterns of genetic alterations, indicative of the prior exposure to carcinogens and alkylating agents because of BQ chewing and tobacco use, have not yet been elucidated.
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Bian T, Corral P, Wang Y, Botello J, Kingston R, Daniels T, Salloum RG, Johnston E, Huo Z, Lu J, Liu AC, Xing C. Kava as a Clinical Nutrient: Promises and Challenges. Nutrients 2020; 12:E3044. [PMID: 33027883 PMCID: PMC7600512 DOI: 10.3390/nu12103044] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2020] [Revised: 09/21/2020] [Accepted: 09/25/2020] [Indexed: 12/20/2022] Open
Abstract
Kava beverages are typically prepared from the root of Piper methysticum. They have been consumed among Pacific Islanders for centuries. Kava extract preparations were once used as herbal drugs to treat anxiety in Europe. Kava is also marketed as a dietary supplement in the U.S. and is gaining popularity as a recreational drink in Western countries. Recent studies suggest that kava and its key phytochemicals have anti-inflammatory and anticancer effects, in addition to the well-documented neurological benefits. While its beneficial effects are widely recognized, rare hepatotoxicity had been associated with use of certain kava preparations, but there are no validations nor consistent mechanisms. Major challenges lie in the diversity of kava products and the lack of standardization, which has produced an unmet need for quality initiatives. This review aims to provide the scientific community and consumers, as well as regulatory agencies, with a broad overview on kava use and its related research. We first provide a historical background for its different uses and then discuss the current state of the research, including its chemical composition, possible mechanisms of action, and its therapeutic potential in treating inflammatory and neurological conditions, as well as cancer. We then discuss the challenges associated with kava use and research, focusing on the need for the detailed characterization of kava components and associated risks such as its reported hepatotoxicity. Lastly, given its growing popularity in clinical and recreational use, we emphasize the urgent need for quality control and quality assurance of kava products, pharmacokinetics, absorption, distribution, metabolism, excretion, and foundational pharmacology. These are essential in order to inform research into the molecular targets, cellular mechanisms, and creative use of early stage human clinical trials for designer kava modalities to inform and guide the design and execution of future randomized placebo controlled trials to maximize kava's clinical efficacy and to minimize its risks.
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Affiliation(s)
- Tengfei Bian
- Department of Medicinal Chemistry, College of Pharmacy, University of Florida, Gainesville, FL 32610, USA; (T.B.); (P.C.); (Y.W.); (J.B.)
| | - Pedro Corral
- Department of Medicinal Chemistry, College of Pharmacy, University of Florida, Gainesville, FL 32610, USA; (T.B.); (P.C.); (Y.W.); (J.B.)
| | - Yuzhi Wang
- Department of Medicinal Chemistry, College of Pharmacy, University of Florida, Gainesville, FL 32610, USA; (T.B.); (P.C.); (Y.W.); (J.B.)
| | - Jordy Botello
- Department of Medicinal Chemistry, College of Pharmacy, University of Florida, Gainesville, FL 32610, USA; (T.B.); (P.C.); (Y.W.); (J.B.)
| | - Rick Kingston
- College of Pharmacy, University of Minnesota, Minneapolis, MN 55455, USA;
| | - Tyler Daniels
- Thorne Research Inc., Industrial Road, 620 Omni Dr, Summerville, SC 29483, USA;
| | - Ramzi G. Salloum
- Department of Health Outcome & Biomedical Informatics, College of Medicine, University of Florida, Gainesville, FL 32610, USA;
| | - Edward Johnston
- The Association for Hawaiian Awa (kava), Pepe’ekeo, HI 96783, USA;
| | - Zhiguang Huo
- Department of Biostatistics, College of Public Health & Health Professions, College of Medicine, University of Florida, Gainesville, FL 32610, USA;
| | - Junxuan Lu
- Department of Pharmacology, Penn State University College of Medicine, Hershey, PA 17033, USA;
| | - Andrew C. Liu
- Department of Physiology and Functional Genomics, College of Medicine, University of Florida, Gainesville, FL 32610, USA;
| | - Chengguo Xing
- Department of Medicinal Chemistry, College of Pharmacy, University of Florida, Gainesville, FL 32610, USA; (T.B.); (P.C.); (Y.W.); (J.B.)
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